Creation and Long-term Preservation of Digital Multimedia Resources:Some Preliminary Practices

Institute of Scientific and Technical Information of China (English)

ZHAO BAOYING; LUO YUNCHUAN

2008-01-01

This paper gives a comprehensive introduction of National Cultural Information Resources Sharing Project.It discusses the best practices in creation and long-term preservation of multimedia digital resources,and recommends solutions to the key issues in resource selection,standards & specifications and copyright.

The rural pipeline to longer-term rural practice: General practitioners and specialists.

Directory of Open Access Journals (Sweden)

Marcella M S Kwan

Full Text Available Rural medical workforce shortage contributes to health disadvantage experienced by rural communities worldwide. This study aimed to determine the regional results of an Australian Government sponsored national program to enhance the Australian rural medical workforce by recruiting rural background students and establishing rural clinical schools (RCS. In particular, we wished to determine predictors of graduates' longer-term rural practice and whether the predictors differ between general practitioners (GPs and specialists.A cross-sectional cohort study, conducted in 2012, of 729 medical graduates of The University of Queensland 2002-2011. The outcome of interest was primary place of graduates' practice categorised as rural for at least 50% of time since graduation ('Longer-term Rural Practice', LTRP among GPs and medical specialists. The main exposures were rural background (RB or metropolitan background (MB, and attendance at a metropolitan clinical school (MCS or the Rural Clinical School for one year (RCS-1 or two years (RCS-2.Independent predictors of LTRP (odds ratio [95% confidence interval] were RB (2.10 [1.37-3.20], RCS-1 (2.85 [1.77-4.58], RCS-2 (5.38 [3.15-9.20], GP (3.40 [2.13-5.43], and bonded scholarship (2.11 [1.19-3.76]. Compared to being single, having a metropolitan background partner was a negative predictor (0.34 [0.21-0.57]. The effects of RB and RCS were additive-compared to MB and MCS (Reference group: RB and RCS-1 (6.58[3.32-13.04], RB and RCS-2 (10.36[4.89-21.93]. Although specialists were less likely than GPs to be in LTRP, the pattern of the effects of rural exposures was similar, although some significant differences in the effects of the duration of RCS attendance, bonded scholarships and partner's background were apparent.Among both specialists and GPs, rural background and rural clinical school attendance are independent, duration-dependent, and additive, predictors of longer-term rural practice. Metropolitan

Practice variation in the Dutch long-term care and the role of supply-sensitive care: Is access to the Dutch long-term care equitable?

Science.gov (United States)

Duell, Daisy; Koolman, Xander; Portrait, France

2017-12-01

Universal access and generous coverage are important goals of the Dutch long-term care (LTC) system. It is a legal requirement that everyone eligible for LTC should be able to receive it. Institutional care (IC) made up for 90% of Dutch LTC spending. To investigate whether access to IC is as equitable as the Dutch government aspires, we explored practice variation in entitlements to IC across Dutch regions. We used a unique dataset that included all individual applications for Dutch LTC in January 2010-December 2013 (N = 3,373,358). This dataset enabled an accurate identification of the need for care. We examined the local variation in the probability of being granted long-term IC and in the intensity of the care granted given that individuals have applied for LTC. We also investigated whether the variation observed was related to differences in the local availability of care facilities. Although our analyses indicated the presence of some practice variation, its magnitude was very small by national and international standards (up to 3%). Only a minor part of the practice variation could be accounted for by local supply differences in care facilities. Overall, we conclude that, unlike many other developed countries, the Dutch system ensured equitable access to long-term IC. © 2017 The Authors. Health Economics Published by John Wiley & Sons Ltd.

The long-term effects of undertaking a research course on clinical practice.

Science.gov (United States)

Hazel, Rangeley; Joyce, Arthurs

2004-03-01

Purpose. The aim of the study was to examine the students perceptions of the long-term effectiveness of the English National Board (ENB) 870 course (Understanding and Application of Research). Method. Both quantitative and qualitative strategies examined four objectives focusing on: research utilisation, usefulness of the course in the "real world", factors affecting research use and student support. A total sample comprised all 315 students from 1995 to 1998. Data were collected by postal questionnaires and by two focus group interviews. The responding sample of nurses, midwives and health visitors, all with a minimum of one years practice since completing the course totaled 145, achieving a response rate of 45%. Results. Evidence identified that practitioners were using research at a variety of levels to inform everyday practice. The skills developed in the course had transferred well to real life practice and a critical, confident, proactive approach within and across professional boundaries was demonstrated. A generally supportive culture was identified in the workplace but a lack of time and staff had prevented optimum utilisation of the new skills. A much more positive approach to research-based care was reported and many respondents stated that they had become more autonomous, accountable and better practitioners.

Prostate-specific antigen and long-term prediction of prostate cancer incidence and mortality in the general population

DEFF Research Database (Denmark)

Ørsted, David Dynnes; Nordestgaard, Børge G; Jensen, Gorm B

2012-01-01

It is largely unknown whether prostate-specific antigen (PSA) level at first date of testing predicts long-term risk of prostate cancer (PCa) incidence and mortality in the general population.......It is largely unknown whether prostate-specific antigen (PSA) level at first date of testing predicts long-term risk of prostate cancer (PCa) incidence and mortality in the general population....

Long-Term Care Workforce Issues: Practice Principles for Quality Dementia Care.

Science.gov (United States)

Gilster, Susan D; Boltz, Marie; Dalessandro, Jennifer L

2018-01-18

This article is one in a series of articles in this supplement addressing best practice for quality dementia care. The Alzheimer's Association, in revising their Dementia Care Practice Recommendations for 2017 has identified staff across the long-term care spectrum as a distinct and important determinant of quality dementia care. The purpose of this article is to highlight areas for developing and supporting a dementia-capable workforce. The Alzheimer's Association Principles For Advocacy To Assure Quality Dementia Care Across Settings provide a framework to examine interventions to support the dementia care workforce in long-term care settings. Evidence-based approaches that represent these principles are discussed: (a) staffing, (b) staff training, (c) compensation, (d) supportive work environments, (e) career growth and retention, and (f) engagement with family. Although not all settings currently require attention to the principles described, this article proposes these principles as best practice recommendations. Recommendations and future research considerations to further improve the lives of those who live and work in nursing homes, assisted living, hospice, and home care, are proposed. Additional areas to improve the quality of a dementia care workforce person-centered care information, communication and interdepartmental teamwork, and ongoing evaluation are discussed. © The Author(s) 2018. 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.

IRRIGATION PRACTICES IN LONG-TERM SURVIVORS OF COLORECTAL CANCER (CRC) WITH COLOSTOMIES

OpenAIRE

Grant, Marcia; McMullen, Carmit K.; Altschuler, Andrea; Hornbrook, Mark C.; Herrinton, Lisa J.; Wendel, Christopher S.; Baldwin, Carol M.; Krouse, Robert S.

2012-01-01

Creation of a colostomy in colorectal (CRC) cancer patients results in a loss of control over bowel evacuation. The only way to re-establish some control is through irrigation, a procedure that involves instilling fluid into the bowel to allow for gas and fecal output. This article reports on irrigation practices of participants in a large, multi-site, multi-investigator study of health-related quality of life (HR-QOL) in long term CRC survivors. Questions about irrigation practices were iden...

Enabling Long-Term Earth Science Research: Changing Data Practices (Invited)

Science.gov (United States)

Baker, K. S.

2013-12-01

Data stewardship plans are shaped by our shared experiences. As a result, community engagement and collaborative activities are central to the stewardship of data. Since modes and mechanisms of engagement have changed, we benefit from asking anew: ';Who are the communities?' and ';What are the lessons learned?'. Data stewardship with its long-term care perspective, is enriched by reflection on community experience. This presentation draws on data management issues and strategies originating from within long-term research communities as well as on recent studies informed by library and information science. Ethnographic case studies that capture project activities and histories are presented as resources for comparative analysis. Agency requirements and funding opportunities are stimulating collaborative endeavors focused on data re-use and archiving. Research groups including earth scientists, information professionals, and data systems designers are recognizing the possibilities for new ways of thinking about data in the digital arena. Together, these groups are re-conceptualizing and reconfiguring for data management and data curation. A differentiation between managing data for local use and production of data for re-use remotely in locations and fields remote from the data origin is just one example of the concepts emerging to facilitate development of data management. While earth scientists as data generators have the responsibility to plan new workflows and documentation practices, data and information specialists have responsibility to promote best practices as well as to facilitate the development of community resources such as controlled vocabularies and data dictionaries. With data-centric activities and changing data practices, the potential for creating dynamic community information environments in conjunction with development of data facilities exists but remains elusive.

Implementing structured functional assessments in general practice for persons with long-term sick leave: a cluster randomised controlled trial

Directory of Open Access Journals (Sweden)

Benth Jūratė

2009-05-01

Full Text Available Abstract Background The increasing attention on functional assessments in medical and vocational rehabilitation requires a focus change for the general practitioners (GP into paying attention to patient resources, possibilities and coping instead of symptoms, problems and limitations. The GPs report difficulties in performing the requested explicit functional assessments. The purpose of this study was to implement a structured method in general practice for assessing functional ability in persons with long-term sick leave. The study aim was to evaluate intervention effects on important GP parameters; knowledge, attitudes, self-efficacy towards functional assessments and knowledge about patient work factors. Methods Fifty-seven GPs were randomly assigned to an intervention or a control group. The intervention group GPs attended an introductory one-day work-shop and implemented structured functional assessments during an eight months intervention period. GP knowledge, GP attitudes, and GP self-efficacy towards functional assessments, as well as GP knowledge of patient work factors, were collected before, after and six months after the intervention period started. Evaluation score-sheets were filled in by both the intervention GPs and their patients immediately after the consultation to evaluate the GPs' knowledge of patient work factors. Results The intervention GPs reported increased knowledge (B: 0.56, 95% CI (0.19, 0.91 and self-efficacy (B: 0.90, 95% CI (0.53, 1.26 towards functional assessments, and increased knowledge about their patients' workplace (B: 0.75, 95% CI (0.35, 1.15 and perceived stressors (B: 0.55, 95% CI (0.23, 0.88 with lasting effects at the second follow-up. No intervention effect was seen in relation to GP attitudes. Both before and after the intervention, the GPs were most informed about physical stressors, and less about mental and work organisational stressors (Guttman's reproducibility coefficient: 0.95 and 1.00. After

Implementing structured functional assessments in general practice for persons with long-term sick leave: a cluster randomised controlled trial.

Science.gov (United States)

Østerås, Nina; Gulbrandsen, Pål; Benth, Jūrate Saltyte; Hofoss, Dag; Brage, Søren

2009-05-06

The increasing attention on functional assessments in medical and vocational rehabilitation requires a focus change for the general practitioners (GP) into paying attention to patient resources, possibilities and coping instead of symptoms, problems and limitations. The GPs report difficulties in performing the requested explicit functional assessments. The purpose of this study was to implement a structured method in general practice for assessing functional ability in persons with long-term sick leave. The study aim was to evaluate intervention effects on important GP parameters; knowledge, attitudes, self-efficacy towards functional assessments and knowledge about patient work factors. Fifty-seven GPs were randomly assigned to an intervention or a control group. The intervention group GPs attended an introductory one-day work-shop and implemented structured functional assessments during an eight months intervention period. GP knowledge, GP attitudes, and GP self-efficacy towards functional assessments, as well as GP knowledge of patient work factors, were collected before, after and six months after the intervention period started. Evaluation score-sheets were filled in by both the intervention GPs and their patients immediately after the consultation to evaluate the GPs' knowledge of patient work factors. The intervention GPs reported increased knowledge (B: 0.56, 95% CI (0.19, 0.91)) and self-efficacy (B: 0.90, 95% CI (0.53, 1.26)) towards functional assessments, and increased knowledge about their patients' workplace (B: 0.75, 95% CI (0.35, 1.15)) and perceived stressors (B: 0.55, 95% CI (0.23, 0.88)) with lasting effects at the second follow-up. No intervention effect was seen in relation to GP attitudes. Both before and after the intervention, the GPs were most informed about physical stressors, and less about mental and work organisational stressors (Guttman's reproducibility coefficient: 0.95 and 1.00). After the consultation, both the intervention GPs

Recommendations From the International Consortium on Professional Nursing Practice in Long-Term Care Homes.

Science.gov (United States)

McGilton, Katherine S; Bowers, Barbara J; Heath, Hazel; Shannon, Kay; Dellefield, Mary Ellen; Prentice, Dawn; Siegel, Elena O; Meyer, Julienne; Chu, Charlene H; Ploeg, Jenny; Boscart, Veronique M; Corazzini, Kirsten N; Anderson, Ruth A; Mueller, Christine A

2016-02-01

In response to the International Association of Gerontology and Geriatrics' global agenda for clinical research and quality of care in long-term care homes (LTCHs), the International Consortium on Professional Nursing Practice in Long Term Care Homes (the Consortium) was formed to develop nursing leadership capacity and address the concerns regarding the current state of professional nursing practice in LTCHs. At its invitational, 2-day inaugural meeting, the Consortium brought together international nurse experts to explore the potential of registered nurses (RNs) who work as supervisors or charge nurses within the LTCHs and the value of their contribution in nursing homes, consider what RN competencies might be needed, discuss effective educational (curriculum and practice) experiences, health care policy, and human resources planning requirements, and to identify what sustainable nurse leadership strategies and models might enhance the effectiveness of RNs in improving resident, family, and staff outcomes. The Consortium made recommendations about the following priority issues for action: (1) define the competencies of RNs required to care for older adults in LTCHs; (2) create an LTCH environment in which the RN role is differentiated from other team members and RNs can practice to their full scope; and (3) prepare RN leaders to operate effectively in person-centered care LTCH environments. In addition to clear recommendations for practice, the Consortium identified several areas in which further research is needed. The Consortium advocated for a research agenda that emphasizes an international coordination of research efforts to explore similar issues, the pursuit of examining the impact of nursing and organizational models, and the showcasing of excellence in nursing practice in care homes, so that others might learn from what works. Several studies already under way are also described. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care

Weight Changes in General Practice.

Science.gov (United States)

Køster-Rasmussen, Rasmus

2017-06-01

This PhD thesis is about weight changes. What determines long-term weight changes in the adult general population? Is it possible that weight loss may not always be healthy? The present clinical guidelines for general practice advice most overweight persons and patients with type 2 diabetes to lose weight. Are the guidelines based on firm evidence?   METHODS: The back-bone of the thesis is constituted by three scientific articles based on three different population based cohort studies. Multivariable modeling and other epidemiological methods were used.   RESULTS: Article 1 examined weight changes in the general population in relation to smoking status, and proposed a graphical 'smoking cessation weight change model', demonstrating the importance of time, age and smoking status in relation to long-term weight changes. Article 2 suggested new methods to improve the processing of dietary data. It was demonstrated how median imputation for missing values and assumptions about standard portion sizes were inferior to stochastic methods conditioning on information about physiology of the individual. Article 3 evaluated the influence of prospectively planned intentional weight loss on long-term morbidity and mortality in patients with type 2 diabetes. Therapeutic intentional weight loss supervised by a medical doctor was not associated with reduced morbidity or mortality. In the general population the dietary intake of fructose and soft drinks sweetened with sugar was not associated with weight change over 9 years. Weight gain rates were large in young adults and incrementally smaller in middle aged adults. Subjects more than 60 years lost weight on average. Historical weight data suggest that the body weight increases throughout life to the age of 60-65years. A study with simulated data indicates that bias in baseline BMI may misleadingly have favored weight loss in earlier cohort studies of intentional weight loss and mortality.   DISCUSSION: The findings regarding

Marketing in the long-term care continuum.

Science.gov (United States)

Laurence, J Nathan; Kash, Bita A

2010-04-01

Today, long-term care facilities are composed of independent, assisted living, and skilled nursing facilities along with many variations of those themes in between. The clientele for these various types of facilities differ because of the level of care the facility provides as well as the amenities long-term care consumers are looking for. However, there many similarities and common approaches to how reaching the target audience through effective marketing activities. Knowing who the target audience is, how to reach them, and how to communicate with them will serve any facility well in this competitive market. Developing marketing strategies for long-term care settings is as important as understanding what elements of care can be marketed individually as a niche market. Determining the market base for a facility is equally crucial since the target populations differ among the three types of facilities. By reviewing current marketing articles and applying marketing practices, we have crafted some general principles for which each facility type can learn from. Finally, we will discuss the types of marketing and how they related to the spectrum of long-term care facilities.

The Long-Term Effects of Childhood Music Instruction on Intelligence and General Cognitive Abilities

Science.gov (United States)

Costa-Giomi, Eugenia

2015-01-01

This article reviews research on the effects of music instruction on general cognitive abilities. The review of more than 75 reports shows (1) the consistency in results pertaining to the short-term effects of music instruction on cognitive abilities and the lack of clear evidence on the long-term effects on intelligence; (2) the complex nature of…

Influence of long-term Sahaja Yoga meditation practice on emotional processing in the brain: An ERP study.

Science.gov (United States)

Reva, N V; Pavlov, S V; Loktev, K V; Korenyok, V V; Aftanas, L I

2014-12-05

Despite growing interest in meditation as a tool for alternative therapy of stress-related and psychosomatic diseases, brain mechanisms of beneficial influences of meditation practice on health and quality of life are still unclear. We propose that the key point is a persistent change in emotional functioning, specifically the modulation of the early appraisal of motivational significance of events. The main aim was to study the effects of long-term meditation practice on event-related brain potentials (ERPs) during affective picture viewing. ERPs were recorded in 20 long-term Sahaja Yoga meditators and 20 control subjects without prior experience in meditation. The meditators' mid-latency (140-400ms) ERPs were attenuated for both positive and negative pictures (i.e. there were no arousal-related increases in ERP positivity) and this effect was more prominent over the right hemisphere. However, we found no differences in the long latency (400-800ms) responses to emotional images, associated with meditation practice. In addition we found stronger ERP negativity in the time window 200-300ms for meditators compared to the controls, regardless of picture valence. We assume that long-term meditation practice enhances frontal top-down control over fast automatic salience detection, based on amygdala functions. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

The impact of professional development on classroom teaching for science educators participating in a long term community of practice

Science.gov (United States)

Jensen, Aaron C.

Efforts to modify and improve science education in the United States have seen minimal success (Crawford, 2000; Borko & Putman, 1996; Puntambekar, Stylianou & Goldstein, 2007; Lustick, 2011). One important reason for this is the professional development that teachers go through in order to learn about and apply these new ideas is generally of poor quality and structured incorrectly for long-term changes in the classroom (Little, 1993; Fullen, 1996; Porter, 2000; Jeanpierre, Oberhauser, & Freeman, 2005). This grounded theory study explores a science community of practice and how the professional development achieved through participation in that community has effected the instruction of the teachers involved, specifically the incorporation of researched based effective science teaching instructional strategies. This study uses personal reflection papers written by the participants, interviews, and classroom observations to understand the influence that the science community of practice has had on the participants. Results indicate that participation in this science community of practice has significant impact on the teachers involved. Participants gained greater understanding of science content knowledge, incorporated effective science instructional strategies into their classroom, and were able to practice both content knowledge and strategies in a non-threatening environment thus gaining a greater understanding of how to apply them in the classrooms. These findings motivate continued research in the role that communities of practice may play in teacher professional develop and the effectiveness of quality professional development in attaining long-term, sustained improvement in science education.

Relationships among leadership practices, work environments, staff communication and outcomes in long-term care.

Science.gov (United States)

Tourangeau, Ann; Cranley, Lisa; Spence Laschinger, Heather K; Pachis, Jaime

2010-11-01

To examine the role that work relationships have on two long-term care outcomes: job satisfaction and turnover intention. It is easy to overlook the impact that human relations have in shaping work environments that are conducive to organizational effectiveness. Employee job satisfaction and retention are important organizational outcomes. Six hundred and seventy-five nursing and other staff from 26 long-term care facilities were surveyed about their work environments, work group relationships, observed leadership practices, organizational support, job satisfaction and turnover intention. Higher job satisfaction was associated with lower emotional exhaustion burnout, higher global empowerment, higher organizational support, higher psychological empowerment, stronger work group cohesion and higher personal accomplishment. Higher turnover intention was associated with lower job satisfaction, higher emotional exhaustion burnout, more outside job opportunities, weaker work group cohesion, lower personal accomplishment and higher depersonalization. No relationship was found between leadership practices and job satisfaction or turnover intention. Stronger work group relationships, stronger sense of personal accomplishment and lower emotional exhaustion have direct effects on increasing job satisfaction and lowering turnover intention. To retain long-term care staff, attention should be paid to fostering positive work group cohesion, supporting and acknowledging staff accomplishments and minimizing staff burnout. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Audit of long-term and short-term liabilities

Directory of Open Access Journals (Sweden)

Korinko M.D.

2017-03-01

Full Text Available The article determines the importance of long-term and short-term liabilities for the management of financial and material resources of an enterprise. It reviews the aim, objects and information generators for realization of audit of short-term and long-term obligations. The organizing and methodical providing of audit of long-term and short-term liabilities of an enterprise are generalized. The authors distinguish the stages of realization of audit of long-term and short-term liabilities, the aim of audit on each of the presented stages, and recommend methodical techniques. It is fixed that it is necessary to conduct the estimation of the systems of internal control and record-keeping of an enterprise by implementation of public accountant procedures for determination of volume and maintenance of selection realization. After estimating the indicated systems, a public accountant determines the methodology for realization of public accountant verification of long-term and short-term liabilities. The analytical procedures that public accountants are expedient to use for realization of audit of short-term and long-term obligations are determined. The authors suggest the classification of the educed defects on the results of the conducted public accountant verification of short-term and long-term obligations.

Witnessing Interparental Violence, Parenting Practices, and Children´s Long-Term Psychological Distress

Directory of Open Access Journals (Sweden)

Manuel Gámez-Guadix

2011-07-01

Full Text Available The first objective of this study was to examine the relationship between witnessing interparental violence and children´s long-term psychological distress, and the extent to which this relation is mediated by deteriorating parenting practices (i.e., harsh discipline, affection/support, interparental and intraparental consistency. The second objective was to analyze the possible gender differences in the relationships specified. The sample comprised 680 Spanish university students (62.4% females selected by random, stratified, and proportional sampling (by faculty and sex. Participants retrospectively reported the physical and psychological violence perpetrated by one of his or her parents against the other, the parenting practices when they were preadolescents, and the psychological distress during the past two weeks. Results revealed that harsh discipline and the level of affection and affection/support partially mediated the association between children´s witnessing interparental violence and their long-term psychological distress. These relationships were not significantly different as a function of participants´ sex. Lastly, we discuss the implications of these findings for the planning and development of intervention programs.

The long-term career outcome study: lessons learned and implications for educational practice.

Science.gov (United States)

Durning, Steven J; Dong, Ting; LaRochelle, Jeffrey L; Artino, Anthony R; Gilliland, William R; DeZee, Kent J; Saguil, Aaron; Cruess, David F; Picho, Katherine; McManigle, John E

2015-04-01

The work of the Long-Term Career Outcome Study has been a program of scholarship spanning 10 years. Borrowing from established quality assurance literature, the Long-Term Career Outcome Study team has organized its scholarship into three phases; before medical school, during medical school, and after medical school. The purpose of this commentary is to address two fundamental questions: (1) what has been learned? and (2) how does this knowledge translate to educational practice and policy now and into the future? We believe that answers to these questions are relevant not only to our institution but also to other educational institutions seeking to provide high-quality health professions education. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Practical implications for RPV irradiation surveillance under long term operation based on latest research results

International Nuclear Information System (INIS)

Hein, H.; Keim, E.; Barthelmes, J.; Schnabel, H.

2015-01-01

The international programs CARISMA, CARINA and LONGLIFE belong to the research programs which have been performed during the last 10 years to study the irradiation behavior of RPV steels under long term operation of more than 60 years. Some characteristic but different irradiated RPV steels used in Pressurized Water Reactors have been extensively investigated in each of those three programs. Whereas the CARISMA and CARINA programs were mainly focused on material testing to study the irradiation-induced change of material properties in terms of fracture toughness, the main objective of LONGLIFE was to investigate the change of microstructure with various analysis techniques and to understand the mechanisms behind. In this way it was possible to get a comprehensive material characterization in terms of macro-physical properties and micro-structural features for a number of RPV steels which have been studied at different irradiation levels up to 8*10 19 cm -2 (E > 1 MeV). The essential macro-physical and micro-structural results are summarized, in particular regarding the impact of copper and nickel, and the neutron flux on the irradiation behavior and with respect to possible late irradiation effects under long term operation. Moreover, the change of material properties is linked with embrittlement mechanisms such as formation of element specific precipitations, segregations, and matrix defects. Well-known trend curves are also applied to the measured T 41 and T 0 data in order to assess their appropriateness for long term operation. Based on the comprehensive available data base, practical implications for RPV irradiation surveillance programs under long term operation are highlighted with respect to issues like material specific application of reference temperature concepts, data scattering, prediction of high fluence behavior and how to cope with possible late irradiation effects. Finally, best practices for RPV irradiation surveillance programs are suggested from

Provision of hormonal and long-acting reversible contraceptive services by general practices in Scotland, UK (2004-2009).

Science.gov (United States)

Reddy, Anusha; Watson, Margaret; Hannaford, Philip; Lefevre, Karen; Ayansina, Dolapo

2014-01-01

In the UK, a large proportion of contraceptive services are provided from general practice. However, little is known about which contraceptive services are provided and to whom. Descriptive serial cross-sectional study of women aged 12-55 years, registered with 191 general practices in Scotland, UK between 2004 and 2009. Annual incidence of provision of hormonal and long-acting reversible contraceptives (LARCs) increased from 27.7% in 2004 to 30.1% in 2009. Amongst those women registered with a general practice for the full 5-year period the provision of LARCs increased from 8.8% to 12.5% (pemergency hormonal contraception (EHC) decreased from 5.2% to 2.6% (pcontraceptives and LARCs from general practices. It is important that a full range of contraceptive options remains easily available to women.

Dynamics of volume of competition practice and facilities of training of jumpers in length and triple in the process of long-term preparation

Directory of Open Access Journals (Sweden)

Sovenko S.P.

2012-12-01

Full Text Available Analysed and systematized information in relation to the volume of competition practice and facilities of different primary orientation of jumpers in length and triple in the process of long-term preparation. The expert questioning is conducted 16 trainers. The documents of planning of training process are analysed, the analysis of diaries of sportsmen is carried out (n=22. The volume of competition practice of sportsmen and facilities of training of different primary orientation is certain. The results of analysis in relation to the construction of training process are reflected by the leading trainers of Ukraine on track-and-field. An approach classification of facilities of training taking into account the specific of training process of sportsmen is presented. It is set that the volume of facilities of general preparation is most on the initial stages of long-term perfection, then stabilized on the stages specialized base and preparations to higher achievements and a few diminishes on maximal implementation of individual possibilities and maintainance of higher sporting trade phases. It is related to diminishing of duration of the general preparatory stages of annual preparation.

Differences in health status between long-term and short-term benzodiazepine users.

NARCIS (Netherlands)

Zandstra, S.M.; Furer, J.W.; Lisdonk, E.H. van de; Bor, J.H.J.; Zitman, F.G.; Weel, C. van

2002-01-01

BACKGROUND: Despite generally accepted advice to keep treatment short, benzodiazepines are often prescibed for more than six months. Prevention of long-term benzodiazepine use could be facilitated by the utilisation of risk indicators for long-term use. However, the characteristics of long-term

Pivmecillinam versus sulfamethizole for short-term treatment of uncomplicated acute cystitis in general practice

DEFF Research Database (Denmark)

Bjerrum, Lars; Gahrn-Hansen, Bente; Grinsted, Per

2009-01-01

Objective. To investigate whether short-term treatment with pivmecillinam was more effective than sulfamethizole in patients with acute uncomplicated urinary tract infection (UTI). Design. Randomized controlled trial. Setting. General practice, Denmark. Subjects. Patients (n =167) with uncomplica......Objective. To investigate whether short-term treatment with pivmecillinam was more effective than sulfamethizole in patients with acute uncomplicated urinary tract infection (UTI). Design. Randomized controlled trial. Setting. General practice, Denmark. Subjects. Patients (n =167......) with uncomplicated UTI confirmed by positive urine phase-contrast microscopy. Main outcome measures. Drug efficacy based on clinical and bacteriological cure. Results. Urinary symptoms disappeared first in patients treated with pivmecillinam, but after five days there was no significant difference in clinical cure...... in 68.8% of patients randomized to pivmecillinam and in 77.9% randomized to sulfamethizole (difference -9.2%, CI -24.7%; 6.3%). Some 26.8% of patients randomized to pivmecillinam experienced a new UTI within 6 months after treatment compared with 18.4% of patients randomized to sulfamethizole...

A review of methodologies applied in Australian practice to evaluate long-term coastal adaptation options

Directory of Open Access Journals (Sweden)

Timothy David Ramm

2017-01-01

Full Text Available Rising sea levels have the potential to alter coastal flooding regimes around the world and local governments are beginning to consider how to manage uncertain coastal change. In doing so, there is increasing recognition that such change is deeply uncertain and unable to be reliably described with probabilities or a small number of scenarios. Characteristics of methodologies applied in Australian practice to evaluate long-term coastal adaptation options are reviewed and benchmarked against two state-of-the-art international methods suited for conditions of uncertainty (Robust Decision Making and Dynamic Adaptive Policy Pathways. Seven out of the ten Australian case studies assumed the uncertain parameters, such as sea level rise, could be described deterministically or stochastically when identifying risk and evaluating adaptation options across multi-decadal periods. This basis is not considered sophisticated enough for long-term decision-making, implying that Australian practice needs to increase the use of scenarios to explore a much larger uncertainty space when assessing the performance of adaptation options. Two Australian case studies mapped flexible adaptation pathways to manage uncertainty, and there remains an opportunity to incorporate quantitative methodologies to support the identification of risk thresholds. The contextual framing of risk, including the approach taken to identify risk (top-down or bottom-up and treatment of uncertain parameters, were found to be fundamental characteristics that influenced the methodology selected to evaluate adaptation options. The small sample of case studies available suggests that long-term coastal adaptation in Australian is in its infancy and there is a timely opportunity to guide local government towards robust methodologies for developing long-term coastal adaptation plans.

Prosthetists' perceptions and use of outcome measures in clinical practice: Long-term effects of focused continuing education.

Science.gov (United States)

Hafner, Brian J; Spaulding, Susan E; Salem, Rana; Morgan, Sara J; Gaunaurd, Ignacio; Gailey, Robert

2017-06-01

Continuing education is intended to facilitate clinicians' skills and knowledge in areas of practice, such as administration and interpretation of outcome measures. To evaluate the long-term effect of continuing education on prosthetists' confidence in administering outcome measures and their perceptions of outcomes measurement in clinical practice. Pretest-posttest survey methods. A total of 66 prosthetists were surveyed before, immediately after, and 2 years after outcomes measurement education and training. Prosthetists were grouped as routine or non-routine outcome measures users, based on experience reported prior to training. On average, prosthetists were just as confident administering measures 1-2 years after continuing education as they were immediately after continuing education. In all, 20% of prosthetists, initially classified as non-routine users, were subsequently classified as routine users at follow-up. Routine and non-routine users' opinions differed on whether outcome measures contributed to efficient patient evaluations (79.3% and 32.4%, respectively). Both routine and non-routine users reported challenges integrating outcome measures into normal clinical routines (20.7% and 45.9%, respectively). Continuing education had a long-term impact on prosthetists' confidence in administering outcome measures and may influence their clinical practices. However, remaining barriers to using standardized measures need to be addressed to keep practitioners current with evolving practice expectations. Clinical relevance Continuing education (CE) had a significant long-term impact on prosthetists' confidence in administering outcome measures and influenced their clinical practices. In all, approximately 20% of prosthetists, who previously were non-routine outcome measure users, became routine users after CE. There remains a need to develop strategies to integrate outcome measurement into routine clinical practice.

Industrial Foundations as Long-Term Owners

DEFF Research Database (Denmark)

Thomsen, Steen; Poulsen, Thomas; Børsting, Christa Winther

Short-termism has become a serious concern for corporate governance, and this has inspired a search for institutional arrangements to promote long-term decision-making. In this paper, we call attention to long-term ownership by industrial foundations, which is common in Northern Europe but little...... known in the rest of the world. We use a unique Danish data set to document that industrial foundations are long-term owners that practice long-term governance. We show that foundation ownership is highly stable compared to other ownership structures. Foundation-owned companies replace managers less...... frequently. They have conservative capital structures with low financial leverage. They score higher on an index of long-termism in finance, investment, and employment. They survive longer. Overall, our paper supports the hypothesis that corporate time horizons are influenced by ownership structures...

Long-term stabilization of uranium mill tailings

International Nuclear Information System (INIS)

Voorhees, L.D.; Sale, M.J.; Webb, J.W.; Mulholland, P.J.

1984-01-01

The primary hazard associated with uranium mill tailings is exposure to a radioactive gas, radon-222, the concentration of which has been correlated with the occurrence of lung cancer. Previous studies on radon attenuation conclude that the placement of earthen cover materials over the tailings is the most effective technique for reducing radioactive emissions and dispersal of tailings. The success of such a plan, however, is dependent on ensuring the long-term integrity of these cover materials. Soil erosion from water and wind is the major natural cause of destabilizing earthen cover materials. Field data related to the control of soil loss are limited and only indirectly apply to the problem of isolation of uranium mill tailings over very long time periods (up to 80,000 a). However, sufficient information is available to determine benefits that will result from changes in specific design variables and to evaluate the need for different design strategies among potential disposal sites. The three major options available for stabilization of uranium mill tailings are (1) rock cover, (2) soil and revegetation, or (3) a combination of both on different portions of the tailings cover. The optimal choice among these alternatives depends on site-specific characteristics such as climate and local geomorphology and soils, and on design variables such as embankment heights and slopes, modification of upstream drainage, and revegetation practices. Generally, geomorphic evidence suggests that use of soil and vegetation alone will not be adequate to reduce erosion on slopes greater than about 5 to 9%. For these steeper slopes, the use of rock talus or riprap will be necessary to maximize the probability of long-term stability. The use of vegetation to control erosion on the flatter portions of the site may be practicable in regions of the USA with sufficient rainfall and suitable soil types, but revegetation practices must be carefully evaluated to ensure that long-term

Long-term effectiveness of a quality improvement program for patients with type 2 diabetes in general practice.

NARCIS (Netherlands)

Renders, C.M.; Valk, G.D.; Franse, L.V.; Schellevis, F.; Eijk, J.T.M. van; Wal, G. van der

2001-01-01

OBJECTIVE— To assess the long-term effectiveness of a quality improvement program on care provided and patient outcomes in patients with diabetes. RESEARCH DESIGN AND METHODS— A nonrandomized trial was performed with 312 patients with type 2 diabetes in the intervention group and 77 patients with

Behavioral tagging is a general mechanism of long-term memory formation.

Science.gov (United States)

Ballarini, Fabricio; Moncada, Diego; Martinez, Maria Cecilia; Alen, Nadia; Viola, Haydée

2009-08-25

In daily life, memories are intertwined events. Little is known about the mechanisms involved in their interactions. Using two hippocampus-dependent (spatial object recognition and contextual fear conditioning) and one hippocampus-independent (conditioned taste aversion) learning tasks, we show that in rats subjected to weak training protocols that induce solely short term memory (STM), long term memory (LTM) is promoted and formed only if training sessions took place in contingence with a novel, but not familiar, experience occurring during a critical time window around training. This process requires newly synthesized proteins induced by novelty and reveals a general mechanism of LTM formation that begins with the setting of a "learning tag" established by a weak training. These findings represent the first comprehensive set of evidences indicating the existence of a behavioral tagging process that in analogy to the synaptic tagging and capture process, need the creation of a transient, protein synthesis-independent, and input specific tag.

Radiating low back pain in general practice : Incidence, prevalence, diagnosis, and long-term clinical course of illness

NARCIS (Netherlands)

Spijker-Huiges, Antje; Groenhof, Feikje; Winters, Jan C.; van Wijhe, Marten; Groenier, Klaas H.; van der Meer, Klaas

Objective. The aim of this study was to calculate the incidence and prevalence of radiating low back pain, to explore the long-term clinical course of radiating low back pain including the influence of radiculopathy (in a subsample of the study population) and non-radiating low back pain thereon,

General Exercise Does Not Improve Long-Term Pain and Disability in Individuals With Whiplash-Associated Disorders: A Systematic Review.

Science.gov (United States)

Griffin, Alexandra; Leaver, Andrew; Moloney, Niamh

2017-07-01

Study Design Systematic review of randomized controlled trials. Background General exercise, defined as purposeful physical activity involving repetitive exercises and incorporating multiple muscle groups, is frequently used in the management of whiplash-associated disorders (WADs). Evidence supporting its efficacy is not well established. Objectives To determine whether general exercise is effective in reducing pain and disability in people with WAD. Methods Studies published in English in peer-reviewed journals between January 1990 and May 2015 were eligible if they evaluated a general exercise intervention compared with a different intervention or control. Studies were required to evaluate pain and disability at medium-term (6-14 weeks) and long-term (52 weeks) follow-ups. The mean ± SD and sample size were recorded for follow-up scores and for change scores from baseline to follow-up. Results Of the 3 high-quality studies that were eligible for inclusion, none investigated general exercise alone. There were no clinically meaningful differences between comprehensive exercise programs, which included general exercise, and minimal intervention controls in the medium and long term. No studies directly compared general exercise with a no-treatment control. All included studies used different control interventions, preventing meta-analysis. Conclusion A lack of significant long-term improvements from general exercise interventions in individuals with WAD was identified. This finding differs from the positive benefits of general exercise for other musculoskeletal conditions. This may, in part, relate to the complexity of whiplash conditions. This may also reflect the challenge of exercise prescription in this population, where the need for sufficient intensity is balanced against the impact that exercise has on pain. Level of Evidence Therapy, level 1a. J Orthop Sports Phys Ther 2017;47(7):472-480. Epub 16 Jun 2017. doi:10.2519/jospt.2017.7081.

IRRIGATION PRACTICES IN LONG-TERM SURVIVORS OF COLORECTAL CANCER (CRC) WITH COLOSTOMIES

Science.gov (United States)

Grant, Marcia; McMullen, Carmit K.; Altschuler, Andrea; Hornbrook, Mark C.; Herrinton, Lisa J.; Wendel, Christopher S.; Baldwin, Carol M.; Krouse, Robert S.

2014-01-01

Creation of a colostomy in colorectal (CRC) cancer patients results in a loss of control over bowel evacuation. The only way to re-establish some control is through irrigation, a procedure that involves instilling fluid into the bowel to allow for gas and fecal output. This article reports on irrigation practices of participants in a large, multi-site, multi-investigator study of health-related quality of life (HR-QOL) in long term CRC survivors. Questions about irrigation practices were identified in open-ended questions within a large HR-QOL survey and in focus groups of men and women with high and low HR-QOL. Descriptive data on survivors were combined with content analysis of irrigation knowledge and practices. Patient education and use of irrigation in the United States has decreased over the years, with no clear identification of why this change in practice has occurred. Those respondents who used irrigation had their surgery longer ago, and spent more time in colostomy care than those that did not irrigate. Reasons for the decrease in colostomy irrigation are unreported and present priorities for needed research. PMID:23022935

Long-term mortality rates (>8-year) improve as compared to the general and obese population following bariatric surgery.

Science.gov (United States)

Telem, Dana A; Talamini, Mark; Shroyer, A Laurie; Yang, Jie; Altieri, Maria; Zhang, Qiao; Gracia, Gerald; Pryor, Aurora D

2015-03-01

Sparse data are available on long-term patient mortality following bariatric surgery as compared to the general population. The purpose of this study was to assess long-term mortality rates and identify risk factors for all-cause mortality following bariatric surgery. New York State (NYS) Planning and Research Cooperative System (SPARCS) longitudinal administrative data were used to identify 7,862 adult patients who underwent a primary laparoscopic bariatric surgery from 1999 to 2005. The Social Security Death Index database identified >30-day mortalities. Risk factors for mortality were screened using a univariate Cox proportional hazard (PH) model and analyzed using a multiple PH model. Based on age, gender, and race/ethnicity, actuarial projections for NYS mortality rates obtained from Centers of Disease Control were compared to the actual post-bariatric surgery mortality rates observed. The mean bariatric mortality rate was 2.5 % with 8-14 years of follow-up. Mean time to death ranged from 4 to 6 year and did not differ by operation (p = 0.073). From 1999 to 2010, the actuarial mortality rate predicted for the general NYS population was 2.1 % versus the observed 1.5 % for the bariatric surgery population (p = 0.005). Extrapolating to 2013, demonstrated the actuarial mortality predictions at 3.1 % versus the bariatric surgery patients' observed morality rate of 2.5 % (p = 0.01). Risk factors associated with an earlier time to death included: age, male gender, Medicare/Medicaid insurance, congestive heart failure, rheumatoid arthritis, pulmonary circulation disorders, and diabetes. No procedure-specific or perioperative complication impact for time-to-death was found. Long-term mortality rate of patients undergoing bariatric surgery significantly improves as compared to the general population regardless of bariatric operation performed. Additionally, perioperative complications do not increase long-term mortality risk. This study did identify specific patient

Very long-term sequelae of craniopharyngioma.

Science.gov (United States)

Wijnen, Mark; van den Heuvel-Eibrink, Marry M; Janssen, Joseph A M J L; Catsman-Berrevoets, Coriene E; Michiels, Erna M C; van Veelen-Vincent, Marie-Lise C; Dallenga, Alof H G; van den Berge, J Herbert; van Rij, Carolien M; van der Lely, Aart-Jan; Neggers, Sebastian J C M M

2017-06-01

Studies investigating long-term health conditions in patients with craniopharyngioma are limited by short follow-up durations and generally do not compare long-term health effects according to initial craniopharyngioma treatment approach. In addition, studies comparing long-term health conditions between patients with childhood- and adult-onset craniopharyngioma report conflicting results. The objective of this study was to analyse a full spectrum of long-term health effects in patients with craniopharyngioma according to initial treatment approach and age group at craniopharyngioma presentation. Cross-sectional study based on retrospective data. We studied a single-centre cohort of 128 patients with craniopharyngioma treated from 1980 onwards (63 patients with childhood-onset disease). Median follow-up since craniopharyngioma presentation was 13 years (interquartile range: 5-23 years). Initial craniopharyngioma treatment approaches included gross total resection ( n  = 25), subtotal resection without radiotherapy ( n  = 44), subtotal resection with radiotherapy ( n  = 25), cyst aspiration without radiotherapy ( n  = 8), and 90 Yttrium brachytherapy ( n  = 21). Pituitary hormone deficiencies (98%), visual disturbances (75%) and obesity (56%) were the most common long-term health conditions observed. Different initial craniopharyngioma treatment approaches resulted in similar long-term health effects. Patients with childhood-onset craniopharyngioma experienced significantly more growth hormone deficiency, diabetes insipidus, panhypopituitarism, morbid obesity, epilepsy and psychiatric conditions compared with patients with adult-onset disease. Recurrence-/progression-free survival was significantly lower after initial craniopharyngioma treatment with cyst aspiration compared with other therapeutic approaches. Survival was similar between patients with childhood- and adult-onset craniopharyngioma. Long-term health conditions were comparable after

Homeopathic medical practice: Long-term results of a cohort study with 3981 patients

Directory of Open Access Journals (Sweden)

Baur Roland

2005-11-01

Full Text Available Abstract Background On the range of diagnoses, course of treatment, and long-term outcome in patients who chose to receive homeopathic medical treatment very little is known. We investigated homeopathic practice in an industrialized country under everyday conditions. Methods In a prospective, multicentre cohort study with 103 primary care practices with additional specialisation in homeopathy in Germany and Switzerland, data from all patients (age >1 year consulting the physician for the first time were observed. The main outcome measures were: Patient and physician assessments (numeric rating scales from 0 to 10 and quality of life at baseline, and after 3, 12, and 24 months. Results A total of 3,981 patients were studied including 2,851 adults (29% men, mean age 42.5 ± 13.1 years; 71% women, 39.9 ± 12.4 years and 1,130 children (52% boys, 6.5 ± 3.9 years; 48% girls, 7.0 ± 4.3 years. Ninety-seven percent of all diagnoses were chronic with an average duration of 8.8 ± 8 years. The most frequent diagnoses were allergic rhinitis in men, headache in women, and atopic dermatitis in children. Disease severity decreased significantly (p Conclusion Disease severity and quality of life demonstrated marked and sustained improvements following homeopathic treatment period. Our findings indicate that homeopathic medical therapy may play a beneficial role in the long-term care of patients with chronic diseases.

Creature comforts: personal communities, pets and the work of managing a long-term condition.

Science.gov (United States)

Brooks, Helen L; Rogers, Anne; Kapadia, Dharmi; Pilgrim, Jack; Reeves, David; Vassilev, Ivaylo

2013-06-01

To explore in the context of peoples' personal social networks, the contribution that pets make to 'the work' associated with the management of long-term conditions. Mixed methods survey with nested parallel qualitative study; 300 participants were drawn from diabetes and chronic heart disease registers of General Practices across Greater Manchester in the North West of England. Notions of 'work' were used to describe the illness and everyday activities associated with chronic illness. Nineteen percent of participants identified at least one pet within their network. Pets contributed mostly to managing emotions (emotional work), to enhancing a sense of self identity (biographical work) and to a lesser extent practical tasks (everyday work). There were indicators that pets mediated relationships for people living with a long-term condition through very weak ties with others in domestic and community settings. The findings suggest that pets have unique qualities and are not simply substitutes for human relationships in long-term condition management. The study has potential implications for furthering a social contextual analysis of chronic illness, the understanding of relationships, and the meaning and the role of companion animals in long-term condition management.

Developmental Dyslexia and Explicit Long-Term Memory

Science.gov (United States)

Menghini, Deny; Carlesimo, Giovanni Augusto; Marotta, Luigi; Finzi, Alessandra; Vicari, Stefano

2010-01-01

The reduced verbal long-term memory capacities often reported in dyslexics are generally interpreted as a consequence of their deficit in phonological coding. The present study was aimed at evaluating whether the learning deficit exhibited by dyslexics was restricted only to the verbal component of the long-term memory abilities or also involved…

Resilience, respite and general practice:taking a mindful approach to culture change

OpenAIRE

Brewster, Liz

2016-01-01

Demand for primary care services is high, with more patients and fewer practitioners leading to concerns that primary care physicians are struggling to cope with patient demand (1). General practice workload is seen as a potential risk to patients, simply because GPs are overworked (2). It may be time to be concerned about the long-term future of the family doctor—and to think personally, as well as professionally. These pressures clearly have an effect on those who currently practice in prim...

A security/safety survey of long term care facilities.

Science.gov (United States)

Acorn, Jonathan R

2010-01-01

What are the major security/safety problems of long term care facilities? What steps are being taken by some facilities to mitigate such problems? Answers to these questions can be found in a survey of IAHSS members involved in long term care security conducted for the IAHSS Long Term Care Security Task Force. The survey, the author points out, focuses primarily on long term care facilities operated by hospitals and health systems. However, he believes, it does accurately reflect the security problems most long term facilities face, and presents valuable information on security systems and practices which should be also considered by independent and chain operated facilities.

Long-range terms in atomic collisions

International Nuclear Information System (INIS)

McGuire, J.H.; Weaver, O.L.

1986-01-01

Various separations, or ''gauge choices,'' are possible for the decomposition of the total Hamiltonian into electronic and internuclear terms. We show that, for one particular choice, all long-range Coulomb terms are associated with the internuclear motion. The potential then associated with electronic transitions is non-Coulombic. Some practical consequences of this gauge choice are discussed

A qualitative study of collaboration in general practice: understanding the general practice nurse's role.

Science.gov (United States)

McInnes, Susan; Peters, Kath; Bonney, Andrew; Halcomb, Elizabeth

2017-07-01

To explore the nature of collaboration between registered nurses and general practitioners in Australian general practice. There is international recognition that collaboration between health professionals can improve care coordination, enhance health outcomes, optimise the work environment and reduce healthcare costs. However, effective collaboration requires a clear understanding of each team member's role. A qualitative approach guided by Naturalistic Inquiry was used to elicit and interpret participant narratives. Eight general practitioners and fourteen registered nurses working in general practice were purposefully recruited. Data were collected via individual, semi-structured face-to-face interviews during February to May 2015. Interviews were audio recorded and transcribed verbatim. Data were analysed using thematic analysis. Data revealed three overarching themes. This study presents the data for the overarching theme 'Understanding the general practice registered nurse's role'. Many general practitioner participants lacked clarity around the role and scope of practice of the registered nurse. At the same time, nursing participants often articulated their role as an assistant rather than as an independent health professional. This limited collaboration and the nurses' role within the team. Collaboration was enhanced when general practitioners actively sought an understanding of the registered nurses scope of practice. Clarifying the nurses' role promotes collaboration and supports nurses to work to the full extent of their practice. This is important in terms of optimising the nurses' role within the team and reinforcing their professional identity. Identification of key issues around understanding the nurses' role may help inform strategies that improve collaboration and workplace relations. © 2016 John Wiley & Sons Ltd.

Long-Term Safety Analysis of Baldone Radioactive Waste Repository and Updating of Waste Acceptance Criteria

International Nuclear Information System (INIS)

2001-12-01

The main objective of the project was to provide advice to the Latvian authorities on the safety enhancements and waste acceptance criteria for near surface radioactive waste disposal facilities of the Baldone repository. The project included the following main activities: Analysis of the current status of the management of radioactive waste in Latvia in general and, at the Baldone repository in particular Development of the short and long-term safety analysis of the Baldone repository, including: the planned increasing of capacity for disposal and long term storage, the radiological analysis for the post-closure period Development of the Environment Impact Statement, for the new foreseen installations, considering the non radiological components Proposal of recommendations for future updating of radioactive waste acceptance criteria Proposal of recommendations for safety upgrades to the facility. The work programme has been developed in phases and main tasks as follows. Phase 0: Project inception, Phase 1: Establishment of current status, plans and practices (Legislation, regulation and standards, Radioactive waste management, Waste acceptance criteria), Phase 2: Development of future strategies for long-term safety management and recommendations for safety enhancements. The project team found the general approach use at the installation, the basic design and the operating practices appropriate to international standards. Nevertheless, a number of items subject to potential improvements were also identified. These upgrading recommendations deal with general aspects of the management (mainly storage versus disposal of long-lived sources), site and environmental surveillance, packaging (qualification of containers, waste characterization requirements), the design of an engineered cap and strategies for capping. (author)

A simple score for estimating the long-term risk of fracture in patients with multiple sclerosis

DEFF Research Database (Denmark)

Bazelier, M. T.; van Staa, T. P.; Uitdehaag, B. M. J.

2012-01-01

was converted into integer risk scores. Results: In comparison with the FRAX calculator, our risk score contains several new risk factors that have been linked with fracture, which include MS, use of antidepressants, use of anticonvulsants, history of falling, and history of fatigue. We estimated the 5- and 10......Objective: To derive a simple score for estimating the long-term risk of osteoporotic and hip fracture in individual patients with MS. Methods: Using the UK General Practice Research Database linked to the National Hospital Registry (1997-2008), we identified patients with incident MS (n = 5......,494). They were matched 1:6 by year of birth, sex, and practice with patients without MS (control subjects). Cox proportional hazards models were used to calculate the long-term risk of osteoporotic and hip fracture. We fitted the regression model with general and specific risk factors, and the final Cox model...

What Legislators Need to Know about Long-Term Care Insurance.

Science.gov (United States)

Landes, David

This booklet discusses the potential importance to states of long-term care insurance, describes general policy characteristics, and summarizes state actions to both regulate and promote long-term care insurance. It is intended as a resource for legislators and others involved in long-term care financing and public policy formulation. Long-term…

Organization and change in general practice

DEFF Research Database (Denmark)

Andersen, John Sahl

Organization and change in general practice Abstract for a symposium at Nordic Congress for General Practice Thursday 14 May at 15.30-17.00 General practice is under increasing pressure to assume new tasks, adopt new technologies and engage in new organizational structures. However, in a field...... of multiple actors and concerns such visions are rarely straightforward to realize. This symposium explores the significance of various organizational, cultural and regulative features of general practice in relation to proposals for change in the sector. Presentations: Thorkil Thorsen, Marius Kousgaard...... primary care. One purpose is to give more freedom to the patients to choose care-givers. Another is to create a more competitive health care system. These reforms will be evaluated in a research project to be presented. Chairman: John Sahl Andersen MESH-terms: Delivery of Health Care, Health Care Reform...

Explicit and exact solutions for a generalized long-short wave resonance equations with strong nonlinear term

International Nuclear Information System (INIS)

Shang Yadong

2005-01-01

In this paper, the evolution equations with strong nonlinear term describing the resonance interaction between the long wave and the short wave are studied. Firstly, based on the qualitative theory and bifurcation theory of planar dynamical systems, all of the explicit and exact solutions of solitary waves are obtained by qualitative seeking the homoclinic and heteroclinic orbits for a class of Lienard equations. Then the singular travelling wave solutions, periodic travelling wave solutions of triangle functions type are also obtained on the basis of the relationships between the hyperbolic functions and that between the hyperbolic functions with the triangle functions. The varieties of structure of exact solutions of the generalized long-short wave equation with strong nonlinear term are illustrated. The methods presented here also suitable for obtaining exact solutions of nonlinear wave equations in multidimensions

Long-term monitoring for closed special sites

International Nuclear Information System (INIS)

Golchert, N.W.; Sedlet, J.

1987-01-01

A methodology is presented for planning and implementing a long-term environmental monitoring program for closed special radioactive waste disposal sites. The steps in the method involve collection of the available background information on the site history, site and area characteristics, waste inventory, pathway analysis, prior monitoring programs, applicable standards, and the legal/regulatory requirements. This information is coupled with factors such as experience, half-life, radionuclide migration rates, and potential hazard to develop a monitoring program. As an example, a site-specific long-term monitoring program is described for the AMAX site using the available information. Sampling techniques and practices for the monitoring program are discussed and techniques and practices expected to be available in the future are considered. 7 references, 2 tables

Pre-hospital thrombolytic therapy with either alteplase or streptokinase. : Practical applications, complications and long-term results in 529 patients.

NARCIS (Netherlands)

E.W.M. Grijseels (Els); M.J.M. Bouten; J.W. Deckers (Jaap); A.W. Hoes (Arno); J.A.M. Hartman; E. van der Does (Emiel); M.L. Simoons (Maarten); T. Lenderink (Timo)

1995-01-01

markdownabstractOBJECTIVE: To assess the practical application, safety and long-term outcome of pre-hospital thrombolytic intervention with either alteplase or streptokinase in patients with extensive myocardial infarction. DESIGN: Prospective study. SUBJECTS: Patients with chest pain of more

Long-term Follow-Up of Individuals with Celiac Disease: An Evaluation of Current Practice Guidelines

Directory of Open Access Journals (Sweden)

Jocelyn A Silvester

2007-01-01

Full Text Available INTRODUCTION: Celiac disease can be treated by following a strict gluten-free diet for life. If properly followed, the diet resolves symptoms and nutritional deficiencies. It is generally recommended that individuals with celiac disease have careful long-term follow-up. However, it is not clear which elements of disease status evaluation, laboratory investigations and self-management support should be included in follow-up.

Long-Term Dynamics of Autonomous Fractional Differential Equations

Science.gov (United States)

Liu, Tao; Xu, Wei; Xu, Yong; Han, Qun

This paper aims to investigate long-term dynamic behaviors of autonomous fractional differential equations with effective numerical method. The long-term dynamic behaviors predict where systems are heading after long-term evolution. We make some modification and transplant cell mapping methods to autonomous fractional differential equations. The mapping time duration of cell mapping is enlarged to deal with the long memory effect. Three illustrative examples, i.e. fractional Lotka-Volterra equation, fractional van der Pol oscillator and fractional Duffing equation, are studied with our revised generalized cell mapping method. We obtain long-term dynamics, such as attractors, basins of attraction, and saddles. Compared with some existing stability and numerical results, the validity of our method is verified. Furthermore, we find that the fractional order has its effect on the long-term dynamics of autonomous fractional differential equations.

Evaluation of a program to strengthen general practice care for patients with chronic disease in Germany

NARCIS (Netherlands)

Wensing, M.; Szecsenyi, J.; Stock, C.; Kolle, P.K.; Laux, G.

2017-01-01

BACKGROUND: A program to strengthen general practice care for patients with chronic disease was offered in Germany. Enrollment was a free individual choice for both patients and physicians. This study aimed to examine the long-term impact of this program. METHODS: Two comparative evaluations were

Long-term duration of function of ovarian tissue transplants

DEFF Research Database (Denmark)

Andersen, Claus; Silber, Sherman J; Berghold, Stinne Holm

2012-01-01

These three case reports describe the long-term duration of function of ovarian cortical tissue grafts among patients in a university fertility preservation programme in Europe and in a private practice programme in the USA. One woman underwent sterilizing cancer treatment and had frozen ovarian...... or to alleviate its symptoms. These three case reports describe the long-term duration of function of ovarian cortical tissue grafts among patients in a university fertility preservation programme in Europe and in a private practice programme in the USA. One woman underwent sterilizing cancer treatment and had...

Analysing long term discursive processes

DEFF Research Database (Denmark)

Horsbøl, Anders

which extend beyond the single interaction, for instance negotiations or planning processes, seems to have played a less important role, with studies such as Iedema 2001 and Wodak 2000 as exceptions. These long term processes, however, are central to the constitution and workings of organizations......What do timescales - the notion that processes take place or can be viewed within a shorter or longer temporal range (Lemke 2005) - mean for the analysis of discourse? What are the methodological consequences of analyzing discourse at different timescales? It may be argued that discourse analysis...... in general has favored either the analysis of short term processes such as interviews, discussions, and lessons, or the analysis of non-processual entities such as (multimodal) texts, arguments, discursive repertoires, and discourses (in a Foucaultian sense). In contrast, analysis of long term processes...

The effect of long term combined yoga practice on the basal metabolic rate of healthy adults

Directory of Open Access Journals (Sweden)

Nagendra HR

2006-08-01

Full Text Available Abstract Background Different procedures practiced in yoga have stimulatory or inhibitory effects on the basal metabolic rate when studied acutely. In daily life however, these procedures are usually practiced in combination. The purpose of the present study was to investigate the net change in the basal metabolic rate (BMR of individuals actively engaging in a combination of yoga practices (asana or yogic postures, meditation and pranayama or breathing exercises for a minimum period of six months, at a residential yoga education and research center at Bangalore. Methods The measured BMR of individuals practicing yoga through a combination of practices was compared with that of control subjects who did not practice yoga but led similar lifestyles. Results The BMR of the yoga practitioners was significantly lower than that of the non-yoga group, and was lower by about 13 % when adjusted for body weight (P Conclusion This study shows that there is a significantly reduced BMR, probably linked to reduced arousal, with the long term practice of yoga using a combination of stimulatory and inhibitory yogic practices.

Modeling framework for representing long-term effectiveness of best management practices in addressing hydrology and water quality problems: Framework development and demonstration using a Bayesian method

Science.gov (United States)

Liu, Yaoze; Engel, Bernard A.; Flanagan, Dennis C.; Gitau, Margaret W.; McMillan, Sara K.; Chaubey, Indrajeet; Singh, Shweta

2018-05-01

Best management practices (BMPs) are popular approaches used to improve hydrology and water quality. Uncertainties in BMP effectiveness over time may result in overestimating long-term efficiency in watershed planning strategies. To represent varying long-term BMP effectiveness in hydrologic/water quality models, a high level and forward-looking modeling framework was developed. The components in the framework consist of establishment period efficiency, starting efficiency, efficiency for each storm event, efficiency between maintenance, and efficiency over the life cycle. Combined, they represent long-term efficiency for a specific type of practice and specific environmental concern (runoff/pollutant). An approach for possible implementation of the framework was discussed. The long-term impacts of grass buffer strips (agricultural BMP) and bioretention systems (urban BMP) in reducing total phosphorus were simulated to demonstrate the framework. Data gaps were captured in estimating the long-term performance of the BMPs. A Bayesian method was used to match the simulated distribution of long-term BMP efficiencies with the observed distribution with the assumption that the observed data represented long-term BMP efficiencies. The simulated distribution matched the observed distribution well with only small total predictive uncertainties. With additional data, the same method can be used to further improve the simulation results. The modeling framework and results of this study, which can be adopted in hydrologic/water quality models to better represent long-term BMP effectiveness, can help improve decision support systems for creating long-term stormwater management strategies for watershed management projects.

Long-term surveillance plan for the Lowman, Idaho, disposal site

International Nuclear Information System (INIS)

1993-09-01

The long-term surveillance plan (LTSP) for the Lowman, Idaho, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Lowman disposal cell. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This preliminary final LTSP is being submitted to the US Nuclear Regulatory Commission (NRC) as a requirement for issuance of a general license for custody and long-term care for the disposal site. The general license requires that the disposal cell be cared for in accordance with the provisions of this LTSP. The LTSP documents whether the land and interests are owned by the United States or an Indian tribe, and describes, in detail, how the long-term care of the disposal site will be carried out through the UMTRA Project long-term surveillance program. The Lowman, Idaho, LTSP is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program, (DOE, 1992)

Care plans and care planning in the management of long-term conditions in the UK: a controlled prospective cohort study.

Science.gov (United States)

Reeves, David; Hann, Mark; Rick, Jo; Rowe, Kelly; Small, Nicola; Burt, Jenni; Roland, Martin; Protheroe, Joanne; Blakeman, Tom; Richardson, Gerry; Kennedy, Anne; Bower, Peter

2014-09-01

In the UK, the use of care planning and written care plans has been proposed to improve the management of long-term conditions, yet there is limited evidence concerning their uptake and benefits. To explore the implementation of care plans and care planning in the UK and associations with the process and outcome of care. A controlled prospective cohort study among two groups of patients with long-term conditions who were similar in demographic and clinical characteristics, but who were registered with general practices varying in their implementation of care plans and care planning. Implementation of care plans and care planning in general practice was assessed using the 2009-2010 GP Patient Survey, and relationships with patient outcomes (self-management and vitality) were examined using multilevel, mixed effects linear regression modelling. The study recruited 38 practices and 2439 patients. Practices in the two groups (high and low users of written documents) were similar in structural and population characteristics. Patients in the two groups of practices were similar in demographics and baseline health. Patients did demonstrate significant differences in reported experiences of care planning, although the differences were modest. Very few patients in the cohort reported a written plan that could be confirmed. Analysis of outcomes suggested that most patients show limited change over time in vitality and self-management. Variation in the use of care plans at the practice level was very limited and not related to patient outcomes over time. The use of written care plans in patients with long-term conditions is uncommon and unlikely to explain a substantive amount of variation in the process and outcome of care. More proactive efforts at implementation may be required to provide a rigorous test of the potential of care plans and care planning. © British Journal of General Practice 2014.

Simulated biomass, environmental impacts and best management practices for long-term switchgrass systems in a semi-arid region

International Nuclear Information System (INIS)

Wang, Limei; Qian, Yaling; Brummer, Joe E.; Zheng, Jiyong; Wilhelm, Sarah; Parton, William J.

2015-01-01

Long-term information on switchgrass (Panicum virgatum L.) as a biomass energy crop grown on marginally saline soil and the associated impacts on soil carbon (C) and nitrogen (N) dynamics, greenhouse gas (GHG) emissions, and best management practices (BMPs) are limited. In this study, we employed the DAYCENT model, based on a 4-year switchgrass field experiment, to evaluate the long-term biomass yield potential and environmental impacts, and further to develop BMPs for switchgrass in a semi-arid region. The model showed that long-term (14-year) annual mean biomass yields were 9.6 and 5.2 Mg ha −1 for irrigated and rainfed switchgrass systems, respectively. The simulated biomass yields correlated well with field-measured biomass with r 2 values of 0.99 and 0.89 for irrigated and rainfed systems, respectively. Soil organic carbon (SOC) and soil total nitrogen (STN) accumulated rapidly after switchgrass establishment, with mean accrual rates of 0.99–1.13 Mg C ha −1  yr −1 and 0.04–0.08 Mg N ha −1  yr −1 , respectively. Based on the outputs of numerous long-term model simulations with variable irrigation water supplies and N rates, the irrigation regime and N rate with the highest yield to input ratio were chosen as BMPs. The DAYCENT model predicted-BMP was irrigating every 14 days at 70% potential evapotranspiration combined with an N rate of 67 kg ha −1  yr −1 . Switchgrass established and produced biomass reasonably well in this semi-arid region; however, appropriate irrigation and N fertilization were needed for optimal biomass yield. Switchgrass had a great potential to sequester C into soils with low N 2 O emissions while supplying significant quantities of biomass for biofuel synthesis. - Highlights: • The DAYCENT model reliably simulated the growth of switchgrass on marginal land. • Long-term biomass and environmental impacts were simulated using the DAYCENT model. • Switchgrass produced biomass well on marginal land, but

Experiences of using email for general practice consultations: a qualitative study.

Science.gov (United States)

Atherton, Helen; Pappas, Yannis; Heneghan, Carl; Murray, Elizabeth

2013-11-01

Reports suggest approximately 21-23% of GPs in the UK have consulted with patients using email, but little is known about the nature of this use and what it means for clinicians and patients in general practice. To understand the use of email consultation in general practice by investigating the experiences of existing users and views of experts. A qualitative study conducted in 2010 using purposive sampling and semi-structured interviews in general practice and community settings in some London boroughs. A maximum variation sample of GPs and patients who had used email for consultation in general practice were recruited, as were policy and/or implementation experts. Interviews continued until saturation was achieved. In total 10 GPs, 14 patients, and six experts were interviewed. Consultation by email was often triggered by logistic or practical issues; motivators for ongoing use were the benefits, such as convenience, for GPs and patients. Both GPs and patients reported concerns about safety and lack of guidance about the 'rules of engagement' in email consultations, with GPs also concerned about workload. In response, both groups attempted to introduce their own rules, although this only went some way to addressing uncertainty. Long term, participants felt there was a need for regulation and guidance. Consultations by email in general practice occur in an unregulated and unstructured way. Current UK policy is to promote consultations by email, making it crucial to consider the responsibility and workload faced by clinicians, and the changes required to ensure safe use; not doing so may risk safety breaches and result in suboptimal care for patients.

Compressed air system best practice programmes: What needs to change to secure long-term energy savings for New Zealand?

International Nuclear Information System (INIS)

Neale, James R.; Kamp, Peter J.J.

2009-01-01

The establishment of a compressed air system (CAS) best practice programme is a key component of one of the initial industrial energy efficiency programmes being driven by New Zealand government ministries and agencies. In a global context this is not a new initiative in that existing programmes have been functioning in Europe and USA, yet in each of these cases the impact ten years-on has been patchy with limited long-term improvements in overall energy efficiency. The New Zealand CAS best practice programme currently under development is sponsored by the Electricity Commission (EC) and the Energy Efficiency Conservation Authority (EECA). It takes a new approach in policy direction, with variations from those used in other international programmes. A significant level of electricity levy money is to be committed to this programme and it is timely to highlight its merits and potential weaknesses, and what is required to generate long-term energy savings beyond the levels achieved by more mature overseas programmes.

Effect of education intervention on the quality and long-term outcomes of root canal treatment in general practice.

Science.gov (United States)

Koch, M; Wolf, E; Tegelberg, Å; Petersson, K

2015-07-01

To compare the technical quality and long-term outcomes of root canal treatment by general practitioners of a Swedish Public Dental Service, before and after an endodontic education including Ni-Ti rotary technique (NiTiR). A random sample was compiled, comprising one root filled tooth from each of 830 patients, treated by 69 general practitioners participating in the education: 414 teeth root filled in 2002, pre-education, using primarily stainless steel instrumentation and filling by lateral compaction, and 416 teeth root filled post-education (2005), using mainly NiTiR and single-cone obturation. Follow-up radiographs taken in 2009 were evaluated alongside immediate post-filling radiographs from 2002 to 2005. The density and length of the root fillings were registered. Periapical status was assessed by the Periapical Index (PAI), using two definitions of disease: apical periodontitis (AP) (PAI 3 + 4 + 5) and definite AP (PAI 4 + 5). Tooth survival was registered. Root fillings pre- and post-education were compared using chi-square and Fisher's exact tests. Crude extraction rates per 100 years were calculated for comparison of tooth survival. Explanatory variables (type of tooth, root filling quality, periapical status, marginal bone loss, type and quality of coronal restoration) in relation to the dependent variable (AP at follow-up) were analysed by multivariable logistic regression. Follow-up data were available for 229 (55%) of teeth treated pre- and 288 (69%) treated post-education: both tooth survival (P < 0.001) and root filling quality were significantly higher (P < 0.001) in the latter. However, there was no corresponding improvement in periapical status. Both pre- and post-education, root fillings with definite AP on completion of treatment had significantly higher odds of AP or definite AP at follow-up. For teeth treated post-education, inadequate root filling quality was significantly associated with AP at follow-up. Despite a higher tooth survival

The impact of statin therapy on long-term cardiovascular outcomes in an outpatient cardiology practice

Science.gov (United States)

Lai, Hoang M.; Aronow, Wilbert S.; Mercando, Anthony D.; Kalen, Phoenix; Desai, Harit V.; Gandhi, Kaushang; Sharma, Mala; Amin, Harshad; Lai, Trung M.

2011-01-01

Summary Background Statins reduce coronary events in patients with coronary artery disease. Material/Methods Chart reviews were performed in 305 patients (217 men and 88 women, mean age 74 years) not treated with statins during the first year of being seen in an outpatient cardiology practice but subsequently treated with statins. Based on the starting date of statins use, the long-term outcomes of myocardial infarction (MI), percutaneous coronary intervention (PCI), and coronary artery bypass graft surgery (CABGS) before and after statin use were compared. Results Mean follow-up was 65 months before statins use and 66 months after statins use. MI occurred in 31 of 305 patients (10%) before statins, and in 13 of 305 patients (4%) after statins (pcardiology practice reduces the incidence of MI, PCI, and CABGS. PMID:22129898

GENERALIZED MILANKOVITCH CYCLES AND LONG-TERM CLIMATIC HABITABILITY

International Nuclear Information System (INIS)

Spiegel, David S.; Dressing, Courtney D.; Raymond, Sean N.; Scharf, Caleb A.; Mitchell, Jonathan L.

2010-01-01

Although Earth's orbit is never far from circular, terrestrial planets around other stars might experience substantial changes in eccentricity. Eccentricity variations could lead to climate changes, including possible 'phase transitions' such as the snowball transition (or its opposite). There is evidence that Earth has gone through at least one globally frozen, 'snowball' state in the last billion years, which it is thought to have exited after several million years because global ice-cover shut off the carbonate-silicate cycle, thereby allowing greenhouse gases to build up to sufficient concentration to melt the ice. Due to the positive feedback caused by the high albedo of snow and ice, susceptibility to falling into snowball states might be a generic feature of water-rich planets with the capacity to host life. This paper has two main thrusts. First, we revisit one-dimensional energy balance climate models as tools for probing possible climates of exoplanets, investigate the dimensional scaling of such models, and introduce a simple algorithm to treat the melting of the ice layer on a globally frozen planet. We show that if a terrestrial planet undergoes Milankovitch-like oscillations of eccentricity that are of great enough magnitude, it could melt out of a snowball state. Second, we examine the kinds of variations of eccentricity that a terrestrial planet might experience due to the gravitational influence of a giant companion. We show that a giant planet on a sufficiently eccentric orbit can excite extreme eccentricity oscillations in the orbit of a habitable terrestrial planet. More generally, these two results demonstrate that the long-term habitability (and astronomical observables) of a terrestrial planet can depend on the detailed architecture of the planetary system in which it resides.

Short-term and long-term effects of diazepam on the memory for discrimination and generalization of scopolamine.

Science.gov (United States)

Casasola-Castro, C; Weissmann-Sánchez, L; Calixto-González, E; Aguayo-Del Castillo, A; Velázquez-Martínez, D N

2017-10-01

Benzodiazepines are among the most widely prescribed and misused psychopharmaceutical drugs. Although they are well-tolerated, they are also capable of producing amnestic effects similar to those observed after pharmacological or organic cholinergic dysfunction. To date, the effect of benzodiazepine diazepam on the memory for discrimination of anticholinergic drugs has not been reported. The aim of the present study was to analyze the immediate and long-term effects of diazepam on a drug discrimination task with scopolamine. Male Wistar rats were trained to discriminate between scopolamine and saline administration using a two-lever discrimination task. Once discrimination was acquired, the subjects were divided into three independent groups, (1) control, (2) diazepam, and (3) diazepam chronic administration (10 days). Subsequently, generalization curves for scopolamine were obtained. Additionally, the diazepam and control groups were revaluated after 90 days without having been given any other treatment. The results showed that diazepam produced a significant reduction in the generalization gradient for scopolamine, indicating an impairment of discrimination. The negative effect of diazepam persisted even 90 days after drug had been administered. Meanwhile, the previous administration of diazepam for 10 days totally abated the generalization curve and the general performance of the subjects. The results suggest that diazepam affects memory for the stimulus discrimination of anticholinergic drugs and does so persistently, which could be an important consideration during the treatment of amnesic patients with benzodiazepines.

Modeling framework for representing long-term effectiveness of best management practices in addressing hydrology and water quality problems: Framework development and demonstraton using a Bayesian method

Science.gov (United States)

Best management practices (BMPs) are popular approaches used to improve hydrology and water quality. Uncertainties in BMP effectiveness over time may result in overestimating long-term efficiency in watershed planning strategies. To represent varying long-term BMP effectiveness in hydrologic/water q...

Drivers for successful long-term lifestyle change, the role of e-health

DEFF Research Database (Denmark)

Brandt, Carl Joakim; Clemensen, Jane; Nielsen, Jesper Bo

2018-01-01

Objectives Assisting patients in lifestyle change using collaborative e-health tools can be an efficient treatment for non-communicable diseases like diabetes, cardiovascular disease and chronic obstructive lung disease that are caused or aggravated by unhealthy living in the form of unhealthy diet......, physical inactivity or tobacco smoking. In a prospective pilot study, we tested an online collaborative e-health tool in general practice. The aim of this study was to identify drivers of importance for long-term personal lifestyle changes from a patient perspective when using a collaborative e-health tool......, including the support of peers and healthcare professionals. Setting General practice clinics in the Region of Southern Denmark. Participants 10 overweight patients who had previously successfully used a hybrid online collaborative e-health tool with both face-to-face and online consultations to lose weight...

Sexuality and physical intimacy in long-term care.

Science.gov (United States)

Lichtenberg, Peter A

2014-01-01

Sexuality and sexual needs in older adults remains a neglected area of clinical intervention, particularly so in long-term care settings. Because older adults in medical rehabilitation and long-term care beds present with significant frailties, and often significant neurocognitive disorders, it makes it difficult for occupational therapists and other staff to evaluate the capacity of an older adult resident to participate in sexual relationships. The current paper reviews the current literature on sexuality and aging, examines some of the clinical practices and guidelines regarding sexual expression in long-term care, and presents two case examples. A semistructured interview and decision tree is presented to assist therapists in making careful and informed decisions and thereby balancing the needs for protection with the needs for autonomy.

Medical Underwriting In Long-Term Care Insurance: Market Conditions Limit Options For Higher-Risk Consumers.

Science.gov (United States)

Cornell, Portia Y; Grabowski, David C; Cohen, Marc; Shi, Xiaomei; Stevenson, David G

2016-08-01

A key feature of private long-term care insurance is that medical underwriters screen out would-be buyers who have health conditions that portend near-term physical or cognitive disability. We applied common underwriting criteria based on data from two long-term care insurers to a nationally representative sample of individuals in the target age range (50-71 years) for long-term care insurance. The screening criteria put upper bounds on the current proportion of Americans who could gain coverage in the individual market without changes to medical underwriting practice. Specifically, our simulations show that in the target age range, approximately 30 percent of those whose wealth meets minimum industry standards for suitability for long-term care insurance would have their application for such insurance rejected at the underwriting stage. Among the general population-without considering financial suitability-we estimated that 40 percent would have their applications rejected. The predicted rejection rates are substantially higher than the rejection rates of about 20-25 percent of applicants in the actual market. In evaluating reforms for long-term care financing and their potential to increase private insurance rates, as well as to reduce financial pressure on public safety-net programs, policy makers need to consider the role of underwriting in the market for long-term care insurance. Project HOPE—The People-to-People Health Foundation, Inc.

Self-reported musculoskeletal pain predicts long-term increase in general health care use

DEFF Research Database (Denmark)

Hartvigsen, Jan; Davidsen, Michael; Søgaard, Karen

2014-01-01

reported during the past two weeks from the Danish National Cohort Study were merged with data from the Danish National Health Insurance Registry and the National Patient Registry containing information on consultations in the Danish primary and secondary care sector. Absolute and relative rates for all......Aims: Musculoskeletal pain and disability is a modern epidemic and a major reason for seeking health care. The aim of this study is to determine absolute and relative rates of care seeking over 20 years for adults reporting musculoskeletal complaints. Methods: Interview data on musculoskeletal pain...... to any of the outcomes. CONCLUSIONS SELF-REPORT OF MUSCULOSKELETAL PAIN REPORTED WITHIN THE PAST TWO WEEKS PREDICTS A STATISTICALLY SIGNIFICANT LONG-TERM INCREASE IN GENERAL USE OF HEALTH CARE SERVICES IN BOTH THE PRIMARY AND THE SECONDARY HEALTH CARE SECTOR:...

Long-term surveillance plan for the Maybell, Colorado Disposal Site

International Nuclear Information System (INIS)

1997-09-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Maybell disposal site in Moffat County, Colorado. The U.S. Nuclear Regulatory Commission (NRC) has developed regulations for the issuance of a general license for the custody and long-term care of UMTRA Project disposal sites in 10 CFR Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites are cared for in a manner that protects the public health and safety and the environment. Before each disposal site is licensed, the NRC requires the DOE to submit a site-specific LTSP. The DOE prepared this LTSP to meet this requirement for the Maybell disposal site. The general license becomes effective when the NRC concurs with the DOE's determination that remedial action is complete for the Maybell site and the NRC formally accepts this LTSP. This document describes the long-term surveillance program the DOE will implement to ensure the Maybell disposal site performs as designed. The program is based on site inspections to identify threats to disposal cell integrity. The LTSP is based on the UMTRA Project long-term surveillance program guidance document and meets the requirements of 10 CFR section 40.27(b) and 40 CFR section 192.03

[Dental care and oral hygiene practices in long-term geriatric care institutions].

Science.gov (United States)

Ferreira, Raquel Conceição; Schwambach, Carolina Wolff; de Magalhães, Cláudia Silami; Moreira, Allyson Nogueira

2011-04-01

This study evaluated the activities of dentists, dental care and oral hygiene practices in the long-term care institutions of Belo Horizonte (Minas Gerais, Brazil). A semi-structured questionnaire was handed out to the coordinators of 37 philanthropic and 30 private institutions. The data was compared by the chi-square and Fisher's Exact Tests. 81% of the questionnaires were answered. The majority of the private (74.2%) and philanthropic institutions (87%) do not have a dentist (p=0.21). The location, period of existence, type institution kind and number of residents weren't factors regarding the presence of a dentist (p>0.05). 67% of the philanthropic institutions with equipped consultation rooms had dentists, though there were none when there was no consultation room. Even without consultation rooms, 13% of the private institutions had dentists. When necessary, 69.6% of the philanthropic institutions refer the elderly to public health centers, while 58.1% of the private institutions refer them to their family dentists. A higher percentage of the private institutions adopted systematic oral hygiene procedures (p=0.01), with a considerable divergence of treatment reported. There is a need to include a dentist on the health staff in the institutions and for systematization of oral hygiene practices.

Effects of Long-term and Continius Horticatural Practices on Distribution of Potassium Forms and their Adsorption Properties in Urmia Region

Directory of Open Access Journals (Sweden)

zahra amirpour

2017-02-01

trees (The study area is generally under the apple orchard user which had the great need for K. Consequently, due to lack of fertilizers application and agricultural practices,the amount of available K declined in soils about 80percent. On the other hand, In the Non-exchangeable K amount with long-term horticultural practices non- significant reduction occurred. Since the amount of exchangeable and available k in these soils is high, it seems to be enough to satisfy the needs of the regional products.

Scientific Understanding from Long Term Observations: Insights from the Long Term Ecological Research (LTER) Program

Science.gov (United States)

Gosz, J.

2001-12-01

The network dedicated to Long Term Ecological Research (LTER) in the United States has grown to 24 sites since it was formed in 1980. Long-term research and monitoring are performed on parameters thatare basic to all ecosystems and are required to understand patterns, processes, and relationship to change. Collectively, the sites in the LTER Network provide opportunities to contrast marine, coastal, and continental regions, the full range of climatic gradients existing in North America, and aquatic and terrestrial habitats in a range of ecosystem types. The combination of common core areas and long-term research and monitoring in many habitats have allowed unprecedented abilities to understand and compare complex temporal and spatial dynamics associated with issues like climate change, effects of pollution, biodiversity and landuse. For example, McMurdo Dry Valley in the Antarctic has demonstrated an increase in glacier mass since 1993 which coincides with a period of cooler than normal summers and more than average snowfall. In contrast, the Bonanza Creek and Toolik Lake sites in Alaska have recorded a warming period unprecedented in the past 200 years. Nitrogen deposition effects have been identified through long-term watershed studies on biogeochemical cycles, especially at Coweeta Hydrological Lab, Harvard Forest, and the Hubbard Brook Experimental Forest. In aquatic systems, such as the Northern Temperate Lakes site, long-term data revealed time lags in effects of invaders and disturbance on lake communities. Biological recovery from an effect such as lake acidification was shown to lag behind chemical recovery. The long-term changes documented over 2 decades have been instrumental in influencing management practices in many of the LTER areas. In Puerto Rico, the Luquillo LTER demonstrated that dams obstruct migrations of fish and freshwater shrimp and water abstraction at low flows can completely obliterate downstream migration of juveniles and damage

How common is multiple general practice attendance in Australia?

Science.gov (United States)

Wright, Michael; Hall, Jane; van Gool, Kees; Haas, Marion

2018-05-01

Australians can seek general practice care from multiple general practitioners (GPs) in multiple locations. This provides high levels of patient choice but may reduce continuity of care. The aim of this study was to estimate the prevalence of attendance at multiple general practices in Australia, and identify patient characteristics associated with multiple practice attendances. A cross-sectional survey of 2477 Australian adults was conducted online in July 2013. Respondents reported whether they had attended more than one general practice in the past year, and whether they had a usual general practice and GP. Demographic information, health service use and practice characteristics were also obtained from the survey. Over one-quarter of the sample reported attending more than one practice in the previous year. Multiple practice attendance is less common with increasing age, and less likely for survey respondents from regional Australia, compared with respondents from metropolitan areas. Multiple practice attenders are just as likely as single practice attenders to have a usual GP. A significant proportion of general practice care is delivered away from usual practices. This may have implications for health policy, in terms of continuity and quality of primary care.

A unit-level perspective on the long-term sustainability of a nursing best practice guidelines program: An embedded multiple case study.

Science.gov (United States)

Fleiszer, Andrea R; Semenic, Sonia E; Ritchie, Judith A; Richer, Marie-Claire; Denis, Jean-Louis

2016-01-01

Best practice guidelines are a tool for narrowing research-to-practice gaps and improving care outcomes. There is some empirical understanding of guideline implementation in nursing settings, yet there has been almost no consideration of the longer-term sustainability of guideline-based practice improvements. Many healthcare innovations are not sustained, underscoring the need for knowledge about how to promote their survival. To understand how a nursing best practice guidelines program was sustained on acute healthcare center nursing units. We undertook a qualitative descriptive case study of an organization-wide nursing best practice guidelines program with four embedded nursing unit subcases. The setting was a large, tertiary/quaternary urban health center in Canada. The nursing department initiated a program to enhance patient safety through the implementation of three guidelines: falls prevention, pressure ulcer prevention, and pain management. We selected four inpatient unit subcases that had differing levels of program sustainability at an average of almost seven years post initial program implementation. Data sources included 39 key informant interviews with nursing leaders/administrators and frontline nurses; site visits; and program-related documents. Data collection and content analysis were guided by a framework for the sustainability of healthcare innovations. Program sustainability was characterized by three elements: benefits, routinization, and development. Seven key factors most accounted for the differences in the level of program sustainability between subcases. These factors were: perceptions of advantages, collaboration, accountability, staffing, linked levels of leadership, attributes of formal unit leadership, and leaders' use of sustainability activities. Some prominent relationships between characteristics and factors explained long-term program sustainability. Of primary importance was the extent to which unit leaders used sustainability

Patient empowerment in long-term conditions: development and preliminary testing of a new measure

Science.gov (United States)

2013-01-01

Background Patient empowerment is viewed by policy makers and health care practitioners as a mechanism to help patients with long-term conditions better manage their health and achieve better outcomes. However, assessing the role of empowerment is dependent on effective measures of empowerment. Although many measures of empowerment exist, no measure has been developed specifically for patients with long-term conditions in the primary care setting. This study presents preliminary data on the development and validation of such a measure. Methods We conducted two empirical studies. Study one was an interview study to understand empowerment from the perspective of patients living with long-term conditions. Qualitative analysis identified dimensions of empowerment, and the qualitative data were used to generate items relating to these dimensions. Study two was a cross-sectional postal study involving patients with different types of long-term conditions recruited from general practices. The survey was conducted to test and validate our new measure of empowerment. Factor analysis and regression were performed to test scale structure, internal consistency and construct validity. Results Sixteen predominately elderly patients with different types of long-term conditions described empowerment in terms of 5 dimensions (identity, knowledge and understanding, personal control, personal decision-making, and enabling other patients). One hundred and ninety seven survey responses were received from mainly older white females, with relatively low levels of formal education, with the majority retired from paid work. Almost half of the sample reported cardiovascular, joint or diabetes long-term conditions. Factor analysis identified a three factor solution (positive attitude and sense of control, knowledge and confidence in decision making and enabling others), although the structure lacked clarity. A total empowerment score across all items showed acceptable levels of internal

Winning market positioning strategies for long term care facilities.

Science.gov (United States)

Higgins, L F; Weinstein, K; Arndt, K

1997-01-01

The decision to develop an aggressive marketing strategy for its long term care facility has become a priority for the management of a one-hundred bed facility in the Rocky Mountain West. Financial success and lasting competitiveness require that the facility in question (Deer Haven) establish itself as the preferred provider of long term care for its target market. By performing a marketing communications audit, Deer Haven evaluated its present market position and created a strategy for solidifying and dramatizing this position. After an overview of present conditions in the industry, we offer a seven step process that provides practical guidance for positioning a long term care facility. We conclude by providing an example application.

Long-term Consequences of Childhood ADHD on Criminal Activities*

OpenAIRE

Fletcher, Jason; Wolfe, Barbara

2009-01-01

The question of whether childhood mental illness has long term consequences in terms of criminal behavior has been little studied, yet it could have major consequences for both the individual and society more generally. In this paper, we focus on Attention-Deficit/Hyperactivity Disorder (ADHD), one of the most prevalent mental conditions in school-age children, to examine the long-term effects of childhood mental illness on criminal activities, controlling for a rich set of individual, family...

General interest and investment. Long-term marginal cost and pricing at Electricite de France (1948-1949)

International Nuclear Information System (INIS)

Yon, Guillaume

2014-01-01

The paper investigates the construction of a concept in economic theory, long-term marginal cost pricing. It does so by exploring the work done within electricite de France in 1948-1949 by a group of engineer-economists who came out with the notion while they were engaged in completely remaking the pricing policy of the new public monopoly. I will show that the concept envisages a large-scale reorganization of the national power generation capacity in order to enact a certain conception of the general interest in the electric sector

Long-term surveillance plan for the Gunnison, Colorado disposal site

International Nuclear Information System (INIS)

1996-04-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Gunnison disposal site in Gunnison County, Colorado. The U.S. Nuclear Regulatory Commission (NRC) has developed regulations for the issuance of a general license for the custody and long-term care of UMTRA Project disposal sites in 10 CFR Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites will be cared for in a manner that protects the public health and safety and the environment. For each disposal site to be licensed, the NRC requires the DOE to submit a site-specific LTSP. The DOE prepared this LTSP to meet this requirement for the Gunnison disposal site. The general license becomes effective when the NRC concurs with the DOE's determination of completion of remedial action for the Gunnison site and the NRC formally accepts this LTSP. This LTSP describes the long-term surveillance program the DOE will implement to ensure that the Gunnison disposal site performs as designed. The program is based on two distinct activities: (1) site inspections to identify threats to disposal cell integrity, and (2) ground water monitoring to demonstrate disposal cell performance. The LTSP is based on the UMTRA Project long-term surveillance program guidance and meets the requirements of 10 CFR section 40.27(b) and 40 CFR section 192.03

Long-term surveillance plan for the Gunnison, Colorado, disposal site

International Nuclear Information System (INIS)

1997-04-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Gunnison disposal site in Gunnison County, Colorado. The U.S. Nuclear Regulatory Commission (NRC) has developed regulations for the issuance of a general license for the custody and long-term care of UMTRA Project disposal sites in 10 CFR Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites will be cared for in a manner that protects the public health and safety and the environment. Before each disposal site is licensed, the NRC requires the DOE to submit a site-specific LTSP. The DOE prepared this LTSP to meet this requirement for the Gunnison disposal site. The general license becomes effective when the NRC concurs with the DOE's determination of completion of remedial action for the Gunnison site and the NRC formally accepts this LTSP. This LTSP describes the long-term surveillance program the DOE will implement to ensure that the Gunnison disposal site performs as designed. The program is based on two distinct activities: (1) site inspections to identify threats to disposal cell integrity, and (2) ground water monitoring to demonstrate disposal cell performance. The LTSP is based on the UMTRA Project long-term surveillance program guidance and meets the requirements of 10 CFR section 40.27(b) and 40 CFR section 192.03

Long-term surveillance plan for the Gunnison, Colorado disposal site

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-04-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy`s (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Gunnison disposal site in Gunnison County, Colorado. The U.S. Nuclear Regulatory Commission (NRC) has developed regulations for the issuance of a general license for the custody and long-term care of UMTRA Project disposal sites in 10 CFR Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites will be cared for in a manner that protects the public health and safety and the environment. For each disposal site to be licensed, the NRC requires the DOE to submit a site-specific LTSP. The DOE prepared this LTSP to meet this requirement for the Gunnison disposal site. The general license becomes effective when the NRC concurs with the DOE`s determination of completion of remedial action for the Gunnison site and the NRC formally accepts this LTSP. This LTSP describes the long-term surveillance program the DOE will implement to ensure that the Gunnison disposal site performs as designed. The program is based on two distinct activities: (1) site inspections to identify threats to disposal cell integrity, and (2) ground water monitoring to demonstrate disposal cell performance. The LTSP is based on the UMTRA Project long-term surveillance program guidance and meets the requirements of 10 CFR {section}40.27(b) and 40 CFR {section}192.03.

Long-term surveillance plan for the Gunnison, Colorado, disposal site

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-04-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy`s (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Gunnison disposal site in Gunnison County, Colorado. The U.S. Nuclear Regulatory Commission (NRC) has developed regulations for the issuance of a general license for the custody and long-term care of UMTRA Project disposal sites in 10 CFR Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites will be cared for in a manner that protects the public health and safety and the environment. Before each disposal site is licensed, the NRC requires the DOE to submit a site-specific LTSP. The DOE prepared this LTSP to meet this requirement for the Gunnison disposal site. The general license becomes effective when the NRC concurs with the DOE`s determination of completion of remedial action for the Gunnison site and the NRC formally accepts this LTSP. This LTSP describes the long-term surveillance program the DOE will implement to ensure that the Gunnison disposal site performs as designed. The program is based on two distinct activities: (1) site inspections to identify threats to disposal cell integrity, and (2) ground water monitoring to demonstrate disposal cell performance. The LTSP is based on the UMTRA Project long-term surveillance program guidance and meets the requirements of 10 CFR {section}40.27(b) and 40 CFR {section}192.03.

Long-term surveillance plan for the Gunnison, Colorado, disposal site

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-05-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy`s (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Gunnison disposal site in Gunnison County, Colorado. The U.S. Nuclear Regulatory Commission (NRC) has developed regulations for the issuance of a general license for the custody and long-term care of UMTRA Project disposal sites in 10 CFR Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites will be cared for in a manner that protects the public health and safety and the environment. For each disposal site to be licensed, the NRC requires the DOE to submit a site-specific LTSP. The DOE prepared this LTSP to meet this requirement for the Gunnison disposal site. The general license becomes effective when the NRC concurs with the DOE`s determination of completion of remedial action for the Gunnison site and the NRC formally accepts this LTSP. This LTSP describes the long-term surveillance program the DOE will implement to ensure that the Gunnison disposal site performs as designed. The program is based on two distinct activities: (1) site inspections to identify threats to disposal cell integrity, and (2) ground water monitoring to demonstrate disposal cell performance. The LTSP is based on the UMTRA Project long-term surveillance program guidance and meets the requirements of 10 CFR {section}40.27(b) and 40 CFR {section}192.03.

Long-term surveillance plan for the Gunnison, Colorado, disposal site

International Nuclear Information System (INIS)

1996-05-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Gunnison disposal site in Gunnison County, Colorado. The U.S. Nuclear Regulatory Commission (NRC) has developed regulations for the issuance of a general license for the custody and long-term care of UMTRA Project disposal sites in 10 CFR Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites will be cared for in a manner that protects the public health and safety and the environment. For each disposal site to be licensed, the NRC requires the DOE to submit a site-specific LTSP. The DOE prepared this LTSP to meet this requirement for the Gunnison disposal site. The general license becomes effective when the NRC concurs with the DOE's determination of completion of remedial action for the Gunnison site and the NRC formally accepts this LTSP. This LTSP describes the long-term surveillance program the DOE will implement to ensure that the Gunnison disposal site performs as designed. The program is based on two distinct activities: (1) site inspections to identify threats to disposal cell integrity, and (2) ground water monitoring to demonstrate disposal cell performance. The LTSP is based on the UMTRA Project long-term surveillance program guidance and meets the requirements of 10 CFR section 40.27(b) and 40 CFR section 192.03

General practitioners' views on (long-term) prescription and use of problematic and potentially inappropriate medication for oldest-old patients-A qualitative interview study with GPs (CIM-TRIAD study).

Science.gov (United States)

Pohontsch, Nadine Janis; Heser, Kathrin; Löffler, Antje; Haenisch, Britta; Parker, Debora; Luck, Tobias; Riedel-Heller, Steffi G; Maier, Wolfgang; Jessen, Frank; Scherer, Martin

2017-02-17

Potentially inappropriate medication (PIM) is defined as medication with uncertain therapeutic effects and/or potential adverse drug reactions outweighing the clinical benefits. The prescription rate of PIM for oldest-old patients is high despite the existence of lists of PIM (e.g. the PRISCUS list) and efforts to raise awareness. This study aims at identifying general practitioners' views on PIM and aspects affecting the (long-term) use of PIM. As part of the CIM-TRIAD study, we conducted semi-structured, qualitative interviews with 47 general practitioners, discussing 25 patients with and 22 without PIM (according to the PRISCUS list). The interview guideline included generic and patient-specific questions. Interviews were digitally recorded and transcribed verbatim. We content analyzed the interviews using deductive and inductive category development. The majority of the general practitioners were not aware of the PRISCUS list. Agents deemed potentially inappropriate from the general practitioners' point of view and the PRISCUS list are not completely superimposable. General practitioners named their criteria to identify appropriate medication for elderly patients (e.g. renal function, cognitive state) and emphasized the importance of monitoring. We identified prescription- (e.g. benzodiazepines on alternative private prescription), medication- (e.g. subjective perception that PIM has no alternative), general practitioner- (e.g. general practitioner relies on specialists), patient- (e.g. "demanding high-user", positive subjective benefit-risk-ratio) and system-related aspects (e.g. specialists lacking holistic view, interface problems) related to the (long term) use of PIM. While the PRISCUS list does not seem to play a decisive role in general practice, general practitioners are well aware of risks associated with PIM. Our study identifies some starting points for a safer handling of PIM, e.g. stronger dissemination of the PRISCUS list, better compensation of

Guidance for implementing the UMTRA Project long-term surveillance program

International Nuclear Information System (INIS)

1992-09-01

The US Nuclear Regulatory Commission (NRC) has issued a general license for the custody and long-term care of US Department of Energy (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project permanent disposal sites. The purpose of this general license is to ensure that the UMTRA disposal sites will be cared for in such a manner as to protect the public health and safety and the environment upon completion of remedial actions. The general license will be in effect for a disposal site when NRC accepts the disposal site long-term surveillance plan (LTSP) that meets the requirements of 10 CFR 40.27. The site LTSP describes in detail the long-term surveillance program, including any monitoring, maintenance, and emergency measures necessary to fulfill the conditions of the general license. This guidance document provides (1) instructions for preparing the disposal site LTSPs and (2) instructions for carrying out the UMTRA Project long-term surveillance program, including any monitoring that may be required. The information provided in this document also is in accordance with the regulatory requirements set forth in 40 CFR 192. On January 5, 1985, the US Tenth Circuit Court of Appeals remanded the groundwater standards, 40 CFR 192.02. Proposed groundwater standards were issued for comment on September 24, 1987 (52 FR 3600). When the groundwater standards become final, this document will be revised, as appropriate. This document also will be updated in response to any changes to 10 CFR 40, or in response to changes in the manner in which the long-term care of the licensed disposal sites is carried out

Factors influencing the long-term sustainment of quality improvements made in addiction treatment facilities: a qualitative study.

Science.gov (United States)

Stumbo, Scott P; Ford, James H; Green, Carla A

2017-11-01

A greater understanding of the factors that influence long-term sustainment of quality improvement (QI) initiatives is needed to promote organizational ability to sustain QI practices over time, help improve future interventions, and increase the value of QI investments. We approached 83 of 201 executive sponsors or change leaders at addiction treatment organizations that participated in the 2007-2009 NIATx200 QI intervention. We completed semi-structured interviews with 33 individuals between November 2015 and April 2016. NIATx200 goals were to decrease wait time, increase admissions and improve retention in treatment. Interviews sought to understand factors that either facilitated or impeded long-term sustainment of organizational QI practices made during the intervention. We used thematic analysis to organize the data and group patterns of responses. We assessed available quantitative outcome data and intervention engagement data to corroborate qualitative results. We used narrative analysis to group four important themes related to long-term sustainment of QI practices: (1) finding alignment between business- and client-centered practices; (2) staff engagement early in QI process added legitimacy which facilitated sustainment; (3) commitment to integrating data into monitoring practices and the identification of a data champion; and (4) adequate organizational human resources devoted to sustainment. We found four corollary factors among agencies which did not sustain practices: (1) lack of evidence of impact on business practices led to discontinuation; (2) disengaged staff and lack of organizational capacity during implementation period led to lack of sustainment; (3) no data integration into overall business practices and no identified data champion; and (4) high staff turnover. In addition, we found that many agencies' current use of NIATx methods and tools suggested a legacy effect that might improve quality elsewhere, even absent overall sustainment of

Energy in 2010 - 2020. Long term challenges; Energie 2010-2020. Les defis du long terme

Energy Technology Data Exchange (ETDEWEB)

Dessus, Benjamin [ed.] [Centre National de la Recherche Scientifique (CNRS), 75 - Paris (France)

2000-02-02

This report presents the results of a workshop intending to anticipate the long term challenges, to guide better the short term power options, to understand the available political, economical and technical assumptions for the prospective world situation, to give some strategic hints on the necessary transition. Indeed, the difficult issue which the workshop tried to tackle was how should we prepare to reveal the energetic challenge of the development of the eight to ten billion inhabitants of our Planet in the next century without jeopardizing its existence. The energetic problems, a hardcore of the international preoccupation of both growth and environment, as it was recently evidenced by the climatic conference in Kyoto, have ever been the object of a particular attention on the part of General Commissariat of Plan. Thus, the commission 'Energy in 2010 - 2020' has been instituted in April 1996 in order to update the works done in 1990 - 1991 by the commission 'Energy 2010'. Soon it occurred to this new commission the task of illuminating its works by a long term (2050 - 2100) world prospective analysis of the challenges and problems linked to energy, growth and environment. In conclusion, this document tried to find answers to questions like: - which are the risks the energy consumption augmentation entail? - can we control them by appropriate urbanism and transport policies or technological innovation?. Four options for immediate action are suggested: - the energy efficiency should become a priority objective of policies; -coping with the long term challenges requires acting at present; - building the transition between governmental leadership and market; - taking profit of all the possible synergies between short and long term planning.

Development Of The Technique Of Assessment Of Banking Risks Of Long-Term Crediting Of Investments (On The Example Of Banks Of Sevastopol

Directory of Open Access Journals (Sweden)

Ulyana Viktorovna Dremova

2015-03-01

Full Text Available The external destabilizing factor — financial crisis — has significantly influenced on the level increase of riskiness of the banking credit operations. Taking into account that the increased level of risk follows long-term credits, these operations has been influenced the most, that can be as one of the constraining conditions for the provision of bank long-term credit resources. It, in turn, causes the need to develop the risk assessment technique of long-term credits in regulation of banks’ long-term credit operations. As the risk assessment of credit operations in banking practice is generally limited to the calculation of credit risk, it is efficient to consider the scientifically reasonable approach to a risks assessment of long-term crediting including influence of private risks for the purpose of carrying out the generalized assessment of riskiness both separate types of long-term credits, and a long-term credit portfolio in general. The offered method is based on the calculation of aggregate risk coefficient of the long-term credits, calculated by means of mathematical method of principal component. In the work, it is offered to perform an assessment of private risks by means of statistics: the expectation value, mean square deviation, and the coefficient of a variation. The use of the principal components’ method at the risk assessment of longterm crediting meets such requirements as a lack of value judgment, accounting of specific features of private risks of long-term credits, mathematical validity. It gives the chance to apply the offered risk assessment method of long-term credits in banking. The conclusion is made that the application of an aggregative risk indicator of a long-term crediting will allow banks to trace more accurately the level of riskiness of a long-term credit portfolio and separate types of long-term credits that will strengthen the bank information and analytical base on risk regulation in the field and

Assessment and modelling of general practice and community setting capacity for medical trainees in northern New Zealand.

Science.gov (United States)

Goodyear-Smith, Felicity; Al-Murrani, Abbas

2017-09-22

To estimate the capacity of general practice to accommodate undergraduate and postgraduate medical trainees, and model efficient ways to utilise identified capacity and increase capacity. We conducted an online survey, with phone follow-up to non-responders, of all general practices in the northern half of New Zealand. The main outcome measures were current placements and future intentions for taking medical trainees; factors influencing decisions and possible incentives to take trainees. Sixty percent of existing practices take no medical trainees. On average, practices take trainees for 50% of available cycles per year. Postgraduate trainees displace undergraduate student placements due to space limitations. Only 1.9% practices demonstrate current capacity for full vertical training by taking all three types of trainee (undergraduate, PGY, registrar). Modelling on current use means 69 additional practices will be needed to be recruited by 2020. A number of strategies are presented aimed at increasing short-term undergraduate teaching practice capacity in New Zealand, but also relevant to Australia and elsewhere. In the long-term, establishment of the proposed School of Rural Health would enable integrated vertical teaching and address the GP training capacity issues.

Long-term surveillance plan for the Gunnison, Colorado, disposal site

International Nuclear Information System (INIS)

1996-05-01

This long-term surveillance plan (LTSP) describes the US Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Gunnison disposal site in Gunnison County, Colorado. The US Nuclear Regulatory Commission (NRC) has developed regulations for the issuance of a general license for the custody and long-term care of UMTRA Project disposal sites in 10 CFR Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites will be cared for in a manner that protects the public health and safety and the environment.For each disposal site to be licensed, the NRC requires the DOE to submit a site-specific LTSP. The DOE prepared this LTSP to meet this requirement for the Gunnison disposal site. The general license becomes effective when the NRC concurs with the DOE's determination of completion of remedial action for the Gunnison site and the NRC formally accepts this LTSP

Oncology nurses′ recognition of long-term cancer survivorship care in Japan

Directory of Open Access Journals (Sweden)

Asako Miura

2015-01-01

Full Text Available Objective: This study aims to assess the knowledge of definition of cancer survivors among Japanese oncology nurses and their roles in long-term cancer survivorship care. Methods: A structured self-administered and self-report questionnaire created by the study investigators was given to members of the Japanese Society of Cancer Nursing. The subjects were 81 female oncology nurses. Results: Forty-nine nurses had 11 or more years of nursing experience, while 27 nurses had cancer-related nursing certifications such as, certification in oncology nursing specialist. This study population had rather rich experience in oncology nursing. Sixty-two nurses defined a cancer survivor from the time of diagnosis, while the nurses′ recognition of long-term survivorship care was poor, compared with nursing care at the time of diagnosis, during treatment, and end of life. Conclusions: The nurses were aware of the needs to recognize and address issues faced by long-term cancer survivors and for nursing study, but very few put the effective patient education and interventions into practice. It is because oncology nurses have few chances to see cancer survivors who go out of the hands of healthcare professionals. In increasing the number of long-term survivors, long-term survivorship care is needed in addition to incorporating such education into undergraduate and graduate programs. Further study on the knowledge of long-term cancer survivorship care and nursing practices are required.

Practice patterns and long-term survival for early-stage rectal cancer.

Science.gov (United States)

Stitzenberg, Karyn B; Sanoff, Hanna K; Penn, Dolly C; Meyers, Michael O; Tepper, Joel E

2013-12-01

Standard of care treatment for most stage I rectal cancers is total mesorectal excision (TME). Given the morbidity associated with TME, local excision (LE) for early-stage rectal cancer has been explored. This study examines practice patterns and overall survival (OS) for early-stage rectal cancer. All patients in the National Cancer Data Base diagnosed with rectal cancer from 1998 to 2010 were initially included. Use of LE versus proctectomy and use of adjuvant radiation therapy were compared over time. Adjusted Cox proportional hazards models were used to compare OS based on treatment. LE was used to treat 46.5% of patients with T1 and 16.8% with T2 tumors. Use of LE increased steadily over time (P OS than those treated with proctectomy alone or multimodality therapy. Guideline-concordant adoption of LE for treatment of low-risk stage I rectal cancer is increasing. However, use of LE is also increasing for higher-risk rectal cancers that do not meet guideline criteria for LE. Treatment with LE alone is associated with poorer long-term OS. Additional studies are warranted to understand the factors driving increased use of LE.

Long-term follow-up study and long-term care of childhood cancer survivors

Directory of Open Access Journals (Sweden)

Hyeon Jin Park

2010-04-01

Full Text Available The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.

Monitoring long-term oral corticosteroids.

Science.gov (United States)

Mundell, Lewis; Lindemann, Roberta; Douglas, James

2017-01-01

Corticosteroids are synthetic analogues of human hormones normally produced by the adrenal cortex. They have both glucocorticoid and mineralocorticoid properties. The glucocortoid components are anti-inflammatory, immunosuppressive, anti-proliferative and vasoconstrictive. They influence the metabolism of carbohydrate and protein, in addition to playing a key role in the body's stress response. Mineralocorticoid's main significance is in the balance of salt and water concentrations. Due to the combination of these effects, corticosteroids can cause many adverse effects. Oral corticosteroids are absorbed systemically and are therefore more likely to cause adverse effects than topical or inhaled corticosteroids. Furthermore, it is assumed that greater duration of treatment will lead to a greater number of adverse effects, and therefore the most at risk group are those taking high dose, long-term oral corticosteroids (LTOC). High dose is defined as a prescription of >5 mg oral prednisolone and long term as duration of treatment >1 month (based on National Institute for Health and Care Excellence guidance for patient's 'at risk' of systemic side effects). Parameters to be monitored in primary care include weight, blood pressure, triglycerides, glucose and urea and electrolytes. From clinical experience within the general practice setting, the authors propose that these patients do not receive adequate baseline monitoring before starting corticosteroids nor are these markers monitored consistently thereafter. This project intended to evidence this claim, evaluate the adverse effect profile and improve monitoring in this patient group. The initial audit of 22 patients, within a single general practice, detected at least one documented adverse effect in 64% of patients, while 41% reported more than one adverse effect. 45% had recorded weight gain, 18% had recorded osteoporosis, 18% had at least one recorded cataract, 14% had recorded Hypertension, 14% had recorded

Long- and short-term complications of episiotomy

Directory of Open Access Journals (Sweden)

İsmet Gün

2016-09-01

Full Text Available Although extensively applied in obstetrics practice to facilitate delivery by increasing the vaginal birth conduit, most episiotomy studies are in the context of short- or medium-term outcomes, and the number of studies investigating the long-term effects is insufficient. Episiotomy is often considered associated with urinary and/or anal incontinence and dyspareunia; however, there is no concrete evidence for this issue. Current meta-analyses and reviews that assessed the studies available in the literature revealed that episiotomy does not decrease the rates of urinary incontinence, perineal pain, and sexual dysfunction and that routine episiotomy does not prevent pelvic floor damage; thus, the recommended use of mediolateral episiotomy is restricted, rather than routine. According to the limited number of studies on sexual function, there seems to be a linear relationship between the degree of perineal laceration and postpartum dyspareunia. It is still not clear whether episiotomy has any impact on pelvic floor relaxation, pelvic organ prolapse, and sexual dysfunction in the long term. PRECIS: The long-term influences of episiotomy on urinary and/or fecal incontinence, pelvic floor dysfunction, sexual function, and dyspareunea are still not clear and studies on these issues are necessary.

Sheet GT3-2. General approach of life phases on a long term for uranium mining residues storages and comparison with other storages

International Nuclear Information System (INIS)

2009-01-01

This document aims at specifying the short term, middle term and long term boundaries for a sustainable management and rehabilitated ancient uranium mining sites and of uranium mining residue storage sites. It presents a general overview of site evolution in time, and then, more precisely, the different functions (rehabilitation management, corrective actions, control and monitoring, and so on) and equipment (confinement works, measurement system) at stake in the management of these sites and the control of their impacts. Functions and equipment implemented on such a site, as well as time scales corresponding to different approaches are compared with those of other types of storage. The peculiarity of ancient uranium mining sites and its implications in terms of management on a long term are discussed

Measuring forgetting: a critical review of accelerated long-term forgetting studies.

Science.gov (United States)

Elliott, Gemma; Isaac, Claire L; Muhlert, Nils

2014-05-01

Accelerated long-term forgetting (ALF) refers to abnormal forgetting over hours to weeks despite normal acquisition or initial consolidation. Since standardised assessments of memory typically only test at delays of up to 40-minutes, ALF may go undetected in clinical practice. The memory difficulties associated with ALF can however cause considerable distress to patients. It is important therefore that clinicians are aware that ALF may represent a distinct phenomenon that will require additional and careful assessment to aid patients' understanding of the condition and assist in developing strategies to address its effects. At the same time, ALF may also provide insight into long-term memory processes. Studies of ALF in patients with epilepsy have so far demonstrated mixed results, which may reflect differences in methodology. This review explores the methodological issues that can affect forgetting, such as the effects of age, general cognitive function, test sensitivity and initial learning. It then evaluates the extent to which existing studies have considered these key issues. We outline the points to consider when designing ALF studies that can be used to help improve their validity. These issues can also help to explain some of the mixed findings in studies of ALF and inform the design of standardised tests for assessing ALF in clinical practice. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Long-term effects of emissions to the sea from the offshore sector. General note; Langtidsvirkninger fra utslipp til sjoe fra offshoresektoren

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-06-01

This general note reviews the general understanding of the long-term effects of emission to the sea from the offshore sector and the need for competence and research. During the last 20 years, considerable efforts have been made in environmental research and monitoring in the oil sector. Nevertheless, evidently more research is needed in several fields. Priority has been given to the research needed according to (1) the amount of money needed for increased knowledge about the long-term effects of emissions to the sea from the oil sector, (2) the extent of missing knowledge, (3) to what extent new knowledge would be expected to contribute to improved decisions about environmental measures, (4) the extent of potential impacts on the ecosystems in Norwegian seas and the geographical extent of a possible effect. The identified research areas are, according to priority, (1) effects in the water column of produced water, (2) sudden emissions and drilling fluid, (3) joint research and monitoring, (4) special research programmes in arctic regions, (5) emissions in progress from cuttings and long-term effects of sudden emissions in coastal zones and beach zones. Research currently in progress should be co-ordinated through a special research programme, for which there is a clear need. The funds for such a programme should come from both the industry and the authorities.

Improvement of Regulatory Framework for Long-Term Operation and Ageing Management of NPPs

International Nuclear Information System (INIS)

Kostenko, S.P.

2015-01-01

The regulatory framework for long-term operation and ageing management of NPP units in Ukraine was reviewed and deficiencies were identified. The procedure for improving regulatory framework for long-term operation and ageing management is presented. It takes into consideration IAEA recommendations and international practices, as well as experience obtained in long-term operation efforts for Rivne NPP-1, 2 and South Ukraine NPP-1. The paper demonstrates interrelations between standards and technical documents on long-term operation and ageing management. The information is presented regarding the current state of regulatory and legal documentation development and industry-specific standards on long-term operation and ageing management of NPP units in Ukraine

Long-term course of opioid addiction.

Science.gov (United States)

Hser, Yih-Ing; Evans, Elizabeth; Grella, Christine; Ling, Walter; Anglin, Douglas

2015-01-01

Opioid addiction is associated with excess mortality, morbidities, and other adverse conditions. Guided by a life-course framework, we review the literature on the long-term course of opioid addiction in terms of use trajectories, transitions, and turning points, as well as other factors that facilitate recovery from addiction. Most long-term follow-up studies are based on heroin addicts recruited from treatment settings (mostly methadone maintenance treatment), many of whom are referred by the criminal justice system. Cumulative evidence indicates that opioid addiction is a chronic disorder with frequent relapses. Longer treatment retention is associated with a greater likelihood of abstinence, whereas incarceration is negatively related to subsequent abstinence. Over the long term, the mortality rate of opioid addicts (overdose being the most common cause) is about 6 to 20 times greater than that of the general population; among those who remain alive, the prevalence of stable abstinence from opioid use is low (less than 30% after 10-30 years of observation), and many continue to use alcohol and other drugs after ceasing to use opioids. Histories of sexual or physical abuse and comorbid mental disorders are associated with the persistence of opioid use, whereas family and social support, as well as employment, facilitates recovery. Maintaining opioid abstinence for at least five years substantially increases the likelihood of future stable abstinence. Recent advances in pharmacological treatment options (buprenorphine and naltrexone) include depot formulations offering longer duration of medication; their impact on the long-term course of opioid addiction remains to be assessed.

Institutionalization and Organizational Long-term Success

Directory of Open Access Journals (Sweden)

Denise L. Fleck

2007-05-01

Full Text Available Institutionalization processes have an ambivalent effect on organizational long-term success. Even though they foster organizational stability and permanence, they also bring about rigidity and resistance to change. As a result, successful organizations are likely to lose their competitive advantage over time. The paper addresses this issue through the investigation of the institutionalization processes of two long-lived companies: General Electric, a firm that has been a long-term success and its rival, Westinghouse, which was broken up after eleven decades of existence. The longitudinal, multilevel analysis of firms and industry has identified two different modes of organizational institutionalization. The reactive mode gives rise to rigidity and change resistance, much like institutional theory predicts; the proactive mode, on the other hand, neutralizes those negative effects of institutionalization processes. In the reactive mode, structure predominates. In the proactive mode, agency plays a major role in organizational institutionalization, and in managing the organization’s relations with the environment, clearly contributing to environmental institutionalization.

Long-term surveillance plan for the Rifle, Colorado, Disposal site

International Nuclear Information System (INIS)

1996-09-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Estes Gulch disposal site in Garfield County, Colorado. The U.S. Environmental Protection Agency (EPA) has developed regulations for the issuance of a general license by the U.S. Nuclear Regulatory Commission (NRC) for the custody and long-term care of UMTRA Project disposal Sites in 10 CFR Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites, will be cared for in a manner that protects the public health and safety and the environment. For each disposal site to be licensed, the NRC requires the DOE to submit a site-specific LTSP. The DOE prepared this LTSP to meet this requirement for the Estes Gulch disposal site. The general license becomes effective when the NRC concurs with the DOE's determination of completion of remedial action for the Estes Gulch site and the NRC formally accepts this LTSP

Long-term outcomes of acute ischemic stroke patients treated with endovascular thrombectomy: A real-world experience.

Science.gov (United States)

Zhao, Wenbo; Shang, Shuyi; Li, Chuanhui; Wu, Longfei; Wu, Chuanjie; Chen, Jian; Song, Haiqing; Zhang, Hongqi; Zhang, Yunzhou; Duan, Jiangang; Feng, Wuwei; Ji, Xunming

2018-07-15

Long-term follow-up of large trials have confirmed the superiority of endovascular thrombectomy (ET) for treating acute ischemic stroke (AIS). However, it is still unknown whether these results can be generalized to clinical practice. In this study, we aimed to determine the long-term outcomes of AIS post-ET in the real-world clinical practice. This observational study is based on a single-center prospective registry study. AIS patients were treated with second-generation stent retrievers from December 2012 to April 2016. The primary outcome was modified Ranks scale (mRS) at the time of the latest assessment. Favorable outcome was defined as mRS scores 0-2, and the unfavorable outcome was defined as mRS scores 3-6. Eighty-nine AIS subjects with large artery occlusion in anterior circulation undergoing ET were eligible for analysis. Median follow-up duration was 20 months (interquartile range 6-32), and 47 subjects (53%) achieved favorable outcome whereas 17 subjects (19%) were functional dependence and 25 subjects (28%) died. Independent predicators for long-term unfavorable outcome were higher baseline National Institutes of Health Stroke Scale (NIHSS) score (odd ratio:1.21;95% confidence interval 1.09-1.35; p < 0.001) and symptomatic intracerebral hemorrhage (sICH) (odd ratio:16.45;95% confidence interval 1.34-193.44; p = 0.026). More subjects of large-artery-atherosclerosis underwent permanent intracranial stenting (22%vs.10%) as compared with those of cardioembolism, while subjects of cardioembolism were more likely to experience sICH (13%vs.8%) and died (32%vs.16%). Over half of AIS patients can achieve favorable long-term outcomes post-ET. Higher baseline NIHSS scores and sICH are independently associated with unfavorable outcome. Overall, clinical practice in this single canter can replicate the long-term outcomes from the published endovascular clinical trials. Copyright © 2018 Elsevier B.V. All rights reserved.

Long-Term Ownership by Industrial Foundations

DEFF Research Database (Denmark)

Børsting, Christa Winther; Kuhn, Johan Moritz; Poulsen, Thomas

2016-01-01

in Denmark. Industrial foundations are independent legal entities without owners or members typically with the dual objective of preserving the company and using excess profits for charity. We use a unique Danish data set to examine the governance of foundation-owned companies. We show that they are long......-term in several respects. Foundations hold on to their shares for longer. Foundation-owned companies replace managers less frequently. They have more conservative capital structures with less leverage. Their companies survive longer. Their business decisions appear to be more long term. This paper supports...... the hypothesis that time horizons are influenced by ownership structures and particularly that industrial foundations promote longtermism. Policymakers which are interested in promoting longtermism should allow and perhaps even encourage the creation of industrial foundations. More generally they should consider...

Devil in the Details? Developmental Dyslexia and Visual Long-Term Memory for Details

Directory of Open Access Journals (Sweden)

Lynn eHuestegge

2014-07-01

Full Text Available Cognitive theories on causes of developmental dyslexia can be divided into language-specific and general accounts. While the former assume that words are special in that associated processing problems are rooted in language-related cognition (e.g., phonology deficits, the latter propose that dyslexia is rather rooted in a general impairment of cognitive (e.g., visual and/or auditory processing streams. In the present study, we examined to what extent dyslexia (typically characterized by poor orthographic representations may be associated with a general deficit in visual long-term memory for details. We compared object- and detail-related visual long-term memory performance (and phonological skills between dyslexic primary school children and IQ-, age- and gender-matched controls. The results revealed that while the overall amount of long-term memory errors was comparable between groups, dyslexic children exhibited a greater portion of detail-related errors. The results suggest that not only phonological, but also general visual resolution deficits in long-term memory may play an important role in developmental dyslexia.

Quality indicators for the acute and long-term management of anaphylaxis

DEFF Research Database (Denmark)

Dhami, Sangeeta; Sheikh, Aadam; Muraro, Antonella

2017-01-01

BACKGROUND: The quality of acute and long-term anaphylaxis management is variable and this contributes to the poor outcomes experienced by many patients. Clinical practice guidelines have the potential to improve outcomes, but implementing guideline recommendations in routine practice is challeng...

Long Term Debt and the Political Support for a Monetary Union

NARCIS (Netherlands)

Uhlig, H.F.H.V.S.

1997-01-01

This paper examines the role of long term debt for the political support of a monetary union or, more generally, an inflation-reduction policy. The central idea is that the decision about membership in the union leads to a redistribution between debtors and creditors, if they are holding long term

Long-term economic outlook. Annual review

Energy Technology Data Exchange (ETDEWEB)

1988-01-01

This review provides economic growth forecast tables for Ontario, Canada, the US, Western Europe, and Japan. Economic growth, government policy, the long-term prospects for inflation, interest rates and foreign exchange rates, trends in the Canadian dollar, and energy markets and prices are also reviewed. Data generally cover 1965-2025. Appendices give a summary of historical and forecast data. 18 figs., 16 tabs.

[Long-term psychiatric hospitalizations].

Science.gov (United States)

Plancke, L; Amariei, A

2017-02-01

Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had

Factors influencing the long-term sustainment of quality improvements made in addiction treatment facilities: a qualitative study

Directory of Open Access Journals (Sweden)

Scott P. Stumbo

2017-11-01

Full Text Available Abstract Background A greater understanding of the factors that influence long-term sustainment of quality improvement (QI initiatives is needed to promote organizational ability to sustain QI practices over time, help improve future interventions, and increase the value of QI investments. Methods We approached 83 of 201 executive sponsors or change leaders at addiction treatment organizations that participated in the 2007–2009 NIATx200 QI intervention. We completed semi-structured interviews with 33 individuals between November 2015 and April 2016. NIATx200 goals were to decrease wait time, increase admissions and improve retention in treatment. Interviews sought to understand factors that either facilitated or impeded long-term sustainment of organizational QI practices made during the intervention. We used thematic analysis to organize the data and group patterns of responses. We assessed available quantitative outcome data and intervention engagement data to corroborate qualitative results. Results We used narrative analysis to group four important themes related to long-term sustainment of QI practices: (1 finding alignment between business- and client-centered practices; (2 staff engagement early in QI process added legitimacy which facilitated sustainment; (3 commitment to integrating data into monitoring practices and the identification of a data champion; and (4 adequate organizational human resources devoted to sustainment. We found four corollary factors among agencies which did not sustain practices: (1 lack of evidence of impact on business practices led to discontinuation; (2 disengaged staff and lack of organizational capacity during implementation period led to lack of sustainment; (3 no data integration into overall business practices and no identified data champion; and (4 high staff turnover. In addition, we found that many agencies’ current use of NIATx methods and tools suggested a legacy effect that might improve

[Participation as Target of Social Medicine and Nursing Care: - Legal Definition of Long-Term Care Dependency - Strategies to Prevent Long-Term Care Dependency].

Science.gov (United States)

Nüchtern, Elisabeth; Gansweid, Barbara; Gerber, Hans; von Mittelstaedt, Gert

2017-01-01

Objective: By the "Second Bill to Strengthen Long-Term Care", a new concept of long-term care dependency will be introduced, valid from 2017. Long-term care dependency according to Social Code XI will be defined covering more aspects than today. Therefore, the working group "Nursing Care" of the division "Social Medicine in Practice and Rehabilitation" in the German Society for Social Medicine and Prevention presents their results after working on the social medicine perspective of the definition and prevention of long-term care dependency. Methods: Both the definition and strategies to prevent long-term care dependency are systematically taken into consideration from the point of view of social medicine on the basis of the International Classification of Functioning, Disability and Health (ICF), as long-term care dependency means a defined condition of disability. Results: Both the current and the new concept of long-term care dependency focus activity limitations. The perspective of social medicine considers the interactions of health condition, its effects on daily activities and personal as well as environmental factors. From this point of view approaches for social benefits concerning prevention and rehabilitation can be identified systematically so as to work against the development and progression of long-term care dependency. The reference to the ICF can facilitate the communication between different professions. The new "graduation" of long-term care dependency would allow an international "translation" referring to the ICF. Conclusion: Experts from the field of social medicine as well as those of nursing care, care-givers and nursing researchers have in common the objective that persons in need of nursing care can participate in as many aspects of life of importance to them in an autonomous and self-determined way. The point of view of social medicine on long-term care dependency is fundamental for all occupational groups that are involved and for their

Quality of Life and Functional Health Status of Long-Term Meditators

Directory of Open Access Journals (Sweden)

Ramesh Manocha

2012-01-01

Full Text Available Background. There is very little data describing the long-term health impacts of meditation. Aim. To compare the quality of life and functional health of long-term meditators to that of the normative population in Australia. Method. Using the SF-36 questionnaire and a Meditation Lifestyle Survey, we sampled 343 long-term Australian Sahaja Yoga meditation practitioners and compared their scores to those of the normative Australian population. Results. Six SF-36 subscales (bodily pain, general health, mental health, role limitation—emotional, social functioning, and vitality were significantly better in meditators compared to the national norms whereas two of the subscales (role limitation—physical, physical functioning were not significantly different. A substantial correlation between frequency of mental silence experience and the vitality, general health, and especially mental health subscales (P<0.005 was found. Conclusion. Long-term practitioners of Sahaja yoga meditation experience better functional health, especially mental health, compared to the general population. A relationship between functional health, especially mental health, and the frequency of meditative experience (mental silence exists that may be causal. Evidence for the potential role of this definition of meditation in enhancing quality of life, functional health and wellbeing is growing. Implications for primary mental health prevention are discussed.

Towards a practical Johnson noise thermometer for long-term measurements in harsh environments

International Nuclear Information System (INIS)

Greenen, Adam; Pearce, Jonathan; Cruickshank, David; Bramley, Paul

2015-01-01

The impact of mechanical and chemical changes in conventional sensors such as thermocouples and resistance thermometers can be avoided by instead using temperature sensors based on fundamental thermometry. A prime example of this is Johnson noise thermometry, which is based on measurement of the fluctuations in the voltage of a resistor arising from thermal motion of charge carriers - i.e. the 'Johnson noise'. A Johnson noise thermometer never needs calibration and is insensitive to the condition of the sensor material. It is therefore ideally suited to long-term temperature measurements in harsh environments, such as nuclear reactor coolant circuits, in-pile measurements, nuclear waste management and storage, and severe accident monitoring. There have been a number of previous attempts to develop a Johnson noise thermometer for the nuclear industry, but none have reached commercial exploitation because of technical problems in practical implementation. The main challenge is to extract the tiny Johnson noise signal from ambient electrical noise influences, both from the internal amplification electronics, and from external electrical noise sources. Recent advances in electronics technology and digital signal processing techniques have opened up new possibilities for developing a viable, practical Johnson noise thermometer. We describe a project funded by the UK Technology Strategy Board (now Innovate UK) 'Developing the nuclear supply chain' call, currently underway, to develop a practical Johnson noise thermometer that makes use of innovative electronics for ultralow noise amplification and signal processing. The new electronics technology has the potential to help overcome the problems encountered with previous attempts at constructing a practical Johnson noise thermometer. An outline of the new developments is presented, together with an overview of the current status of the project. (authors)

Towards a practical Johnson noise thermometer for long-term measurements in harsh environments

Energy Technology Data Exchange (ETDEWEB)

Greenen, Adam; Pearce, Jonathan [National Physical Laboratory, Hampton Road, Teddington, TW11 0LW, (United Kingdom); Cruickshank, David; Bramley, Paul [Metrosol Limited, Plum Park Estate, Watling Street, Paulerspury, Northamptonshire, NN12 6LQ, (United Kingdom)

2015-07-01

The impact of mechanical and chemical changes in conventional sensors such as thermocouples and resistance thermometers can be avoided by instead using temperature sensors based on fundamental thermometry. A prime example of this is Johnson noise thermometry, which is based on measurement of the fluctuations in the voltage of a resistor arising from thermal motion of charge carriers - i.e. the 'Johnson noise'. A Johnson noise thermometer never needs calibration and is insensitive to the condition of the sensor material. It is therefore ideally suited to long-term temperature measurements in harsh environments, such as nuclear reactor coolant circuits, in-pile measurements, nuclear waste management and storage, and severe accident monitoring. There have been a number of previous attempts to develop a Johnson noise thermometer for the nuclear industry, but none have reached commercial exploitation because of technical problems in practical implementation. The main challenge is to extract the tiny Johnson noise signal from ambient electrical noise influences, both from the internal amplification electronics, and from external electrical noise sources. Recent advances in electronics technology and digital signal processing techniques have opened up new possibilities for developing a viable, practical Johnson noise thermometer. We describe a project funded by the UK Technology Strategy Board (now Innovate UK) 'Developing the nuclear supply chain' call, currently underway, to develop a practical Johnson noise thermometer that makes use of innovative electronics for ultralow noise amplification and signal processing. The new electronics technology has the potential to help overcome the problems encountered with previous attempts at constructing a practical Johnson noise thermometer. An outline of the new developments is presented, together with an overview of the current status of the project. (authors)

Long-term potentiation and long-term depression: a clinical perspective

Directory of Open Access Journals (Sweden)

Timothy V.P. Bliss

2011-01-01

Full Text Available Long-term potentiation and long-term depression are enduring changes in synaptic strength, induced by specific patterns of synaptic activity, that have received much attention as cellular models of information storage in the central nervous system. Work in a number of brain regions, from the spinal cord to the cerebral cortex, and in many animal species, ranging from invertebrates to humans, has demonstrated a reliable capacity for chemical synapses to undergo lasting changes in efficacy in response to a variety of induction protocols. In addition to their physiological relevance, long-term potentiation and depression may have important clinical applications. A growing insight into the molecular mechanisms underlying these processes, and technological advances in non-invasive manipulation of brain activity, now puts us at the threshold of harnessing long-term potentiation and depression and other forms of synaptic, cellular and circuit plasticity to manipulate synaptic strength in the human nervous system. Drugs may be used to erase or treat pathological synaptic states and non-invasive stimulation devices may be used to artificially induce synaptic plasticity to ameliorate conditions arising from disrupted synaptic drive. These approaches hold promise for the treatment of a variety of neurological conditions, including neuropathic pain, epilepsy, depression, amblyopia, tinnitus and stroke.

Long term contracts in portfolios of core LDC gas supply

International Nuclear Information System (INIS)

John, F.E.

1992-01-01

This paper recommends that local distribution companies (LDCs) should use a portfolio approach for their gas supply strategy. The author recommends that LDCs not rely on spot supplies to meet the peak needs of the core residential and commercial markets. He recommends that a secure supply through long-term contracts are better sources than spot or even intermediate term suppliers. The paper provides a brief outline format of the advantages to the use of a portfolio approach which include the rapid restructuring of the market, general changes in the market, and general market performance. By maintaining a portfolio, a list of available natural gas suppliers is always available. This portfolio also acts to compare pricing between short, medium, and long-term pricing for the LDCs

Open-access ultrasound referrals from general practice.

LENUS (Irish Health Repository)

Hughes, P

2015-03-01

Direct access referral for radiological investigations from General Practice (GP) provides an indispensable diagnostic tool and avoids the inherently long waiting time that referral through a hospital based specialty would entail. Improving access to hospital based radiology services is one of Health Information and Quality Authority\\'s key recommendations in its report on patient referrals from general practice. This study aimed to review all GP referrals for ultrasound investigations to a tertiary referral teaching hospital over a seven month period with respect to their demographics, waiting times and diagnostic outcomes. 1,090 ultrasounds originating in general practice were carried out during the study period. Positive findings were recorded in 332 (30.46%) examinations. The median waiting time from receipt of referral to the diagnostic investigation was 56 days (range 16 - 91 years). 71 (6.5%) patients had follow-up imaging investigations while recommendation for hospital based specialty referral was made in 35 cases (3.2%). Significant findings included abdominal aortic aneurysms, metastatic disease and lymphoma. Direct access to ultrasound for general practitioners allows the referring physician to make an informed decision with regard to the need for specialist referral. We believe these findings help support the case for national direct access to diagnostic ultrasound for general practitioners.

Implementing Montessori Methods for Dementia™ in Ontario long-term care homes: Recreation staff and multidisciplinary consultants' perceptions of policy and practice issues.

Science.gov (United States)

Ducak, Kate; Denton, Margaret; Elliot, Gail

2018-01-01

Montessori-based activities use a person-centred approach to benefit persons living with dementia by increasing their participation in, and enjoyment of, daily life. This study investigated recreation staff and multidisciplinary consultants' perceptions of factors that affected implementing Montessori Methods for Dementia™ in long-term care homes in Ontario, Canada. Qualitative data were obtained during semi-structured telephone interviews with 17 participants who worked in these homes. A political economy of aging perspective guided thematic data analysis. Barriers such as insufficient funding and negative attitudes towards activities reinforced a task-oriented biomedical model of care. Various forms of support and understanding helped put Montessori Methods for Dementia™ into practice as a person-centred care program, thus reportedly improving the quality of life of residents living with dementia, staff and family members. These results demonstrate that when Montessori Methods for Dementia™ approaches are learned and understood by staff they can be used as practical interventions for long-term care residents living with dementia.

Utilisation of strategic communication to create willingness to change work practices among primary care staff: a long-term follow-up study.

Science.gov (United States)

Morténius, Helena; Fridlund, Bengt; Marklund, Bertil; Palm, Lars; Baigi, Amir

2012-04-01

To evaluate the long-term utilisation of strategic communication as a factor of importance when changing work practices among primary care staff. In many health care organisations, there is a gap between theory and practice. This gap hinders the provision of optimal evidence-based practice and, in the long term, is unfavourable for patient care. One way of overcoming this barrier is systematically structured communication between the scientific theoretical platform and clinical practice. This longitudinal evaluative study was conducted among a primary care staff cohort. Strategic communication was considered to be the intervention platform and included a network of ambassadors who acted as a component of the implementation. Measurements occurred 7 and 12 years after formation of the cohort. A questionnaire was used to obtain information from participants. In total, 846 employees (70%) agreed to take part in the study. After 12 years, the 352 individuals (60%) who had remained in the organisation were identified and followed up. Descriptive statistics and multivariate analysis were used to analyse the data. Continuous information contributed to significant improvements over time with respect to new ideas and the intention to change work practices. There was a statistically significant synergistic effect on the new way of thinking, that is, willingness to change work practices. During the final two years, the network of ambassadors had created a distinctive image for itself in the sense that primary care staff members were aware of it and its activities. This awareness was associated with a positive change with regard to new ways of thinking. More years of practice was inversely associated with willingness to change work practices. Strategic communication may lead to a scientific platform that promotes high-quality patient care by means of new methods and research findings.

[Comparison of long-term dental treatment effects of children treated under general anesthesia and passive restraint].

Science.gov (United States)

Zhou, F; Xia, B; Zhang, S; Ma, W L; Xiao, Y M; Ge, L H

2017-02-09

Objective: To compare the long-term dental treatment effects, oral health habits and oral-health-related qualities of life of children treated under general anesthesia (GA) and passive restraint (PR), respectively. Methods: Twenty seven 2 to 4-year-old children treated under GA and thirty four children treated under PR were recruited in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology. Up to 2 years after the treatment, a follow up assessment was conducted. The data of general information, dental plaque level and the unplanned treatments were recorded and analyzed. The questionnaire of oral health habits and early childhood oral health impact scale (ECOHIS) for each child was also completed and analyzed. The survival rate and median survival time of the deciduous teeth were calculated. Multivariate analysis was performed by using Cox proportional hazard model. Results: Twenty-five children under GA and 32 under PR were finally included, with a total of 1 098 deciduous teeth. The postoperative dental plaque indicesin both GA and PR groups had significantly improved than that of before the treatments ( P= 0.019, P< 0.001). The oral health habits had also improved, and the improvement in PR group was more obvious than that in GA group. Totally 128 teeth (27.0%) appeared unplanned treatments in GA group and 232 teeth (37.2%) in PR group during the follow-ups. The new caries and recurrent caries in PR group were significantly more than that in GA group ( P< 0.001, P= 0.012). No significant differences were found between the two groups in restoration failure, secondary caries and endodontic diseases ( P= 0.129, P= 0.822, P= 0.642). However, the time of occurrence of endodontic disease and secondary caries in GA group were significantly longer than that in PR group ( P< 0.01, P< 0.001). The median survival time of teeth in GA group was 1 018 days comparing to 944 days in PR group. The difference was statistically significant ( P

Influenza in long-term care facilities.

Science.gov (United States)

Lansbury, Louise E; Brown, Caroline S; Nguyen-Van-Tam, Jonathan S

2017-09-01

Long-term care facility environments and the vulnerability of their residents provide a setting conducive to the rapid spread of influenza virus and other respiratory pathogens. Infections may be introduced by staff, visitors or new or transferred residents, and outbreaks of influenza in such settings can have devastating consequences for individuals, as well as placing extra strain on health services. As the population ages over the coming decades, increased provision of such facilities seems likely. The need for robust infection prevention and control practices will therefore remain of paramount importance if the impact of outbreaks is to be minimised. In this review, we discuss the nature of the problem of influenza in long-term care facilities, and approaches to preventive and control measures, including vaccination of residents and staff, and the use of antiviral drugs for treatment and prophylaxis, based on currently available evidence. © 2017 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

[Long-term disease in Danish children reported by the parents].

Science.gov (United States)

Nielsen, Anne M; Koefoed, Birgitte Gade; Møller, Ralf; Laursen, Bjarne

2006-01-23

The aim of this study was to report the prevalence and nature of long-term diseases and their consequences in children under the age of 16 in Denmark, and to identify the socio-demographic determinants of disease. Parents and stepparents participating in the Danish Health and Morbidity Survey, 2000, were interviewed at home about long-term diseases, including impairments and sequelae after injury and disease, in children under the age of 16 living at home. Answers were given for 7,670 children, and diseases were coded according to ICD-10 by two doctors. Logistic regression analysis was used to identify the determinants and consequences of disease. A total of 16.2% of children had one or more long-term diseases, boys (17.5%) more frequently than girls (14.8%). The prevalence increased through the first six years of life. A social gradient was seen: children of parents with low socioeconomic status or with little education had a higher prevalence. The most frequent disease was asthma (4.9%). Also frequent were congenital disorders (1.6%), otitis media (1.4%) and hearing impairment (0.6%). Children with long-term disease suffered more frequently than others from poor health in general, recent sick leave and poor thriving. The figures for long-term disease reported by the parents participating in the study were in accordance with what was found in earlier studies, but stigmatising and less severe diseases, as well as periodically recurring diseases, were probably underreported. Attention should be paid to the high prevalence of asthma, to the poorer thriving and to the general health status of children with long-term disease, and to the social inequality in children's health.

Long term contracts signed in Slovak timber business

International Nuclear Information System (INIS)

Haluza, I.

2005-01-01

The Slovak timber business is changing. The state-owned company, SR Forests, which cuts more then 50% of Slovak timber has signed long term agreements with major domestic timber processing companies - Smrecina, the Rettenmeier Tatra Timber saw mill in Liptovsky Mikulas and two paper mills - Mondi SCP Ruzomberok and Kappa Sturovo. In the past, only quarterly contracts were signed. Now, for the first time, two-year contracts have been signed that should help the timber processing industry and the forestry sector. The General Director of Lesy SR (SR Forests), Karol Vins, hopes for better sale prices. Company headquarters wants to maintain better control of prices than under the old system of timber sales by its branches. In the opinion of the General Director of the Forestry Section at the Ministry of Agriculture, long term contracts will guarantee a stable delivery of timber to processing companies, giving investors in new production capacity a better position in negotiations with banks regarding financing. According to K. Vins, long term contracts have so far only been negotiated with major timber processing companies which are mostly controlled by foreign capital and therefore have good payment discipline. The Association of the Timber Processing Industry is unhappy regarding developments and Lesy SR has not invited domestic companies to these negotiations

Imaging windows for long-term intravital imaging: General overview and technical insights.

Science.gov (United States)

Alieva, Maria; Ritsma, Laila; Giedt, Randy J; Weissleder, Ralph; van Rheenen, Jacco

2014-01-01

Intravital microscopy is increasingly used to visualize and quantitate dynamic biological processes at the (sub)cellular level in live animals. By visualizing tissues through imaging windows, individual cells (e.g., cancer, host, or stem cells) can be tracked and studied over a time-span of days to months. Several imaging windows have been developed to access tissues including the brain, superficial fascia, mammary glands, liver, kidney, pancreas, and small intestine among others. Here, we review the development of imaging windows and compare the most commonly used long-term imaging windows for cancer biology: the cranial imaging window, the dorsal skin fold chamber, the mammary imaging window, and the abdominal imaging window. Moreover, we provide technical details, considerations, and trouble-shooting tips on the surgical procedures and microscopy setups for each imaging window and explain different strategies to assure imaging of the same area over multiple imaging sessions. This review aims to be a useful resource for establishing the long-term intravital imaging procedure.

Advancing nursing leadership in long-term care.

Science.gov (United States)

O'Brien, Jennifer; Ringland, Margaret; Wilson, Susan

2010-05-01

Nurses working in the long-term care (LTC) sector face unique workplace stresses, demands and circumstances. Designing approaches to leadership training and other supportive human-resource strategies that reflect the demands of the LTC setting fosters a positive work life for nurses by providing them with the skills and knowledge necessary to lead the care team and to address resident and family issues. Through the St. Joseph's Health Centre Guelph demonstration site project, funded by the Nursing Secretariat of Ontario's Ministry of Health and Long-Term Care, the Excelling as a Nurse Leader in Long Term Care training program and the Mentor Team program were developed to address these needs. Evaluation results show that not only have individual nurses benefitted from taking part in these programs, but also that the positive effects were felt in other parts of the LTC home (as reported by Directors of Care). By creating a generally healthier work environment, it is anticipated that these programs will also have a positive effect on recruitment and retention.

Long-term surveillance plan for the South Clive Disposal Site, Clive, Utah

International Nuclear Information System (INIS)

1996-03-01

This long-term surveillance plan (LTSP) describes the US Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project South Clive disposal site in Clive, Utah. The US Nuclear Regulatory Commission (NRC) has developed regulations for the issuance of a general license for the custody and long-term care of UMTRA Project disposal sites in 10 CRF Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites will be cared for in a manner that protects the public health and safety and the environment. For each disposal site to be licensed, the NRC requires the DOE to submit a site-specific LTSP. The DOE prepared this LTSP to meet this requirement for the South Clive disposal site. The general license becomes effective when the NRC concurs with the DOE's determination of completion of remedial action for the South Clive site and the NRC formally accepts this LTSP. This LTSP describes the long-term surveillance program the DOE will implement to ensure that the South Clive disposal site performs as designed. The program's primary activity is site inspections to identify threats to disposal cell integrity

Long-Term Symbolic Learning

National Research Council Canada - National Science Library

Kennedy, William G; Trafton, J. G

2007-01-01

What are the characteristics of long-term learning? We investigated the characteristics of long-term, symbolic learning using the Soar and ACT-R cognitive architectures running cognitive models of two simple tasks...

Pediatric polytrauma : Short-term and long-term outcomes

NARCIS (Netherlands)

vanderSluis, CK; Kingma, J; Eisma, WH; tenDuis, HJ

Objective: To assess the short-term and long-term outcomes of pediatric polytrauma patients and to analyze the extent to which short-term outcomes can predict long-term outcomes. Materials and Methods: Ail pediatric polytrauma patients (Injury Severity Score of greater than or equal to 16, less than

Structuring Diabetes Mellitus Care in Long-Term Nursing Home Residents

LENUS (Irish Health Repository)

Fitzpatrick, D

2018-03-01

Nursing home residents with diabetes have more complex care needs with higher levels of comorbidity, disability and cognitive impairment. We compared current practice in the 44 long-term residents in Peamount hospital with the standards recommended in the Diabetes UK “Good Clinical Practice Guidelines for Care Home Residents with Diabetes”. Of 44 residents, 11 were diabetic. Residents did not have specific diabetes care plans. There were some elements of good practice with a low incidence of hypoglycaemia and in-house access to dietetics and chiropody. However, diabetes care was delivered on an ad-hoc basis without individualised care plans, documented glycaemic targets, or scheduled monitoring for complications and no formal screening for diabetes on admission. National and local policy to guide management of diabetes mellitus should be developed. There should be individualised diabetes care plans, clear policies for hypoglycaemia, hyperglycaemia and long-term diabetes complications, screening on admission and increased uptake of the national retinal screening and foot care programmes.

Women's experiences of long term sickness absence: implications for rehabilitation practice and theory.

Science.gov (United States)

Ockander, Marlene K; Timpka, Toomas

2003-01-01

In most European countries, spells of long-term absence contribute the largest number of days that are reimbursed as a result of sickness absence. This group is growing and it is constituted mainly of women. The present study seeks further knowledge about what happens then and there, i.e. how women on long-term sickness absence handle and explain, for themselves and others, this interruption in their daily life. Semi-structured interviews were performed with 82 middle-aged women with personal experience of long-term sickness absence. The women's accounts of sickness absence contained interpretations of what had happened to them, how things were at present, and what they thought the future would bring. Three different accounts could be distinguished: crisis, breakpoint, and migration. The perception of their own situation and especially what they thought about their future was associated with their feeling of power to take the initiative, and their well-being. From this study the authors have found implications for central topics of importance: time elapse, sense of coherence, reorientation/adaptation, vital goals, and gender.

Nuclear Energy, Long Term Requirements

International Nuclear Information System (INIS)

Knapp, V.

2006-01-01

There are serious warnings about depletion of oil and gas and even more serious warnings about dangers of climate change caused by emission of carbon dioxide. Should developed countries be called to replace CO2 emitting energy sources as soon as possible, and the time available may not be longer then few decades, can nuclear energy answer the call and what are the requirements? Assuming optimistic contribution of renewable energy sources, can nuclear energy expand to several times present level in order to replace large part of fossil fuels use? Paper considers intermediate and long-term requirements. Future of nuclear power depends on satisfactory answers on several questions. First group of questions are those important for near and intermediate future. They deal with economics and safety of nuclear power stations in the first place. On the same time scale a generally accepted concept for radioactive waste disposal is also required. All these issues are in the focus of present research and development. Safer and more economical reactors are targets of international efforts in Generation IV and INPRO projects, but aiming further ahead these innovative projects are also addressing issues such as waste reduction and proliferation resistance. However, even assuming successful technical development of these projects, and there is no reason to doubt it, long term and large-scale nuclear power use is thereby not yet secured. If nuclear power is to play an essential role in the long-term future energy production and in reduction of CO2 emission, than several additional questions must be replied. These questions will deal with long-term nuclear fuel sufficiency, with necessary contribution of nuclear power in sectors of transport and industrial processes and with nuclear proliferation safety. This last issue is more political then technical, thus sometimes neglected by nuclear engineers, yet it will have essential role for the long-term prospects of nuclear power. The

Long-term surveillance plan for the Gunnison, Colorado disposal site. Revision 2

International Nuclear Information System (INIS)

1997-02-01

This long-term surveillance plan (LTSP) describes the US Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Gunnison disposal site in Gunnison County, Colorado. The US Nuclear Regulatory Commission (NRC) has developed regulations for the issuance of a general license for the custody and long-term care of UMTRA Project disposal sites in 10 CFR Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites will be cared for in a manner that protects the public health and safety and the environment. Before each disposal site is licensed, the NRC requires the DOE to submit a site-specific LTSP. This LTSP describes the long-term surveillance program the DOE will implement to ensure that the Gunnison disposal site performs as designed. The program is based on two distinct activities: (1) site inspections to identify threats to disposal cell integrity, and (2) ground water monitoring to demonstrate disposal cell performance

Brain morphometry shows effects of long-term musical practice in middle-aged keyboard players

Directory of Open Access Journals (Sweden)

Hanna eGärtner

2013-09-01

Full Text Available To what extent does musical practice change the structure of the brain? In order to understand how long-lasting musical training changes brain structure, 20 male right-handed, middle-aged professional musicians and 19 matched controls were investigated. Among the musicians, 13 were pianists or organists with intensive practice regimes. The others were either music teachers at schools or string instrumentalists, who had studied the piano at least as a subsidiary subject, and practiced less intensively. The study was based on T1-weighted MR images, which were analyzed using Deformation Field Morphometry. Cytoarchitectonic probabilistic maps of cortical areas and subcortical nuclei as well as myeloarchitectonic maps of fiber tracts were used as regions of interest to compare volume differences in the brains of musicians and controls. In addition, maps of voxel-wise volume differences were computed and analyzed.Musicians showed a significantly better symmetric motor performance as well as a greater capability of controlling hand independence than controls. Structural MRI-data revealed significant volumetric differences between the brains of keyboard players, who practiced intensively and controls in right sensorimotor areas and the corticospinal tract as well as in the entorhinal cortex and the left superior parietal lobule. Moreover, they showed also larger volumes in a comparable set of regions than the less intensively practicing musicians. The structural changes in the sensory and motor systems correspond well to the behavioral results, and can be interpreted in terms of plasticity as a result of intensive motor training. Areas of the superior parietal lobule and the entorhinal cortex might be enlarged in musicians due to their special skills in sight-playing and memorizing of scores. In conclusion, intensive and specific musical training seems to have an impact on brain structure, not only during the sensitive period of childhood but throughout

Diesel fuel long term storage and treatment- recommended tests and practices (U)

Energy Technology Data Exchange (ETDEWEB)

Gross, R. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2009-06-05

The Clean Air Act (1970) is the comprehensive federal law that regulates air emissions from stationary and mobile sources. Among other things, this law authorized the Environmental Protection Agency (EPA) to establish National Ambient Air Quality Standards to protect public health and public welfare and to regulate emissions of hazardous air pollutants. In recent years, EPA regulations have forced oil refineries into producing a very low sulfur diesel fuel and incentives for adding up to 5% bio-diesel. These changes to the fuel oil formulation are beneficial to air quality and to energy conservation, but adversely impact heat content, long term storage stability, engine power, and injection system reliability. Diesel engines typically have a high incidence of injector failure resulting from poor diesel fuel quality. Since standby diesel engines do not run continuously it is necessary to implement periodic surveillance's to ensure the quality of diesel fuel is acceptable for reliable operation when a loss of power occurs. The information contained in this document is a compilation of best practices to be used as a guide for maintenance of a reliable diesel fuel system.

Self-perceived long-term transfer of learning after postpartum hemorrhage simulation training.

Science.gov (United States)

de Melo, Brena Carvalho Pinto; Rodrigues Falbo, Ana; Sorensen, Jette Led; van Merriënboer, Jeroen J G; van der Vleuten, Cees

2018-05-01

To explore long-term transfer (application of acquired knowledge and skills on the job) after postpartum hemorrhage simulation training based on either instructional design (ID) principles or conventional best practice. In this qualitative study, semi-structured interviews with obstetrics and gynecology healthcare practitioners were conducted between August 7 and September 26, 2015, in Recife, Brazil. The participants were randomly selected from each of two postpartum hemorrhage simulations attended 2 years earlier (one ID and one conventional best practice). Thematic analysis was used to explore (1) residents' perceptions of long-term transfer of learning, (2) ID elements influencing the perceived long-term transfer, and (3) differences in the participants' perceptions according to the type of simulation attended. There were 12 interview participants. After either simulation format, residents perceived long-term transfer effects. Training design factors influencing transfer were, in their opinion, related to trainees' characteristics, simulation design, and workplace environment. Trainees who participated in the ID-based simulation perceived better communication skills and better overall situational awareness: "I didn't do that before." All residents perceived long-term transfer after simulation training for postpartum hemorrhage. Those who attended the ID format additionally perceived improvements in communication skills and situational awareness, which are fundamental factors in the management of postpartum hemorrhage. © 2018 International Federation of Gynecology and Obstetrics.

Uncertainty Assessment in Long Term Urban Drainage Modelling

DEFF Research Database (Denmark)

Thorndahl, Søren

the probability of system failures (defined as either flooding or surcharge of manholes or combined sewer overflow); (2) an application of the Generalized Likelihood Uncertainty Estimation methodology in which an event based stochastic calibration is performed; and (3) long term Monte Carlo simulations...

Longitudinal study of accelerated long-term forgetting in children with genetic generalized epilepsy: Evidence of ongoing deficits.

Science.gov (United States)

Grayson-Collins, Jasmin; Gascoigne, Michael B; Barton, Belinda; Webster, Richard; Gill, Deepak; Lah, Suncica

2017-09-15

Accelerated long-term forgetting (ALF) is a recently described memory disorder characterised by adequate recall after short, but not long delays. Currently, the prevailing conceptualisation of ALF is of a seizure related phenomenon. The main aim of this study was to assess whether ALF subsides as epilepsy severity and seizures abate in children with genetic generalized epilepsy (GGE). Eighteen children with GGE were compared over time to 29 healthy controls on a range of cognitive measures. The primary outcome was a modified version of the California Verbal Learning Test for Children with a long delay (seven day) recall component. At approximately two years follow up, ALF was apparent, although epilepsy severity subsided and seizures resolved in many children. This result contrasts with the dominant conceptualisation of ALF being a seizure related phenomenon. Moreover, at follow-up, worse recall at the long delay was related to greater epilepsy severity at baseline and earlier age of seizure onset, but not to being seizure free at follow-up. While at follow-up worse recall at the long delay related to the worse baseline recall at the long delay, this recall did not relate to scores obtained on standardised memory tests at baseline. Our study suggests that ALF may not be seizure related and identifies factors associated with risk of ALF in children with GGE. Copyright © 2017 Elsevier Ltd. All rights reserved.

PSA modeling of long-term accident sequences

International Nuclear Information System (INIS)

Georgescu, Gabriel; Corenwinder, Francois; Lanore, Jeanne-Marie

2014-01-01

In the context of the extension of PSA scope to include external hazards, in France, both operator (EDF) and IRSN work for the improvement of methods to better take into account in the PSA the accident sequences induced by initiators which affect a whole site containing several nuclear units (reactors, fuel pools,...). These methodological improvements represent an essential prerequisite for the development of external hazards PSA. However, it has to be noted that in French PSA, even before Fukushima, long term accident sequences were taken into account: many insight were therefore used, as complementary information, to enhance the safety level of the plants. IRSN proposed an external events PSA development program. One of the first steps of the program is the development of methods to model in the PSA the long term accident sequences, based on the experience gained. At short term IRSN intends to enhance the modeling of the 'long term' accident sequences induced by the loss of the heat sink or/and the loss of external power supply. The experience gained by IRSN and EDF from the development of several probabilistic studies treating long term accident sequences shows that the simple extension of the mission time of the mitigation systems from 24 hours to longer times is not sufficient to realistically quantify the risk and to obtain a correct ranking of the risk contributions and that treatment of recoveries is also necessary. IRSN intends to develop a generic study which can be used as a general methodology for the assessment of the long term accident sequences, mainly generated by external hazards and their combinations. This first attempt to develop this generic study allowed identifying some aspects, which may be hazard (or combinations of hazards) or related to initial boundary conditions, which should be taken into account for further developments. (authors)

Long-term impact of sales promotion on brand image

Directory of Open Access Journals (Sweden)

Danijela Mandić

2009-12-01

Full Text Available Sales promotion (SP is an inevitable tool in the marketing communications mix, especially in the FMCG markets, due to pressures such as retailers’ growing demands and increasing competition. This has proven to be an issue for many companies, especially those with a premium brand positioning and those concerned about the impact that SP might have on the long-term image of the company. Despite the fact that literature is replete with research on SP, it seems to be vastly generalized and mostly focused on price reductions. Thus, this paper aims to analyze and discuss the issue of the long-term impact that SP has on companies, especially on premium brands in the FMCG markets. It concludes that, when used properly and strategically, SP may have a positive long-term impact on brands.

Turnover of regulated nurses in long-term care facilities.

Science.gov (United States)

Chu, Charlene H; Wodchis, Walter P; McGilton, Katherine S

2014-07-01

To describe the relationship between nursing staff turnover in long-term care (LTC) homes and organisational factors consisting of leadership practices and behaviours, supervisory support, burnout, job satisfaction and work environment satisfaction. The turnover of regulated nursing staff [Registered Nurses (RNs) and Registered Practical Nurses (RPNs)] in LTC facilities is a pervasive problem, but there is a scarcity of research examining this issue in Canada. The study was conceptualized using a Stress Process model. Distinct surveys were distributed to administrators to measure organisational factors and to regulated nurses to measure personal and job-related sources of stress and workplace support. In total, 324 surveys were used in the linear regression analysis to examine factors associated with high turnover rates. Higher leadership practice scores were associated with lower nursing turnover; a one score increase in leadership correlated with a 49% decrease in nursing turnover. A significant inverse relationship between leadership turnover and nurse turnover was found: the higher the administrator turnover the lower the nurse turnover rate. Leadership practices and administrator turnover are significant in influencing regulated nurse turnover in LTC. Long-term care facilities may want to focus on building good leadership and communication as an upstream method to minimize nurse turnover. © 2013 John Wiley & Sons Ltd.

The roles of long-term phonotactic and lexical prosodic knowledge in phonological short-term memory.

Science.gov (United States)

Tanida, Yuki; Ueno, Taiji; Lambon Ralph, Matthew A; Saito, Satoru

2015-04-01

Many previous studies have explored and confirmed the influence of long-term phonological representations on phonological short-term memory. In most investigations, phonological effects have been explored with respect to phonotactic constraints or frequency. If interaction between long-term memory and phonological short-term memory is a generalized principle, then other phonological characteristics-that is, suprasegmental aspects of phonology-should also exert similar effects on phonological short-term memory. We explored this hypothesis through three immediate serial-recall experiments that manipulated Japanese nonwords with respect to lexical prosody (pitch-accent type, reflecting suprasegmental characteristics) as well as phonotactic frequency (reflecting segmental characteristics). The results showed that phonotactic frequency affected the retention not only of the phonemic sequences, but also of pitch-accent patterns, when participants were instructed to recall both the phoneme sequence and accent pattern of nonwords. In addition, accent pattern typicality influenced the retention of the accent pattern: Typical accent patterns were recalled more accurately than atypical ones. These results indicate that both long-term phonotactic and lexical prosodic knowledge contribute to phonological short-term memory performance.

Near-Term Actions to Address Long-Term Climate Risk

Science.gov (United States)

Lempert, R. J.

2014-12-01

Addressing climate change requires effective long-term policy making, which occurs when reflecting on potential events decades or more in the future causes policy makers to choose near-term actions different than those they would otherwise pursue. Contrary to some expectations, policy makers do sometimes make such long-term decisions, but not as commonly and successfully as climate change may require. In recent years however, the new capabilities of analytic decision support tools, combined with improved understanding of cognitive and organizational behaviors, has significantly improved the methods available for organizations to manage longer-term climate risks. In particular, these tools allow decision makers to understand what near-term actions consistently contribute to achieving both short- and long-term societal goals, even in the face of deep uncertainty regarding the long-term future. This talk will describe applications of these approaches for infrastructure, water, and flood risk management planning, as well as studies of how near-term choices about policy architectures can affect long-term greenhouse gas emission reduction pathways.

Listening to old beech and young cherry trees - long-term research in the Alleghenies

Science.gov (United States)

Susan L. Stout; Coeli M. Hoover; Todd E. Ristau

2006-01-01

Long-term research results have been a foundation of forestry practice on the Allegheny Plateau since the 1970s. This includes results from monitoring reference conditions in areas set aside for this purpose and from long-running manipulative studies, some dating back to the 1920s. The success of long-term research in this region reflects the commitment of a handful of...

Mechanisms of translation control underlying long-lasting synaptic plasticity and the consolidation of long-term memory.

Science.gov (United States)

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

2014-01-01

The complexity of memory formation and its persistence is a phenomenon that has been studied intensely for centuries. Memory exists in many forms and is stored in various brain regions. Generally speaking, memories are reorganized into broadly distributed cortical networks over time through systems level consolidation. At the cellular level, storage of information is believed to initially occur via altered synaptic strength by processes such as long-term potentiation. New protein synthesis is required for long-lasting synaptic plasticity as well as for the formation of long-term memory. The mammalian target of rapamycin complex 1 (mTORC1) is a critical regulator of cap-dependent protein synthesis and is required for numerous forms of long-lasting synaptic plasticity and long-term memory. As such, the study of mTORC1 and protein factors that control translation initiation and elongation has enhanced our understanding of how the process of protein synthesis is regulated during memory formation. Herein we discuss the molecular mechanisms that regulate protein synthesis as well as pharmacological and genetic manipulations that demonstrate the requirement for proper translational control in long-lasting synaptic plasticity and long-term memory formation. © 2014 Elsevier Inc. All rights reserved.

Long Term Financing of Infrastructure

OpenAIRE

Sinha, Sidharth

2014-01-01

Infrastructure projects, given their long life, require long term financing. The main sources of long term financings are insurance and pension funds who seek long term investments with low credit risk. However, in India household financial savings are mainly invested in bank deposits. Insurance and pension funds account for only a small percentage of household financial savings. In addition most infrastructure projects do not qualify for investment by insurance and pension funds because of t...

Long-term meditation is associated with increased gray matter density in the brain stem

DEFF Research Database (Denmark)

Vestergaard-Poulsen, Peter; Beek, Martijn van; Skewes, Joshua

2009-01-01

density in lower brain stem regions of experienced meditators compared with age-matched nonmeditators. Our findings show that long-term practitioners of meditation have structural differences in brainstem regions concerned with cardiorespiratory control. This could account for some......Extensive practice involving sustained attention can lead to changes in brain structure. Here, we report evidence of structural differences in the lower brainstem of participants engaged in the long-term practice of meditation. Using magnetic resonance imaging, we observed higher gray matter...

Long-term surveillance plan for the Mexican Hat Disposal Site, Mexican Hat, Utah

International Nuclear Information System (INIS)

1996-02-01

This plan describes the long-term surveillance activities for the Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site at Mexican Hat, Utah. The U.S. Department of Energy (DOE) will carry out these activities to ensure that the disposal site continues to function as designed. This long-term surveillance plan (LTSP) was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive material (RRM). This LTSP (based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program), documents the land ownership interests and details how the long-term care of the disposal site will be accomplished

[The Development of Long-Term Care Policies and the Impact on Nursing].

Science.gov (United States)

Wu, Shiao-Chi; Tsai, Yin-Yin; Yeh, Shin-Ting

2015-10-01

The government must reform and enhance current medical and long-term care services in order to respond effectively to societal ageing and labor shortage trends and to ensure sustainable operations. The post-acute care system should be reoriented on the home and community instead of the hospital. The Long Term Care Service Act integrates long-term care services that were previously dispersed amongst different departments, sets up a long-term care development fund, and improves the quality and allocation of long-term care services. Moreover, the Long Term Care Insurance Act will implement a bundle payment system to assist disabled families. The integration of automation and information technology will make long-term care more efficient. Although nurses are more skilled at elderly care and counseling than other community care professionals, nurses generally lack training in business management. Home and community-based services thus require better-trained manpower, opportunities to set care agents, and opportunities to offer flexible caring jobs. Therefore, nurses should strengthen their capabilities in post-acute care, business management, cooperation, and coordination.

Long-term surveillance plan for the Ambrosia Lake, New Mexico disposal site

International Nuclear Information System (INIS)

1995-11-01

This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Ambrosia Lake disposal site in McKinley County, New Mexico, describes the US Department of Energy's (DOE) long-term care program for the disposal site. The DOE will carry out this program to ensure that the disposal cell continues to function as designed. This LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials

Development and validation of a prediction model for long-term sickness absence based on occupational health survey variables.

Science.gov (United States)

Roelen, Corné; Thorsen, Sannie; Heymans, Martijn; Twisk, Jos; Bültmann, Ute; Bjørner, Jakob

2018-01-01

The purpose of this study is to develop and validate a prediction model for identifying employees at increased risk of long-term sickness absence (LTSA), by using variables commonly measured in occupational health surveys. Based on the literature, 15 predictor variables were retrieved from the DAnish National working Environment Survey (DANES) and included in a model predicting incident LTSA (≥4 consecutive weeks) during 1-year follow-up in a sample of 4000 DANES participants. The 15-predictor model was reduced by backward stepwise statistical techniques and then validated in a sample of 2524 DANES participants, not included in the development sample. Identification of employees at increased LTSA risk was investigated by receiver operating characteristic (ROC) analysis; the area-under-the-ROC-curve (AUC) reflected discrimination between employees with and without LTSA during follow-up. The 15-predictor model was reduced to a 9-predictor model including age, gender, education, self-rated health, mental health, prior LTSA, work ability, emotional job demands, and recognition by the management. Discrimination by the 9-predictor model was significant (AUC = 0.68; 95% CI 0.61-0.76), but not practically useful. A prediction model based on occupational health survey variables identified employees with an increased LTSA risk, but should be further developed into a practically useful tool to predict the risk of LTSA in the general working population. Implications for rehabilitation Long-term sickness absence risk predictions would enable healthcare providers to refer high-risk employees to rehabilitation programs aimed at preventing or reducing work disability. A prediction model based on health survey variables discriminates between employees at high and low risk of long-term sickness absence, but discrimination was not practically useful. Health survey variables provide insufficient information to determine long-term sickness absence risk profiles. There is a need for

A Demography and Taxonomy of Long-term Immigration Detention in Australia

Directory of Open Access Journals (Sweden)

Melissa Bull

2013-04-01

Full Text Available The practice of long-term immigration detention is a relatively recent aspect of Australian Government policy. There has been much debate about the wisdom of such policy, raising concerns regarding the health of detainees, the dereliction of human rights, and the legal robustness of such practice. Despite considerable interest, little detail is available describing who is being held and the reasons for their long-term detention. This paper addresses this noticeable gap through a systematic analysis of the Commonwealth Ombudsman’s Immigration Reports over the period 2005 through 2009. From such reporting it has been possible to produce a demographic profile of people held in Australian detention and to develop a taxonomy of the reasons contributing to the ongoing containment.

Long-term surveillance plan for the Cheney disposal site near Grand Junction, Colorado

International Nuclear Information System (INIS)

1997-04-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Cheney disposal site. The site is in Mesa County near Grand Junction, Colorado. The U.S. Nuclear Regulatory Commission (NRC) has developed regulations for the issuance of a general license for the custody and long-term care of UMTRA Project disposal sites in 10 CFR Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites are cared for in a manner that protects public health and safety and the environment. Before each disposal site may be licensed, the NRC requires the DOE to submit a site-specific LTSP. The DOE prepared this LTSP to meet this requirement for the Cheney disposal site. The general license becomes effective when the NRC concurs with the DOE's determination that remedial action is complete and the NRC formally accepts this plan. This document describes the long-term surveillance program the DOE will implement to ensure that the Cheney disposal site performs as designed. The program is based on site inspections to identify potential threats to disposal cell integrity. The LTSP is based on the UMTRA Project long-term surveillance program guidance and meets the requirements of 10 CFR section 40.27(b) and 40 CFR section 192.03

Testing the generalized complementary relationship of evaporation with continental-scale long-term water-balance data

Science.gov (United States)

Szilagyi, Jozsef; Crago, Richard; Qualls, Russell J.

2016-09-01

The original and revised versions of the generalized complementary relationship (GCR) of evaporation (ET) were tested with six-digit Hydrologic Unit Code (HUC6) level long-term (1981-2010) water-balance data (sample size of 334). The two versions of the GCR were calibrated with Parameter-Elevation Regressions on Independent Slopes Model (PRISM) mean annual precipitation (P) data and validated against water-balance ET (ETwb) as the difference of mean annual HUC6-averaged P and United States Geological Survey HUC6 runoff (Q) rates. The original GCR overestimates P in about 18% of the PRISM grid points covering the contiguous United States in contrast with 12% of the revised version. With HUC6-averaged data the original version has a bias of -25 mm yr-1 vs the revised version's -17 mm yr-1, and it tends to more significantly underestimate ETwb at high values than the revised one (slope of the best fit line is 0.78 vs 0.91). At the same time it slightly outperforms the revised version in terms of the linear correlation coefficient (0.94 vs 0.93) and the root-mean-square error (90 vs 92 mm yr-1).

SOIL AGROCHEMICAL PROPERTIES IMPROVEMENT IN LONG TERM FIELD EXPERIMENT WITH FERTILIZERS

Directory of Open Access Journals (Sweden)

Mihaela Lungu

2005-10-01

Full Text Available Soil fertility is studied in long-term field experiments. Researches are carried out in several agricultural research stations, out of which the following have been chosen for the present paper: Albic Luvisol* at Albota; Haplic Phaeozem at Fundulea; Chromic Luvisol at Şimnic; Calcic Chernozem at Secuieni; and Haplic Chernozem at Podu Iloaiei. Long term fertilization with nitrogen and phosphorus generally improved the soil agrochemical properties. The evolution of organic matter, nitrogen, mobile phosphorus and potassium, and mobile microelements contents were studied, using the standardized method used in the ICPA laboratories. The organic matter and total nitrogen contents didn’t change significantly under the nitrogen and phosphorus long-term fertilization influence. The mobile phosphorus contents have the tendency to grow very significantly with the growth of phosphorus fertilizers. At the same time, slight depletions of these contents are registered as the high nitrogen doses from fertilizers stimulate plant growth and, obviously, nutritive elements absorption. Mobile potassium contents changes very little, with insignificant differences. Significant depletions are registered only with high fertilizers doses, due to the stimulation of the nutritive elements absorption in plants. Microelements contents don’t change almost at all. They are within the normal content limits and no excess or deficiency was registered, in any of the studied stations. For the agricultural practice, economical studies are recommended, about how high fertilizing expenses are covered by the yield growth. Not the least, production quality study in different variants of mineral fertilization could prove interesting.

Long term stability of power systems

Energy Technology Data Exchange (ETDEWEB)

Kundur, P; Gao, B [Powertech Labs. Inc., Surrey, BC (Canada)

1994-12-31

Power system long term stability is still a developing subject. In this paper we provide our perspectives and experiences related to long term stability. The paper begins with the description of the nature of the long term stability problem, followed by the discussion of issues related to the modeling and solution techniques of tools for long term stability analysis. Cases studies are presented to illustrate the voltage stability aspect and plant dynamics aspect of long term stability. (author) 20 refs., 11 figs.

Child maltreatment: pathway to chronic and long-term conditions?

Science.gov (United States)

Taylor, Julie; Bradbury-Jones, Caroline; Lazenbatt, Anne; Soliman, Francesca

2016-09-01

The manifesto Start Well, Live Better by the UK Faculty of Public Health (Start Well, Live Better-A Manifesto for the Public's Health. London: UK Faculty of Public Health, 2014) sets out 12 compelling priorities for the protection of people's health. The focus of this document is preventative, calling for a comprehensive strategy to target a wide-ranging set of challenges to public health; however, it fails to mention child maltreatment and its negative impact on long-term health outcomes. In this article, we explore the long-term negative consequences of child maltreatment and how these can be conceptually aligned with four different characteristics of long-term health conditions. We suggest that situating child maltreatment within a long-term conditions framework could have significant advantages and implications for practice, policy and research, by strengthening a commitment across disciplines to apply evidence-based principles linked with policy and evaluation and recognizing the chronic effects of maltreatment to concentrate public, professional and government awareness of the extent and impact of the issue. We argue that a public health approach is the most effective way of focusing preventative efforts on the long-term sequelae of child maltreatment and to foster cooperation in promoting children's rights to grow and develop in a safe and caring environment free from violence and abuse. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Long term assurance of supply of heavy water

International Nuclear Information System (INIS)

1978-01-01

The answer of Switzerland and Great Britain to a number of questions concerning the long-term assurance of the supply of heavy water are presented. The original problems are seen in the wider context of raw materials supply and its assurance in general. Non-proliferation aspects are touched

Long-term surveillance plan for the Mexican Hat disposal site, Mexican Hat, Utah

International Nuclear Information System (INIS)

1996-01-01

This plan describes the long-term surveillance activities for the Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site at Mexican Hat, Utah. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal site continues to function as designed. This long-term surveillance plan (LTSP) was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive material (RRM). This LTSPC documents the land ownership interests and details how the long-term care of the disposal site will be accomplished

Perspective of long term demand and supply of energy and general inspection of energy policy

International Nuclear Information System (INIS)

1983-01-01

Since the oil crisis, Japanese energy policy was promoted to get rid of the excess dependence on petroleum and to attain energy security, but energy situation largely changed during the past ten years, and it has become necessary to make general inspection on the long term demand and supply of energy and the energy policy. After the second oil crisis, the worldwide demand of petroleum decreased drastically due to the rapid price rise, and the base price of crude oil was lowered for the first time. It is necessary to positively endeavor to reduce energy cost with new idea. The points of the general inspection are the correspondence of the energy policy to the large structural change of energy, the most desirable system for attaining the optimum structure of energy demand and supply and the utilization of market mechanism as far as possible. This report is the results of discussion held eight times since April, 1983. The change of energy situation in Japan and abroad and the perspective, the new problems in energy countermeasures and the trend of response, the preferential and effective promotion of general energy countermeasures and so on are reported. This report shows the fundamental direction of energy countermeasures hereafter, and the concrete and special examination must be made on many remaining problems. (Kako, I.)

The long-term psychiatric and medical prognosis of perinatal mental illness.

Science.gov (United States)

Meltzer-Brody, Samantha; Stuebe, Alison

2014-01-01

The perinatal period provides an important window into a woman's long-term health. Perinatal mental illness is a common condition conferring potential serious long-term psychiatric and medical consequences for the mother and family. It is known that childbirth acts as a powerful trigger for depressive episodes in some women, and that women with histories of a mood disorder are particularly vulnerable. Some evidence links perinatal mental illness with obstetrical complications and reduced lactation initiation and duration. Therefore, perinatal mental illness may be a marker for long-term risk, and may contribute directly to subsequent cardiometabolic disease through both neuroendocrine mechanisms and the effects of mental illness on health behaviours. In clinical practice, these associations underscore the importance of screening and treating women with perinatal mental illness to ensure best possible long-term outcomes. Early screening and treatment may both mitigate the primary disease process and reduce the risk of comorbid medical conditions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Establishing Long Term Data Management Research Priorities via a Data Decadal Survey

Science.gov (United States)

Wilson, A.; Uhlir, P.; Meyer, C. B.; Robinson, E.

2013-12-01

We live in a time of unprecedented collection of and access to scientific data. Improvements in sensor technologies and modeling capabilities are constantly producing new data sources. Data sets are being used for unexpected purposes far from their point of origin, as research spans projects, discipline domains, and temporal and geographic boundaries. The nature of science is evolving, with more open science, open publications, and changes to the nature of peer review and data "publication". Data-intensive, or computational science, has been identified as a new research paradigm. There is recognition that the creation of a data set can be a contribution to science deserving of recognition comparable to other scientific publications. Federally funded projects are generally expected to make their data open and accessible to everyone. In this dynamic environment, scientific progress is ever more dependent on good data management practices and policies. Yet current data management and stewardship practices are insufficient. Data sets created at great, and often public, expense are at risk of being lost for technological or organizational reasons. Insufficient documentation and understanding of data can mean that the data are used incorrectly or not at all. Scientific results are being scrutinized and questioned, and occasionally retracted due to problems in data management. The volume of data is greatly increasing while funding for data management is meager and generally must be found within existing budgets. Many federal government agencies, including NASA, USGS, NOAA and NSF are already making efforts to address data management issues. Executive memos and directives give substantial impetus to those efforts, such as the May 9 Executive Order directing agencies to implement Open Data Policy requirements and regularly report their progress. However, these distributed efforts risk duplicating effort, lack a unifying, long-term strategic vision, and too often work in

Long-term surveillance plan for the Ambrosia Lake, New Mexico disposal site

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-07-01

This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Ambrosia Lake disposal site in McKinley County, New Mexico, describes the U.S. Department of Energy`s (DOE) long-term care program for the disposal site. The DOE will carry out this program to ensure that the disposal cell continues to function as designed. This LTSP was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials.

Long-term surveillance plan for the Ambrosia Lake, New Mexico disposal site

International Nuclear Information System (INIS)

1996-07-01

This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Ambrosia Lake disposal site in McKinley County, New Mexico, describes the U.S. Department of Energy's (DOE) long-term care program for the disposal site. The DOE will carry out this program to ensure that the disposal cell continues to function as designed. This LTSP was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials

Long-term meditation is associated with increased gray matter density in the brain stem

DEFF Research Database (Denmark)

Vestergaard-Poulsen, Peter; Beek, Martijn van; Skewes, Joshua

2009-01-01

Extensive practice involving sustained attention can lead to changes in brain structure. Here, we report evidence of structural differences in the lower brainstem of participants engaged in the long-term practice of meditation. Using magnetic resonance imaging, we observed higher gray matter...... density in lower brain stem regions of experienced meditators compared with age-matched nonmeditators. Our findings show that long-term practitioners of meditation have structural differences in brainstem regions concerned with cardiorespiratory control. This could account for some...... of the cardiorespiratory parasympathetic effects and traits, as well as the cognitive, emotional, and immunoreactive impact reported in several studies of different meditation practices....

Emulation of long-term changes in global climate: Application to the late Pliocene and future

KAUST Repository

Lord, Natalie S.

2017-04-26

Multi-millennial transient simulations of climate changes have a range of important applications, such as for investigating key geologic events and transitions for which high-resolution palaeoenvironmental proxy data are available, or for projecting the long-term impacts of future climate evolution on the performance of geological repositories for the disposal of radioactive wastes. However, due to the high computational requirements of current fully coupled general circulation models (GCMs), long-term simulations can generally only be performed with less complex models and/or at lower spatial resolution. In this study, we present novel long-term

Emulation of long-term changes in global climate: application to the late Pliocene and future

KAUST Repository

Lord, Natalie S.

2017-11-16

Multi-millennial transient simulations of climate changes have a range of important applications, such as for investigating key geologic events and transitions for which high-resolution palaeoenvironmental proxy data are available, or for projecting the long-term impacts of future climate evolution on the performance of geological repositories for the disposal of radioactive wastes. However, due to the high computational requirements of current fully coupled general circulation models (GCMs), long-term simulations can generally only be performed with less complex models and/or at lower spatial resolution. In this study, we present novel long-term

Emulation of long-term changes in global climate: application to the late Pliocene and future

KAUST Repository

Lord, Natalie S.; Crucifix, Michel; Lunt, Dan J.; Thorne, Mike C.; Bounceur, Nabila; Dowsett, Harry; O& apos; Brien, Charlotte L.; Ridgwell, Andy

2017-01-01

Multi-millennial transient simulations of climate changes have a range of important applications, such as for investigating key geologic events and transitions for which high-resolution palaeoenvironmental proxy data are available, or for projecting the long-term impacts of future climate evolution on the performance of geological repositories for the disposal of radioactive wastes. However, due to the high computational requirements of current fully coupled general circulation models (GCMs), long-term simulations can generally only be performed with less complex models and/or at lower spatial resolution. In this study, we present novel long-term

Emulation of long-term changes in global climate: Application to the late Pliocene and future

KAUST Repository

Lord, Natalie S.; Crucifix, Michel; Lunt, Dan J.; Thorne, Mike C.; Bounceur, Nabila; Dowsett, Harry; O& apos; Brien, Charlotte L.; Ridgwell, Andy

2017-01-01

Multi-millennial transient simulations of climate changes have a range of important applications, such as for investigating key geologic events and transitions for which high-resolution palaeoenvironmental proxy data are available, or for projecting the long-term impacts of future climate evolution on the performance of geological repositories for the disposal of radioactive wastes. However, due to the high computational requirements of current fully coupled general circulation models (GCMs), long-term simulations can generally only be performed with less complex models and/or at lower spatial resolution. In this study, we present novel long-term

Long-term personality data collection in support of spaceflight and analogue research.

Science.gov (United States)

Musson, David M; Helmreich, Robert L

2005-06-01

This is a review of past and present research into personality and performance at the University of Texas (UT) Human Factors Research Project. Specifically, personality trait data collected from astronauts, pilots, Antarctic personnel, and other groups over a 15-yr period is discussed with particular emphasis on research in space and space analogue environments. The UT Human Factors Research Project conducts studies in personality and group dynamics in aviation, space, and medicine. Current studies include personality determinants of professional cultures, team effectiveness in both medicine and aviation, and personality predictors of long-term astronaut performance. The Project also studies the design and effectiveness of behavioral strategies used to minimize error and maximize team performance in safety-critical work settings. A multi-year personality and performance dataset presents many opportunities for research, including long-term and follow-up studies of human performance, analyses of trends in recruiting and attrition, and the ability to adapt research design to operational changes and methodological advances. Special problems posed by such long-duration projects include issues of confidentiality and security, as well as practical limitations imposed by current peer-review and short-term funding practices. Practical considerations for ongoing dataset management include consistency of assessment instruments over time, variations in data acquisition from one year to the next, and dealing with changes in theory and practice that occur over the life of the project. A fundamental change in how research into human performance is funded would be required to ensure the ongoing development of such long-duration research databases.

Long term plan of atomic energy development and utilization

International Nuclear Information System (INIS)

1982-01-01

The atomic energy utilization and development in Japan have progressed remarkably, and already nuclear power generation has borne an important part in electric power supply, while radiation has been utilized in the fields of industry, agriculture, medicine and so on. Now, atomic energy is indispensable for national life and industrial activity. The former long term plan was decided in September, 1978, and the new long term plan should be established since the situation has changed largely. The energy substituting for petroleum has been demanded, and the expectation to nuclear power generation has heightened because it enables stable and economical power supply. The independently developed technology related to atomic energy must be put in practical use. The peaceful utilization of atomic energy must be promoted, while contributing to the nuclear non-proliferation policy. The Atomic Energy Commission of Japan decided the new long term plan to clearly show the outline of the important measures related to atomic energy development and utilization in 10 years hereafter, and the method of its promotion. The basic concept of atomic energy development and utilization, the long term prospect and the concept on the promotion, the method of promoting the development and utilization, and the problems of funds, engineers and location are described. (kako, I.)

Introduction: Long term prediction

International Nuclear Information System (INIS)

Beranger, G.

2003-01-01

Making a decision upon the right choice of a material appropriate to a given application should be based on taking into account several parameters as follows: cost, standards, regulations, safety, recycling, chemical properties, supplying, transformation, forming, assembly, mechanical and physical properties as well as the behaviour in practical conditions. Data taken from a private communication (J.H.Davidson) are reproduced presenting the life time range of materials from a couple of minutes to half a million hours corresponding to applications from missile technology up to high-temperature nuclear reactors or steam turbines. In the case of deep storage of nuclear waste the time required is completely different from these values since we have to ensure the integrity of the storage system for several thousand years. The vitrified nuclear wastes should be stored in metallic canisters made of iron and carbon steels, stainless steels, copper and copper alloys, nickel alloys or titanium alloys. Some of these materials are passivating metals, i.e. they develop a thin protective film, 2 or 3 nm thick - the so-called passive films. These films prevent general corrosion of the metal in a large range of chemical condition of the environment. In some specific condition, localized corrosion such as the phenomenon of pitting, occurs. Consequently, it is absolutely necessary to determine these chemical condition and their stability in time to understand the behavior of a given material. In other words the corrosion system is constituted by the complex material/surface/medium. For high level nuclear wastes the main features for resolving problem are concerned with: geological disposal; deep storage in clay; waste metallic canister; backfill mixture (clay-gypsum) or concrete; long term behavior; data needed for modelling and for predicting; choice of appropriate solution among several metallic candidates. The analysis of the complex material/surface/medium is of great importance

General practice registrars' views on maternity care in general practice in New Zealand.

Science.gov (United States)

Preston, Hanna; Jaye, Chrystal; Miller, Dawn L

2015-12-01

The number of general practitioners (GPs) providing maternity care in New Zealand has declined dramatically since legislative changes of the 1990s. The Ministry of Health wants GPs to provide maternity care again. To investigate New Zealand general practice registrars' perspectives on GPs' role in maternity care; specifically, whether maternity services should be provided by GPs, registrars' preparedness to provide such services, and training opportunities available or required to achieve this. An anonymous online questionnaire was distributed to all registrars enrolled in The Royal New Zealand College of General Practitioners' (RNZCGP's) General Practice Education Programme (GPEP) in 2012, via their online learning platform OWL. 165 of the 643 general practice registrars responded (25.7% response rate). Most (95%) believe that GPs interested and trained in maternity care should consider providing antenatal, postnatal or shared care with midwives, and 95% believe women should be able to access maternity care from their general practice. When practising as a GP, 90% would consider providing antenatal and postnatal care, 47.3% shared care, and 4.3% full pregnancy care. Professional factors including training and adequate funding were most important when considering providing maternity care as a GP. Ninety-five percent of general practice registrars who responded to our survey believe that GPs should provide some maternity services, and about 90% would consider providing maternity care in their future practice. Addressing professional issues of training, support and funding are essential if more GPs are to participate in maternity care in New Zealand.

Guidance for disposal of uranium-mill tailings: long-term stabilization of earthen cover materials

International Nuclear Information System (INIS)

Voorhees, L.D.; Sale, M.J.; Webb, J.W.; Mulholland, P.J.

1983-06-01

The primary hazard associated with uranium-mill tailings is exposure to a radioactive gas, 222 Rn, the concentration of which has been correlated with the occurrence of lung cancer. Previous studies on radon attenuation conclude that the placement of earthen cover materials over the tailings is the most effective technique for reducing radioactive emissions and dispersal of tailings. The success of such a plan, however, depends on long-term protection of these cover materials. 230 Th, which decays to 222 Rn, has a half-life of about 80,000 years. The three major options available for stabilization of uranium-mill tailings are (1) rock cover, (2) soil and revegetation, or (3) a combination of both on different portions of the tailings cover. The optimal choice among these alternatives depends on site-specific characteristics such as climate and local geomorphology and soils, and on design variables such as embankment heights and slopes, modification of upstream drainage, and revegetation practices. Generally, geomorphic evidence suggests that use of soil and vegetation alone will not be adequate to reduce erosion on slopes greater than about 5 0 . For these steeper slopes, riprap will be necessary to maximize the probability of long-term stability. The use of vegetation to control erosion on the flatter portions of the site may be practicable in regions with sufficient rainfall and suitable soil types, but revegetation practices must be carefully evaluated

Long-term surveillance plan for the Shiprock disposal site, Shiprock, New Mexico

International Nuclear Information System (INIS)

1993-12-01

The long-term surveillance plan (LTSP) for the Shiprock, New Mexico, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Shiprock disposal cell. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP is being submitted to the US Nuclear Regulatory Commission (NRC) as a requirement for issuance of a general license for custody and long-term care for the disposal site. The general license requires that the disposal cell be cared for in accordance with the provisions of this LTSP. This Shiprock, New Mexico, LTSP documents whether the land and interests are owned by the US or an Indian tribe and describes in detail the long-term care program through the UMTRA Project Office

Long-term surveillance plan for the Green River, Utah, disposal site

International Nuclear Information System (INIS)

1997-06-01

The long-term surveillance plan (LTSP) for the Green River, Utah, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Green River disposal cell. The U.S. Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). This LTSP documents whether the land and interests are owned by the United States or an Indian tribe and details how the long-term care of the disposal site will be carried out. The Green River, Utah, LTSP is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a)

Improving long-term care provision: towards demand-based care by means of modularity

Directory of Open Access Journals (Sweden)

Meijboom Bert

2010-09-01

Full Text Available Abstract Background As in most fields of health care, societal and political changes encourage suppliers of long-term care to put their clients at the center of care and service provision and become more responsive towards client needs and requirements. However, the diverse, multiple and dynamic nature of demand for long-term care complicates the movement towards demand-based care provision. This paper aims to advance long-term care practice and, to that end, examines the application of modularity. This concept is recognized in a wide range of product and service settings for its ability to design demand-based products and processes. Methods Starting from the basic dimensions of modularity, we use qualitative research to explore the use and application of modularity principles in the current working practices and processes of four organizations in the field of long-term care for the elderly. In-depth semi-structured interviews were conducted with 38 key informants and triangulated with document research and observation. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software. Results Our data suggest that a modular setup of supply is employed in the arrangement of care and service supply and assists providers of long-term care in providing their clients with choice options and variation. In addition, modularization of the needs assessment and package specification process allows the case organizations to manage client involvement but still provide customized packages of care and services. Conclusion The adequate setup of an organization's supply and its specification phase activities are indispensible for long-term care providers who aim to do better in terms of quality and efficiency. Moreover, long-term care providers could benefit from joint provision of care and services by means of modular working teams. Based upon our findings, we are able to

Improving long-term care provision: towards demand-based care by means of modularity

Science.gov (United States)

2010-01-01

Background As in most fields of health care, societal and political changes encourage suppliers of long-term care to put their clients at the center of care and service provision and become more responsive towards client needs and requirements. However, the diverse, multiple and dynamic nature of demand for long-term care complicates the movement towards demand-based care provision. This paper aims to advance long-term care practice and, to that end, examines the application of modularity. This concept is recognized in a wide range of product and service settings for its ability to design demand-based products and processes. Methods Starting from the basic dimensions of modularity, we use qualitative research to explore the use and application of modularity principles in the current working practices and processes of four organizations in the field of long-term care for the elderly. In-depth semi-structured interviews were conducted with 38 key informants and triangulated with document research and observation. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software. Results Our data suggest that a modular setup of supply is employed in the arrangement of care and service supply and assists providers of long-term care in providing their clients with choice options and variation. In addition, modularization of the needs assessment and package specification process allows the case organizations to manage client involvement but still provide customized packages of care and services. Conclusion The adequate setup of an organization's supply and its specification phase activities are indispensible for long-term care providers who aim to do better in terms of quality and efficiency. Moreover, long-term care providers could benefit from joint provision of care and services by means of modular working teams. Based upon our findings, we are able to elaborate on how to further

Relating long-term studies to conservation practice: the case of the Serengeti Cheetah Project.

Science.gov (United States)

Durant, Sarah M; Bashir, Sultana; Maddox, Thomas; Laurenson, M Karen

2007-06-01

Although detailed, long-term scientific studies provide potentially crucial information for conservation, they are rare. Moreover, there is often a disjunction between scientists and managers that can affect whether scientific results are applied to help solve conservation problems. Long-term studies can promote increased communication between scientists and managers and hence offer an opportunity for constructive engagement between the two groups. We examined direct and indirect impacts of a 30-year study, the Serengeti Cheetah Project (SCP). Much of what is currently known about wild cheetahs comes from the SCP. In particular, the SCP has demonstrated that cheetahs have a combination of semisociality and ranging patterns that is unique among mammals. This system arises because cheetahs need to be mobile to avoid predators and competitors, yet maintain access to prey; this results in densities much lower than for other large carnivores and a requirement for large areas of heterogenous and connected habitat. The SCP started as a research project, but expanded into a national program, developing capacity for carnivore conservation within Tanzania. Long-term studies such as the SCP are uniquely placed to establish effective working relationships between scientists and managers, engage local and national institutions, and strengthen national capacity for biodiversity conservation. This process is best realized through the establishment of frameworks for conservation that seek to align scientific research with management needs. Long-term studies also play an important role in identifying international priorities for conservation. Nonetheless, the integration of science and management in conservation is a two-way process that requires concerted efforts by both sides to improve and maintain dialogue. Ultimately, conservation depends on people, and maintaining a commitment to a particular area over many years-such as through implementation of a long-term research project

Unsaturated consolidation theory for the prediction of long-term municipal solid waste landfill settlement.

Science.gov (United States)

Liu, Chia-Nan; Chen, Rong-Her; Chen, Kuo-Sheng

2006-02-01

The understanding of long-term landfill settlement is important for landfill design and rehabilitation. However, suitable models that can consider both the mechanical and biodecomposition mechanisms in predicting the long-term landfill settlement are generally not available. In this paper, a model based on unsaturated consolidation theory and considering the biodegradation process is introduced to simulate the landfill settlement behaviour. The details of problem formulations and the derivation of the solution for the formulated differential equation of gas pressure are presented. A step-by-step analytical procedure employing this approach for estimating settlement is proposed. The proposed model can generally model the typical features of short-term and long-term behaviour. The proposed model also yields results that are comparable with the field measurements.

Long-term surveillance plan for the Shiprock Disposal site, Shiprock, New Mexico

International Nuclear Information System (INIS)

1994-09-01

The long-term surveillance plan (LTSP) for the Shiprock, New Mexico, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Shiprock disposal cell. The U.S. Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). This LTSP documents the land ownership interests and details how the long-term care of the disposal site will be carried out. It is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a)

Termite and earthworm abundance and taxonomic richness under long-term conservation soil management in Saria, Burkina Faso, West Africa

NARCIS (Netherlands)

Zida, Z.; Ouedraogo, E.; Mando, A.; Stroosnijder, L.

2011-01-01

Unsustainable crop and soil management practices are major causes of soil degradation and declining soil biodiversity in West Africa. Identifying soil management practices that favor macrofauna abundance is highly desirable for long-term soil health. This study investigates the effects of long-term

Adjunctive levetiracetam in children, adolescents, and adults with primary generalized seizures: Open-label, noncomparative, multicenter, long-term follow-up study.

LENUS (Irish Health Repository)

Delanty, Norman

2012-02-01

Purpose: To evaluate the long-term efficacy and tolerability of adjunctive levetiracetam (LEV) in patients with uncontrolled idiopathic generalized epilepsy (IGE). Methods: This phase III, open-label, long-term, follow-up study (N167; NCT00150748) enrolled patients (4 to <65 years) with primary generalized seizures (tonic-clonic, myoclonic, absence). Patients received adjunctive LEV at individualized doses (1,000-4,000 mg\\/day; 20-80 mg\\/kg\\/day for children\\/adolescents weighing <50 kg). Efficacy results are reported for all seizure types [intention-to-treat (ITT) population, N = 217] and subpopulations with tonic-clonic (n = 152), myoclonic (n = 121), and\\/or absence (n = 70) seizures at baseline. Key Findings: One hundred twenty-five (57.6%) of 217 patients were still receiving treatment at the end of the study. Mean (standard deviation, SD) LEV dose was 2,917.5 (562.9) mg\\/day. Median (Q1-Q3) exposure to LEV was 2.1 (1.5-2.8) years, and the maximum duration was 4.6 years. Most patients were taking one (124\\/217, 57.1%) or >\\/=2 (92\\/217, 42.4%) concomitant antiepileptic drugs (AEDs). Seizure freedom of >\\/=6 months (all seizure types; primary efficacy end point) was achieved by 122 (56.2%) of 217 patients, and 49 (22.6%) of 217 patients had complete seizure freedom. Seizure freedom of >\\/=6 months from tonic-clonic, myoclonic, and absence seizures was achieved by 95 (62.5%) of 152, 75 (62.0%) of 121, and 44 (62.9%) of 70 patients, respectively. Mean (SD) maximum seizure freedom duration was 371.7 (352.4) days. At least one treatment-emergent adverse event (TEAE) was reported by 165 (76%) of 217 patients; most TEAEs were mild\\/moderate in severity, with no indication of an increased incidence over time. Seventeen (7.8%) of 217 patients discontinued medication because of TEAEs. The most common psychiatric TEAEs were depression (16\\/217, 7.4%), insomnia (9\\/217, 4.1%), nervousness (8\\/217, 3.7%), and anxiety (7\\/217, 3.2%). Significance: Adjunctive

Long-term urethral catheterisation.

Science.gov (United States)

Turner, Bruce; Dickens, Nicola

This article discusses long-term urethral catheterisation, focusing on the relevant anatomy and physiology, indications for the procedure, catheter selection and catheter care. It is important that nurses have a good working knowledge of long-term catheterisation as the need for this intervention will increase with the rise in chronic health conditions and the ageing population.

Self-perceived long-term transfer of learning after postpartum hemorrhage simulation training

DEFF Research Database (Denmark)

Melo, Brena C P; Falbo, Ana R; Sorensen, Jette Led

2018-01-01

OBJECTIVE: To explore long-term transfer (application of acquired knowledge and skills on the job) after postpartum hemorrhage simulation training based on either instructional design (ID) principles or conventional best practice. METHODS: In this qualitative study, semi-structured interviews...... simulation format, residents perceived long-term transfer effects. Training design factors influencing transfer were, in their opinion, related to trainees' characteristics, simulation design, and workplace environment. Trainees who participated in the ID-based simulation perceived better communication...... skills and better overall situational awareness: "I didn't do that before." CONCLUSION: All residents perceived long-term transfer after simulation training for postpartum hemorrhage. Those who attended the ID format additionally perceived improvements in communication skills and situational awareness...

Periprocedural and long-term outcomes of endovascular abdominal aortic aneurysm repair in cardiology practice.

Science.gov (United States)

Basoor, Abhijeet; Patel, Kiritkumar C; Halabi, Abdul R; Todorov, Mina; Senthilvadivel, Prashanth; Choksi, Nishit; Phan, Thanh; LaLonde, Thomas; Yamasaki, Hiroshi; DeGregorio, Michele

2014-12-01

Endovascular repair of abdominal aortic aneurysm (AAA) has recently been made a class I indication in the treatment of AAA. In comparison to the conventional open surgical treatment, endovascular AAA repair (EVAR) is associated with equivalent long-term morbidity and mortality rates. Vascular surgeons perform majority of EVAR. There are no reports for the long-term results of this intervention performed by interventional cardiologists. We present one of the first reports of periprocedural and long-term outcomes of EVAR performed by interventional cardiologists. Retrospective chart review on patients with attempted EVAR between September 2005 and January 2011 was performed. Included cases were all consecutive patients who had attempted EVAR by interventional cardiologists. During the study period EVAR was attempted in 170 patients, with 27% being women. The mean age was 74 years (range 52-93). The endovascular graft placement was successful in 96% (163/170) of patients. Procedure failures were more common in women (6 of 46 vs 1 of 124, P = 0.003). The 30-day mortality was 1.8 % (3 of 170). In patients with successful EVAR the mean follow-up was 30 months and mean length of hospital stay was 3.5 ± 3.2 days. Major periprocedural complications were noted in 9% patients (15 of 167). During follow-up, six patients (3.5%) required re-intervention and additional 16 patients died with no aneurysm related deaths. EVAR primarily performed by interventional cardiologists demonstrates high periprocedural and long-term success rates. A higher EVAR failure rate has been observed in women. © 2014 Wiley Periodicals, Inc.

Self-reported Occupational Skin Exposure and Risk of Physician-certified Long-term Sick Leave

DEFF Research Database (Denmark)

Alfonso, Jose H; Tynes, Tore; Thyssen, Jacob P

2016-01-01

Little is known about the contribution of occupational skin exposure as a risk factor for physician-certified long-term sick leave in the general working population of Norway. This study drew a cohort (n = 12,255; response at baseline 69.9%) randomly from the general population of Norway. Occupat......Little is known about the contribution of occupational skin exposure as a risk factor for physician-certified long-term sick leave in the general working population of Norway. This study drew a cohort (n = 12,255; response at baseline 69.9%) randomly from the general population of Norway....... Occupational skin exposure (in 2009) was measured based on 5 items. The outcome of interest was physician-certified long-term sick leave ≥ 16 days during 2010. Statistical adjustment for psychosocial and mechanical occupational exposures was performed. Long-term sick leave was predicted by occupational skin...... exposure to cleaning products (odds ratio (OR) 1.7; 95% confidence interval (95% CI) 1.1-2.5) and waste (OR 2.1; 95% CI 1.1-3.7) among men, and occupational skin exposure to water (OR 1.3; 95% CI 1.0-1.6) among women. The estimated population attributable risk for occupational skin exposure was 14...

Long-Term Effects of Adderall XR in ADHD

Directory of Open Access Journals (Sweden)

J Gordon Millichap

2005-06-01

Full Text Available The long-term tolerability and effectiveness of extended release mixed amphetamine salts (Adderall XR in children with attention deficit hyperactivity disorder (ADHD were evaluated in a 24-month, multicenter, open-label extension of 2 placebo-controlled studies at UCLA, Massachusetts General Hospital, UC-Irvine, Maitland, FL, and Shire Pharmaceutical, Wayne, PA.

A retrieval account of the long-term modality effect.

Science.gov (United States)

Glenberg, A M

1984-01-01

When to-be-remembered (TBR) word pairs are separated by distractor activity, recall of the last few audibly presented pairs is greater than recall of the last few visually presented pairs. The effect is found even after a considerably long distractor-filled retention interval. Five experiments disconfirm echoic storage, short-term storage and long-term storage accounts of these effects, as well as demonstrating that the effect is not an artifact of differential use of a recency-first output strategy. The data are generally consistent with the proposition that retrieval is disrupted by modality-specific similarity between to-be-remembered items and distractor information.

NUMO-RMS: a practical requirements management system for the long-term management of the deep geological disposal project - 16304

International Nuclear Information System (INIS)

Ueda, Hiroyoshi; Suzuki, Satoru; Ishiguro, Katsuhiko; Oyamada, Kiyoshi; Yashio, Shoko; White, Matt; Wilmot, Roger

2009-01-01

NUMO (Nuclear Waste Management Organization of Japan) has the responsibility for implementing deep geological disposal of high-level (HLW) and transuranic (TRU) radioactive waste from the Japanese nuclear programme. A formal Requirements Management System (RMS) is planned to efficiently and effectively support the computerised implementation of the management strategy and the methodology required to drive the step-wise siting processes, and the following repository operational phase,. The RMS will help in the comprehensive management of the decision-making processes in the geological disposal project, in change management as the disposal system is optimised, in driving projects such as the R and D programme efficiently, and in maintaining structured records regarding past decisions, all of which lead to soundness of the project in terms of long-term continuity. The system is planned to have information handling and management functions using a database that includes the decisions/requirements in the programme under consideration, the way in which these are structured in terms of the decision-making process and other associated information. A two-year development programme is underway to develop and enhance an existing trial RMS to a practical system. Functions for change management, history management and association with the external timeline management system are being implemented in the system development work. The database format is being improved to accommodate the requirements management data relating to the facility design and to safety assessment of the deep geological repository. This paper will present an outline of the development work with examples to demonstrate the system's practicality. In parallel with the system/database developments, a case research of the use of requirements management in radioactive waste disposal projects was undertaken to identify key issues in the development of an RMS for radioactive waste disposal and specify a number of

Making Markets in Long-Term Care: Or How a Market Can Work by Being Invisible.

Science.gov (United States)

Grit, Kor; Zuiderent-Jerak, Teun

2017-09-01

Many Western countries have introduced market principles in healthcare. The newly introduced financial instrument of "care-intensity packages" in the Dutch long-term care sector fit this development since they have some characteristics of a market device. However, policy makers and care providers positioned these instruments as explicitly not belonging to the general trend of marketisation in healthcare. Using a qualitative case study approach, we study the work that the two providers have done to fit these instruments to their organisations and how that enables and legitimatises market development. Both providers have done various types of work that could be classified as market development, including creating accounting systems suitable for markets, redefining public values in the context of markets, and starting commercial initiatives. Paradoxically, denying the existence of markets for long-term care and thus avoiding ideological debates on the marketisation of healthcare has made the use of market devices all the more likely. Making the market invisible seems to be an operative element in making the market work. Our findings suggest that Dutch long-term care reform points to the need to study the 'making' rather than the 'liberalising' of markets and that the study of healthcare markets should not be confined to those practices that explicitly label themselves as such.

Long-term effect of urethral dilatation and internal urethrotomy for urethral strictures.

Science.gov (United States)

Veeratterapillay, Rajan; Pickard, Rob S

2012-11-01

Urethral dilatation and direct visual internal urethrotomy (DVIU) are widely used minimally invasive options to manage men with urethral strictures. Advances in open urethroplasty with better long-term cure rates have fuelled the continuing debate as to which treatment is best for primary and recurrent urethral strictures. We reviewed recent literature to identify contemporary practice of urethral dilatation and DVIU and the long-term outcome of these procedures. Systematic literature search for the period January 2010 to December 2011 showed that urethral dilatation and DVIU remain frequently used treatment options as confirmed by surveys of urologists in the USA and the Netherlands. Multiple reports of laser DVIU confirm the safety of this approach but long-term data were lacking. Stricture free rates from urethra dilatation and DVIU vary from 10 to 90% at 12 months, although adjunctive intermittent self-dilatation can reduce time to recurrence. Although quality-of-life benefit appears good in the short term, repeated procedures may harm sexual function in the long-term. Urethral dilatation and DVIU remain widely used in urethral stricture management but high-level comparative evidence of benefit and harms against urethroplasty in the short and long-term is still lacking.

General practice training and virtual communities of practice - a review of the literature.

Science.gov (United States)

Barnett, Stephen; Jones, Sandra C; Bennett, Sue; Iverson, Don; Bonney, Andrew

2012-08-21

Good General Practice is essential for an effective health system. Good General Practice training is essential to sustain the workforce, however training for General Practice can be hampered by a number of pressures, including professional, structural and social isolation. General Practice trainees may be under more pressure than fully registered General Practitioners, and yet isolation can lead doctors to reduce hours and move away from rural practice. Virtual communities of practice (VCoPs) in business have been shown to be effective in improving knowledge sharing, thus reducing professional and structural isolation. This literature review will critically examine the current evidence relevant to virtual communities of practice in General Practice training, identify evidence-based principles that might guide their construction and suggest further avenues for research. Major online databases Scopus, Psychlit and Pubmed were searched for the terms "Community of Practice" (CoP) AND (Online OR Virtual OR Electronic) AND (health OR healthcare OR medicine OR "Allied Health"). Only peer-reviewed journal articles in English were selected. A total of 76 articles were identified, with 23 meeting the inclusion criteria. There were no studies on CoP or VCoP in General Practice training. The review was structured using a framework of six themes for establishing communities of practice, derived from a key study from the business literature. This framework has been used to analyse the literature to determine whether similar themes are present in the health literature and to identify evidence in support of virtual communities of practice for General Practice training. The framework developed by Probst is mirrored in the health literature, albeit with some variations. In particular the roles of facilitator or moderator and leader whilst overlapping, are different. VCoPs are usually collaborations between stakeholders rather than single company VCoPs. Specific goals are important

Government Debt and Long-Term Interest Rates

OpenAIRE

Noriaki Kinoshita

2006-01-01

This paper examines the relationship between government debt and long-term interest rates. A dynamic general equilibrium model that incorporates debt nonneutrality is specified and solved, and numerical simulations using the model are undertaken. In addition, empirical evidence using panel data for 19 industrial countries is examined. The estimation provides some evidence supporting the theoretical predictions: the paper finds that the simulated and estimated interest rate effects of governme...

Long-term follow-up results of umbilical hernia repair.

Science.gov (United States)

Venclauskas, Linas; Jokubauskas, Mantas; Zilinskas, Justas; Zviniene, Kristina; Kiudelis, Mindaugas

2017-12-01

Multiple suture techniques and various mesh repairs are used in open or laparoscopic umbilical hernia (UH) surgery. To compare long-term follow-up results of UH repair in different hernia surgery groups and to identify risk factors for UH recurrence. A retrospective analysis of 216 patients who underwent elective surgery for UH during a 10-year period was performed. The patients were divided into three groups according to surgery technique (suture, mesh and laparoscopic repair). Early and long-term follow-up results including hospital stay, postoperative general and wound complications, recurrence rate and postoperative patient complaints were reviewed. Risk factors for recurrence were also analyzed. One hundred and forty-six patients were operated on using suture repair, 52 using open mesh and 18 using laparoscopic repair technique. 77.8% of patients underwent long-term follow-up. The postoperative wound complication rate and long-term postoperative complaints were significantly higher in the open mesh repair group. The overall hernia recurrence rate was 13.1%. Only 2 (1.7%) patients with small hernias ( 30 kg/m 2 , diabetes and wound infection were independent risk factors for umbilical hernia recurrence. The overall umbilical hernia recurrence rate was 13.1%. Body mass index > 30 kg/m 2 , diabetes and wound infection were independent risk factors for UH recurrence. According to our study results, laparoscopic medium and large umbilical hernia repair has slight advantages over open mesh repair concerning early postoperative complications, long-term postoperative pain and recurrence.

Long-term surveillance plan for the Collins Ranch disposal site, Lakeview, Oregon

International Nuclear Information System (INIS)

1994-08-01

This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Collins Ranch disposal site, Lakeview, Oregon, describes the surveillance activities for the disposal cell. The U.S. Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the U.S. Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials. This LTSP documents whether the land and interests are owned by the United States and details how long-term care of the disposal site will be carried out. It is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a)

Long-term associative learning predicts verbal short-term memory performance.

Science.gov (United States)

Jones, Gary; Macken, Bill

2018-02-01

Studies using tests such as digit span and nonword repetition have implicated short-term memory across a range of developmental domains. Such tests ostensibly assess specialized processes for the short-term manipulation and maintenance of information that are often argued to enable long-term learning. However, there is considerable evidence for an influence of long-term linguistic learning on performance in short-term memory tasks that brings into question the role of a specialized short-term memory system separate from long-term knowledge. Using natural language corpora, we show experimentally and computationally that performance on three widely used measures of short-term memory (digit span, nonword repetition, and sentence recall) can be predicted from simple associative learning operating on the linguistic environment to which a typical child may have been exposed. The findings support the broad view that short-term verbal memory performance reflects the application of long-term language knowledge to the experimental setting.

Long-term management of radioactive waste. Ethics and the environment

International Nuclear Information System (INIS)

Pescatore, C.

1999-01-01

The protection of the environment and the ethical issues that it raises are important topics in the debate on the long-term management of radioactive waste. An overview of the general ethical principles developed in the wider context of the debate on the environment is presented and the specific case of the management of long-lived radioactive waste is addressed. (author)

General practice training and virtual communities of practice - a review of the literature

Directory of Open Access Journals (Sweden)

Barnett Stephen

2012-08-01

Full Text Available Abstract Background Good General Practice is essential for an effective health system. Good General Practice training is essential to sustain the workforce, however training for General Practice can be hampered by a number of pressures, including professional, structural and social isolation. General Practice trainees may be under more pressure than fully registered General Practitioners, and yet isolation can lead doctors to reduce hours and move away from rural practice. Virtual communities of practice (VCoPs in business have been shown to be effective in improving knowledge sharing, thus reducing professional and structural isolation. This literature review will critically examine the current evidence relevant to virtual communities of practice in General Practice training, identify evidence-based principles that might guide their construction and suggest further avenues for research. Methods Major online databases Scopus, Psychlit and Pubmed were searched for the terms “Community of Practice” (CoP AND (Online OR Virtual OR Electronic AND (health OR healthcare OR medicine OR “Allied Health”. Only peer-reviewed journal articles in English were selected. A total of 76 articles were identified, with 23 meeting the inclusion criteria. There were no studies on CoP or VCoP in General Practice training. The review was structured using a framework of six themes for establishing communities of practice, derived from a key study from the business literature. This framework has been used to analyse the literature to determine whether similar themes are present in the health literature and to identify evidence in support of virtual communities of practice for General Practice training. Results The framework developed by Probst is mirrored in the health literature, albeit with some variations. In particular the roles of facilitator or moderator and leader whilst overlapping, are different. VCoPs are usually collaborations between stakeholders

Evaluation of short-term and long-term stability of emulsions by centrifugation and NMR

International Nuclear Information System (INIS)

Tcholakova, S.; Denkov, N.; Ivanov, I.; Marinov, R.

2004-01-01

The effect of storage time on the coalescence stability and drop size distribution of egg yolk and whey protein concentrate stabilized emulsions is studied. The emulsion stability is evaluated by centrifugation, whereas the drop size distribution is measured by means of NMR and optical microscopy. The experimental results show that there is no general relation between the emulsion stability and the changes in the mean drop diameter upon shelf-storage of protein emulsions. On the other hand, it is shown that the higher short-term stability, measured by centrifugation immediately after emulsion preparation, corresponds to higher long-term stability (after their self-storage up to 60 days) for emulsions stabilized by the same type of emulsifier. In this way, we are able to obtain information for the long-term stability of emulsions in a relatively short period of time.(authors)

Long-term surveillance plan for the Mexican Hat disposal site Mexican Hat, Utah

International Nuclear Information System (INIS)

1997-05-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Mexican Hat, Utah, disposal site. The U.S. Nuclear Regulatory Commission (NRC) has developed regulations for the issuance of a general license for the custody and long-term care of UMTRA Project disposal sites in 10 CFR Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites will be cared for in a manner that protects the public health and safety and the environment. Before each disposal site is licensed, the NRC requires the DOE to submit a site-specific LTSP. The DOE prepared this LTSP to meet this requirement for the Mexican Hat disposal site. The general license becomes effective when the NRC concurs with the DOE's determination of completion of remedial action for the disposal site and the NRC formally accepts this LTSP. This LTSP describes the long-term surveillance program the DOE will implement to ensure that the Mexican Hat disposal site performs as designed. The program is based on two distinct types of activities: (1) site inspections to identify potential threats to disposal cell integrity, and (2) monitoring of selected seeps to observe changes in flow rates and water quality. The LTSP is based on the UMTRA Project long-term surveillance program guidance and meets the requirements of 10 CFR section 40.27(b) and 40 CFR section 192.03. 18 refs., 6 figs., 1 tab

Frequent Prescribed Burning as a Long-term Practice in Longleaf Pine Forests Does Not Affect Detrital Chemical Composition.

Science.gov (United States)

Coates, T Adam; Chow, Alex T; Hagan, Donald L; Wang, G Geoff; Bridges, William C; Dozier, James H

2017-09-01

The O horizon, or detrital layer, of forest soils is linked to long-term forest productivity and health. Fuel reduction techniques, such as prescribed fire, can alter the thickness and composition of this essential ecosystem component. Developing an understanding of the changes in the chemical composition of forest detritus due to prescribed fire is essential for forest managers and stakeholders seeking sustainable, resilient, and productive ecosystems. In this study, we evaluated fuel quantity, fuel structure, and detrital chemical composition in longleaf pine ( Miller) forests that have been frequently burned for the last 40 yr at the Tom Yawkey Wildlife Center in Georgetown, SC. Our results suggest that frequent prescribed fire reduces forest fuel quantity ( burned detritus. Our burning activities varied in the short term, consisting of annual dormant, annual growing, and biennial dormant season burns. Seasonal distinctions were present for fuel quantity and vertical fuel structure, but these differences were not noted for the benzene/phenol ratio. These results are significant as more managers consider burning existing longleaf stands while determining effective management practices for longleaf stands yet to be established. Managers of such stands can be confident that frequent, low-intensity, low-severity prescribed burns in longleaf pine forests do little to affect the long-term chemical composition of forest detritus. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Improving students' long-term knowledge retention through personalized review.

Science.gov (United States)

Lindsey, Robert V; Shroyer, Jeffery D; Pashler, Harold; Mozer, Michael C

2014-03-01

Human memory is imperfect; thus, periodic review is required for the long-term preservation of knowledge and skills. However, students at every educational level are challenged by an ever-growing amount of material to review and an ongoing imperative to master new material. We developed a method for efficient, systematic, personalized review that combines statistical techniques for inferring individual differences with a psychological theory of memory. The method was integrated into a semester-long middle-school foreign-language course via retrieval-practice software. Using a cumulative exam administered after the semester's end, we compared time-matched review strategies and found that personalized review yielded a 16.5% boost in course retention over current educational practice (massed study) and a 10.0% improvement over a one-size-fits-all strategy for spaced study.

SHORT-TERM AND LONG-TERM WATER LEVEL PREDICTION AT ONE RIVER MEASUREMENT LOCATION

Directory of Open Access Journals (Sweden)

Rudolf Scitovski

2012-12-01

Full Text Available Global hydrological cycles mainly depend on climate changes whose occurrence is predominantly triggered by solar and terrestrial influence, and the knowledge of the high water regime is widely applied in hydrology. Regular monitoring and studying of river water level behavior is important from several perspectives. On the basis of the given data, by using modifications of general approaches known from literature, especially from investigation in hydrology, the problem of long- and short-term water level forecast at one river measurement location is considered in the paper. Long-term forecasting is considered as the problem of investigating the periodicity of water level behavior by using linear-trigonometric regression and short-term forecasting is based on the modification of the nearest neighbor method. The proposed methods are tested on data referring to the Drava River level by Donji Miholjac, Croatia, in the period between the beginning of 1900 and the end of 2012.

The long-term health of vegetarians and vegans.

Science.gov (United States)

Appleby, Paul N; Key, Timothy J

2016-08-01

Vegetarians, who do not eat any meat, poultry or fish, constitute a significant minority of the world's population. Lacto-ovo-vegetarians consume dairy products and/or eggs, whereas vegans do not eat any foods derived wholly or partly from animals. Concerns over the health, environmental and economic consequences of a diet rich in meat and other animal products have focussed attention on those who exclude some or all of these foods from their diet. There has been extensive research into the nutritional adequacy of vegetarian diets, but less is known about the long-term health of vegetarians and vegans. We summarise the main findings from large cross-sectional and prospective cohort studies in western countries with a high proportion of vegetarian participants. Vegetarians have a lower prevalence of overweight and obesity and a lower risk of IHD compared with non-vegetarians from a similar background, whereas the data are equivocal for stroke. For cancer, there is some evidence that the risk for all cancer sites combined is slightly lower in vegetarians than in non-vegetarians, but findings for individual cancer sites are inconclusive. Vegetarians have also been found to have lower risks for diabetes, diverticular disease and eye cataract. Overall mortality is similar for vegetarians and comparable non-vegetarians, but vegetarian groups compare favourably with the general population. The long-term health of vegetarians appears to be generally good, and for some diseases and medical conditions it may be better than that of comparable omnivores. Much more research is needed, particularly on the long-term health of vegans.

Long-term athletic development- part 1: a pathway for all youth.

Science.gov (United States)

Lloyd, Rhodri S; Oliver, Jon L; Faigenbaum, Avery D; Howard, Rick; De Ste Croix, Mark B A; Williams, Craig A; Best, Thomas M; Alvar, Brent A; Micheli, Lyle J; Thomas, D Phillip; Hatfield, Disa L; Cronin, John B; Myer, Gregory D

2015-05-01

The concept of developing talent and athleticism in youth is the goal of many coaches and sports systems. Consequently, an increasing number of sporting organizations have adopted long-term athletic development models in an attempt to provide a structured approach to the training of youth. It is clear that maximizing sporting talent is an important goal of long-term athletic development models. However, ensuring that youth of all ages and abilities are provided with a strategic plan for the development of their health and physical fitness is also important to maximize physical activity participation rates, reduce the risk of sport- and activity-related injury, and to ensure long-term health and well-being. Critical reviews of independent models of long-term athletic development are already present within the literature; however, to the best of our knowledge, a comprehensive examination and review of the most prominent models does not exist. Additionally, considerations of modern day issues that may impact on the success of any long-term athletic development model are lacking, as are proposed solutions to address such issues. Therefore, within this 2-part commentary, Part 1 provides a critical review of existing models of practice for long-term athletic development and introduces a composite youth development model that includes the integration of talent, psychosocial and physical development across maturation. Part 2 identifies limiting factors that may restrict the success of such models and offers potential solutions.

Cancer Investigation in General Practice

DEFF Research Database (Denmark)

Jensen, Jacob Reinholdt; Møller, Henrik; Thomsen, Janus Laust

2014-01-01

Initiation of cancer investigations in general practice Background Close to 90% of all cancers are diagnosed because the patient presents symptoms and signs. Of these patients, 85% initiate the diagnostic pathway in general practice. Therefore, the initiation of a diagnostic pathway in general...... practice becomes extremely important. On average, a general practitioner (GP) is involved in 7500 consultations each year, and in the diagnostic process of 8-10 incident cancers. One half of cancer patients consult their GP with either general symptoms, which are not indicative of cancer, or vague and non......-specific symptoms. The other half present with what the GP assess as alarm symptoms. Three months prior to diagnosis, patients who are later diagnosed with cancer have twice as many GP consultations than a comparable reference population. Thus the complex diagnostic process in general practice requires the GP...

Short, medium and long term consequences of inadequate defect fuel management

Energy Technology Data Exchange (ETDEWEB)

Roberts, J.G. [CANTECH Associates Limited, Burlington, Ontario (Canada); Nashiem, R.; McQueen, M.; Ma, G. [Bruce Power, Tiverton, Ontario (Canada)

2011-07-01

Defect fuel pencils result in short, medium and long term consequences to the environment within and external to the nuclear power station. The paper will describe these consequences and specify the Defect Fuel Management Practices required to avoid these consequences. (author)

Short, medium and long term consequences of inadequate defect fuel management

International Nuclear Information System (INIS)

Roberts, J.G.; Nashiem, R.; McQueen, M.; Ma, G.

2011-01-01

Defect fuel pencils result in short, medium and long term consequences to the environment within and external to the nuclear power station. The paper will describe these consequences and specify the Defect Fuel Management Practices required to avoid these consequences. (author)

Short, medium and long term consequences of inadequate defect fuel management

International Nuclear Information System (INIS)

Roberts, J.G.; McQueen, M.; Nashiem, R.; Ma, G.

2011-01-01

Defect fuel pencils result in short, medium and long term consequences to the environment within and external to the nuclear power station. The paper will describe these consequences and specify the Defect Fuel Management Practices required to avoid these consequences.

Short, medium and long term consequences of inadequate defect fuel management

Energy Technology Data Exchange (ETDEWEB)

Roberts, J.G. [CANTECH Associates Ltd., Burlington, ON (Canada); McQueen, M.; Nashiem, R.; Ma, G. [Bruce Power, Tiverton, ON (Canada)

2011-07-01

Defect fuel pencils result in short, medium and long term consequences to the environment within and external to the nuclear power station. The paper will describe these consequences and specify the Defect Fuel Management Practices required to avoid these consequences.

Short, medium and long term consequences of inadequate defect fuel management

Energy Technology Data Exchange (ETDEWEB)

Roberts, J.G., E-mail: alchemy@tnt21.com [CANTECH Associates Ltd., Burlington, Ontario (Canada); Nashiem, R.; McQueen, M.; Ma, G., E-mail: Rod.nashiem@brucepower.com, E-mail: Maureen.mcqueen@brucepower.com, E-mail: guoping.ma@brucepower.com [Bruce Power, Tiverton (Canada)

2010-07-01

Defect fuel pencils result in short, medium and long term consequences to the environment within and external to the nuclear power station. The paper will describe these consequences and specify the Defect Fuel Management Practices required to avoid these consequences. (author)

Short, medium and long term consequences of inadequate defect fuel management

International Nuclear Information System (INIS)

Roberts, J.G.; Nashiem, R.; McQueen, M.; Ma, G.

2010-01-01

Defect fuel pencils result in short, medium and long term consequences to the environment within and external to the nuclear power station. The paper will describe these consequences and specify the Defect Fuel Management Practices required to avoid these consequences. (author)

Long-term management of GERD in the elderly with pantoprazole

Directory of Open Access Journals (Sweden)

Carlo Calabrese

2007-04-01

Full Text Available Carlo Calabrese, Anna Fabbri, Giulio Di FeboDepartment of Internal Medicine and Gastroenterology, University of Bologna, ItalyAbstract: The prevalence of gastroesophageal reflux disease (GERD increases with age and elderly are more likely to develop severe disease. Older patients often complain of less severe or frequent heartburn than younger patients and they may present with atypical symptoms such as dysphagia, weight loss, or extraesophageal symptoms. Proton pump inhibitors (PPIs are central in the management of GERD and are unchallenged with regards to their efficacy. They are considered safe and more effective than histamine receptor antagonists for healing esophagitis and for preventing its recurrence using a long term maintenance treatment. PPI have minimal side effects and few slight drug interactions and are considered safe for long term treatment. Pantoprazole is significantly effective both for acute and long-term treatment with excellent control of relapse and symptoms. It is well tolerated even for long-term therapy and its tolerability is optimal. Pantoprazole shows to have minimal interactions with other drugs because of a lower affinity for cytocrome P450 than older PPIs. Although the majority of elderly has concomitant illnesses and receive other drugs, this does not adversely effect the efficacy of pantoprazole because of its pharmacokinetics, which are independent of patient age. Clinical practice suggests that a low dose maintenance of PPIs should be used in older patients with GERD.Keywords: GERD, long-term management, pantoprazole, safety, efficacy, tolerability

Axisymmetric general relativistic hydrodynamics: Long-term evolution of neutron stars and stellar collapse to neutron stars and black holes

International Nuclear Information System (INIS)

Shibata, Masaru

2003-01-01

We report a new implementation for axisymmetric simulation in full general relativity. In this implementation, the Einstein equations are solved using the Nakamura-Shibata formulation with the so-called cartoon method to impose an axisymmetric boundary condition, and the general relativistic hydrodynamic equations are solved using a high-resolution shock-capturing scheme based on an approximate Riemann solver. As tests, we performed the following simulations: (i) long-term evolution of nonrotating and rapidly rotating neutron stars, (ii) long-term evolution of neutron stars of a high-amplitude damping oscillation accompanied with shock formation, (iii) collapse of unstable neutron stars to black holes, and (iv) stellar collapses to neutron stars. Tests (i)-(iii) were carried out with the Γ-law equation of state, and test (iv) with a more realistic parametric equation of state for high-density matter. We found that this new implementation works very well: It is possible to perform the simulations for stable neutron stars for more than 10 dynamical time scales, to capture strong shocks formed at stellar core collapses, and to accurately compute the mass of black holes formed after the collapse and subsequent accretion. In conclusion, this implementation is robust enough to apply to astrophysical problems such as stellar core collapse of massive stars to a neutron star, and black hole, phase transition of a neutron star to a high-density star, and accretion-induced collapse of a neutron star to a black hole. The result for the first simulation of stellar core collapse to a neutron star started from a realistic initial condition is also presented

Customer assessment of long-term care pharmacy provider services.

Science.gov (United States)

Clark, Thomas R

2008-09-01

Assess performance of long-term care pharmacy providers on key services offered to nursing facilities. Cross-sectional; nursing facility team. Random phone survey of nursing facility team members. 485 nursing facility team members (practicing in nursing facilities, interacting with > or = 1 consultant pharmacist); 46 members excluded, unable to identify facility's pharmacy provider. Directors of nursing, medical directors, and administrators were asked to rate long-term care pharmacy provider performance of eight commonly offered pharmacy services. All groups evaluated pharmacy provider performance of these services using a five-point scale. Results are broken down by employer type. Average rating for eight pharmacy services was 3.64. Top two services: "Labeling medications accurately" ranked in top 1-2 services for all groups (combined rating of 3.97) and "Provides medication administration system" ranked in top 1-3 services for all groups (combined rating of 3.95). One service, "Provides educational inservices," ranked lowest for all groups (combined rating of 3.54). In general, when looking at the eight services in combination for all providers, all services were ranked between Good and Very Good (average score of 3.64). Therefore, while the pharmacy provider is performing above average for these services, there is room for improvement in all of these services. These results can be used as a benchmark. Detailed data results and sample surveys are available online at www.ascp.com/supplements. These surveys can be used by the pharmacy provider to solicit assessments from their own facilities on these services.

Nigerian Journal of General Practice: Submissions

African Journals Online (AJOL)

Author Guidelines. The Nigerian Journal of General Practice is the Official Publication of the Association of General and Private Medical Practitioners of Nigeria [AGPMPN] and a forum for family private/general practice medicine education and research. The Nigerian Journal of General Practice invites scholarly manuscripts ...

Evaluating long term forecasts

Energy Technology Data Exchange (ETDEWEB)

Lady, George M. [Department of Economics, College of Liberal Arts, Temple University, Philadelphia, PA 19122 (United States)

2010-03-15

The U.S. Department of Energy's Energy Information Administration (EIA), and its predecessor organizations, has published projections of U.S. energy production, consumption, distribution and prices annually for over 30 years. A natural issue to raise in evaluating the projections is an assessment of their accuracy compared to eventual outcomes. A related issue is the determination of the sources of 'error' in the projections that are due to differences between the actual versus realized values of the associated assumptions. One way to do this would be to run the computer-based model from which the projections are derived at the time the projected values are realized, using actual rather than assumed values for model assumptions; and, compare these results to the original projections. For long term forecasts, this approach would require that the model's software and hardware configuration be archived and available for many years, possibly decades, into the future. Such archival creates many practical problems; and, in general, it is not being done. This paper reports on an alternative approach for evaluating the projections. In the alternative approach, the model is run many times for cases in which important assumptions are changed individually and in combinations. A database is assembled from the solutions and a regression analysis is conducted for each important projected variable with the associated assumptions chosen as exogenous variables. When actual data are eventually available, the regression results are then used to estimate the sources of the differences in the projections of the endogenous variables compared to their eventual outcomes. The results presented here are for residential and commercial sector natural gas and electricity consumption. (author)

Statistical Models for Tornado Climatology: Long and Short-Term Views.

Science.gov (United States)

Elsner, James B; Jagger, Thomas H; Fricker, Tyler

2016-01-01

This paper estimates regional tornado risk from records of past events using statistical models. First, a spatial model is fit to the tornado counts aggregated in counties with terms that control for changes in observational practices over time. Results provide a long-term view of risk that delineates the main tornado corridors in the United States where the expected annual rate exceeds two tornadoes per 10,000 square km. A few counties in the Texas Panhandle and central Kansas have annual rates that exceed four tornadoes per 10,000 square km. Refitting the model after removing the least damaging tornadoes from the data (EF0) produces a similar map but with the greatest tornado risk shifted south and eastward. Second, a space-time model is fit to the counts aggregated in raster cells with terms that control for changes in climate factors. Results provide a short-term view of risk. The short-term view identifies a shift of tornado activity away from the Ohio Valley under El Niño conditions and away from the Southeast under positive North Atlantic oscillation conditions. The combined predictor effects on the local rates is quantified by fitting the model after leaving out the year to be predicted from the data. The models provide state-of-the-art views of tornado risk that can be used by government agencies, the insurance industry, and the general public.

Mid- and long-term effects of family constellation seminars in a general population sample: 8- and 12-month follow-up.

Science.gov (United States)

Hunger, Christina; Weinhold, Jan; Bornhäuser, Annette; Link, Leoni; Schweitzer, Jochen

2015-06-01

In a previous randomized controlled trial (RCT), short-term efficacy of family constellation seminars (FCSs) in a general population sample was demonstrated. In this article, we examined mid- and long-term stability of these effects. Participants were 104 adults (M = 47 years; SD = 9; 84% female) who were part of the intervention group in the original RCT (3-day FCS; 64 active participants and 40 observing participants). FCSs were carried out according to manuals. It was predicted that FCSs would improve psychological functioning (Outcome Questionnaire OQ-45.2) at 8- and 12-month follow-up. Additionally, we assessed the effects of FCSs on psychological distress, motivational incongruence, individuals' experience in their personal social systems, and overall goal attainment. Participants yielded significant improvement in psychological functioning (d = 0.41 at 8-month follow-up, p = .000; d = 0.40 at 12-month follow-up, p = .000). Results were confirmed for psychological distress, motivational incongruence, the participants' experience in their personal social systems, and overall goal attainment. No adverse events were reported. This study provides first evidence for the mid- and long-term efficacy of FCSs in a nonclinical population. The implications of the findings are discussed. © 2014 Family Process Institute.

Backcasting long-term climate data: evaluation of hypothesis

Science.gov (United States)

Saghafian, Bahram; Aghbalaghi, Sara Ghasemi; Nasseri, Mohsen

2018-05-01

Most often than not, incomplete datasets or short-term recorded data in vast regions impedes reliable climate and water studies. Various methods, such as simple correlation with stations having long-term time series, are practiced to infill or extend the period of observation at stations with missing or short-term data. In the current paper and for the first time, the hypothesis on the feasibility of extending the downscaling concept to backcast local observation records using large-scale atmospheric predictors is examined. Backcasting is coined here to contrast forecasting/projection; the former is implied to reconstruct in the past, while the latter represents projection in the future. To assess our hypotheses, daily and monthly statistical downscaling models were employed to reconstruct past precipitation data and lengthen the data period. Urmia and Tabriz synoptic stations, located in northwestern Iran, constituted two case study stations. SDSM and data-mining downscaling model (DMDM) daily as well as the group method of data handling (GMDH) and model tree (Mp5) monthly downscaling models were trained with National Center for Environmental Prediction (NCEP) data. After training, reconstructed precipitation data of the past was validated against observed data. Then, the data was fully extended to the 1948 to 2009 period corresponding to available NCEP data period. The results showed that DMDM performed superior in generation of monthly average precipitation compared with the SDSM, Mp5, and GMDH models, although none of the models could preserve the monthly variance. This overall confirms practical value of the proposed approach in extension of the past historic data, particularly for long-term climatological and water budget studies.

National Strength and Conditioning Association Position Statement on Long-Term Athletic Development.

Science.gov (United States)

Lloyd, Rhodri S; Cronin, John B; Faigenbaum, Avery D; Haff, G Gregory; Howard, Rick; Kraemer, William J; Micheli, Lyle J; Myer, Gregory D; Oliver, Jon L

2016-06-01

There has recently been a growing interest in long-term athletic development for youth. Because of their unique physical, psychological, and social differences, children and adolescents should engage in appropriately prescribed exercise programs that promote physical development to prevent injury and enhance fitness behaviors that can be retained later in life. Irrespective of whether a child is involved in organized sport or engages in recreational physical activity, there remains a need to adopt a structured, logical, and evidence-based approach to the long-term development of athleticism. This is of particular importance considering the alarmingly high number of youth who fail to meet global physical activity recommendations and consequently present with negative health profiles. However, appropriate exercise prescription is also crucial for those young athletes who are physically underprepared and at risk of overuse injury because of high volumes of competition and an absence of preparatory conditioning. Whether the child accumulates insufficient or excessive amounts of exercise, or falls somewhere between these opposing ends of the spectrum, it is generally accepted that the young bodies of modern day youth are often ill-prepared to tolerate the rigors of sports or physical activity. All youth should engage in regular physical activity and thus should be viewed as "athletes" and afforded the opportunity to enhance athleticism in an individualized, holistic, and child-centered manner. Because of emerging interest in long-term athletic development, an authorship team was tasked on behalf of the National Strength and Conditioning Association (NSCA) to critically synthesize existing literature and current practices within the field and to compose a relevant position statement. This document was subsequently reviewed and formally ratified by the NSCA Board of Directors. A list of 10 pillars of successful long-term athletic development are presented, which summarize

Long-term surveillance plan for the Falls City Disposal Site, Falls City, Texas

International Nuclear Information System (INIS)

1995-06-01

This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Falls City disposal site, Falls City, Texas, describes the surveillance activities for the disposal site. DOE will carry out these activities to ensure that the disposal cell continues to function as designed. This LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials. This LTSP documents whether the land and interests are owned by the United States and details how long-term care of the disposal site will be carried out. It is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a)

Responses and damages during long-term continuous irradiation in plants

International Nuclear Information System (INIS)

Watanabe, Yoshito

2011-01-01

Effects of long-term continuous irradiation are relevant to studies in radiation ecotoxicology. To investigate plants biological responses to continuous irradiation, we performed metabolome and transcriptome analysis in a model plant, arabidopsis. Comprehensive analysis of primary metabolites using capillary electrophoresis mass spectrometry revealed extensive metabolic changes at early onset of growth inhibition in plants exposed to gamma rays at the dose rate of 20 Gy/day. The changes included elevated levels of B vitamins and second metabolites, commonly responsive to many abiotic and biotic stresses. Responses at early onset of growth inhibition were also observed in the transcriptome analysis using microarray, which showed up-regulation of 55 genes in plants exposed to gamma rays at 20 Gy/day. Although about a half of the up-regulated genes were also responsive just after acute irradiation, the other half was responsive only during long-term continuous irradiation. Database analyses showed that the specifically up-regulated genes to long-term continuous irradiation included genes relating to general stress responses and protein metabolism. The results of these analyses appear to reflect plants responses to progressive radiation damages, from radiation-specific responses, which repair primary DNA damage, to more general stress responses, which maintain homoeostasis against secondary damages. (author)

Long-term survival and function after suspected gram-negative sepsis.

Science.gov (United States)

Perl, T M; Dvorak, L; Hwang, T; Wenzel, R P

1995-07-26

To determine the long-term (> 3 months) survival of septic patients, to develop mathematical models that predict patients likely to survive long-term, and to measure the health and functional status of surviving patients. A large tertiary care university hospital and an associated Veterans Affairs Medical Center. From December 1986 to December 1990, a total of 103 patients with suspected gram-negative sepsis entered a double-blind, placebo-controlled efficacy trial of monoclonal antiendotoxin antibody. Of these, we followed up 100 patients for 7667 patient-months. Beginning in May 1992, we reviewed hospital records and contacted all known survivors. We measured the health status of all surviving patients. The determinants of long-term survival (up to 6 years) were identified through two Cox proportional hazard regression models: one that included patient characteristics identified at the time of sepsis (bedside model) and another that included bedside, infection-related, and treatment characteristics (overall model). Of the 60 patients in the cohort who died at a median interval of 30.5 days after sepsis, 32 died within the first month of the septic episode, seven died within 3 months, and four more died within 6 months. In the bedside multivariate model constructed to predict long-term survival, large hazard ratios (HRs) were associated with severity of underlying illness as classified by McCabe and Jackson criteria (for rapidly fatal disease, HR = 30.4, P respiratory distress syndrome (HR = 2.3; P = .02) predicted patients most likely to die. The Acute Physiology and Chronic Health Evaluation II score was not a significant predictor of outcome when either model included the simpler McCabe and Jackson classification of underlying disease severity. We compared the health status scores with norms for the general population and found that patients with resolved sepsis reported more physical dysfunction (P bedridden), suggesting that the patients' physical function

Effect of aromatherapy massage on elderly patients under long-term hospitalization in Japan.

Science.gov (United States)

Satou, Tadaaki; Chikama, Mizuki; Chikama, Yoshiko; Hachigo, Masato; Urayama, Haruna; Murakami, Shio; Hayashi, Shinichiro; Koikem, Kazuo

2013-03-01

To verify the effectiveness of aromatherapy massage on elderly patients under long-term hospitalization. Aromatherapy massage was performed twice a week for a total of eight times. Nursing home. Elderly women under long-term hospitalization. Questionnaire and measurement of stress marker levels (salivary amylase activity) before and after the first, fifth, and eighth aromatherapy massages. Questionnaire (Face scale, General Health Questionnaire-12 [GHQ-12]), measurement of salivary amylase activity. A decrease in stress after aromatherapy massage compared to before each massage was confirmed at all measurement times and with the stress marker. No marked reduction was observed in Face scale or saliva amylase activity as a whole over the long term, although decreasing tendencies were seen. Marked reductions in GHQ-12 were observed over the long term. Aroma massage appears likely to prove effective in reducing psychological stress among elderly patients under long-term hospitalization.

Long-term deconditioning of gas-filled surge arresters

Science.gov (United States)

Stanković, Koviljka; Brajović, Dragan; Alimpijević, Mališa; Lončar, Boris

2016-07-01

The aim of this paper is to identify parameters that influence the long-term deconditioning effect of gas-filled surge arrester (GFSA) and to provide practical recommendations for mitigating this effect. Namely, after some period of time, on order of hours or days, during which there is no activation due to overvoltage, the deconditioning of GFSA occurs. This effect was observed experimentally within the paper. The observed parameters that could influence the long-term deconditioning effect were the following: shape of voltage load, gas type, gas pressure, interelectrode distance, electrode material, electrode surface topography as well as GFSA design such as two- or three-electrode configuration. According to the results obtained, it has been shown that the occurrence of long-term deconditioning in an insulating system, insulated by a noble gas at a subpressure and with small interelectrode distances, is a phenomenon that always occurs when the insulating system is at rest for about an hour. It has been found that the type of noble gas does not influence the long-term deconditioning. Analysis of such insulating systems' parameters, with a prospect of being used as GFSAs, has demonstrated that this phenomenon is less pronounced at higher pressures (for the same value of the pressure (p) and interelectrode distance (d) product) and for electrodes with microscopically embossed surfaces. According to the results that were obtained by noble gases and their mixtures, as well as the results that were obtained by mixtures of SF6 gas with noble gasses, it can be claimed with confidence that the effect of the long-term deconditioning is an electrode effect. It has also been established that the deconditioning effect does not depend on the electrode material except in the case of electrodes made out of noble metals, which reduce the effect. Based on these results, it can be recommended that the working point of GFSAs be set (according to the DC breakdown voltage value) at a

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

Science.gov (United States)

Baker, Karen S.; Chandler, Cynthia L.

2008-09-01

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

Safety of Long-term Interim Storage Facilities - Workshop Proceedings

International Nuclear Information System (INIS)

2014-01-01

The objective of this workshop was to discuss and review current national activities, plans and regulatory approaches for the safety of long term interim storage facilities dedicated to spent nuclear fuel (SF), high level waste (HLW) and other radioactive materials with prolonged storage regimes. It was also intended to discuss results of experiments and to identify necessary R and D to confirm safety of fuel and cask during the long-term storage. Safety authorities and their Technical Support Organisation (TSO), Fuel Cycle Facilities (FCF) operating organisations and international organisations were invited to share information on their approaches, practices and current developments. The workshop was organised in an opening session, three technical sessions, and a conclusion session. The technical sessions were focused on: - National approaches for long term interim storage facilities; - Safety requirements, regulatory framework and implementation issues; - Technical issues and operational experience, needs for R and D. Each session consisted of a number of presentations followed by a panel discussion moderated by the session Chairs. A summary of each session and subsequent discussion that ensued are provided as well as a summary of the results of the workshop with the text of the papers given and presentations made

Geoethical issues in long-term assessment of geohazards and related mitigation policies

Science.gov (United States)

Tinti, Stefano; Armigliato, Alberto

2015-04-01

Long-term assessment of large-impact and relatively (or very) infrequent geohazards like earthquakes, tsunamis and volcanic eruptions is nowadays a common practice for geoscientists and many groups have been and are involved in producing global and regional hazard maps in response of an increasing demand of the society. Though the societal needs are the basic motivations for such studies, often this aspect is not pondered enough and a lack of communication between geoscientists and the society might be a serious limit to the effective exploitation of the hazard assessment products and to the development of adequate mitigation policies. This paper is an analysis of the role of geoscientists in the process of the production of long-term assessments of dangerous natural phenomena (such as mapping of seismic, tsunami and volcanic hazards), with special emphasis given to the role of communicators and disseminators (with respect to the general public, to authorities, to restricted specialized audiences…), but also of providers of active support to the planners who should be given key elements for making decision. Geoethics imposes geoscientists to take clear and full responsibilities on the products resulting from their assessments, but also to be aware that these products are valuable insofar they are scientifically sound, known, understandable, and utilizable by a wide universe of users.

Long-term Prostate-specific Antigen Velocity in Improved Classification of Prostate Cancer Risk and Mortality

DEFF Research Database (Denmark)

Ørsted, David Dynnes; Bojesen, Stig E; Kamstrup, Pia R

2013-01-01

BACKGROUND: It remains unclear whether adding long-term prostate-specific antigen velocity (PSAV) to baseline PSA values improves classification of prostate cancer (PCa) risk and mortality in the general population. OBJECTIVE: To determine whether long-term PSAV improves classification of PCa risk...

Social evolution and genetic interactions in the short and long term.

Science.gov (United States)

Van Cleve, Jeremy

2015-08-01

The evolution of social traits remains one of the most fascinating and feisty topics in evolutionary biology even after half a century of theoretical research. W.D. Hamilton shaped much of the field initially with his 1964 papers that laid out the foundation for understanding the effect of genetic relatedness on the evolution of social behavior. Early theoretical investigations revealed two critical assumptions required for Hamilton's rule to hold in dynamical models: weak selection and additive genetic interactions. However, only recently have analytical approaches from population genetics and evolutionary game theory developed sufficiently so that social evolution can be studied under the joint action of selection, mutation, and genetic drift. We review how these approaches suggest two timescales for evolution under weak mutation: (i) a short-term timescale where evolution occurs between a finite set of alleles, and (ii) a long-term timescale where a continuum of alleles are possible and populations evolve continuously from one monomorphic trait to another. We show how Hamilton's rule emerges from the short-term analysis under additivity and how non-additive genetic interactions can be accounted for more generally. This short-term approach reproduces, synthesizes, and generalizes many previous results including the one-third law from evolutionary game theory and risk dominance from economic game theory. Using the long-term approach, we illustrate how trait evolution can be described with a diffusion equation that is a stochastic analogue of the canonical equation of adaptive dynamics. Peaks in the stationary distribution of the diffusion capture classic notions of convergence stability from evolutionary game theory and generally depend on the additive genetic interactions inherent in Hamilton's rule. Surprisingly, the peaks of the long-term stationary distribution can predict the effects of simple kinds of non-additive interactions. Additionally, the peaks

The long-term patient in the era of community treatment.

Science.gov (United States)

Lamb, H R; Goertzel, V

1977-06-01

Post hospital follow-up studies do not encompass the total population of long-term, psychiatrically disabled patients in the community, because a large proportion (in this study, 64%) have not had a recent hospitalization, either state or local. The authors identified a population of long-term, psychiatrically disabled patients in the community, all of whom carried functional psychotic diagnoses. Long-term disabled patients generally lead inactive lives, but in California seldom return to state hospitals. One third have been hospitalized locally within the past two years-younger patients much more than older patients. Almost half use private (Medicaid) outpatient services, but one fourth receive no mental health services at all. Less than a third live in board and care homes or cheap hotels; most live in nonsegregated, noninsitutional settings. The role of Supplemental Security Income (SSI) in enhancing adaptation of the chronically disabled was impressive to the research team.

Memory Reactivation Enables Long-Term Prevention of Interference.

Science.gov (United States)

Herszage, Jasmine; Censor, Nitzan

2017-05-22

The ability of the human brain to successively learn or perform two competing tasks constitutes a major challenge in daily function. Indeed, exposing the brain to two different competing memories within a short temporal offset can induce interference, resulting in deteriorated performance in at least one of the learned memories [1-4]. Although previous studies have investigated online interference and its effects on performance [5-13], whether the human brain can enable long-term prevention of future interference is unknown. To address this question, we utilized the memory reactivation-reconsolidation framework [2, 12] stemming from studies at the synaptic level [14-17], according to which reactivation of a memory enables its update. In a set of experiments, using the motor sequence learning task [18] we report that a unique pairing of reactivating the original memory (right hand) in synchrony with novel memory trials (left hand) prevented future interference between the two memories. Strikingly, these effects were long-term and observed a month following reactivation. Further experiments showed that preventing future interference was not due to practice per se, but rather specifically depended on a limited time window induced by reactivation of the original memory. These results suggest a mechanism according to which memory reactivation enables long-term prevention of interference, possibly by creating an updated memory trace integrating original and novel memories during the reconsolidation time window. The opportunity to induce a long-term preventive effect on memories may enable the utilization of strategies optimizing normal human learning, as well as recovery following neurological insults. Copyright © 2017 Elsevier Ltd. All rights reserved.

Methodological practicalities in analytical generalization

DEFF Research Database (Denmark)

Halkier, Bente

2011-01-01

generalization. Theoretically, the argumentation in the article is based on practice theory. The main part of the article describes three different examples of ways of generalizing on the basis of the same qualitative data material. There is a particular focus on describing the methodological strategies......In this article, I argue that the existing literature on qualitative methodologies tend to discuss analytical generalization at a relatively abstract and general theoretical level. It is, however, not particularly straightforward to “translate” such abstract epistemological principles into more...... operative methodological strategies for producing analytical generalizations in research practices. Thus, the aim of the article is to contribute to the discussions among qualitatively working researchers about generalizing by way of exemplifying some of the methodological practicalities in analytical...

Future long-term trials of postmenopausal hormone replacement therapy - what is possible and what is the optimal protocol and regimen?

Science.gov (United States)

Purbrick, B; Stranks, K; Sum, C; MacLennan, A H

2012-06-01

The ideal long-term, randomized, placebo-controlled trial of hormone replacement therapy (HRT) from near menopause for up to 30 years to assess major morbidity and mortality is impractical because of high cost, participant retention, therapy compliance, and continuity of research staff and funding. Also the trial regimen may become outdated. It is nihilistic to demand such a long-term trial before endorsing HRT. However, medium-term trials using surrogate measures for long-term morbidity and mortality are possible and two are near completion. If these studies have been able to maintain reasonable participant retention, therapy compliance and minimal breach of protocol, they will set standards for trials of new HRT regimens. This paper discusses lessons learnt from past attempts at long-term trials and suggests the currently optimal protocol and cost of assessing new HRT regimens to optimize potential benefits and minimize adverse effects. A 5-7-year randomized, placebo-controlled trial of a flexible transdermal estrogen regimen ± either a selective estrogen receptor modulator, e.g. bazedoxifene, or micronized progesterone is discussed. Mild to moderately symptomatic women, 1-4 years post menopause, can be recruited via general practice and group meetings. Future trials should be funded by independent agencies and are high priority in women's health.

Management of long term sickness absence: a systematic realist review.

Science.gov (United States)

Higgins, Angela; O'Halloran, Peter; Porter, Sam

2012-09-01

The increasing impact and costs of long term sickness absence have been well documented. However, the diversity and complexity of interventions and of the contexts in which these take place makes a traditional review problematic. Therefore, we undertook a systematic realist review to identify the dominant programme theories underlying best practice, to assess the evidence for these theories, and to throw light on important enabling or disabling contextual factors. A search of the scholarly literature from 1950 to 2011 identified 5,576 articles, of which 269 formed the basis of the review. We found that the dominant programme theories in relation to effective management related to: early intervention or referral by employers; having proactive organisational procedures; good communication and cooperation between stakeholders; and workplace-based occupational rehabilitation. Significant contextual factors were identified as the level of support for interventions from top management, the size and structure of the organisation, the level of financial and organisational investment in the management of long-term sickness absence, and the quality of relationships between managers and staff. Consequently, those with responsibility for managing absence should bear in mind the contextual factors that are likely to have an impact on interventions, and do what they can to ensure stakeholders have at least a mutual understanding (if not a common purpose) in relation to their perceptions of interventions, goals, culture and practice in the management of long term sickness absence.

Fondaparinux in the initial and long-term treatment of venous thromboembolism.

Science.gov (United States)

Pesavento, Raffaele; Amitrano, Maria; Trujillo-Santos, Javier; Di Micco, Pierpaolo; Mangiacapra, Sara; López-Jiménez, Luciano; Falgá, Conxita; García-Bragado, Fernando; Piovella, Chiara; Prandoni, Paolo; Monreal, Manuel

2015-02-01

Even in the absence of evidence on its long-term efficacy and safety, a number of patients with venous thromboembolism (VTE) receive long-term therapy with fondaparinux alone in everyday practice. We used the Registro Informatizado de Enfermedad Tromboembólica (RIETE) registry to compare the rate of VTE recurrences and major bleeding at 10 and 90 days in patients with and without cancer. For long-term therapy, fondaparinux was compared with vitamin K antagonists (VKA) in patients without cancer and with low-molecular-weight heparin (LMWH) in those with cancer. Of 47,378 patients recruited, 46,513 were initially treated with heparin, 865 with fondaparinux. Then, 263 patients (78 with cancer) were treated for at least 3 months with fondaparinux. After propensity-score matching, there were no differences between patients receiving initial therapy with heparin or fondaparinux. Among patients with cancer, there were no differences between fondaparinux and LMWH. Among patients without cancer, the long-term use of fondaparinux was associated with an increased risk of major bleeding (3.24 % vs. 0.95 %, p<0.05). An unexpected high rate of major bleeding was observed in non-cancer patients treated with long-term fondaparinux. Our small sample does not allow to derive relevant conclusions on the use of fondaparinux in cancer patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

Dispositional optimism as predictor of outcome in short- and long-term psychotherapy.

Science.gov (United States)

Heinonen, Erkki; Heiskanen, Tiia; Lindfors, Olavi; Härkäpää, Kristiina; Knekt, Paul

2017-09-01

Dispositional optimism predicts various beneficial outcomes in somatic health and treatment, but has been little studied in psychotherapy. This study investigated whether an optimistic disposition differentially predicts patients' ability to benefit from short-term versus long-term psychotherapy. A total of 326 adult outpatients with mood and/or anxiety disorder were randomized into short-term (solution-focused or short-term psychodynamic) or long-term psychodynamic therapy and followed up for 3 years. Dispositional optimism was assessed by patients at baseline with the self-rated Life Orientation Test (LOT) questionnaire. Outcome was assessed at baseline and seven times during the follow-up, in terms of depressive (BDI, HDRS), anxiety (SCL-90-ANX, HARS), and general psychiatric symptoms (SCL-90-GSI), all seven follow-up points including patients' self-reports and three including interview-based measures. Lower dispositional optimism predicted faster symptom reduction in short-term than in long-term psychotherapy. Higher optimism predicted equally rapid and eventually greater benefits in long-term, as compared to short-term, psychotherapy. Weaker optimism appeared to predict sustenance of problems early in long-term therapy. Stronger optimism seems to best facilitate engaging in and benefiting from a long-term therapy process. Closer research might clarify the psychological processes responsible for these effects and help fine-tune both briefer and longer interventions to optimize treatment effectiveness for particular patients and their psychological qualities. Weaker dispositional optimism does not appear to inhibit brief therapy from effecting symptomatic recovery. Patients with weaker optimism do not seem to gain added benefits from long-term therapy, but instead may be susceptible to prolonged psychiatric symptoms in the early stages of long-term therapy. © 2016 The British Psychological Society.

Regulating the long-term safety of geological disposal of radioactive waste: practical issues and challenges

International Nuclear Information System (INIS)

2008-01-01

Regulating the long-term safety of geological disposal of radioactive waste is a key part of making progress on the radioactive waste management issue. A survey of member countries has shown that differences exist both in the protection criteria being applied and in the methods for demonstrating compliance, reflecting historical and cultural differences between countries which in turn result in a diversity of decision-making approaches and frameworks. At the same time, however, these differences in criteria are unlikely to result in significant differences in long-term protection, as all the standards being proposed are well below levels at which actual effects of radiological exposure can be observed and a range of complementary requirements is foreseen. In order to enable experts from a wide range of backgrounds to debate the various aspects of these findings, the NEA organised an international workshop in November 2006 in Paris, France. Discussions focused on diversity in regulatory processes; the basis and tools for assuring long-term protection; ethical responsibilities of one generation to later generations and how these can be discharged; and adapting regulatory processes to the long time frames involved in implementing geological disposal. These proceedings include a summary of the viewpoints expressed as well as the 22 papers presented at the workshop. (author)

Prediction of long-term behaviour for nuclear waste disposal

International Nuclear Information System (INIS)

Shoesmith, D.W.; Ikeda, B.M.; King, F.; Sunder, S.

1996-09-01

The modelling procedures developed for the long-term prediction of the corrosion of used fuel and of titanium and copper nuclear waste containers are described. The corrosion behaviour of these materials changes with time as the conditions within the conceptual disposal vault evolve from an early warm, oxidizing phase to an indefinite period of cool, anoxic conditions. For the two candidate container materials, this evolution of conditions means that the containers will be initially susceptible to localized corrosion but that in the long-term, corrosion should be more general in nature. The propagation of the pitting of Cu and of the crevice corrosion of Ti alloys is modelled using statistical models. General corrosion processes are modelled deterministically. For the fuel, deterministic electrochemical models have been developed to predict the long-term dissolution rate of U0 2 . The corrosion behaviour of materials in the disposal vault can be influenced by reengineering the vault environment. For instance, increasing the areal loading of containers will produce higher vault temperatures resulting in more extensive drying of the porous backfill materials. The initiation of crevice corrosion on Ti may then be delayed, leading to longer container lifetimes. For copper containers, minimizing the amount Of O 2 initially trapped in the pores of the backfill, or adding reducing agents to consume this O 2 faster, will limit the extent of corrosion, permitting a reduction of the container wall thickness necessary for containment. (author). 55 refs., 19 figs

Reforming Long-Term Care Funding in Alberta.

Science.gov (United States)

Crump, R Trafford; Repin, Nadya; Sutherland, Jason M

2015-01-01

Like many provinces across Canada, Alberta is facing growing demand for long-term care. Issues with the mixed funding model used to pay long-term care providers had Alberta Health Services concerned that it was not efficiently meeting the demand for long-term care. Consequently, in 2010, Alberta Health Services introduced the patient/care-based funding (PCBF) model. PCBF is similar to activity-based funding in that it directly ties the complexity and care needs of long-term care residents to the payment received by long-term care providers. This review describes PCBF and discusses some of its strengths and weaknesses. In doing so, this review is intended to inform other provinces faced with similar long-term care challenges and contemplating their own funding reforms.

Andra long term memory project - 59277

International Nuclear Information System (INIS)

Charton, Patrick; Boissier, Fabrice; Martin, Guillaume

2012-01-01

Document available in abstract form only. Full text of publication follows: Long term memory of repositories is required by safety, reversibility and social expectations. Thus Andra has implemented since 2010 a long-term memory project to reinforce and diversify its current arrangements in this field, as well as to explore opportunities to extend memory keeping over thousands years. The project includes opportunity studies of dedicated facilities. The 'Ecotheque' and 'Geotheque' projects contribute to memory respectively through environmental and geological samples preservation. The options of creating (i) an archive centre for Andra's interim and permanent archives, (ii) an artist center to study the contribution of arts to memory preservation, (iii) a museum of radioactive waste disposal history and technology (radium industry..., sea disposal, current solutions...) are considered. Other studies provided by the project examine our heritage. This includes the continuity of languages and symbolic systems, the continuity of writing and engraving methods, the archaeology of landscapes (memory of the earths evolution, multi-century memory of industrial and agricultural landscapes), the archaeology practices (how might a future archaeologist be interested in our current activity?), the preservation of historical sites and industrial memory, the continuity of institutional organizations, the memory and history of science evolution as well as broad history

Long-term surveillance plan for the Collins Ranch Disposal Site, Lakeview, Oregon

International Nuclear Information System (INIS)

1993-12-01

This long-term surveillance plan (LTSP) for the Lakeview, Oregon, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Lakeview (Collins Ranch) disposal cell, which will be referred to as the Collins Ranch disposal cell throughout this document. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials. This LTSP documents whether the land and interests are owned by the United States or an Indian tribe, and details how the long-term care of the disposal site will be carried out. It is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a)

Long-Term Problems of Nuclear Energy, October 1976

International Nuclear Information System (INIS)

Broda, E.

1976-01-01

The Text was written by Enelbert Broda in Oktober 1976. In this report, the physicist and chemist Engelbert Broda discusses various areas of peaceful uses of nuclear energy and concludes that the negative aspects outweigh the positive and that the use of nuclear energy has to be rejected in the long term. In 16 chapters the biggest and most dangerous problems are discussed. Include the unresolved question of disposal, problems of reprocessing and transport of fissile materials, the proliferation of nuclear weapons technology, risks of terrorism, dismantling and decontamination of old nuclear power plants, the toxicity of fissile material, as well as the general unprofitable use of nuclear power plants. As a long-term alternative the author suggests an intensification of the exploitation of solar energy, as well as a deliberate restriction of the rising demand for energy.(roessner) [de

Long-Term Problems of Nuclear Energy, December 1976

International Nuclear Information System (INIS)

Broda, E.

1976-01-01

The Text was written by Enelbert Broda in Oktober 1976. In this report, the physicist and chemist Engelbert Broda discusses various areas of peaceful uses of nuclear energy and concludes that the negative aspects outweigh the positive and that the use of nuclear energy has to be rejected in the long term. In 16 chapters the biggest and most dangerous problems are discussed. Include the unresolved question of disposal, problems of reprocessing and transport of fissile materials, the proliferation of nuclear weapons technology, risks of terrorism, dismantling and decontamination of old nuclear power plants, the toxicity of fissile material, as well as the general unprofitable use of nuclear power plants. As a long-term alternative the author suggests an intensification of the exploitation of solar energy, as well as a deliberate restriction of the rising demand for energy.(roessner)

Long-term stabilization of uranium mill tailings

International Nuclear Information System (INIS)

Voorhees, L.D.; Sale, M.J.; Webb, J.W.; Mulholland, P.J.

1983-01-01

The primary hazard associated with uranium mill tailings is exposure to a radioactive gas, radon-222, the concentration of which has been correlated with the occurrence of lung cancer. Previous studies on radon attenuation conclude that the placement of earthen cover materials over the tailings is the most effective technique for reducing radioactive emissions and dispersal of tailings. The success of such a plan, however, is dependent on ensuring the long-term integrity of these cover materials. Soil erosion from water and wind is the major natural cause of destabilizing earthen cover materials. Field data related to the control of soil loss are limited and only indirectly apply to the problem of isolation of uranium mill tailings over very long time periods (up to 80,000 a). However, sufficient information is available to determine benefits that will result from the changes in specific design variables and to evaluate the need for different design strategies among potential disposal sites. The three major options available for stabilization of uranium mill tailings are: rock cover, soil and revegetation, or a combination of both on different portions of the tailings cover. The optimal choice among these alternatives depends on site-specific characteristics such as climate and local geomorphology and soils, and on design variables such as embankment, heights and slopes, modification of upstream drainage, and revegetation practices. Generally, geomorphic evidence suggests that use of soil and vegetation alone will not be adequate to reduce erosion on slopes greater than about 5 to 9%

Employment Situation of Parents of Long-Term Childhood Cancer Survivors.

Science.gov (United States)

Mader, Luzius; Rueegg, Corina S; Vetsch, Janine; Rischewski, Johannes; Ansari, Marc; Kuehni, Claudia E; Michel, Gisela

2016-01-01

Taking care of children diagnosed with cancer affects parents' professional life. The impact in the long-term however, is not clear. We aimed to compare the employment situation of parents of long-term childhood cancer survivors with control parents of the general population, and to identify clinical and socio-demographic factors associated with parental employment. As part of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to parents of survivors aged 5-15 years, who survived ≥5 years after diagnosis. Information on control parents of the general population came from the Swiss Health Survey (restricted to men and women with ≥1 child aged 5-15 years). Employment was categorized as not employed, part-time, and full-time employed. We used generalized ordered logistic regression to determine associations with clinical and socio-demographic factors. Clinical data was available from the Swiss Childhood Cancer Registry. We included 394 parent-couples of survivors and 3'341 control parents (1'731 mothers; 1'610 fathers). Mothers of survivors were more often not employed (29% versus 22%; ptrend = 0.007). However, no differences between mothers were found in multivariable analysis. Fathers of survivors were more often employed full-time (93% versus 87%; ptrend = 0.002), which remained significant in multivariable analysis. Among parents of survivors, mothers with tertiary education (OR = 2.40, CI:1.14-5.07) were more likely to be employed. Having a migration background (OR = 3.63, CI: 1.71-7.71) increased the likelihood of being full-time employed in mothers of survivors. Less likely to be employed were mothers of survivors diagnosed with lymphoma (OR = 0.31, CI:0.13-0.73) and >2 children (OR = 0.48, CI:0.30-0.75); and fathers of survivors who had had a relapse (OR = 0.13, CI:0.04-0.36). Employment situation of parents of long-term survivors reflected the more traditional parenting roles. Specific support for parents with low education, additional

Hydrotherapy for the long-term ventilated patient: A case study and implications for practice.

Science.gov (United States)

Wegner, Sally; Thomas, Peter; James, Christine

2017-11-01

Hydrotherapy of mechanically ventilated patients has been shown to be safe and feasible in both the acute stages of critical illness and in those requiring long term mechanical ventilation. This case study describes the hydrotherapy sessions of a 36 year old female, who after suffering complications of pneumococcal meningitis, became an incomplete quadriplegic and required long term mechanical ventilation. When implementing hydrotherapy with patients on mechanical ventilation a number of factors should be considered. These include staff resources and training, airway and ventilation management, patient preparation and safety procedures. Hydrotherapy can be safely utilised with mechanically ventilated patients, and may facilitate a patient's ability to participate in active exercise and rehabilitation. Copyright © 2017 Australian College of Critical Care Nurses Ltd. All rights reserved.

Long-term associative learning predicts verbal short-term memory performance

OpenAIRE

Jones, Gary; Macken, Bill

2017-01-01

Studies using tests such as digit span and nonword repetition have implicated short-term memory across a range of developmental domains. Such tests ostensibly assess specialized processes for the short-term manipulation and maintenance of information that are often argued to enable long-term learning. However, there is considerable evidence for an influence of long-term linguistic learning on performance in short-term memory tasks that brings into question the role of a specialized short-term...

An idealised study for the long term evolution of crescentic bars

Science.gov (United States)

Chen, W. L.; Dodd, N.; Tiessen, M. C. H.; Calvete, D.

2018-01-01

An idealised study that identifies the mechanisms in the long term evolution of crescentic bar systems in nature is presented. Growth to finite amplitude (i.e., equilibration, sometimes referred to as saturation) and higher harmonic interaction are hypothesised to be the leading nonlinear effects in long-term evolution of these systems. These nonlinear effects are added to a linear stability model and used to predict crescentic bar development along a beach in Duck, North Carolina (USA) over a 2-month period. The equilibration prolongs the development of bed patterns, thus allowing the long term evolution. Higher harmonic interaction enables the amplitude to be transferred from longer to shorter lengthscales, which leads to the dominance of shorter lengthscales in latter post-storm stages, as observed at Duck. The comparison with observations indicates the importance of higher harmonic interaction in the development of nearshore crescentic bar systems in nature. Additionally, it is concluded that these nonlinear effects should be included in models simulating the development of different bed patterns, and that this points a way forward for long-term morphodynamical modelling in general.

A United States perspective on long-term management of areas contaminated with radioactive materials.

Science.gov (United States)

Jones, C Rick

2004-01-01

The US has far-reaching and extensive experience in the long-term management of areas contaminated with radioactive materials. This experience base includes the Department of Energy's continued follow-up with Hiroshima and Nagasaki from the 1940s at the Radiological Effects Research Foundation in Hiroshima, Japan, the long-term management of the Marshall Islands Programme, the clean-up of the US nuclear weapons complex and the ongoing management of accident sites such as in Palomares, Spain. This paper discusses the lessons learnt and best practices gained from this far-reaching and extensive experience in the long-term management of areas contaminated with radioactive materials. Copyright 2004 Oxford University Press

A United States perspective on long-term management of areas contaminated with radioactive materials

International Nuclear Information System (INIS)

Jones, C. R.

2004-01-01

The US has far-reaching and extensive experience in the long-term management of areas contaminated with radioactive materials. This experience base includes the Dept. of Energy's continued follow-up with Hiroshima and Nagasaki from the 1940's at the Radiological Effects Research Foundation in Hiroshima (Japan)), the long-term management of the Marshall Islands Programme, the clean-up of the US nuclear weapons complex and the ongoing management of accident sites such as in Palomares (Spain)). This paper discusses the lessons learnt and best practices gained from this far-reaching and extensive experience in the long-term management of areas contaminated with radioactive materials. (authors)

General health status of long-term cervical cancer survivors after radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Lee, Sung Uk; Park, Ji Eun [National Cancer Center, Proton Therapy Center, Research Institute and Hospital, Goyang (Korea, Republic of); Kim, Young Ae [National Cancer Center, Cancer Policy Branch, Research Institute and Hospital, Goyang (Korea, Republic of); Yoon, Young-Ho [Seoul National University College of Medicine, Cancer Research Institute, Seoul (Korea, Republic of); Kim, Yeon-Joo [National Cancer Center, Proton Therapy Center, Research Institute and Hospital, Goyang (Korea, Republic of); National Cancer Center, Center for Uterine Cancer, Research Institute and Hospital, Goyang (Korea, Republic of); Lim, Myong Cheol [National Cancer Center, Center for Uterine Cancer, Research Institute and Hospital, Goyang (Korea, Republic of); National Cancer Center, Gynecologic Cancer Branch, Research Institute and Hospital, Goyang (Korea, Republic of); National Cancer Center, Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, Goyang (Korea, Republic of); Park, Sang-Yoon; Seo, Sang-Soo [National Cancer Center, Center for Uterine Cancer, Research Institute and Hospital, Goyang (Korea, Republic of); Kim, Joo-Young [National Cancer Center, Proton Therapy Center, Research Institute and Hospital, Goyang (Korea, Republic of); National Cancer Center, Center for Uterine Cancer, Research Institute and Hospital, Goyang (Korea, Republic of); National Cancer Center, Research Institute and Hospital, Goyang (Korea, Republic of)

2017-07-15

To evaluate the global health status of long-term cervical cancer survivors (LCCS) who survived for more than 4 years after curative radiation treatment (RT). Medical records of 562 women treated with RT in our institution between 2003 and 2010 were reviewed. Excluding 259 women who died of disease or were lost to follow-up, disease status and late morbidities were evaluated in 303 LCCS. Quality of life (QoL) was analyzed in 168 LCCS using a questionnaire from the European Organization for the Research and Treatment of Cancer, and the results were compared with an age-matched healthy Korean female population. Median follow-up was 6.8 years (range 4.1-12.5 years). There were 14 deaths (7 cancer specific) and 14 recurrences (5 local recurrences and 9 distant metastases). The median time to recurrence was 6.0 years (range 4.1-8.2 years). Grade ≥2 late toxicities were frequently observed in the bladder (19%) and small/large intestine (15%). Multivariate analysis revealed a higher rate of late toxicity in patients aged ≥51 years at diagnosis (small/large intestine: hazard ratio, HR, 2.5 [1.2-5.5]; bladder: HR 2.4 [1.3-4.5]; and bone: HR 4.3 [1.2-15.8]) than patients aged <51 years. Compared to the general population, LCCS exhibited a significantly higher rate of body image concerns, sexual dysfunction, lymphedema, and peripheral neuropathy. New recurrences occurred in 5% of LCCS and grade ≥2 treatment-related morbidities were present in 33%. A significant proportion of LCCS also showed decreased cervical-cancer-specific QoL. These results suggest the need for long-term surveillance and follow-up care for LCCS. (orig.) [German] Bewertung des allgemeinen Gesundheitsstatus bei Langzeitueberlebenden von Gebaermutterhalskrebs (LCCS), die nach Strahlenbehandlung (RT) mehr als 4 Jahre lebten. Ueberprueft wurden Krankenakten von 562 Frauen, die zwischen 2003 und 2010 in unserem Institut mit RT behandelt wurden. Ausgeschlossen wurden 259 Frauen, die aufgrund der Erkrankung

Dienogest in long-term treatment of endometriosis

Directory of Open Access Journals (Sweden)

Schindler AE

2011-07-01

Full Text Available Adolf E SchindlerInstitute for Medical Research and Education, Essen, GermanyAbstract: Endometriosis is a chronic disease primarily affecting women of childbearing age, in which endometriotic lesions form outside the uterus, typically leading to painful symptoms, fatigue, and infertility. The symptoms of endometriosis may cause significant impairment in quality of life and represent a substantial economic burden to patients, families, and society. There is no cure for endometriosis; management consists of alleviating pain and other symptoms, reducing endometriotic lesions, and improving quality of life. Recurrence after surgical intervention is common, while the clinical evidence to support the efficacy and safety of many medications currently used in endometriosis is limited. Dienogest is an oral progestin that has been investigated extensively in the treatment of endometriosis in two clinical programs performed in Europe and Japan, including dose-ranging, placebo-controlled, active comparator-controlled, and long-term (up to 65 weeks studies. These studies demonstrated that dienogest 2 mg daily effectively alleviates the painful symptoms of endometriosis, reduces endometriotic lesions, and improves indices of quality of life. Dienogest showed a favorable safety and tolerability profile in these studies, with predictable adverse effects, high rates of patient compliance, and low withdrawal rates. This review article describes the clinical trial evidence that characterizes the efficacy and safety of dienogest in endometriosis, including two studies characterizing dienogest in long-term use. The relevance of these findings to the management of endometriosis in clinical practice is discussed.Keywords: dienogest, endometriosis, progestins, long-term treatment, quality of life, symptoms, pain

School-based smoking prevention programs with the promise of long-term effects

Directory of Open Access Journals (Sweden)

Flay Brian R

2009-03-01

Full Text Available Abstract I provide a systematic review of trials of school-based smoking prevention programs that had at least 15 sessions, preferably with some in high school, that reported significant short-term effects, and that included long-term follow-up. This is supplemented with a description of some other programs that produce short-term effects that portend large long-term effects. I conclude that school-based programs can have long-term effects of practical importance it they: include 15 or more sessions over multiple years, including some in high school; use the social influence model and interactive delivery methods; include components on norms, commitment not to use, intentions not to use, and training and practice in the use of refusal and other life skills; and use peer leaders in some role. School-based programs of this type can reduce smoking onset by 25–30%, and school plus community programs can reduce smoking onset by 35–40% by the end of high school. Some early childhood programs that do not have smoking prevention as their main aim, including home nursing, the Good Behavior Game, the Positive Action program and others, seem to change the developmental trajectories of children so that they are less likely to engage in multiple problem behaviors, including smoking, as adolescents. This review makes it clear that effective school-based smoking prevention programs exist and can be adopted, adapted and deployed with success – and should be.

IS THE PRICE RIGHT? PRICING FOR LONG TERM PROFITABILITY

Directory of Open Access Journals (Sweden)

Andrea Erika NYÁRÁDI

2007-01-01

Full Text Available The way how we choose our pricing strategy has a significant impact on company’s success. Nowadays companies more and more adopt a new way of thinking in pricing, namely pricing for a long term period in order to bring higher profitability, to build an efficient pricing strategy. Marketers have only recently begun to focus seriously on effective pricing. These companies are the so called progressive companies. They have begun doing more than just worrying about pricing. To increase profitability many are abandoning traditional reactive pricing procedures in favor of proactive pricing, making explicit corporate decisions to change their focus to growth in top-line sales to growth in profitability. The long-term implications of price strategies are still under-researched, and managers should be aware of shifts in customer reactions that may result from frequent adoption of certain strategies. The company pricing strategy should be seen in relation to developments in the company variables, internal ones (capital strength, competencies, organizational conditions, efficiency of the work force etc. as well as external ones (customers, competitors, the technological development etc., adopting strategic pricing. In this paper I will present the most effective pricing strategies leading to long term profitability, and also suggest practical conditions for pricing strategies to maximize profit in the long run.

LONG-TERM OUTCOME IN PEDIATRIC TRICHOTILLOMANIA.

Science.gov (United States)

Schumer, Maya C; Panza, Kaitlyn E; Mulqueen, Jilian M; Jakubovski, Ewgeni; Bloch, Michael H

2015-10-01

To examine long-term outcome in children with trichotillomania. We conducted follow-up clinical assessments an average of 2.8 ± 0.8 years after baseline evaluation in 30 of 39 children who previously participated in a randomized, double-blind, placebo-controlled trial of N-acetylcysteine (NAC) for pediatric trichotillomania. Our primary outcome was change in hairpulling severity on the Massachusetts General Hospital Hairpulling Hospital Hairpulling Scale (MGH-HPS) between the end of the acute phase and follow-up evaluation. We also obtained secondary measures examining styles of hairpulling, comorbid anxiety and depressive symptoms, as well as continued treatment utilization. We examined both correlates and predictors of outcome (change in MGH-HPS score) using linear regression. None of the participants continued to take NAC at the time of follow-up assessment. No significant changes in hairpulling severity were reported over the follow-up period. Subjects reported significantly increased anxiety and depressive symptoms but improvement in automatic pulling symptoms. Increased hairpulling symptoms during the follow-up period were associated with increased depression and anxiety symptoms and increased focused pulling. Older age and greater focused pulling at baseline assessment were associated with poor long-term prognosis. Our findings suggest that few children with trichotillomania experience a significant improvement in trichotillomania symptoms if behavioral treatments are inaccessible or have failed to produce adequate symptom relief. Our findings also confirm results of previous cross-sectional studies that suggest an increased risk of depression and anxiety symptoms with age in pediatric trichotillomania. Increased focused pulling and older age among children with trichotillomania symptoms may be associated with poorer long-term prognosis. © 2015 Wiley Periodicals, Inc.

Vital correspondence: Exploring tactile experience with resident-focused mandalas in long-term care (Innovative practice).

Science.gov (United States)

Graham, Megan E; Fabricius, Andréa

2018-01-01

The materiality of long-term care and its relationship to a resident's identity is often overlooked. In response to the call for more attention to the meaningful aspects of doing art, the tactile experience of residents with dementia is considered in the context of a mandala project at a Canadian seniors' long-term care facility. The significance of making mandalas for residents is explored through three key themes: identity integration through gesture, the importance of artistic discernment and decision-making, and the value of corresponding with recalcitrant materials. Residents' experiences are analysed through a phenomenological lens.

Long-term surveillance plan for the Burro Canyon disposal cell, Slick Rock, Colorado

International Nuclear Information System (INIS)

1998-05-01

This long-term surveillance plan (LTSP) describes the US Department of Energy (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Burro Canyon disposal cell in San Miguel County, Colorado. The US Nuclear Regulatory Commission (NRC) developed regulations for the issuance of a general license for the custody and long-term care of UMTRA Project disposal sites in 10 CFR Part 40. The purpose of this general license is to ensure that the UMTRA Project disposal sites are cared for in a manner that protects the public health and safety and the environment. Before each disposal site is licensed, the NRC requires the DOE to submit a site-specific LTSP. The DOE prepared this LTSP to meet this requirement for the Burro Canyon disposal cell. The general license becomes effective when the NRC concurs with the DOE's determination that remedial action is complete at the Burro Canyon disposal cell and the NRC formally accepts this LTSP. Attachment 1 contains the concurrence letters from NRC. This LTSP describes the long-term surveillance program the DOE will implement to ensure that the Burro Canyon disposal cell performs as designed. The program is based on site inspections to identify threats to disposal cell integrity. Ground water monitoring will not be required at the Burro Canyon disposal cell because the ground water protection strategy is supplemental standards based on low yield from the uppermost aquifer

Change in healthcare utilization and costs following initiation of benzodiazepine therapy for long-term treatment of generalized anxiety disorder: a retrospective cohort study

Directory of Open Access Journals (Sweden)

Berger Ariel

2012-10-01

Full Text Available Abstract Background Selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and benzodiazepine anxiolytics are used in the US to treat generalized anxiety disorder (GAD. While benzodiazepines typically provide rapid symptomatic relief, long-term use is not recommended due to risks of dependency, sedation, falls, and accidents. Methods Using a US health insurance database, we identified all persons with GAD (ICD-9-CM diagnosis code 300.02 who began a long-term course of treatment (≥90 days with a benzodiazepine anxiolytic between 1/1/2003 and 12/31/2007, We compared healthcare utilization and costs over the six-month periods preceding and following the date of treatment initiation (“pretreatment” and “post-treatment”, respectively, and focused attention on accident-related encounters (e.g., for treatment of fractures and care received for other reasons possibly related benzodiazepine use (e.g., sedation, dizziness. Results A total of 866 patients met all study entry criteria; 25% of patients began treatment on an add-on basis (i.e., adjunctive to escitalopram, paroxetine, sertraline, or venlafaxine, while 75% of patients did not receive concomitant therapy. Mean total healthcare costs increased by $2334 between the pretreatment and post-treatment periods (from $4637 [SD=$9840] to $6971 [$17,002]; p Conclusions Healthcare costs increase in patients with GAD beginning long-term (≥90 days treatment with a benzodiazepine anxiolytic; a substantial proportion of this increase is attributable to care associated with accidents and other known sequelae of long-term benzodiazepine use.

Refugee experiences of general practice in countries of resettlement: a literature review.

Science.gov (United States)

Cheng, I-Hao; Drillich, Ann; Schattner, Peter

2015-03-01

Refugees and asylum seekers often struggle to use general practice services in resettlement countries. To describe and analyse the literature on the experiences of refugees and asylum seekers using general practice services in countries of resettlement. Literature review using systematic search and narrative data extraction and synthesis methodologies. International, peer-reviewed literature published in English language between 1990 and 2013. Embase, Ovid MEDLINE, PsycINFO, CSA Sociological Abstracts, and CINAHL databases were searched using the terms: refugee, asylum seeker, experience, perception, doctor, physician, and general practitioner. Titles, abstracts and full texts were reviewed and were critically appraised. Narrative themes describing the refugee or asylum seeker's personal experiences of general practice services were identified, coded, and analysed. From 8722 papers, 85 were fully reviewed and 23 included. These represented the experiences of approximately 864 individuals using general practice services across 11 countries. Common narrative themes that emerged were: difficulties accessing general practice services, language barriers, poor doctor-patient relationships, and problems with the cultural acceptability of medical care. The difficulties refugees and asylum seekers experience accessing and using general practice services could be addressed by providing practical support for patients to register, make appointments, and attend services, and through using interpreters. Clinicians should look beyond refugee stereotypes to focus on the needs and expectations of the individual. They should provide clear explanations about unfamiliar clinical processes and treatments while offering timely management. © British Journal of General Practice 2015.

Long-Term Visual Training Increases Visual Acuity and Long-Term Monocular Deprivation Promotes Ocular Dominance Plasticity in Adult Standard Cage-Raised Mice.

Science.gov (United States)

Hosang, Leon; Yusifov, Rashad; Löwel, Siegrid

2018-01-01

For routine behavioral tasks, mice predominantly rely on olfactory cues and tactile information. In contrast, their visual capabilities appear rather restricted, raising the question whether they can improve if vision gets more behaviorally relevant. We therefore performed long-term training using the visual water task (VWT): adult standard cage (SC)-raised mice were trained to swim toward a rewarded grating stimulus so that using visual information avoided excessive swimming toward nonrewarded stimuli. Indeed, and in contrast to old mice raised in a generally enriched environment (Greifzu et al., 2016), long-term VWT training increased visual acuity (VA) on average by more than 30% to 0.82 cycles per degree (cyc/deg). In an individual animal, VA even increased to 1.49 cyc/deg, i.e., beyond the rat range of VAs. Since visual experience enhances the spatial frequency threshold of the optomotor (OPT) reflex of the open eye after monocular deprivation (MD), we also quantified monocular vision after VWT training. Monocular VA did not increase reliably, and eye reopening did not initiate a decline to pre-MD values as observed by optomotry; VA values rather increased by continued VWT training. Thus, optomotry and VWT measure different parameters of mouse spatial vision. Finally, we tested whether long-term MD induced ocular dominance (OD) plasticity in the visual cortex of adult [postnatal day (P)162-P182] SC-raised mice. This was indeed the case: 40-50 days of MD induced OD shifts toward the open eye in both VWT-trained and, surprisingly, also in age-matched mice without VWT training. These data indicate that (1) long-term VWT training increases adult mouse VA, and (2) long-term MD induces OD shifts also in adult SC-raised mice.

Long-term exposure to indoor air pollution and wheezing symptoms in infants

DEFF Research Database (Denmark)

Raaschou-Nielsen, O.; Hermansen, M.N.; Loland, L.

2010-01-01

Long-term exposure to air pollution is suspected to cause recurrent wheeze in infants. The few previous studies have had ambiguous results. The objective of this study was to estimate the impact of measured long-term exposure to indoor air pollution on wheezing symptoms in infants. We monitored......-point 'any symptom-day' (yes/no) and by standard linear regression with the end-point 'number of symptom-days'. The results showed no systematic association between risk for wheezing symptoms and the levels of these air pollutants with various indoor and outdoor sources. In conclusion, we found no evidence...... of an association between long-term exposure to indoor air pollution and wheezing symptoms in infants, suggesting that indoor air pollution is not causally related to the underlying disease. Practical Implications Nitrogen oxides, formaldehyde and fine particles were measured in the air in infants' bedrooms...

Long-term fish monitoring in large rivers: Utility of “benchmarking” across basins

Science.gov (United States)

Ward, David L.; Casper, Andrew F.; Counihan, Timothy D.; Bayer, Jennifer M.; Waite, Ian R.; Kosovich, John J.; Chapman, Colin; Irwin, Elise R.; Sauer, Jennifer S.; Ickes, Brian; McKerrow, Alexa

2017-01-01

In business, benchmarking is a widely used practice of comparing your own business processes to those of other comparable companies and incorporating identified best practices to improve performance. Biologists and resource managers designing and conducting monitoring programs for fish in large river systems tend to focus on single river basins or segments of large rivers, missing opportunities to learn from those conducting fish monitoring in other rivers. We briefly examine five long-term fish monitoring programs in large rivers in the United States (Colorado, Columbia, Mississippi, Illinois, and Tallapoosa rivers) and identify opportunities for learning across programs by detailing best monitoring practices and why these practices were chosen. Although monitoring objectives, methods, and program maturity differ between each river system, examples from these five case studies illustrate the important role that long-term monitoring programs play in interpreting temporal and spatial shifts in fish populations for both established objectives and newly emerging questions. We suggest that deliberate efforts to develop a broader collaborative network through benchmarking will facilitate sharing of ideas and development of more effective monitoring programs.

Long-term risks of inadequate management practices on the sustainability of agricultural soils

NARCIS (Netherlands)

Vries, de W.; Groenenberg, J.E.; Murányi, A.; Curlík, J.; Sefcík, P.; Römkens, P.F.A.M.; Reinds, G.J.; Bril, J.; Modin, A.K.; Sverdrup, H.U.; Alloway, B.J.

2003-01-01

This report describes the major result of a research project funded by the INCO-Copernicus programma of European Commission under Contract number ERB-IC15-CT98-0133. The study focused on the long-term environmental risk of soil acidification on: (i) mobilisation and leaching and (ii) plant uptake of

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

Energy Technology Data Exchange (ETDEWEB)

Steinmetz, Zacharias; Wollmann, Claudia; Schaefer, Miriam; Buchmann, Christian; David, Jan [Institute for Environmental Sciences, Group of Environmental and Soil Chemistry, University of Koblenz-Landau, Fortstraße 7, 76829 Landau (Germany); Tröger, Josephine [Department of Psychology, University of Koblenz-Landau, Fortstraße 7, 76829 Landau (Germany); Interdisciplinary Research Group on Environmental Issues, University of Koblenz-Landau, Fortstraße 7, 76829 Landau (Germany); Muñoz, Katherine [Institute for Environmental Sciences, Group of Environmental and Soil Chemistry, University of Koblenz-Landau, Fortstraße 7, 76829 Landau (Germany); Interdisciplinary Research Group on Environmental Issues, University of Koblenz-Landau, Fortstraße 7, 76829 Landau (Germany); Frör, Oliver [Institute for Environmental Sciences, Group of Environmental Economics, University of Koblenz-Landau, Fortstraße 7, 76829 Landau (Germany); Schaumann, Gabriele Ellen, E-mail: schaumann@uni-landau.de [Institute for Environmental Sciences, Group of Environmental and Soil Chemistry, University of Koblenz-Landau, Fortstraße 7, 76829 Landau (Germany)

2016-04-15

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

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

International Nuclear Information System (INIS)

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

2016-01-01

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

The development of professional practice standards for Australian general practice nurses.

Science.gov (United States)

Halcomb, Elizabeth; Stephens, Moira; Bryce, Julianne; Foley, Elizabeth; Ashley, Christine

2017-08-01

The aim of this study was to explore the current role of general practice nurses and the scope of nursing practice to inform the development of national professional practice standards for Australian general practice nurses. Increasing numbers of nurses have been employed in Australian general practice to meet the growing demand for primary care services. This has brought significant changes to the nursing role. Competency standards for nurses working in general practice were first developed in Australia in 2005, but limited attention has been placed on articulating the contemporary scope of practice for nurses in this setting. Concurrent mixed methods design. Data collection was conducted during 2013-2014 and involved two online surveys of Registered and Enrolled Nurses currently working in general practice, a series of 14 focus groups across Australia and a series of consultations with key experts. Data collection enabled the development of 22 Practice Standards separated into four domains: (i) Professional Practice; (ii) Nursing Care; (iii) General Practice Environment and (iv) Collaborative Practice. To differentiate the variations in enacting these Standards, performance indicators for the Enrolled Nurse, Registered Nurse and Registered Nurse Advanced Practice are provided under each Standard. The development of national professional practice standards for nurses working in Australian general practice will support ongoing workforce development. These Standards are also an important means of articulating the role and scope of the nurses' practice for both consumers and other health professionals, as well as being a guide for curriculum development and measurement of performance. © 2017 John Wiley & Sons Ltd.

Model complexity and choice of model approaches for practical simulations of CO₂ injection, migration, leakage and long-term fate

Energy Technology Data Exchange (ETDEWEB)

Celia, Michael A. [Princeton Univ., NJ (United States)

2016-12-30

This report documents the accomplishments achieved during the project titled “Model complexity and choice of model approaches for practical simulations of CO₂ injection,migration, leakage and long-term fate” funded by the US Department of Energy, Office of Fossil Energy. The objective of the project was to investigate modeling approaches of various levels of complexity relevant to geologic carbon storage (GCS) modeling with the goal to establish guidelines on choice of modeling approach.

Long-term collections

CERN Multimedia

Collectes à long terme

2007-01-01

The Committee of the Long Term Collections (CLT) asks for your attention for the following message from a young Peruvian scientist, following the earthquake which devastated part of her country a month ago.

Accreditation in general practice in Denmark

DEFF Research Database (Denmark)

Andersen, Merethe K; Pedersen, Line B; Siersma, Volkert

2017-01-01

Background: Accreditation is used increasingly in health systems worldwide. However, there is a lack of evidence on the effects of accreditation, particularly in general practice. In 2016 a mandatory accreditation scheme was initiated in Denmark, and during a 3-year period all practices, as default...... general practitioners in Denmark. Practices allocated to accreditation in 2016 serve as the intervention group, and practices allocated to accreditation in 2018 serve as controls. The selected outcomes should meet the following criteria: (1) a high degree of clinical relevance; (2) the possibility...... practice and mortality. All outcomes relate to quality indicators included in the Danish Healthcare Quality Program, which is based on general principles for accreditation. Discussion: The consequences of accreditation and standard-setting processes are generally under-researched, particularly in general...

Self-Reported Long-Term Benefits of Mindfulness-Based Cognitive Therapy in Patients with Bipolar Disorder.

Science.gov (United States)

Weber, Béatrice; Sala, Loretta; Gex-Fabry, Marianne; Docteur, Aurélie; Gorwood, Philip; Cordera, Paolo; Bondolfi, Guido; Jermann, Françoise; Aubry, Jean-Michel; Mirabel-Sarron, Christine

2017-07-01

This study focused on patients with bipolar disorder (BD), several years after their participation in mindfulness-based cognitive therapy (MBCT). It aimed at documenting sustained mindfulness practice, perceived long-term benefit from the program, and changes regarded as direct consequences of the intervention. This cross-sectional survey took place at least 2 years after MBCT for 70.4% of participants. It was conducted in two specialized outpatient units for BDs that are part of the Geneva University Hospitals (Switzerland) and the Sainte-Anne Hospital in Paris (France). Eligibility criteria were a diagnosis of BD according to DSM-IV and participation in at least four MBCT sessions. Response rate was 66.4%. The final sample included 71 outpatients (71.8% bipolar I, 28.2% bipolar II). A questionnaire retrospectively assessed patient-perceived change, benefit from MBCT, and current mindfulness practice. Proportions of respondents who practiced mindfulness at least once a week were 54.9% for formal practice (body scan, sitting meditation, mindful walking, or movements) and 57.7% for informal practice (mindful daily activities). Perceived benefit for the prevention of relapse was moderate, but patients acknowledged long-lasting effects and persistent changes in their way of life. Formal mindfulness practice at least once a week tended to be associated with increased long-lasting effects (p = 0.052), whereas regular informal practice and mindful breathing were significantly associated with persistent changes in daily life (p = 0.038) and better prevention of depressive relapse (p = 0.035), respectively. The most frequently reported positive change was increased awareness of being able to improve one's health. Despite methodological limitations, this survey allowed documenting mindfulness practice and perceived sustained benefit from MBCT in patients with BD. Participants particularly valued increased awareness that they can influence their own health. Both

Long term preservation of scientific data: Lessons from jet and other domains

International Nuclear Information System (INIS)

Layne, R.; Capel, A.; Cook, N.; Wheatley, M.

2012-01-01

Highlights: ► Data from a fusion experiment must be preserved for decades, and will be required beyond the lifetime of the experiment. ► General principles of long-term data preservation have been identified in domains outside fusion. ► Key challenges are media obsolescence, data organisation, and file format obsolescence. ► Data from JET has to date been preserved for almost three decades: the steps taken to achieve this are discussed. ► Recommendations for new devices in planning for the long-term preservation of their data are made. - Abstract: All fusion devices generate large amounts of data, which must remain accessible throughout and beyond the lifetime of the device. This need for long-term data preservation creates major software and hardware challenges. Issues surrounding long-term data preservation will be discussed, and the main challenges in data curation will be outlined. The paper will then review the approaches taken at JET to ensure accessibility of all of JET's data over almost three decades. Using the JET experience and the wider context, the paper will then suggest how new experiments should plan for the long-term preservation of their data.

Long-term surveillance plan for the Green River, Utah disposal site. Revision 1

International Nuclear Information System (INIS)

1994-08-01

The long-term surveillance plan (LTSP) for the Green River, Utah, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Green River disposal cell. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). This LTSP documents whether the land and interests are owned by the United States or an Indian tribe and details how the long-term care of the disposal site will be carried out. The Green River, Utah, LTSP is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a)

On the Beat Detection Performance in Long-Term ECG Monitoring Scenarios

Directory of Open Access Journals (Sweden)

Francisco-Manuel Melgarejo-Meseguer

2018-05-01

Full Text Available Despite the wide literature on R-wave detection algorithms for ECG Holter recordings, the long-term monitoring applications are bringing new requirements, and it is not clear that the existing methods can be straightforwardly used in those scenarios. Our aim in this work was twofold: First, we scrutinized the scope and limitations of existing methods for Holter monitoring when moving to long-term monitoring; Second, we proposed and benchmarked a beat detection method with adequate accuracy and usefulness in long-term scenarios. A longitudinal study was made with the most widely used waveform analysis algorithms, which allowed us to tune the free parameters of the required blocks, and a transversal study analyzed how these parameters change when moving to different databases. With all the above, the extension to long-term monitoring in a database of 7-day Holter monitoring was proposed and analyzed, by using an optimized simultaneous-multilead processing. We considered both own and public databases. In this new scenario, the noise-avoid mechanisms are more important due to the amount of noise that exists in these recordings, moreover, the computational efficiency is a key parameter in order to export the algorithm to the clinical practice. The method based on a Polling function outperformed the others in terms of accuracy and computational efficiency, yielding 99.48% sensitivity, 99.54% specificity, 99.69% positive predictive value, 99.46% accuracy, and 0.85% error for MIT-BIH arrhythmia database. We conclude that the method can be used in long-term Holter monitoring systems.

Early predictors of the long-term outcome of low back pain - results of a 22-year prospective cohort study from general practice

DEFF Research Database (Denmark)

Lonnberg, F.; Pedersen, P.; Siersma, V.

2010-01-01

, use of painkillers for low back pain, use of health care providers, impairments due to low back pain and unfitness for work caused by low back pain. The influence of the predictors was assessed by relative risks. RESULTS: After 22 years, four out of five patients still experienced low back pain....... The perception of poor working conditions correlates with recurrent low back pain, intake of painkillers and limitations to daily life. CONCLUSION: Compared with pain history and clinical findings, the perception of workload is a better predictor of the long-term outcome of low back pain Udgivelsesdato: 2010/8/3...

Vitamin D and the Promotion of Long-Term Metabolic Health from a Programming Perspective

Directory of Open Access Journals (Sweden)

Saranya Palaniswamy

2015-01-01

Full Text Available Studies linking vitamin D and long-term metabolic health have generated much debate. Recommendations for the intake of vitamin D by the general public and by the health care professionals have been complicated by a number of inconsistencies in the literature. These caveats relate to the methodological approaches, differences in the populations (and the species of study, and the definitions used for thresholds of vitamin D status. This review addresses current evidence available for assessing the potential programming of long-term metabolic health of offspring by maternal vitamin D status in pregnancy. It summarizes knowledge on the early origins of metabolic health and analyzes evidence for an association between the vitamin D status in pregnancy and maternal and fetal health status. In addition, we analyze the link between the regulation of inflammation and the vitamin D status in the general population to inform on the general mechanisms through which early vitamin D might affect the programming of long-term health. The evidence suggests an association between the vitamin D status in early life and the programming of long-term health. However, to the best of our knowledge, the current finding is insufficient to draw a final conclusion for evidence-based preventive actions. The data warrant replication in prospective studies and additional research substantiating the causal factors and pathways.

Compensation for PKMζ in long-term potentiation and spatial long-term memory in mutant mice.

Science.gov (United States)

Tsokas, Panayiotis; Hsieh, Changchi; Yao, Yudong; Lesburguères, Edith; Wallace, Emma Jane Claire; Tcherepanov, Andrew; Jothianandan, Desingarao; Hartley, Benjamin Rush; Pan, Ling; Rivard, Bruno; Farese, Robert V; Sajan, Mini P; Bergold, Peter John; Hernández, Alejandro Iván; Cottrell, James E; Shouval, Harel Z; Fenton, André Antonio; Sacktor, Todd Charlton

2016-05-17

PKMζ is a persistently active PKC isoform proposed to maintain late-LTP and long-term memory. But late-LTP and memory are maintained without PKMζ in PKMζ-null mice. Two hypotheses can account for these findings. First, PKMζ is unimportant for LTP or memory. Second, PKMζ is essential for late-LTP and long-term memory in wild-type mice, and PKMζ-null mice recruit compensatory mechanisms. We find that whereas PKMζ persistently increases in LTP maintenance in wild-type mice, PKCι/λ, a gene-product closely related to PKMζ, persistently increases in LTP maintenance in PKMζ-null mice. Using a pharmacogenetic approach, we find PKMζ-antisense in hippocampus blocks late-LTP and spatial long-term memory in wild-type mice, but not in PKMζ-null mice without the target mRNA. Conversely, a PKCι/λ-antagonist disrupts late-LTP and spatial memory in PKMζ-null mice but not in wild-type mice. Thus, whereas PKMζ is essential for wild-type LTP and long-term memory, persistent PKCι/λ activation compensates for PKMζ loss in PKMζ-null mice.

Health sciences libraries' subscriptions to journals: expectations of general practice departments and collection-based analysis.

Science.gov (United States)

Barreau, David; Bouton, Céline; Renard, Vincent; Fournier, Jean-Pascal

2018-04-01

The aims of this study were to (i) assess the expectations of general practice departments regarding health sciences libraries' subscriptions to journals and (ii) describe the current general practice journal collections of health sciences libraries. A cross-sectional survey was distributed electronically to the thirty-five university general practice departments in France. General practice departments were asked to list ten journals to which they expected access via the subscriptions of their health sciences libraries. A ranked reference list of journals was then developed. Access to these journals was assessed through a survey sent to all health sciences libraries in France. Adequacy ratios (access/need) were calculated for each journal. All general practice departments completed the survey. The total reference list included 44 journals. This list was heterogeneous in terms of indexation/impact factor, language of publication, and scope (e.g., patient care, research, or medical education). Among the first 10 journals listed, La Revue Prescrire (96.6%), La Revue du Praticien-Médecine Générale (90.9%), the British Medical Journal (85.0%), Pédagogie Médicale (70.0%), Exercer (69.7%), and the Cochrane Database of Systematic Reviews (62.5%) had the highest adequacy ratios, whereas Family Practice (4.2%), the British Journal of General Practice (16.7%), Médecine (29.4%), and the European Journal of General Practice (33.3%) had the lowest adequacy ratios. General practice departments have heterogeneous expectations in terms of health sciences libraries' subscriptions to journals. It is important for librarians to understand the heterogeneity of these expectations, as well as local priorities, so that journal access meets users' needs.

Environmental effects of the long term management of wastes

International Nuclear Information System (INIS)

Henry, L.C.

1980-08-01

Criteria for interim application in uranium mill tailings management, pending the outcome of a thorough investigation of the tailings problem, are outlined. For a closed-out tailings site only passive or natural barriers are to be used to control releases; surface water recharge is to be limited to that from direct natural precipitation, and no permanent water pool will be allowed; all designed systems must be evaluated in terms of their long-term durability; long-term performance and economic guarantees will be required; access must be limited to the maximum extent practical; and pathway analyses should be performed to determine the health, safety and environmental impacts of the expected level of releases. Releases to water should be no greater than those experienced during the operating phase of the facility. Radon emanation should not exceed 2-10 pCi/m 2 .s, and gamma radiation should be reduced to 10-50 μR/hr at 1 metre above the surface. Particulate emissions originating from the tailings material should be virtually non-existent

Evaluating strategies for sustainable intensification of US agriculture through the Long-Term Agroecosystem Research network

Science.gov (United States)

Spiegal, S.; Bestelmeyer, B. T.; Archer, D. W.; Augustine, D. J.; Boughton, E. H.; Boughton, R. K.; Cavigelli, M. A.; Clark, P. E.; Derner, J. D.; Duncan, E. W.; Hapeman, C. J.; Harmel, R. D.; Heilman, P.; Holly, M. A.; Huggins, D. R.; King, K.; Kleinman, P. J. A.; Liebig, M. A.; Locke, M. A.; McCarty, G. W.; Millar, N.; Mirsky, S. B.; Moorman, T. B.; Pierson, F. B.; Rigby, J. R.; Robertson, G. P.; Steiner, J. L.; Strickland, T. C.; Swain, H. M.; Wienhold, B. J.; Wulfhorst, J. D.; Yost, M. A.; Walthall, C. L.

2018-03-01

Sustainable intensification is an emerging model for agriculture designed to reconcile accelerating global demand for agricultural products with long-term environmental stewardship. Defined here as increasing agricultural production while maintaining or improving environmental quality, sustainable intensification hinges upon decision-making by agricultural producers, consumers, and policy-makers. The Long-Term Agroecosystem Research (LTAR) network was established to inform these decisions. Here we introduce the LTAR Common Experiment, through which scientists and partnering producers in US croplands, rangelands, and pasturelands are conducting 21 independent but coordinated experiments. Each local effort compares the outcomes of a predominant, conventional production system in the region (‘business as usual’) with a system hypothesized to advance sustainable intensification (‘aspirational’). Following the logic of a conceptual model of interactions between agriculture, economics, society, and the environment, we identified commonalities among the 21 experiments in terms of (a) concerns about business-as-usual production, (b) ‘aspirational outcomes’ motivating research into alternatives, (c) strategies for achieving the outcomes, (d) practices that support the strategies, and (e) relationships between practice outreach and adoption. Network-wide, concerns about business as usual include the costs of inputs, opportunities lost to uniform management approaches, and vulnerability to accelerating environmental changes. Motivated by environmental, economic, and societal outcomes, scientists and partnering producers are investigating 15 practices in aspirational treatments to sustainably intensify agriculture, from crop diversification to ecological restoration. Collectively, the aspirational treatments reveal four general strategies for sustainable intensification: (1) reducing reliance on inputs through ecological intensification, (2) diversifying management

PKMzeta maintains spatial, instrumental, and classically conditioned long-term memories.

Directory of Open Access Journals (Sweden)

Peter Serrano

2008-12-01

Full Text Available How long-term memories are stored is a fundamental question in neuroscience. The first molecular mechanism for long-term memory storage in the brain was recently identified as the persistent action of protein kinase Mzeta (PKMzeta, an autonomously active atypical protein kinase C (PKC isoform critical for the maintenance of long-term potentiation (LTP. PKMzeta maintains aversively conditioned associations, but what general form of information the kinase encodes in the brain is unknown. We first confirmed the specificity of the action of zeta inhibitory peptide (ZIP by disrupting long-term memory for active place avoidance with chelerythrine, a second inhibitor of PKMzeta activity. We then examined, using ZIP, the effect of PKMzeta inhibition in dorsal hippocampus (DH and basolateral amygdala (BLA on retention of 1-d-old information acquired in the radial arm maze, water maze, inhibitory avoidance, and contextual and cued fear conditioning paradigms. In the DH, PKMzeta inhibition selectively disrupted retention of information for spatial reference, but not spatial working memory in the radial arm maze, and precise, but not coarse spatial information in the water maze. Thus retention of accurate spatial, but not procedural and contextual information required PKMzeta activity. Similarly, PKMzeta inhibition in the hippocampus did not affect contextual information after fear conditioning. In contrast, PKMzeta inhibition in the BLA impaired retention of classical conditioned stimulus-unconditioned stimulus (CS-US associations for both contextual and auditory fear, as well as instrumentally conditioned inhibitory avoidance. PKMzeta inhibition had no effect on postshock freezing, indicating fear expression mediated by the BLA remained intact. Thus, persistent PKMzeta activity is a general mechanism for both appetitively and aversively motivated retention of specific, accurate learned information, but is not required for processing contextual, imprecise

PKMzeta maintains spatial, instrumental, and classically conditioned long-term memories.

Science.gov (United States)

Serrano, Peter; Friedman, Eugenia L; Kenney, Jana; Taubenfeld, Stephen M; Zimmerman, Joshua M; Hanna, John; Alberini, Cristina; Kelley, Ann E; Maren, Stephen; Rudy, Jerry W; Yin, Jerry C P; Sacktor, Todd C; Fenton, André A

2008-12-23

How long-term memories are stored is a fundamental question in neuroscience. The first molecular mechanism for long-term memory storage in the brain was recently identified as the persistent action of protein kinase Mzeta (PKMzeta), an autonomously active atypical protein kinase C (PKC) isoform critical for the maintenance of long-term potentiation (LTP). PKMzeta maintains aversively conditioned associations, but what general form of information the kinase encodes in the brain is unknown. We first confirmed the specificity of the action of zeta inhibitory peptide (ZIP) by disrupting long-term memory for active place avoidance with chelerythrine, a second inhibitor of PKMzeta activity. We then examined, using ZIP, the effect of PKMzeta inhibition in dorsal hippocampus (DH) and basolateral amygdala (BLA) on retention of 1-d-old information acquired in the radial arm maze, water maze, inhibitory avoidance, and contextual and cued fear conditioning paradigms. In the DH, PKMzeta inhibition selectively disrupted retention of information for spatial reference, but not spatial working memory in the radial arm maze, and precise, but not coarse spatial information in the water maze. Thus retention of accurate spatial, but not procedural and contextual information required PKMzeta activity. Similarly, PKMzeta inhibition in the hippocampus did not affect contextual information after fear conditioning. In contrast, PKMzeta inhibition in the BLA impaired retention of classical conditioned stimulus-unconditioned stimulus (CS-US) associations for both contextual and auditory fear, as well as instrumentally conditioned inhibitory avoidance. PKMzeta inhibition had no effect on postshock freezing, indicating fear expression mediated by the BLA remained intact. Thus, persistent PKMzeta activity is a general mechanism for both appetitively and aversively motivated retention of specific, accurate learned information, but is not required for processing contextual, imprecise, or

CREB binding protein is required for both short-term and long-term memory formation.

Science.gov (United States)

Chen, Guiquan; Zou, Xiaoyan; Watanabe, Hirotaka; van Deursen, Jan M; Shen, Jie

2010-09-29

CREB binding protein (CBP) is a transcriptional coactivator with histone acetyltransferase activity. Our prior study suggested that CBP might be a key target of presenilins in the regulation of memory formation and neuronal survival. To elucidate the role of CBP in the adult brain, we generated conditional knock-out (cKO) mice in which CBP is completely inactivated in excitatory neurons of the postnatal forebrain. Histological analysis revealed normal neuronal morphology and absence of age-dependent neuronal degeneration in the CBP cKO cerebral cortex. CBP cKO mice exhibited robust impairment in the formation of spatial, associative, and object-recognition memory. In addition to impaired long-term memory, CBP cKO mice also displayed deficits in short-term associative and object-recognition memory. Administration of a histone deacetylase inhibitor, trichostatin A, rescued the reduction of acetylated histones in the CBP cKO cortex but failed to rescue either short- or long-term memory deficits, suggesting that the memory impairment may not be caused by general reduction of histone acetyltransferase activity in CBP cKO mice. Further microarray and Western analysis showed decreased expression of calcium-calmodulin-dependent kinase isoforms and NMDA and AMPA receptor subunits in the cerebral cortex of CBP cKO mice. Collectively, these findings suggest a crucial role for CBP in the formation of both short- and long-term memory.

Just a minute meditation: Rapid voluntary conscious state shifts in long term meditators.

Science.gov (United States)

Nair, Ajay Kumar; Sasidharan, Arun; John, John P; Mehrotra, Seema; Kutty, Bindu M

2017-08-01

Meditation induces a modified state of consciousness that remains under voluntary control. Can meditators rapidly and reversibly bring about mental state changes on demand? To check, we carried out 128 channel EEG recordings on Brahma Kumaris Rajayoga meditators (36 long term: median 14240h meditation; 25 short term: 1095h) and controls (25) while they tried to switch every minute between rest and meditation states in different conditions (eyes open and closed; before and after an engaging task). Long term meditators robustly shifted states with enhanced theta power (4-8Hz) during meditation. Short term meditators had limited ability to shift between states and showed increased lower alpha power (8-10Hz) during eyes closed meditation only when pre and post task data were combined. Controls could not shift states. Thus trained beginners can reliably meditate but it takes long term practice to exercise more refined control over meditative states. Copyright © 2017 Elsevier Inc. All rights reserved.

Long-term applicability of the new ILAE definition of epilepsy. Results from the PRO-LONG study.

Science.gov (United States)

Beretta, Simone; Carone, Davide; Zanchi, Clara; Bianchi, Elisa; Pirovano, Marta; Trentini, Claudia; Padovano, Giada; Colombo, Matteo; Cereda, Diletta; Scanziani, Sofia; Giussani, Giorgia; Gasparini, Sara; Bogliun, Graziella; Ferrarese, Carlo; Beghi, Ettore

2017-09-01

The new epilepsy definition adopted by the International League Against Epilepsy (ILAE) includes patients with one unprovoked seizure with a probability of further seizures, similar to the general recurrence risk after two unprovoked seizures, occurring in a 10-year period. Long-term follow-up of patients diagnosed after a single seizure is needed to assess the applicability of the new epilepsy definition in clinical practice. Patients with newly diagnosed epilepsy were recruited retrospectively with a minimum follow-up of 10 years. Patients were stratified in two groups depending on the occurrence of one (new definition, ND) or two or more unprovoked seizures (traditional definition, TD) at the time of epilepsy diagnosis and compared for disease characteristics and factors predicting seizure recurrence. The primary outcome was the occurrence of a new unprovoked seizure during follow-up in the ND group. The secondary outcome was the achievement of an early remission in both groups. Among 1,006 patients with newly diagnosed epilepsy, 152 (15.1%) were diagnosed after a single seizure. Compared to patients diagnosed using the TD, patients diagnosed according to the ND showed a higher proportion of subjects with an abnormal neurologic examination (19.9% vs. 13.7%, p = 0.0504) and with focal seizures (69.3% vs. 60.4%, p = 0.0021). The two samples differed in the presence of at least one of the factors predicting seizure recurrence (focal seizures or abnormal findings in at least one among the following: neurologic examination, electroencephalography [EEG], and neuroimaging) (94.6% vs. 89.1%, p = 0.0376). Long-term recurrence in patients diagnosed with the new definition was 83.6% at 10 years and 89.1% at 15 years. The probability of early remission did not differ between the two groups. Our results support the applicability of the new epilepsy definition in clinical practice. Individual patient characteristics and a personalized diagnostic approach can justify

Sexuality and Physical Intimacy in Long Term Care: Sexuality, long term care, capacity assessment

OpenAIRE

Lichtenberg, Peter A.

2014-01-01

Sexuality and sexual needs in older adults remains a neglected area of clinical intervention, particularly so in long term care settings. Because older adults in medical rehabilitation and long term care beds present with significant frailties, and often significant neurocognitive disorders it makes it difficult for occupational therapists and other staff to evaluate the capacity of an older adult resident to participate in sexual relationships. The current paper reviews the current literatur...

Prevention of fall-related injuries in long-term care: a randomized controlled trial of staff education.

Science.gov (United States)

Ray, Wayne A; Taylor, Jo A; Brown, Anne K; Gideon, Patricia; Hall, Kathi; Arbogast, Patrick; Meredith, Sarah

2005-10-24

Fall-related injuries, a major public health problem in long-term care, may be reduced by interventions that improve safety practices. Previous studies have shown that safety practice interventions can reduce falls; however, in long-term care these have relied heavily on external funding and staff. The aim of this study was to test whether a training program in safety practices for staff could reduce fall-related injuries in long-term care facilities. A cluster randomization clinical trial with 112 qualifying facilities and 10,558 study residents 65 years or older and not bedridden. The intervention was an intensive 2-day safety training program with 12-month follow-up. The training program targeted living space and personal safety; wheelchairs, canes, and walkers; psychotropic medication use; and transferring and ambulation. The main outcome measure was serious fall-related injuries during the follow-up period. There was no difference in injury occurrence between the intervention and control facilities (adjusted rate ratio, 0.98; 95% confidence interval, 0.83-1.16). For residents with a prior fall in facilities with the best program compliance, there was a nonsignificant trend toward fewer injuries in the intervention group (adjusted rate ratio, 0.79; 95% confidence interval, 0.57-1.10). More intensive interventions are required to prevent fall-related injuries in long-term care facilities.

Suspected cow's milk allergy in everyday general practice: a retrospective cohort study on health care burden and guideline adherence.

Science.gov (United States)

van den Hoogen, Sharayke C T A; van de Pol, Alma C; Meijer, Yolanda; Toet, Jaap; van Klei, Céline; de Wit, Niek J

2014-08-09

Cow's milk allergy (CMA) is the most common food allergy among infants. No data are available on the health care burden of suspected CMA in general practice. This study was conducted to evaluate the burden of suspected CMA in general practice (GP): (a) prevalence, (b) presenting symptoms, (c) diagnostic process, (d) guideline adherence, and (e) dietary measures. A retrospective cohort study was carried out in four Julius Healthcare Centers (JHCs). These JHCs form the core primary care academic network of the department of general practice of the University Medical Center of Utrecht. Electronic records of the first year of infants born May 2009 - April 2010 registered in the JHCs were screened for possible CMA suspicion. Preventive child healthcare (PCH) records were reviewed for additional information. Clinical presentation, diagnostic strategies and dietary measures were extracted. Of 804 infants evaluated, 55 presented with symptoms fitting the suspicion of CMA (prevalence of 7%). Presenting complaints involved the skin (71%); the gastrointestinal tract (60%); the respiratory tract (13%) or other symptoms (36%) and 23 infants presented with symptoms of two or more organ systems. In 31 children (56%) a food challenge was performed (n = 28 open and n = 3 double-blind). Open challenge test results were difficult to interpret due to inadequate implementation or reporting. None had confirmed CMA after an adequate challenge test. Long term milk substitute formulas were prescribed in 39 (71%) infants. On a yearly basis seven percent of children visit their GP for suspected CMA. A positive CMA diagnosis was rarely established after adequate implementation and reporting of diagnostics, yet long term dietary measures were prescribed in >70% of patients. There is definitely need for improvement of diagnosing CMA in primary care.

Implementing long-term data preservation and open access in CMS

CERN Document Server

Lassila-Perini, Katri

2013-01-01

Implementation of the CMS policy on long-term data preservation, re-use and open access has started. Current practices in providing data additional to published papers and distributing simplified data-samples for outreach are promoted and consolidated. The first measures have been taken for analysis and data preservation for the internal use of the collaboration and for open access to part of the data. Two complementary approaches are followed. First, a virtual machine environment, which will pack all ingredients needed to compile and run a software release with which the legacy data was reconstructed. Second, a validation framework, maintaining the capability not only to read the old raw data, but also to reprocess them with an updated release or to another format to guarantee long-term reusability of the legacy data.

Maintenance Issues in Long Term Operation of Nuclear Power Plant

International Nuclear Information System (INIS)

Contri, P.; Bieth, M.; Rieg, C.

2006-01-01

Due to current social and economical framework, in last years many nuclear power plant owners started a program for the Long Term Operation (LTO)/PLEX (Plant Life Extension) of their older nuclear facilities. This process has many nuclear safety implications, other than strategic and political ones. The need for tailoring the available safety assessment tools to such applications has become urgent in recent years and triggered many research actions. The review of regular maintenance and ageing management programs are tools widely used in LTO/PLEX context in many Countries. However, most of these tools are rather general and in many cases they need reshaping in an LTO/PLEX framework before application, with focus to the safety implications of the LTO/PLEX. Many Countries and plants radically modified their maintenance rules towards a condition based approach as a precondition for the implementation of LTO/PLEX programs. In 2004 a network of European Organisations operating Nuclear Power Plants, SENUF, under the coordination of the JRC-IE, carried out an extensive questionnaire on maintenance practice in their facilities aiming at capturing the aspects of the maintenance programs where research is mostly needed. This paper uses some results of the questionnaire, which was not oriented to LTO/PLEX, to draw some conclusions on how the current maintenance programs could support a potential LTO/PLEX, among the other programs running at NPPs. In this sense, it is spin-off of the SENUF WG on maintenance. The paper aims at identifying the technical attributes of the maintenance programs more directly affecting the decision for a long-term safe operation of a nuclear facility, the issues related to their implementation and safety review. The paper includes an analysis of the questionnaire circulated among the SENUF participants and a discussion on the implications of optimised maintenance programs in existing plants. Some examples at WWER plants taken by sources other than

The long-term stock market valuation of customer satisfaction

OpenAIRE

Aksoy, Lerzan

2008-01-01

Firm valuation has been an important domain of interest for finance. However, most financial models do not include customer-related metrics in this process. Studies in marketing have found that one particular customer metric, customer satisfaction, improves the ability to predict future cash flows, long-term financial measures, stock performance, and shareholder value. However, most of these studies predominantly employ models that are not directly used in finance practice. This article exten...

Long-Term Effect of Interactive Online Dietician Weight Loss Advice in General Practice (LIVA) Protocol for a Randomized Controlled Trial

DEFF Research Database (Denmark)

Brandt, Carl J; Brandt, Vibeke; Pedersen, Mathilde

2014-01-01

Background. Internet-based complex interventions aiming to promote weight loss and optimize healthy behaviors have attracted much attention. However, evidence for effect is lacking. Obesity is a growing problem, resulting in an increasing demand for cost efficient weight loss programs suitable...... for use on a large scale, for example, as part of standard primary care. In a previous pilot project by Brandt et al. (2011) without a control group, we examined the effects of online dietician counseling and found an average weight loss of 7.0 kg (95% CI: 4.6 to 9.3 kg) after 20 months. Aims and Methods....... To analyze the effects of a complex intervention using trained dieticians in a general practice setting combined with internet-based interactive and personalized weight management support compared with conventional advice with a noninteractive internet support as placebo treatment in 340 overweight patients...

Long-term cognitive and behavioral consequences of neonatal encephalopathy following perinatal asphyxia: a review

NARCIS (Netherlands)

van Handel, M.; Swaab, H.; de Vries, L.S.; Jongmans, M.J.|info:eu-repo/dai/nl/258268743

2007-01-01

Neonatal encephalopathy (NE) following perinatal asphyxia (PA) is considered an important cause of later neurodevelopmental impairment in infants born at term. This review discusses long-term consequences for general cognitive functioning, educational achievement, neuropsychological functioning and

Toxicological Effects of Caco-2 Cells Following Short-Term and Long-Term Exposure to Ag Nanoparticles

Directory of Open Access Journals (Sweden)

Ni Chen

2016-06-01

Full Text Available Extensive utilization increases the exposure of humans to Ag nanoparticles (NPs via the oral pathway. To comprehensively address the action of Ag NPs to the gastrointestinal systems in real situations, i.e., the long-term low-dose exposure, we evaluated and compared the toxicity of three Ag NPs (20–30 nm with different surface coatings to the human intestine cell Caco-2 after 1-day and 21-day exposures, using various biological assays. In both the short- and long-term exposures, the variety of surface coating predominated the toxicity of Ag NPs in a descending order of citrate-coated Ag NP (Ag-CIT, bare Ag NP (Ag-B, and poly (N-vinyl-2-pyrrolidone-coated Ag NP (Ag-PVP. The short-term exposure induced cell growth inhibition and death. The cell viability loss appeared after cells were exposed to 0.7 μg/mL Ag-CIT, 0.9 μg/mL Ag-B or >1.0 μg/mL Ag-PVP for 24 h. The short-term and higher-dose exposure also induced reactive oxygen species (ROS generation, mitochondrial damage, cell membrane leakage, apoptosis, and inflammation (IL-8 level. The long-term exposure only inhibited the cell proliferation. After 21-day exposure to 0.4 μg/mL Ag-CIT, the cell viability dropped to less than 50%, while cells exposed to 0.5 μg/mL Ag-PVP remained normal as the control. Generally, 0.3 μg/mL is the non-toxic dose for the long-term exposure of Caco-2 cells to Ag NPs in this study. However, cells presented inflammation after exposure to Ag NPs with the non-toxic dose in the long-term exposure.

Taking the long view: a systematic review reporting long-term perspectives on child unintentional injury.

Science.gov (United States)

Mytton, Julie A; Towner, Elizabeth M L; Powell, Jane; Pilkington, Paul A; Gray, Selena

2012-10-01

The relative significance of child injury as a cause of preventable death has increased as mortality from infectious diseases has declined. Unintentional child injuries are now a major cause of death and disability across the world with the greatest burden falling on those who are most disadvantaged. A review of long-term data on child injury mortality was conducted to explore trends and inequalities and consider how data were used to inform policy, practice and research. The authors systematically collated and quality appraised data from publications and documents reporting unintentional child injury mortality over periods of 20 years or more. A critical narrative synthesis explored trends by country income group, injury type, age, gender, ethnicity and socioeconomic group. 31 studies meeting the inclusion criteria were identified of which 30 were included in the synthesis. Only six were from middle income countries and none were from low income countries. An overall trend in falling child injury mortality masked rising road traffic injury deaths, evidence of increasing vulnerability of adolescents and widening disparities within countries when analysed by ethnic group and socioeconomic status. Child injury mortality trend data from high and middle income countries has illustrated inequalities within generally falling trends. There is scope for greater use of existing trend data to inform policy and practice. Similar evidence from low income countries where the burden of injury is greatest is needed.

Long-term surveillance plan for the Green River, Utah disposal site. Revision 2

International Nuclear Information System (INIS)

1998-07-01

The long-term surveillance plan (LTSP) for the Green River, Utah, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Green River disposal cell. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This final LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). This LTSP documents whether the land and interests are owned by the United States or an Indian tribe and details how the long-term care of the disposal site will be carried out

Proof of Learning Outcome by the Advanced Clinical Competency Examination Trial after the Long-term Student's Practice in Pharmaceutical Education.

Science.gov (United States)

Komori, Koji; Kataoka, Makoto; Kuramoto, Nobuyuki; Tsuji, Takumi; Nakatani, Takafumi; Yasuhara, Tomohisa; Mitamura, Shinobu; Hane, Yumiko; Ogita, Kiyokazu

2016-01-01

At Setsunan University, a debrief session (a poster session) is commonly performed by the students who have completed the long-term students' practice. Since the valuable changes in practical competency of the students cannot be evaluated through this session, we specified items that can help evaluate and methods that can help estimate the students' competency as clinical pharmacists. We subsequently carried out a trial called the "Advanced Clinical Competency Examination". We evaluated 103 students who had concluded the students' practice for the second period (Sep 1, 2014, to Nov 16, 2014): 70 students (called "All finish students") who had completed the practice in a hospital and pharmacy, and 33 students (called "Hospital finish students") who had finished the practice at a hospital only. The trial was executed in four stages. In the first stage, students drew pictures of something impressive they had learned during the practice. In the second stage, students were given patient cases and were asked, "What is this patient's problem?" and "How would you solve this problem?". In the third stage, the students discussed their answers in a group. In the fourth stage, each group made a poster presentation in separate rooms. By using a rubric, the teachers evaluated each student individually, the results of which showed that the "All finish students" could identify more problems than the "Hospital finish students".

Long-term surveillance plan for the Bodo Canyon Disposal Site, Durango, Colorado

Energy Technology Data Exchange (ETDEWEB)

1994-03-01

This long-term surveillance plan (LTSP) for the Durango, Colorado, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Durango (Bodo Canyon) disposal site, which will be referred to as the disposal site throughout this document. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal site continues to function as designed. This LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). RRMs include tailings and other uranium ore processing wastes still at the site, which the DOE determines to be radioactive. This LTSP is based on the DOE`s Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992).

Long-term surveillance plan for the Bodo Canyon Disposal Site, Durango, Colorado

International Nuclear Information System (INIS)

1994-03-01

This long-term surveillance plan (LTSP) for the Durango, Colorado, Uranium Mill Tailings Remedial Action (UMTRA) Project disposal site describes the surveillance activities for the Durango (Bodo Canyon) disposal site, which will be referred to as the disposal site throughout this document. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal site continues to function as designed. This LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials (RRM). RRMs include tailings and other uranium ore processing wastes still at the site, which the DOE determines to be radioactive. This LTSP is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992)

Long-term prisoner in prison isolation

Directory of Open Access Journals (Sweden)

Karolina Grudzińska

2013-06-01

Full Text Available Long-term prisoner belongs to a particular category of people who are imprisoned in prisons. On the one hand in this group are often heavily demoralized people who committed the most serious crimes, on the other hand it is a group of prisoners, who should be well thought out and programmed the impact of rehabilitation. The situation of man trapped for years poses in a complicated situation not only the prisoners, but also the entire prison staff. They have to take care of the fact that the prison isolation did not cause the state in which convicts form itself in learned helplessness and lack of skills for self-planning and decision-making. In addition, planning the rehabilitation impact of long-term prisoners should not be forgotten that these prisoners in the short or the long term will return to the libertarian environment therefore, should prevent any negative effects of long-term imprisonment. This article presents the main issues related to the execution of imprisonment against long-term prisoners. It is an attempt to systematize the knowledge of this category of people living in prison isolation.

Competitive short-term and long-term memory processes in spatial habituation.

Science.gov (United States)

Sanderson, David J; Bannerman, David M

2011-04-01

Exposure to a spatial location leads to habituation of exploration such that, in a novelty preference test, rodents subsequently prefer exploring a novel location to the familiar location. According to Wagner's (1981) theory of memory, short-term and long-term habituation are caused by separate and sometimes opponent processes. In the present study, this dual-process account of memory was tested. Mice received a series of exposure training trials to a location before receiving a novelty preference test. The novelty preference was greater when tested after a short, rather than a long, interval. In contrast, the novelty preference was weaker when exposure training trials were separated by a short, rather than a long interval. Furthermore, it was found that long-term habituation was determined by the independent effects of the amount of exposure training and the number of exposure training trials when factors such as the intertrial interval and the cumulative intertrial interval were controlled. A final experiment demonstrated that a long-term reduction of exploration could be caused by a negative priming effect due to associations formed during exploration. These results provide evidence against a single-process account of habituation and suggest that spatial habituation is determined by both short-term, recency-based memory and long-term, incrementally strengthened memory.

Employment Situation of Parents of Long-Term Childhood Cancer Survivors.

Directory of Open Access Journals (Sweden)

Luzius Mader

Full Text Available Taking care of children diagnosed with cancer affects parents' professional life. The impact in the long-term however, is not clear. We aimed to compare the employment situation of parents of long-term childhood cancer survivors with control parents of the general population, and to identify clinical and socio-demographic factors associated with parental employment.As part of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to parents of survivors aged 5-15 years, who survived ≥5 years after diagnosis. Information on control parents of the general population came from the Swiss Health Survey (restricted to men and women with ≥1 child aged 5-15 years. Employment was categorized as not employed, part-time, and full-time employed. We used generalized ordered logistic regression to determine associations with clinical and socio-demographic factors. Clinical data was available from the Swiss Childhood Cancer Registry.We included 394 parent-couples of survivors and 3'341 control parents (1'731 mothers; 1'610 fathers. Mothers of survivors were more often not employed (29% versus 22%; ptrend = 0.007. However, no differences between mothers were found in multivariable analysis. Fathers of survivors were more often employed full-time (93% versus 87%; ptrend = 0.002, which remained significant in multivariable analysis. Among parents of survivors, mothers with tertiary education (OR = 2.40, CI:1.14-5.07 were more likely to be employed. Having a migration background (OR = 3.63, CI: 1.71-7.71 increased the likelihood of being full-time employed in mothers of survivors. Less likely to be employed were mothers of survivors diagnosed with lymphoma (OR = 0.31, CI:0.13-0.73 and >2 children (OR = 0.48, CI:0.30-0.75; and fathers of survivors who had had a relapse (OR = 0.13, CI:0.04-0.36.Employment situation of parents of long-term survivors reflected the more traditional parenting roles. Specific support for parents with low education

Long-term bioventing performance in low-permeability soils

International Nuclear Information System (INIS)

Phelps, M.B.; Stanin, F.T.; Downey, D.C.

1995-01-01

Short-term and long-term bioventing treatability testing has shown that in situ air injection and extraction is a practical method for sustaining increased oxygen levels and enhancing aerobic biodegradation of petroleum hydrocarbons in low-permeability soils. At several test sites, initial physical parameter analysis of soils and air permeability tests indicated that impacted soils (fine sandy silts and clays) had low air permeabilities. Measurements of depleted soil-gas oxygen levels and increased soil-gas carbon dioxide levels indicated that the natural process of aerobic biodegradation of petroleum hydrocarbons was oxygen-limited. Initial treatability testing consisted of air permeability tests to measure the permeability of the soils to air and in situ respiration tests to measure the rates at which native microorganisms could biodegrade the contaminants when provided with sufficient oxygen. During the long-term treatment period, active air injection or extraction systems were operated for 1 year or longer. Soil gas was periodically monitored within the treatment zone to evaluate the success of the bioventing systems in increasing soil-gas oxygen levels in the low-permeability soils. Follow-up respiration tests and soil and soil-gas sampling were conducted to evaluate changes in respiration rates and contaminant concentrations with time

Long-term care policy for older Americans: building a continuum of care.

Science.gov (United States)

Palley, Howard A

2003-01-01

This paper deals primarily with social policy considerations relevant to the development of long-term care policy for the frail elderly in the United States. However, it also includes some commentary on meeting the acute care needs of the frail elderly. It defines chronic care treatment as a mix of "short-term" and "long-term" modes of care. Furthermore, it explores the need for treatment of such long-term illnesses to recognize the importance of alternative modes of caring which include strategies, both medical and nonmedical, delivered within and outside of hospitals and nursing homes. The paper includes an analysis of public and private sector priorities based in data published by the U.S. Health Care Financing Administration. It also includes some discussion of the PACE program in the United States and some other efforts to stimulate more in-home and community-based alternatives to nursing home care. Furthermore, it includes a discussion of the policy goal of "appropriateness" in developing long-term care (as well as general health priorities) and provides a critical discussion of problems with utilizing "cost/benefit analysis." The study concludes that too exclusive a focus on nursing home care for the elderly in the United States is unfortunate-both in terms of the desires of the elderly, their families and friends and in terms of focusing on "appropriateness" as a legitimate policy goal in the development of long-term care policy for the elderly in the United States.

Elderly and long-term care trends and policy in Taiwan: Challenges and opportunities for health care professionals

Directory of Open Access Journals (Sweden)

Hsiu-Hung Wang

2012-09-01

Full Text Available The purpose of this article is to address the trends and policy of elderly and long-term care in Taiwan. In response to the increasing demand of an aging society, healthcare professionals play crucial roles in elderly and long-term care and quality assurance of services. This article focuses on the current situation of elderly health care, demands of long-term care, long-term care policy in Taiwan, draft of the Long-term Care Services Act, and draft of the Long-term Care Insurance Act. After the 10-year long-term care project was proposed by the Taiwan government, the supply of health care services and demand for long-term care have created many challenges and opportunities for innovative health professional development. Challenges consist of low old dependency ratio caused by low birth rate, lack of elderly and long-term care related manpower, services and education reform related to long-term care for the future society, and interprofessional collaboration and team work of long-term care. Opportunities include expanding the roles and the career pathways of healthcare professionals, promoting the concepts of active aging and good quality of life, and developing industrial cooperation related to long-term care services. Under these circumstances, healthcare professonals are actively involved in practice, education and research of long-term care services that ensure elderly and disabled people can live a healthier and better life.

Fishing in dangerous waters: Remarks on a controversial appeal to spawner-recruit theory for long-term impact assessment

International Nuclear Information System (INIS)

Fletcher, R.I.; Deriso, R.B.

1988-01-01

In the Hudson River power plant case, the defending utility companies appealed to the practices of commercial fishery managers as precedent for their own uses of spawner-recruit models in forecasting the effects on stock abundances of long-term water withdrawals by the power plants. In contrast to this perception of spawner-recruit models as commonly accepted instruments of fishery management, the present survey of managers and regulatory agencies revealed instead a universal rejection of such models. The inadequacies of spawner-recruit models were attributed variously to the effects of environmental uncertainty, to imperfect knowledge of population regulation, and to the lack of sufficient biological meaning in the models themselves. In general, impact assessment little resembles fishery regulation because the options and privileges commonly exercised by a fishery manager are closed to impact management. In either case, long-term forecasting remains unreliable due to the problem, as yet unsolved, of predicting reproduction and recruitment in natural populations. 21 refs., 1 fig

Long term liquidity analysis of the firm

Directory of Open Access Journals (Sweden)

Jaroslav Gonos

2009-09-01

Full Text Available Liquidity control is a very difficult and important function. If the business is not liquid in the long term, it is under threatof bankruptcy, and on the other hand surplus of the cash in hand threaten its future efficiency, because the cash in hand is a sourceof only limited profitability. Long term liquidity is related to the ability of the short term and long term liabilities payment. Articleis trying to point out to the monitoring and analyzing of the long term liquidity in the concrete business, in this case the printing industrycompany. Hereby at the end of the article mentioned monitored and analyzed liquidity is evaluated in the five years time period.

Generalized Efficient Inference on Factor Models with Long-Range Dependence

DEFF Research Database (Denmark)

Ergemen, Yunus Emre

. Short-memory dynamics are allowed in the common factor structure and possibly heteroskedastic error term. In the estimation, a generalized version of the principal components (PC) approach is proposed to achieve efficiency. Asymptotics for efficient common factor and factor loading as well as long......A dynamic factor model is considered that contains stochastic time trends allowing for stationary and nonstationary long-range dependence. The model nests standard I(0) and I(1) behaviour smoothly in common factors and residuals, removing the necessity of a priori unit-root and stationarity testing...

Long-term benzodiazepine treatment in patients with psychotic disorders attending a mental health service in rural Greece

Directory of Open Access Journals (Sweden)

Vaios Peritogiannis

2016-01-01

Full Text Available Introduction: Long-term benzodiazepine (BZD treatment in patients with mental disorders is widespread in clinical practice, and this is also the case of patients with schizophrenia, although the evidence is weak and BZD prescription is discouraged by guidelines and medical authorities. Data on BZD prescription are usually derived from national or regional databases whereas information on the use of BZD by patients with schizophrenia and related psychoses in general population-based samples is limited. Materials and Methods: Information for 77 patients with psychotic disorders who were regularly attending follow-up appointments with the multidisciplinary Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia, Northwest Greece, during 1-year period (2015 was obtained from our database. Results: From the total of 77 engaged patients, 30 (39% were regularly prescribed BZDs in the long term, as part of their treatment regimen. Prescribed BZDs were mostly diazepam and lorazepam, in 43.3% of cases each. The mean daily dose of these compounds was 13 mg and 3.77 mg, respectively. Statistical analysis showed a correlation of long-term BZD use with the history of alcohol/substance abuse. Most patients were receiving BZD continuously for several years, and the mean dose was steady within this interval. Conclusions: A large proportion of patients with psychotic disorders were regularly prescribed BZD in long term. It appears that when BZDs are prescribed for some period in the course of a psychotic disorder, their use commonly exceeds the recommended interval and then becomes a regular part of the chronic treatment regimen. Future research should address the factors that may be related to the long-term BZD use by patients with psychotic disorders. Interventions for the reduction of regular BZD prescription should target the primary care setting and all those who treat first episode patients.

Chemistry indices for long term plant health management

International Nuclear Information System (INIS)

Galt, K.J.; Cerisier, S.D.M.; Caris, N.B.

1998-01-01

Eskom's Koeberg Nuclear Power Station has maintained and reported on the WANO Chemistry Performance Index for a number of years. Because of the masking effects of multiple averaging, the value of the Index was questionable. The modified WANO Chemistry Performance Indicator, introduced recently, was considered an improvement. However, it was felt that it is too general to adequately address the long-term plant health management needs of a specific plant; a more tailored, plant-specific indicator is needed. A system of indices for measuring and managing long-term plant health at Eskom's 10 large fossil-fired power stations had been developed in 1996. The major success of these indices in improving plant performance management lay in their inclusion in station performance contracts. The Fossil Chemistry Index was based on the original WANO Chemistry Performance Index and suffered from the same shortcomings. Consequently, a major revision of this index was initiated to address these deficiencies. The objectives set for the revised common indicator were that target and limit values from Eskom Chemistry Standards should be incorporated, that the masking effect of multiple averaging be minimised or eliminated, that weighting factors be introduced to reflect the relative importance of selected parameters, that conditioning chemical effectiveness be monitored, and that ranges of values be accommodated. In tandem with this revision, there was requirement to include Koeberg in the reporting of long term plant health indicators. Instead of developing completely separate chemistry indicators for fossil and nuclear plant. A commonality of approach to Long Term Plant Health indicators was sought. This has resulted in a single indicator determination, with parameter selection, limit values, and target values providing the required plant specificity. (J.P.N.)

Population health needs as predictors of variations in NHS practice payments: a cross-sectional study of English general practices in 2013-2014 and 2014-2015.

Science.gov (United States)

Levene, Louis S; Baker, Richard; Wilson, Andrew; Walker, Nicola; Boomla, Kambiz; Bankart, M John G

2017-01-01

NHS general practice payments in England include pay for performance elements and a weighted component designed to compensate for workload, but without measures of specific deprivation or ethnic groups. To determine whether population factors related to health needs predicted variations in NHS payments to individual general practices in England. Cross-sectional study of all practices in England, in financial years 2013-2014 and 2014-2015. Descriptive statistics, univariable analyses (examining correlations between payment and predictors), and multivariable analyses (undertaking multivariable linear regressions for each year, with logarithms of payments as the dependent variables, and with population, practice, and performance factors as independent variables) were undertaken. Several population variables predicted variations in adjusted total payments, but inconsistently. Higher payments were associated with increases in deprivation, patients of older age, African Caribbean ethnic group, and asthma prevalence. Lower payments were associated with an increase in smoking prevalence. Long-term health conditions, South Asian ethnic group, and diabetes prevalence were not predictive. The adjusted R 2 values were 0.359 (2013-2014) and 0.374 (2014-2015). A slightly different set of variables predicted variations in the payment component designed to compensate for workload. Lower payments were associated with increases in deprivation, patients of older age, and diabetes prevalence. Smoking prevalence was not predictive. There was a geographical differential. Population factors related to health needs were, overall, poor predictors of variations in adjusted total practice payments and in the payment component designed to compensate for workload. Revising the weighting formula and extending weighting to other payment components might better support practices to address these needs. © British Journal of General Practice 2017.

Long-term outcomes of septal reduction for obstructive hypertrophic cardiomyopathy.

Science.gov (United States)

Sedehi, Daniel; Finocchiaro, Gherardo; Tibayan, Yen; Chi, Jeffrey; Pavlovic, Aleksandra; Kim, Young M; Tibayan, Frederick A; Reitz, Bruce A; Robbins, Robert C; Woo, Joseph; Ha, Richard; Lee, David P; Ashley, Euan A

2015-07-01

Surgical myectomy and alcohol septal ablation (ASA) aim to decrease left ventricular outflow tract (LVOT) gradient in hypertrophic cardiomyopathy (HCM). Outcome of myectomy beyond 10 years has rarely been described. We describe 20 years of follow-up of surgical myectomy and 5 years of follow-up for ASA performed for obstructive HCM. We studied 171 patients who underwent myectomy for symptomatic LVOT obstruction between 1972 and 2006. In addition, we studied 52 patients who underwent ASA for the same indication and who declined surgery. Follow-up of New York Heart Association (NYHA) functional class, echocardiographic data, and vital status were obtained from patient records. Mortality rates were compared with expected mortality rates of age- and sex-matched populations. Surgical myectomy improved NYHA class (2.74±0.65 to 1.54±0.74, phistorical data from non-operated HCM patients. Survival after ASA at 2 and 5 years was 97.8% and 94.7%, respectively. Short-term (5 year) survival after ASA (SMR=0.61, p=0.48) was comparable to that of the general population. Long-term follow-up of septal reduction strategies in obstructive HCM reveals that surgical myectomy and ASA are effective for symptom relief and LVOT gradient reduction and are associated with favorable survival. While overall prognosis for the community HCM population is similar to the general population, the need for surgical myectomy may identify a sub-group with poorer long-term prognosis. We await long-term outcomes of more extensive myectomy approaches adopted in the past 10 years at major institutions. Copyright © 2015. Published by Elsevier Ltd.

Esophageal replacement in children: Challenges and long-term outcomes

Directory of Open Access Journals (Sweden)

Giampiero Soccorso

2016-01-01

Full Text Available Replacement of a nonexistent or damaged esophagus continues to pose a significant challenge to pediatric surgeons. Various esophageal replacement grafts and techniques have not produced consistently good outcomes to emulate normal esophagus. Therefore, many techniques are still being practiced and recommended with no clear consensus. We present a concise literature review of the currently used techniques and with discussions on the advantages and anticipated morbidity. There are no randomized controlled pediatric studies to compare different types of esophageal replacements. Management and graft choice are based on geographical and personal predilections rather than on any discernible objective data. The biggest series with long-term outcome are reported for gastric transposition and colonic replacement. Comparison of different studies shows no significant difference in early (graft necrosis and anastomotic leaks or late complications (strictures, poor feeding, gastro-esophageal reflux, tortuosity of the graft, and Barrett′s esophagus. The biggest series seem to have lower complications than small series reflecting the decennials experience in their respective centers. Long-term follow-up is recommended following esophageal replacement for the development of late strictures, excessive tortuosity, and Barrett′s changes within the graft. Once child overcomes initial morbidity and establishes oral feeding, long-term consequences and complications of pediatric esophageal replacement should be monitored and managed in adult life.

Measurement of long term surface inflation signals at GLISP with two independent tiltmeter systems

Energy Technology Data Exchange (ETDEWEB)

Jones, F.W.; Rogers, J.S.; Ertman, M.E.; Thibault, J.

1989-01-06

Long-term monitoring at an Alberta oil recovery project was conducted to trace the Earth surface tilt response to the steam injection and related water movement through the formations at the site. Attempts were also made to relate the tilt to the various enhancement process activities in order to improve understanding of the long-term recovery process. Field comparisons were made between biaxial mercury-level borehole tiltmeters and biaxial bubble sensor tiltmeters, and some results are presented. It was generally found that the two types of tiltmeters reported similar tilt responses. Examples are shown of tilt response correlated with process activity and of a long-term tilt migration effect. 6 figs.

Long-term contracts vs. short-term trade of natural gas - a European perspective

International Nuclear Information System (INIS)

Neuhoff, Karsten; Hirschhausen, Christian von

2005-01-01

This paper analyses the economics of long-term gas contracts under changing institutional conditions, mainly gas sector liberalisation. The paper is motivated by the increasingly tense debate in continental Europe, UK and the US on the security of long-term gas supply. We discuss the main issues regarding long-term contracts, i.e. the changing role of the flexibility clause, the effect of abandoning the destination clause, and the strategic behaviour of producers between long-term sales and spot-sales. The literature suggests consumers and producers benefit from risk hedging through long-term contracts. Furthermore long-term contracts may reduce exercise of market power. Our analysis adds an additional benefit if the long-run demand elasticity is significantly lower than the short-run elasticity, both strategic producers and consumers benefit from lower prices and larger market volume. Some policy implications of the findings are also discussed. (Author)

The uranium industry: long-term planning for short-term competition

International Nuclear Information System (INIS)

Vottero, X.; Georges Capus, G.

2001-01-01

Long term planning for short term competition Today, uranium producers face new challenges in terms of both production (new regulatory, environmental and social constraints) and market conditions (new sources of uranium supply, very low prices and tough competition). In such a context, long-term planning is not just a prerequisite to survive in the nuclear fuel cycle industry. In fact, it also contributes to sustaining nuclear electricity generation facing fierce competition from other energy sources in increasingly deregulated markets. Firstly, the risk of investing in new mining projects in western countries is growing because, on the one hand, of very erratic market conditions and, on the other hand, of increasingly lengthy, complex and unpredictable regulatory conditions. Secondly, the supply of other sources of uranium (uranium derived from nuclear weapons, uranium produced in CIS countries, ...) involve other risks, mainly related to politics and commercial restrictions. Consequently, competitive uranium supply requires not only technical competence but also financial strength and good marketing capabilities in order to anticipate long-term market trends, in terms of both demand and supply. It also requires taking into account new parameters such as politics, environment, regulations, etc. Today, a supplier dedicated to the sustainable production of nuclear electricity must manage a broad range of long-term risks inherent to the procurement of uranium. Taking into account all these parameters in a context of short-term, fast-changing market is a great challenge for the future generation. World Uranium Civilian Supply and Demand. (authors)

Client interpersonal impacts as mediators of long-term outcome in cognitive-behavioral therapy integrated with motivational interviewing for generalized anxiety disorder.

Science.gov (United States)

Constantino, Michael J; Romano, Felicia M; Coyne, Alice E; Westra, Henny A; Antony, Martin M

2017-03-24

A recent trial of generalized anxiety disorder treatment (Westra, H. A., Constantino, M. J., & Antony, M. M. (2016). Integrating Motivational Interviewing With Cognitive-Behavioral Therapy for Severe Generalized Anxiety Disorder: An Allegiance-Controlled Randomized Clinical Trial. Journal of Consulting and Clinical Psychology, 84, 768-782. doi: 10.1037/ccp0000098 ) revealed that cognitive-behavioral therapy (CBT) integrated with motivational interviewing (MI) outperformed CBT alone across a 12-month follow up. The present study examined whether this treatment effect was mediated by MI-CBT clients engaging over time in during-session interpersonal behaviors reflecting more friendly dominance, or agentic actions, and less friendly submissiveness (FS), or trustingly compliant actions both theory-specific MI mechanisms. Clients received 15 sessions of MI-CBT (n = 42) or CBT alone (n = 43). Therapists rated client interpersonal behavior following five sessions, and clients rated their worry at baseline, each session, and 6- and 12-month follow up. Mediator and outcome variables were derived from multilevel models. Mediation was tested using a bootstrapping procedure. There was a significant indirect effect for FS. As expected, CBT clients evidenced greater increases in FS than MI-CBT clients, which in turn, though unexpectedly, related to lower 12-month worry. However, long-term CBT outcomes remained inferior to MI-CBT outcomes even with CBT clients'greater increase in FS. Results suggest that CBT outcomes are more positive when clients trustingly comply; however, MI-CBT remained superior, but for as yet unexplained reasons. Clinical or methodological significance of this article: The findings highlight the clinical importance of GAD clients becoming more friendly dominant in the therapy relationship irrespective of whether they received CBT or integrative MI-CBT. Moreover, it seems clinically indicated to incorporate MI spirit and techniques into CBT when

Long-term biodosimetry Redux

International Nuclear Information System (INIS)

Simon, Steven L.; Bouville, Andre

2016-01-01

This paper revisits and reiterates the needs, purposes and requirements of bio-dosimetric assays for long-term dose and health risk assessments. While the most crucial need for bio-dosimetric assays is to guide medical response for radiation accidents, the value of such techniques for improving our understanding of radiation health risk by supporting epidemiological (long-term health risk) studies is significant. As new cohorts of exposed persons are identified and new health risk studies are undertaken with the hopes that studying the exposed will result in a deeper understanding of radiation risk, the value of reliable dose reconstruction is underscored. The ultimate application of biodosimetry in long-term health risk studies would be to completely replace model-based dose reconstruction-a complex suite of methods for retrospectively estimating dose that is commonly fraught with large uncertainties due to the absence of important exposure-related information, as well as imperfect models. While biodosimetry could potentially supplant model-based doses, there are numerous limitations of presently available techniques that constrain their widespread application in health risk research, including limited ability to assess doses received far in the past, high cost, great inter-individual variability, invasiveness, higher than preferred detection limits and the inability to assess internal dose (for the most part). These limitations prevent the extensive application of biodosimetry to large cohorts and should be considered a challenge to researchers to develop new and more flexible techniques that meet the demands of long-term health risk research. Events in recent years, e.g. the Fukushima reactor accident and the increased threat of nuclear terrorism, underscore that any event that results in significant radiation exposures of a group of people will also produce a much larger population, exposed at lower levels, but that likewise needs (or demands) an exposure

Long-term Surveillance Plan for the Falls City Disposal Site, Falls City, Texas. Revision 1

International Nuclear Information System (INIS)

1995-08-01

This long-term surveillance plan (LTSP) for the Uranium Mill Tailings Remedial Action (UMTRA) Project Falls City disposal site, Falls City, Texas, describes the surveillance activities for the disposal site. The US Department of Energy (DOE) will carry out these activities to ensure that the disposal cell continues to function as designed. This LTSP was prepared as a requirement for acceptance under the US Nuclear Regulatory Commission (NRC) general license for custody and long-term care of residual radioactive materials. This LTSP documents whether the land and interests are owned by the United States and details how long-term care of the disposal site will be carried out. It is based on the DOE's Guidance for Implementing the UMTRA Project Long-term Surveillance Program (DOE, 1992a)

Long term radioactive waste management

International Nuclear Information System (INIS)

Lavie, J.M.

1984-01-01

In France, waste management, a sensitive issue in term of public opinion, is developing quickly, and due to twenty years of experience, is now reaching maturity. With the launching of the French nuclear programme, the use of radioactive sources in radiotherapy and industry, waste management has become an industrial activity. Waste management is an integrated system dealing with the wastes from their production to the long term disposal, including their identification, sortage, treatment, packaging, collection and transport. This system aims at guaranteing the protection of present and future populations with an available technology. In regard to their long term management, and the design of disposals, radioactive wastes are divided in three categories. This classification takes into account the different radioisotopes contained, their half life and their total activity. Presently short-lived wastes are stored in the shallowland disposal of the ''Centre de la Manche''. Set up within the French Atomic Energy Commission (CEA), the National Agency for waste management (ANDRA) is responsible within the framework of legislative and regulatory provisions for long term waste management in France [fr

Modeling long-term dynamics of electricity markets

International Nuclear Information System (INIS)

Olsina, Fernando; Garces, Francisco; Haubrich, H.-J.

2006-01-01

In the last decade, many countries have restructured their electricity industries by introducing competition in their power generation sectors. Although some restructuring has been regarded as successful, the short experience accumulated with liberalized power markets does not allow making any founded assertion about their long-term behavior. Long-term prices and long-term supply reliability are now center of interest. This concerns firms considering investments in generation capacity and regulatory authorities interested in assuring the long-term supply adequacy and the stability of power markets. In order to gain significant insight into the long-term behavior of liberalized power markets, in this paper, a simulation model based on system dynamics is proposed and the underlying mathematical formulations extensively discussed. Unlike classical market models based on the assumption that market outcomes replicate the results of a centrally made optimization, the approach presented here focuses on replicating the system structure of power markets and the logic of relationships among system components in order to derive its dynamical response. The simulations suggest that there might be serious problems to adjust early enough the generation capacity necessary to maintain stable reserve margins, and consequently, stable long-term price levels. Because of feedback loops embedded in the structure of power markets and the existence of some time lags, the long-term market development might exhibit a quite volatile behavior. By varying some exogenous inputs, a sensitivity analysis is carried out to assess the influence of these factors on the long-run market dynamics

Short-term memory and long-term memory are still different.

Science.gov (United States)

Norris, Dennis

2017-09-01

A commonly expressed view is that short-term memory (STM) is nothing more than activated long-term memory. If true, this would overturn a central tenet of cognitive psychology-the idea that there are functionally and neurobiologically distinct short- and long-term stores. Here I present an updated case for a separation between short- and long-term stores, focusing on the computational demands placed on any STM system. STM must support memory for previously unencountered information, the storage of multiple tokens of the same type, and variable binding. None of these can be achieved simply by activating long-term memory. For example, even a simple sequence of digits such as "1, 3, 1" where there are 2 tokens of the digit "1" cannot be stored in the correct order simply by activating the representations of the digits "1" and "3" in LTM. I also review recent neuroimaging data that has been presented as evidence that STM is activated LTM and show that these data are exactly what one would expect to see based on a conventional 2-store view. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Cognitive, physical, and mental health outcomes between long-term cannabis and tobacco users.

Science.gov (United States)

Lovell, M E; Bruno, R; Johnston, J; Matthews, A; McGregor, I; Allsop, D J; Lintzeris, N

2018-04-01

Cannabis intoxication adversely affects health, yet persistent effects following short-term abstinence in long-term cannabis users are unclear. This matched-subjects, cross-sectional study compared health outcomes of long-term cannabis and long-term tobacco-only users, relative to population norms. Nineteen long-term (mean 32.3years of use, mean age 55.7years), abstinent (mean 15h) cannabis users and 16 long-term tobacco users (mean 37.1years of use, mean age 52.9years), matched for age, educational attainment, and lifetime tobacco consumption, were compared on measures of learning and memory, response inhibition, information-processing, sustained attention, executive control, and mental and physical health. Cannabis users exhibited poorer overall learning and delayed recall and greater interference and forgetting than tobacco users, and exhibited poorer recall than norms. Inhibition and executive control were similar between groups, but cannabis users had slower reaction times during information processing and sustained attention tasks. Cannabis users had superior health satisfaction and psychological, somatic, and general health than tobacco users and had similar mental and physical health to norms whilst tobacco users had greater stress, role limitations from emotional problems, and poorer health satisfaction. Long-term cannabis users may exhibit deficits in some cognitive domains despite short-term abstinence and may therefore benefit from interventions to improve cognitive performance. Tobacco alone may contribute to adverse mental and physical health outcomes, which requires appropriate control in future studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Long-term sick leave and its risk factors during pregnancy among Danish hospital employees

DEFF Research Database (Denmark)

Kærlev, Linda; Jacobsen, Lene B.; Olsen, Jørn

2004-01-01

AIM: The authors sought to describe risk indicators of long-term sick leave during pregnancy among hospital employees. METHODS: A register-based study was undertaken of 4,852 female hospital employees aged 20-45 years from the second largest hospital in Denmark during 1995-99 based on job titles...... leave days than other hospital employees. Part-time work, previous sickness absence not related to pregnancy, and previous chronic back pain were risk factors for long-term sick leave as were much walking or standing, long working days, high work level, little practical support from supervisors...... women in a manner that optimizes their health and well-being....

Long-Term Collections

CERN Multimedia

Comité des collectes à long terme

2011-01-01

It is the time of the year when our fireman colleagues go around the laboratory for their traditional calendars sale. A part of the money of the sales will be donated in favour of the long-term collections. We hope that you will welcome them warmly.

Short- and long-term adaptation to cancer : a comparison of patients with the general population

NARCIS (Netherlands)

Schroevers, Maatje Jannetje

2002-01-01

Both from a scientific and common sense point of view, there are many ideas about how patients adjust to a life-threatening disease such as cancer. However, the empirical evidence on this topic is still elusive, especially about the consequences that patients may experience in the long term. The

When satisfied customers do not return : Variety seeking’s effect on short-and long-term intentions

NARCIS (Netherlands)

Sánchez-García, I.; Pieters, R.; Zeelenberg, M.; Bigné, E.

2012-01-01

Even satisfied consumers frequently do not come back, which challenges loyalty theory and marketing practice. It is reasoned that variety-seeking tendencies will significantly affect short-term revisit intentions, whereas satisfaction and regret will mostly determine long-term revisit intentions.

Towards vertical integration in general practice education: literature review and discussion paper.

Science.gov (United States)

O'Regan, A; Culhane, A; Dunne, C; Griffin, M; Meagher, D; McGrath, D; O'Dwyer, P; Cullen, W

2013-09-01

Medical education policy in Ireland has enabled an increase in undergraduate and postgraduate education activity in general practice. Internationally, 'vertical integration in general practice education' is suggested as a key strategy to support the implementation of this policy development. To review the emerging literature on vertical integration in GP education, specifically to define the concept of 'vertical integration' with regard to education in general practice and to describe its benefits and challenges. We searched 'Pubmed', 'Academic Search Complete', 'Google', and 'MEDLINE' databases using multiple terms related to 'vertical integration' and 'general practice education' for relevant articles published since 2001. Discussion papers, reports, policy documents and position statements were identified from reference lists and retrieved through internet searches. The key components of 'vertical integration' in GP education include continuous educational pathway, all stages in GP education, supporting the continuing educational/professional development needs of learners at each stage and effective curriculum planning and delivery. Many benefits (for GPs, learners and the community) and many challenges (for GPs/practices, learners and GPs in training) have been described. Characteristics of successful implementation include role sharing and collaborative organisational structures. Recent developments in medical education in Ireland, such as the increase in medical school clinical placements in general practice and postgraduate GP training and the introduction of new competence assurance requirements offer an important opportunity to further inform how vertical integration can support increased educational activity in general practice. Describing this model, recognising its benefits and challenges and supporting its implementation in practice are priorities for medical education in Ireland.

Identifying critical success factors for designing selection processes into postgraduate specialty training: the case of UK general practice.

Science.gov (United States)

Plint, Simon; Patterson, Fiona

2010-06-01

The UK national recruitment process into general practice training has been developed over several years, with incremental introduction of stages which have been piloted and validated. Previously independent processes, which encouraged multiple applications and produced inconsistent outcomes, have been replaced by a robust national process which has high reliability and predictive validity, and is perceived to be fair by candidates and allocates applicants equitably across the country. Best selection practice involves a job analysis which identifies required competencies, then designs reliable assessment methods to measure them, and over the long term ensures that the process has predictive validity against future performance. The general practitioner recruitment process introduced machine markable short listing assessments for the first time in the UK postgraduate recruitment context, and also adopted selection centre workplace simulations. The key success factors have been identified as corporate commitment to the goal of a national process, with gradual convergence maintaining locus of control rather than the imposition of change without perceived legitimate authority.

Non-intrusive long-term monitoring approaches

International Nuclear Information System (INIS)

Smathers, D.; Mangan, D.

1998-01-01

In order to promote internatinal confidence that the US and Russia are disarming per their commitments under Article 6 of the Non-Proliferation Treaty, an international verification regime may be applied to US and Russian excess fissile materials. Initially, it is envisioned that this verification regime would be applied at storage facilities; however, it should be anticipated that the verification regime would continue throughout any material disposition activities, should such activities be pursued. once the materials are accepted into the verification regime, it is assumed that long term monitoring will be used to maintain continuity of knowledge. The requirements for long term storage monitoring include unattended operation for extended periods of time, minimal intrusiveness on the host nation's safety and security activities, data collection incorporating data authentication, and monitoring redundancy to allow resolution of anomalies and to continue coverage in the event of equipment failures. Additional requirements include effective data review and analysis processes, operation during storage facility loading, procedure for removal of inventory items for safety-related surveillance, and low cost, reliable equipment. A monitoring system might include both continuous monitoring of storagecontainers and continuous area monitoring. These would be complemented with periodic on-site inspections. A fissile material storage facility is not a static operation. The initial studies have shown there are a number of valid reasons why a host nation may need them to remove material from the storage facility. A practical monitoring system must be able to accommodate necessary material movements

Behavioural science in general practice.

Science.gov (United States)

Wood, D R

1979-10-01

Dr Peter Sowerby has written an important criticism of Michael Balint's work based on his understanding of Karl Popper's writings. I dispute Sowerby's interpretation of Popper and disagree with his conclusions, which I suggest would lead general practice into a retreat. I believe Balint made a major contribution to general practice and has helped us towards practising whole-person medicine.

Care planning for long-term conditions – a concept mapping.

Science.gov (United States)

Lhussier, Monique; Eaton, Simon; Forster, Natalie; Thomas, Mathew; Roberts, Sue; Carr, Susan M

2015-10-01

This article focuses on approaches within clinical practice that seek to actively involve patients with long-term conditions (LTCs) and how professionals may understand and implement them. Personalized care planning is one such approach, but its current lack of conceptual clarity might have impeded its widespread implementation to date. A variety of overlapping concepts coexist in the literature, which have the potential to impair both clinical and research agendas. The aim of this article is therefore to explore the meaning of the concept of care planning in relation to other overlapping concepts and how this translates into clinical practice implementation. Searches were conducted in the Cochrane database for systematic reviews, CINHAL and MEDLINE. A staged approach to conducting the concept mapping was undertaken, by (i) an examination of the literature on care planning in LTCs; (ii) identification of related terms; (iii) locating reviews of those terms. Retrieved articles were subjected to a content analysis, which formed the basis of our concept maps. (iv) We then appraised these against knowledge and experience of the implementation of care planning in clinical practice. Thirteen articles were retrieved, in which the core importance of patient-centredness, shared decision making and self-management was highlighted. Literature searches on these terms retrieved a further 24 articles. Our concept mapping exercise shows that whilst there are common themes across the concepts, the differences between them reflect the context and intended outcomes within clinical practice. We argue that this clarification exercise will allow for further development of both research and clinical implementation agendas. © 2013 Blackwell Publishing Ltd.

Long-Term Memory Performance in Adult ADHD.

Science.gov (United States)

Skodzik, Timo; Holling, Heinz; Pedersen, Anya

2017-02-01

Memory problems are a frequently reported symptom in adult ADHD, and it is well-documented that adults with ADHD perform poorly on long-term memory tests. However, the cause of this effect is still controversial. The present meta-analysis examined underlying mechanisms that may lead to long-term memory impairments in adult ADHD. We performed separate meta-analyses of measures of memory acquisition and long-term memory using both verbal and visual memory tests. In addition, the influence of potential moderator variables was examined. Adults with ADHD performed significantly worse than controls on verbal but not on visual long-term memory and memory acquisition subtests. The long-term memory deficit was strongly statistically related to the memory acquisition deficit. In contrast, no retrieval problems were observable. Our results suggest that memory deficits in adult ADHD reflect a learning deficit induced at the stage of encoding. Implications for clinical and research settings are presented.

Long-term trends from ecosystem research at the Hubbard Brook Experimental Forest

Science.gov (United States)

John L. Campbell; Charles T. Driscoll; Christopher Eagar; Gene E. Likens; Thomas G. Siccama; Chris E. Johnson; Timothy J. Fahey; Steven P. Hamburg; Richard T. Holmes; Amey S. Bailey; Donald C. Buso

2007-01-01

Summarizes 52 years of collaborative, long-term research conducted at the Hubbard Brook (NH) Experimental Forest on ecosystem response to disturbances such as air pollution, climate change, forest disturbance, and forest management practices. Also provides explanations of some of the trends and lists references from scientific literature for further reading.

Long-term program on research, development and application of atomic energy

International Nuclear Information System (INIS)

2000-01-01

As the Committee of Atomic Energy in Japan has established eight times of the 'long-term basic program on development and application of atomic energy at every five years since 1956, these have consistently done every important roles as a leader of programmable promotion of policies on research, development and application of atomic energy in Japan. And, they also have showed some basic concepts on its research, development and application such as safety security, keeping of peaceful application, and so on, and also done a role as a strength with universality for promotion of their sure practices. Then, the Committee requested some surveys and discussions on establishment decided as a new long-term program on May, 1999, to a meeting on establishment of the long-term program, so as to clearly show a basic plan and its promoting measures on research, development and application of atomic energy to be adopted by Japan through the 21st Century under understanding of changes of various affairs after establishment of the previous program, to Japanese peoples, international society and nuclear relatives. The finished program is composed of two parts which are the first part of describing some messages toward Japanese peoples and society and international society and the second part of expressing concrete indications and promoting measures for practicing research, development and application of atomic energy. Here was shown on all sentences of the establishment containing the two parts of present condition and future way on research, development and application of atomic energy' and 'future evolution of research, development and application of atomic energy'. (G.K.)

Long-Term Follow-Up of Class II Adults Treated with Orthodontic Camouflage: A Comparison with Orthognathic Surgery Outcomes

National Research Council Canada - National Science Library

Mihalik, Colin

2002-01-01

.... These were compared to similar data for long-term outcomes in patients who had surgical correction. Small mean changes in skeletal landmark positions did occur long-term, but were in general much smaller than in the surgery patients...

A Long-term Plan for Kalk

DEFF Research Database (Denmark)

2017-01-01

In this case, the author demonstrates together with the owner-manager of KALK A/S, Mr Rasmus Jorgensen, how to use the Family Business Map to frame a constructive discussion about long-term planning. The Family Business Map is a tool for long-term planning in family firms developed by Professor...

Virtual Models of Long-Term Care

Science.gov (United States)

Phenice, Lillian A.; Griffore, Robert J.

2012-01-01

Nursing homes, assisted living facilities and home-care organizations, use web sites to describe their services to potential consumers. This virtual ethnographic study developed models representing how potential consumers may understand this information using data from web sites of 69 long-term-care providers. The content of long-term-care web…

Sleep facilitates long-term face adaptation

OpenAIRE

Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

2013-01-01

Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted imag...

Prevalence of Long-Term Opioid Use in Long-Stay Nursing Home Residents.

Science.gov (United States)

Hunnicutt, Jacob N; Chrysanthopoulou, Stavroula A; Ulbricht, Christine M; Hume, Anne L; Tjia, Jennifer; Lapane, Kate L

2018-01-01

Overall and long-term opioid use among older adults have increased since 1999. Less is known about opioid use in older adults in nursing homes (NHs). Cross-sectional. U.S. NHs (N = 13,522). Long-stay NH resident Medicare beneficiaries with a Minimum Data Set 3.0 (MDS) assessment between April 1, 2012, and June 30, 2012, and 120 days of follow-up (N = 315,949). We used Medicare Part D claims to measure length of opioid use in the 120 days from the index assessment (short-term: ≤30 days, medium-term: >30-89 days, long-term: ≥90 days), adjuvants (e.g., anticonvulsants), and other pain medications (e.g., corticosteroids). MDS assessments in the follow-up period were used to measure nonpharmacological pain management use. Modified Poisson models were used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for age, gender, race and ethnicity, cognitive and physical impairment, and long-term opioid use. Of all long-stay residents, 32.4% were prescribed any opioid, and 15.5% were prescribed opioids long-term. Opioid users (versus nonusers) were more commonly prescribed pain adjuvants (32.9% vs 14.9%), other pain medications (25.5% vs 11.0%), and nonpharmacological pain management (24.5% vs 9.3%). Long-term opioid use was higher in women (aPR = 1.21, 95% CI = 1.18-1.23) and lower in racial and ethnic minorities (non-Hispanic blacks vs whites: APR = 0.93, 95% CI = 0.90-0.94) and those with severe cognitive impairment (vs no or mild impairment, aPR = 0.82, 95% CI = 0.79-0.83). One in seven NH residents was prescribed opioids long-term. Recent guidelines on opioid prescribing for pain recommend reducing long-term opioid use, but this is challenging in NHs because residents may not benefit from nonpharmacological and nonopioid interventions. Studies to address concerns about opioid safety and effectiveness (e.g., on pain and functional status) in NHs are needed. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics

Long-term intended and unintended experiences after Advanced Life Support training

DEFF Research Database (Denmark)

Rasmussen, M.B.; Dieckmann, Peter; Issenberg, Berry

2012-01-01

Highly structured simulation-based training (SBT) on managing emergency situations can have a significant effect on immediate satisfaction and learning. However, there are some indications of problems when applying learned skills to practice. The aim of this study was to identify long-term intended...... and unintended learner reactions, experiences and reflections after attending a simulation based Advanced Life Support (ALS) course....

A protocol improves GP recording of long-term sickness absence risk factors

NARCIS (Netherlands)

van Dijk, Paul C. M.; Hogervorst, Wouter; ter Riet, Gerben; van Dijk, Frank

2008-01-01

Background If general practitioners (GPs) were better informed about patients' risks of long-term sickness absence (LTSA), they could incorporate these risk assessments into their patient management plans and cooperate more with occupational physicians to prevent LTSA. Aim To evaluate the

Long-Term Impact of a Cell Phone-Enhanced Parenting Intervention.

Science.gov (United States)

Lefever, Jennifer E Burke; Bigelow, Kathryn M; Carta, Judith J; Borkowski, John G; Grandfield, Elizabeth; McCune, Luke; Irvin, Dwight W; Warren, Steven F

2017-11-01

Home visiting programs support positive parenting in populations at-risk of child maltreatment, but their impact is often limited by poor retention and engagement. The current study assessed whether a cellular phone-supported version (PCI-C) of the Parent-Child Interactions (PCI) intervention improved long-term parenting practices, maternal depression, and children's aggression. Low-income mothers ( n = 371) of preschool-aged children were assigned to one of the three groups: PCI-C, PCI, and a wait-list control (WLC) group. Parenting improved in both intervention groups between baseline and 12-month follow-up compared to the WLC. Children in the PCI-C group were rated to be more cooperative and less aggressive than children in the WLC. The results offer evidence of the long-term effectiveness of PCI and the additional benefits of cellular phone supports for promoting intervention retention and improving children's behavior.

Long-Term Stewardship Baseline Report and Transition Guidance

Energy Technology Data Exchange (ETDEWEB)

Kristofferson, Keith

2001-11-01

Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after facility cleanup is complete. As the Department of Energy’s (DOE) lead laboratory for environmental management programs, the Idaho National Engineering and Environmental Laboratory (INEEL) administers DOE’s long-term stewardship science and technology efforts. The INEEL provides DOE with technical, and scientific expertise needed to oversee its long-term environmental management obligations complexwide. Long-term stewardship is administered and overseen by the Environmental Management Office of Science and Technology. The INEEL Long-Term Stewardship Program is currently developing the management structures and plans to complete INEEL-specific, long-term stewardship obligations. This guidance document (1) assists in ensuring that the program leads transition planning for the INEEL with respect to facility and site areas and (2) describes the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete. Additionally, this document summarizes current information on INEEL facilities, structures, and release sites likely to enter long-term stewardship at the completion of DOE’s cleanup mission. This document is not intended to function as a discrete checklist or local procedure to determine readiness to transition. It is an overarching document meant as guidance in implementing specific transition procedures. Several documents formed the foundation upon which this guidance was developed. Principal among these documents was the Long-Term Stewardship Draft Technical Baseline; A Report to Congress on Long-Term Stewardship, Volumes I and II; Infrastructure Long-Range Plan; Comprehensive Facility Land Use Plan; INEEL End-State Plan; and INEEL Institutional Plan.

Greek long-term energy consumption prediction using artificial neural networks

International Nuclear Information System (INIS)

Ekonomou, L.

2010-01-01

In this paper artificial neural networks (ANN) are addressed in order the Greek long-term energy consumption to be predicted. The multilayer perceptron model (MLP) has been used for this purpose by testing several possible architectures in order to be selected the one with the best generalizing ability. Actual recorded input and output data that influence long-term energy consumption were used in the training, validation and testing process. The developed ANN model is used for the prediction of 2005-2008, 2010, 2012 and 2015 Greek energy consumption. The produced ANN results for years 2005-2008 were compared with the results produced by a linear regression method, a support vector machine method and with real energy consumption records showing a great accuracy. The proposed approach can be useful in the effective implementation of energy policies, since accurate predictions of energy consumption affect the capital investment, the environmental quality, the revenue analysis, the market research management, while conserve at the same time the supply security. Furthermore it constitutes an accurate tool for the Greek long-term energy consumption prediction problem, which up today has not been faced effectively.

Strengthened General Self-Efficacy with Multidisciplinary Vocational Rehabilitation in Women on Long-Term Sick Leave: A Randomised Controlled Trial.

Science.gov (United States)

Andersén, Åsa; Larsson, Kjerstin; Lytsy, Per; Berglund, Erik; Kristiansson, Per; Anderzén, Ingrid

2018-01-09

Purpose To investigate the effects of two vocational rehabilitation interventions on self-efficacy, for women on long-term sick leave ≥ 1 year due to chronic pain and/or mental illness. Methods This study uses data from a randomised controlled trial consisting of two phases and comprising 401 women on long-term sick leave. They were allocated to either (1) a multidisciplinary team assessment and multimodal intervention (TEAM), (2) acceptance and commitment therapy (ACT), or (3) control group. Data were collected through repeated measurements from self-reported questionnaires before intervention, 6 and 12 months later and registry data. Data from measurements of general self-efficacy, sociodemographics, anxiety and depression were analysed with linear regression analyses. Results During the intervention period, the women in the TEAM group's self-efficacy mean increased from 2.29 to 2.74. The adjusted linear regression model, which included group allocation, sociodemographics, self-efficacy pre-treatment, anxiety and depression showed increased self-efficacy for those in the TEAM intervention at 12 months (B = 0.25, 95% CI 0.10-0.41). ACT intervention had no effect on self-efficacy at 12 months (B = 0.02, 95% CI - 0.16 to 0.19). The results in the adjusted model also showed that higher self-efficacy at pre-treatment was associated with a higher level of self-efficacy at 12 months (B = 0.68, 95% CI 0.54-0.81). Conclusion A multidisciplinary team assessment and multimodal intervention increased self-efficacy in women on sick leave for an extremely long time (mean 7.8 years) who had a low mean level of self-efficacy prior to inclusion. Thus, self-efficacy needs to be addressed in vocational rehabilitation.

Short-term versus long-term heart rate variability in ischemic cardiomyopathy risk stratification

Directory of Open Access Journals (Sweden)

Andreas eVoss

2013-12-01

Full Text Available In industrialized countries with aging populations, heart failure affects 0.3%-2% of the general population. The investigation of 24h-ECG recordings revealed the potential of nonlinear indices of heart rate variability (HRV for enhanced risk stratification in patients with ischemic heart failure (IHF. However, long-term analyses are time-consuming, expensive and delay the initial diagnosis. The objective of this study was to investigate whether 30min short-term HRV analysis is sufficient for comparable risk stratification in IHF in comparison to 24h-HRV analysis. From 256 IHF patients (221 at low risk (IHFLR and 35 at high risk (IHFHR a 24h beat-to-beat time series b the first 30min segment c the 30min most stationary day segment and d the 30min most stationary night segment were investigated. We calculated linear (time and frequency domain and nonlinear HRV analysis indices. Optimal parameter sets for risk stratification in IHF were determined for 24 hours and for each 30min segment by applying discriminant analysis on significant clinical and non-clinical indices. Long- and short-term HRV indices from frequency domain and particularly from nonlinear dynamics revealed high univariate significances (p

Guidelines for computer security in general practice.

Science.gov (United States)

Schattner, Peter; Pleteshner, Catherine; Bhend, Heinz; Brouns, Johan

2007-01-01

As general practice becomes increasingly computerised, data security becomes increasingly important for both patient health and the efficient operation of the practice. To develop guidelines for computer security in general practice based on a literature review, an analysis of available information on current practice and a series of key stakeholder interviews. While the guideline was produced in the context of Australian general practice, we have developed a template that is also relevant for other countries. Current data on computer security measures was sought from Australian divisions of general practice. Semi-structured interviews were conducted with general practitioners (GPs), the medical software industry, senior managers within government responsible for health IT (information technology) initiatives, technical IT experts, divisions of general practice and a member of a health information consumer group. The respondents were asked to assess both the likelihood and the consequences of potential risks in computer security being breached. The study suggested that the most important computer security issues in general practice were: the need for a nominated IT security coordinator; having written IT policies, including a practice disaster recovery plan; controlling access to different levels of electronic data; doing and testing backups; protecting against viruses and other malicious codes; installing firewalls; undertaking routine maintenance of hardware and software; and securing electronic communication, for example via encryption. This information led to the production of computer security guidelines, including a one-page summary checklist, which were subsequently distributed to all GPs in Australia. This paper maps out a process for developing computer security guidelines for general practice. The specific content will vary in different countries according to their levels of adoption of IT, and cultural, technical and other health service factors. Making

Possibility of "superfast" consolidation of long-term memory.

Science.gov (United States)

Podolski IYa

1998-01-01

Two new behavioural tests in rats are described which demonstrate the fast consolidation of the long-term memory (LTM) in a dangerous natural situation (water escape). It is shown that after one-trial learning of the motor skill (jumping out of the water), long-term memory traces are retained without forgetting and are resistant to the blockade of M-cholinoreceptors by scopolamine (2 mg/kg) and of D1/D2 dopamine receptors by haloperidol (10 mg/kg) as well as electroconvulsive shock applied tank wall, learning of necessary motor skills, automatization and minimization of the skilled movements in 1.5-3.0 min, after 5 to 7 trials at two-second intervals (superfast learning) is demonstrated. It is suggested that the superfast consolidation of LTM (several minutes) is possible in life-threatening situations, the necessary time being 1-2 orders of magnitude less than it is generally accepted in the modern theories of memory. The proposed behavioural models may be helpful in investigation of some fundamental physiological and molecular mechanisms of stable neuronal interactions, as a basis for LTM consolidation.

Catalytic heat exchangers - a long-term evaluation

Energy Technology Data Exchange (ETDEWEB)

Silversand, Fredrik A. [CATATOR AB, Lund (Sweden)

2003-10-01

A long-term evaluation concerning catalytic heat exchangers (CHEs) has been performed. The idea concerning CHEs was originally described in a number of reports issued by Catator almost a decade ago. The general idea with CHEs is to combust a fuel with a catalyst inside a heat exchanger to enable an effective heat transfer. The first design approaches demonstrated the function and the possibilities with CHEs but were defective concerning the heat exchanger design. Consequently, a heat exchanger company (SWEP International AB), which was specialised on brazed plate-type heat exchangers, joined the continued development project. Indeed, the new design approach containing Catator's wire-mesh catalysts and SWEP's plate-type heat exchangers enabled us to improve the concept considerably. The new design complied with a number of relevant technical demands, e.g.: Simplicity; Compactness and integration (few parts); High thermal efficiency; Low pressure drop; Excellent emissions; High turn-down ratio; Reasonable production cost. Spurred by the technical progresses, the importance of a long-term test under realistic conditions was clear. A long-term evaluation was initialised at Sydkraft Gas premises in Aastorp. The CHE was installed on a specially designed rig to enable accelerated testing with respect to the number of transients. The rig was operated continuously for 5000 hours and emission mapping was carried out at certain time intervals. Following some problems during the initial phase of the long-term evaluation, which unfortunately also delayed the project, the results indicated very stable conditions of operation. The emissions have been rather constant during the course of the test and we cannot see any tendencies to decreased performances. Indeed, the test verifies the function, operability and reliability of the CHE-concept. Apart from domestic boilers we foresee a number of interesting and relevant applications in heating and process technology. Since

Long-Term Prognosis of Plantar Fasciitis

DEFF Research Database (Denmark)

Hansen, Liselotte; Krogh, Thøger Persson; Ellingsen, Torkell

2018-01-01

, exercise-induced symptoms, bilateral heel pain, fascia thickness, and presence of a heel spur) could predict long-term outcomes, (3) to assess the long-term ultrasound (US) development in the fascia, and (4) to assess whether US-guided corticosteroid injections induce atrophy of the heel fat pad. Study....... The risk was significantly greater for women (P heel...... regardless of symptoms and had no impact on prognosis, and neither did the presence of a heel spur. Only 24% of asymptomatic patients had a normal fascia on US at long-term follow-up. A US-guided corticosteroid injection did not cause atrophy of the heel fat pad. Our observational study did not allow us...

Long-term dependence in exchange rates

Directory of Open Access Journals (Sweden)

A. Karytinos

2000-01-01

Full Text Available The extent to which exchange rates of four major currencies against the Greek Drachma exhibit long-term dependence is investigated using a R/S analysis testing framework. We show that both classic R/S analysis and the modified R/S statistic if enhanced by bootstrapping techniques can be proven very reliable tools to this end. Our findings support persistence and long-term dependence with non-periodic cycles for the Deutsche Mark and the French Franc series. In addition a noisy chaos explanation is favored over fractional Brownian motion. On the contrary, the US Dollar and British Pound were found to exhibit a much more random behavior and lack of any long-term structure.

Emerging communities of child-healthcare practice in the management of long-term conditions such as chronic kidney disease: qualitative study of parents' accounts.

Science.gov (United States)

Carolan, Ian; Smith, Trish; Hall, Andy; Swallow, Veronica M

2014-07-07

Parents of children and young people with long-term conditions who need to deliver clinical care to their child at home with remote support from hospital-based professionals, often search the internet for care-giving information. However, there is little evidence that the information available online was developed and evaluated with parents or that it acknowledges the communities of practice that exist as parents and healthcare professionals share responsibility for condition management. The data reported here are part of a wider study that developed and tested a condition-specific, online parent information and support application with children and young people with chronic-kidney disease, parents and professionals. Semi-structured interviews were conducted with 19 fathers and 24 mothers who had recently tested the novel application. Data were analysed using Framework Analysis and the Communities of Practice concept. Evolving communities of child-healthcare practice were identified comprising three components and several sub components: (1) Experiencing (parents making sense of clinical tasks) through Normalising care, Normalising illness, Acceptance & action, Gaining strength from the affected child and Building relationships to formalise a routine; (2) Doing (Parents executing tasks according to their individual skills) illustrated by Developing coping strategies, Importance of parents' efficacy of care and Fear of the child's health failing; and (3) Belonging/Becoming (Parents defining task and group members' worth and creating a personal identity within the community) consisting of Information sharing, Negotiation with health professionals and Achieving expertise in care. Parents also recalled factors affecting the development of their respective communities of healthcare practice; these included Service transition, Poor parent social life, Psycho-social affects, Family chronic illness, Difficulty in learning new procedures, Shielding and avoidance, and

Challenges in long-term operation of nuclear power plants - Implications for regulatory bodies

International Nuclear Information System (INIS)

Soda, Kunihisa; Van Wonterghem, Frederik; Khouaja, Hatem; Vilpas, Martti; Osouf, Nicolas; Harikumar, S.; Ishigaki, Hiroki; Osaki, Toru; Yamada, Tomoho; Carlsson, Lennart; Shepherd, David; Galloway, Melanie; Liszka, Ervin; Svab, Miroslav; Pereira, Ken; Huerta, Alejandro

2012-01-01

Nuclear power reactors have become a major source of electricity supply in many countries in the past half a century. Based on this experience, many operators have sought and have received authorisation for long-term operation, whereby plant operation continues beyond the period considered in the design of the plant. Acceptance of a nuclear power plant for extended service should be based on assurance of the fitness of the plant and the operator for safe and reliable operation over the entire period considered for long-term operation. This assurance may be obtained by establishment of appropriate regulatory requirements, specification of goals and safety levels and regulatory assessment and oversight of the operator's programme for long-term operation. The operators and regulators should ensure that operating experience continues to be evaluated during long-term operation to ensure that any relevant lessons are effectively applied. Other considerations for assurance of safe operation are effective management of ageing, possible need for safety improvements, application of lessons learnt from operating experience, evaluation of environmental impacts, adequate staff resources and performance, review of security at the plant, action in response to emerging issues, and openness and transparency in the transition to long-term operation. Even though most of these considerations are addressed under the regulatory framework that applies to the initial operating period, additional regulatory activities in these areas may be necessary for long-term operation. Although there can be significant differences in regulatory approaches used by different countries for evaluating acceptability of long-term operation, there is general agreement on the purposes and goals of the regulatory reviews. An authorisation of long-term operation could involve a licence renewal or a periodic safety review or an approach that melds elements of both. This report presents guidance that is intended

Short-term versus long-term contracting for uranium enrichment services

International Nuclear Information System (INIS)

Rudy, G.P.

1990-01-01

The US Department of Energy (US DOE) is the world's largest and most experienced supplier of uranium enrichment services. Through the late 1970s and early 1980s, emerging market forces transformed what was once a monopoly into a highly competitive industry. In the early 1980's the DOE lost market share. But as we enter the 1990s, new market forces have emerged. The US DOE believes a responsible balance between long-term and short-term contracting will be the key to success and the key to assuring the long-term health and reliability of the nuclear fuel industry. The US DOE intends to be in this nuclear business for a long time and will continue to offer reliable and responsive services second to none

Using MIQUEST in General Practice

Directory of Open Access Journals (Sweden)

Victoria Hammersley

1998-11-01

Full Text Available This paper describes ten months' experience with MIQUEST software used for the collection of data from computerised databases in General Practice. We report on the following: the MIQUEST software in use, the time costs to the practice, the completeness of confidentiality barriers and the accuracy of data collected using MIQUEST compared with similar data collected by the practice system (EMIS. There were no problems encountered with installation of MIQUEST-related software. With experience, MIQUEST was equal to the practice system for speed and ease of use. The confidentiality safeguards were found to be in accordance with the GMSC/RCGP Guidelines - patients could not be directly, or indirectly, identified from the data extracted by external searches. Inaccuracies in the data collected using MIQUEST were identified, but these were largely attributable to problems with the EMIS-written interpreter available on the practice system at the time, or with the coding schemes used by the practice. In an individual practice, MIQUEST represents an alternative data collection method to the practice-based software. For data collection from multiple general practices it should prove an invaluable tool for Health Authorities and research organisations.

Sphygmomanometers--an audit in general practice.

Science.gov (United States)

Shah, Nayankumar C; Sibbritt, David W; Heaney, Susan; Sharples, Jan

2004-11-01

The accuracy of sphygmomanometers used in Australian general practice is unknown but potentially important. We measured the accuracy of sphygmomanometers in general practice in the Hunter region of New South Wales using a gold standard. Practices were recruited by an advertisement in the division newsletter. Sixty practices (35%) volunteered. A total of 404 instruments were checked. Over 95% of sphygmomanometers were within 4 mmHg of gold standard sphygmomanometer across the clinical pressure range. Mercury sphygmomanometers were more accurate than aneroid (pmercury.

General practice: the DREEM attachment? Comparing the educational environment of hospital and general practice placements.

Science.gov (United States)

Kelly, Martina; Bennett, Deirdre; O'Flynn, Siun

2012-01-01

The clinical learning environment is changing. General practice placements are now a fundamental part of undergraduate medical education. There is growing recognition that changes in hospital work practices are altering the breadth of exposure available to students. Surprisingly little work has been done comparing the quality of clinical placements between the hospital and community using validated tools. Such comparisons inform curriculum planning and resource allocation. The aim of this study was to compare the quality of the educational environment experienced by junior medical students during hospital and general practice placements using a widely used tool. Following the introduction of a new integrated curriculum, all Year 3 students (n=108) completed a standardised evaluation instrument, the Dundee Ready Education Environment Measure (DREEM) at the end of each of their clinical attachments (two different hospital sites and one in general practice), giving a total of 324 questionnaires. All forms were analysed and input into Graphpad INSTAT version 3. Total DREEM scores as well as subscale scores were calculated for each site. These were compared across sites using a Mann-Whitney U non-parametric test. By comparison with international standards, clinical attachments in our new integrated curriculum were rated highly. In particular, attachments in general practice scored highly with a mean score of 156.6 and perform significantly better (P students' perceptions of atmosphere and students' social self-perceptions. Finally, significant differences also emerged in students' perceptions of teachers in general practice when compared to those in the hospital setting. These findings provide evidence of the high-quality educational environment afforded students in primary care. They challenge the traditional emphasis on hospital-based teaching and preempt the question - Is the community a better place for junior students to learn?

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

Science.gov (United States)

Older Women's League, Washington, DC.

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

Remaining uncertainties in predicting long-term performance of nuclear waste glass from experiments

International Nuclear Information System (INIS)

Grambow, B.

1994-01-01

The current knowledge on the glass dissolution mechanism and the representation of glass dissolution concepts within overall repository performance assessment models are briefly summarized and uncertainties related to mechanism, radionuclide chemistry and parameters are discussed. Understanding of the major glass dissolution processes has been significantly increased in recent years. Long-term glass stability is related to the long-term maintenance of silica saturated conditions. The behavior of individual radionuclides in the presence of a dissolving glass has not been sufficiently and results do no yet allow meaningful predictions. Conserving long-term predictions of glass matrix dissolution as upper limit for radionuclide release can be made with sufficient confidence, however these estimations generally result in a situation where the barrier function of the glass is masked by the efficiency of the geologic barrier. Realistic long-term predictions may show that the borosilicate waste glass contributes to overall repository safety to a much larger extent than indicated by overconservatism. Today realistic predictions remain highly uncertain and much more research work is necessary. In particular, the long-term rate under silica saturated conditions needs to be understood and the behavior of individual radionuclides in the presence of a dissolving glass deserves more systematic investigations

The influence of experiential learning on medical equipment adoption in general practices.

Science.gov (United States)

Bourke, Jane; Roper, Stephen

2014-10-01

The benefits of the availability and use of medical equipment for medical outcomes are understood by physicians and policymakers alike. However, there is limited understanding of the decision-making processes involved in adopting and using new technologies in health care organisations. Our study focuses on the adoption of medical equipment in Irish general practices which are marked by considerable autonomy in terms of commercial practice and the range of medical services they provide. We examine the adoption of six items of medical equipment taking into account commercial, informational and experiential stimuli. Our analysis is based on primary survey data collected from a sample of 601 general practices in Ireland on practice characteristics and medical equipment use. We use a multivariate Probit to identify commonalities in the determinants of the adoption. Many factors, such as GP and practice characteristics, influence medical equipment adoption. In addition, we find significant and consistent evidence of the influence of learning-by-using effects on the adoption of medical equipment in a general practice setting. Knowledge generated by experiential or applied learning can have commercial, organisational and health care provision benefits in small health care organisations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Long-term musical training may improve different forms of visual attention ability.

Science.gov (United States)

Rodrigues, Ana Carolina; Loureiro, Maurício Alves; Caramelli, Paulo

2013-08-01

Many studies have suggested that structural and functional cerebral neuroplastic processes result from long-term musical training, which in turn may produce cognitive differences between musicians and non-musicians. We aimed to investigate whether intensive, long-term musical practice is associated with improvements in three different forms of visual attention ability: selective, divided and sustained attention. Musicians from symphony orchestras (n=38) and non-musicians (n=38), who were comparable in age, gender and education, were submitted to three neuropsychological tests, measuring reaction time and accuracy. Musicians showed better performance relative to non-musicians on four variables of the three visual attention tests, and such an advantage could not solely be explained by better sensorimotor integration. Moreover, in the group of musicians, significant correlations were observed between the age at the commencement of musical studies and reaction time in all visual attention tests. The results suggest that musicians present augmented ability in different forms of visual attention, thus illustrating the possible cognitive benefits of long-term musical training. Copyright © 2013 Elsevier Inc. All rights reserved.

Profile of mood states and stress-related biochemical indices in long-term yoga practitioners

Directory of Open Access Journals (Sweden)

Sudo Nobuyuki

2011-06-01

Full Text Available Abstract Background Previous studies have shown the short-term or intermediate-term practice of yoga to be useful for ameliorating several mental disorders and psychosomatic disorders. However, little is known about the long-term influences of yoga on the mental state or stress-related biochemical indices. If yoga training has a stress-reduction effect and also improves an individual's mental states for a long time, long-term yoga practitioners may have a better mental state and lower stress-related biochemical indices in comparison to non-experienced participants. This study simultaneously examined the differences in mental states and urinary stress-related biochemical indices between long-term yoga practitioners and non-experienced participants. Methods The participants were 38 healthy females with more than 2 years of experience with yoga (long-term yoga group and 37 age-matched healthy females who had not participated in yoga (control group. Their mental states were assessed using the Profile of Mood States (POMS questionnaire. The level of cortisol, 8-hydroxydeoxyguanosine (8-OHdG and biopyrrin in urine were used as stress-related biochemical indices. Results The average self-rated mental disturbance, tension-anxiety, anger-hostility, and fatigue scores of the long-term yoga group were lower than those of the control group. There was a trend toward a higher vigor score in the long-term yoga group than that in the control group. There were no significant differences in the scores for depression and confusion in the POMS between the two groups. The urine 8-OHdG concentration showed a trend toward to being lower in the long-term yoga group in comparison to the control group. There were no significant differences in the levels of urine biopyrrin or cortisol. Conclusions The present findings suggest that long-term yoga training can reduce the scores related to mental health indicators such as self-rated anxiety, anger, and fatigue.

Long term wet spent nuclear fuel storage

International Nuclear Information System (INIS)

1987-04-01

The meeting showed that there is continuing confidence in the use of wet storage for spent nuclear fuel and that long-term wet storage of fuel clad in zirconium alloys can be readily achieved. The importance of maintaining good water chemistry has been identified. The long-term wet storage behaviour of sensitized stainless steel clad fuel involves, as yet, some uncertainties. However, great reliance will be placed on long-term wet storage of spent fuel into the future. The following topics were treated to some extent: Oxidation of the external surface of fuel clad, rod consolidation, radiation protection, optimum methods of treating spent fuel storage water, physical radiation effects, and the behaviour of spent fuel assemblies of long-term wet storage conditions. A number of papers on national experience are included

Long-Term Collections

CERN Multimedia

Staff Association

2016-01-01

45 years helping in developing countries! CERN personnel have been helping the least fortunate people on the planet since 1971. How? With the Long-Term Collections! Dear Colleagues, The Staff Association’s Long-Term Collections (LTC) Committee is delighted to share this important milestone in the life of our Laboratory with you. Indeed, whilst the name of CERN is known worldwide for scientific discoveries, it also shines in the many humanitarian projects which have been supported by the LTC since 1971. Several schools and clinics, far and wide, carry its logo... Over the past 45 years, 74 projects have been supported (9 of which are still ongoing). This all came from a group of colleagues who wanted to share a little of what life offered them here at CERN, in this haven of mutual understanding, peace and security, with those who were less fortunate elsewhere. Thus, the LTC were born... Since then, we have worked as a team to maintain the dream of these visionaries, with the help of regular donat...

Long-Term Collection

CERN Multimedia

Staff Association

2016-01-01

Dear Colleagues, As previously announced in Echo (No. 254), your delegates took action to draw attention to the projects of the Long-Term Collections (LTC), the humanitarian body of the CERN Staff Association. On Tuesday, 11 October, at noon, small Z-Cards were widely distributed at the entrances of CERN restaurants and we thank you all for your interest. We hope to have achieved an important part of our goal, which was to inform you, convince you and find new supporters among you. We will find out in the next few days! An exhibition of the LTC was also set up in the Main Building for the entire week. The Staff Association wants to celebrate the occasion of the Long-Term Collection’s 45th anniversary at CERN because, ever since 1971, CERN personnel have showed great support in helping the least fortunate people on the planet in a variety of ways according to their needs. On a regular basis, joint fundraising appeals are made with the Directorate to help the victims of natural disasters around th...

Assessment of long-term leaching from waste incineration air-pollution-control residues

DEFF Research Database (Denmark)

Astrup, Thomas; Mosbæk, Hans; Christensen, Thomas Højlund

2006-01-01

Assessment of long-term leaching from MSWI air-pollution-control (APC) residues is discussed with respect to use in environmental impact assessment, such as life-cycle assessment (LCA). A method was proposed for estimating leaching as a function of the liquid-to-solid (L/S) ratio in a long......-term perspective (L/S 5000l/kg). Data for changes in residue pH as a function of L/S was used in combination with pH dependent leaching data to predict leachate concentrations of Al, Ca, Cd, Ba, Mg, Ni, Pb, S, Pb, V and Zn as a function of L/S. Mass balance calculations were used to determine the element fractions...... leached with respect to L/S. The estimated long-term leaching from a semi-dry residue and a fly ash was compared with short-term leaching determined by batch tests at L/S 10l/kg, both carbonated and non-carbonated versions of the residues were investigated. Generally, very high L/S ratios above 2000l...

Private capital investments in health care provision through mergers and acquisitions: from long-term to acute care.

Science.gov (United States)

Angeli, Federica; Maarse, Hans

2016-10-01

This work aims to test whether different segments of healthcare provision differentially attract private capital and thus offer heterogeneous opportunities for private investors' diversification strategies. Thomson Reuter's SDC Platinum database provided data on 2563 merger and acquisition (M&A) deals targeting healthcare providers in Western Europe between 1990 and 2010. Longitudinal trends of industrial and geographical characteristics of M&As' targets and acquirers are examined. Our analyses highlight: (i) a relative decrease of long-term care facilities as targets of M&As, replaced by an increasing prominence of general hospitals, (ii) a shrinking share of long-term care facilities as targets of financial service organizations' acquisitions, in favor of general hospitals, and (iii) an absolute and relative decrease of long-term care facilities' role as target of cross-border M&As. We explain the decreasing interest of private investors towards long-term care facilities along three lines of reasoning, which take into account the saturation of the long-term care market and the liberalization of acute care provision across Western European countries, regulatory interventions aimed at reducing private ownership to ensure resident outcomes and new cultural developments in favor of small-sized facilities, which strengthen the fragmentation of the sector. These findings advance the literature investigating the effect of private ownership on health outcomes in long-term facilities. Market, policy and cultural forces have emerged over two decades to jointly regulate the presence of privately owned, large-sized long-term care providers, seemingly contributing to safeguard residents' well-being. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Psychometrics Matter in Health Behavior: A Long-term Reliability Generalization Study.

Science.gov (United States)

Pickett, Andrew C; Valdez, Danny; Barry, Adam E

2017-09-01

Despite numerous calls for increased understanding and reporting of reliability estimates, social science research, including the field of health behavior, has been slow to respond and adopt such practices. Therefore, we offer a brief overview of reliability and common reporting errors; we then perform analyses to examine and demonstrate the variability of reliability estimates by sample and over time. Using meta-analytic reliability generalization, we examined the variability of coefficient alpha scores for a well-designed, consistent, nationwide health study, covering a span of nearly 40 years. For each year and sample, reliability varied. Furthermore, reliability was predicted by a sample characteristic that differed among age groups within each administration. We demonstrated that reliability is influenced by the methods and individuals from which a given sample is drawn. Our work echoes previous calls that psychometric properties, particularly reliability of scores, are important and must be considered and reported before drawing statistical conclusions.

Process evaluation of a practice nurse-led smoking cessation trial in Australian general practice: views of general practitioners and practice nurses.

Science.gov (United States)

Halcomb, Elizabeth J; Furler, John S; Hermiz, Oshana S; Blackberry, Irene D; Smith, Julie P; Richmond, Robyn L; Zwar, Nicholas A

2015-08-01

Support in primary care can assist smokers to quit successfully, but there are barriers to general practitioners (GPs) providing this support routinely. Practice nurses (PNs) may be able to effectively take on this role. The aim of this study was to perform a process evaluation of a PN-led smoking cessation intervention being tested in a randomized controlled trial in Australian general practice. Process evaluation was conducted by means of semi-structured telephone interviews with GPs and PNs allocated in the intervention arm (Quit with PN) of the Quit in General Practice trial. Interviews focussed on nurse training, content and implementation of the intervention. Twenty-two PNs and 15 GPs participated in the interviews. The Quit with PN intervention was viewed positively. Most PNs were satisfied with the training and the materials provided. Some challenges in managing patient data and follow-up were identified. The Quit with PN intervention was acceptable to participating PNs and GPs. Issues to be addressed in the planning and wider implementation of future trials of nurse-led intervention in general practice include providing ongoing mentoring support, integration into practice management systems and strategies to promote greater collaboration in GPs and PN teams in general practice. The ongoing feasibility of the intervention was impacted by the funding model supporting PN employment and the competing demands on the PNs time. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Effect of anemia on child development: long-term consequences].

Science.gov (United States)

Zavaleta, Nelly; Astete-Robilliard, Laura

2017-01-01

Anemia in children younger than 3 years is a public health problem in Peru and worldwide. It is believed that one of the primary causes of anemia is iron deficiency. Numerous studies and reviews have reported that iron deficiency limited psychomotor development in children and that, despite the correction of anemia, children with iron deficiency experienced poorer long-term performance in cognitive, social, and emotional functioning. These outcomes were reported in observational studies, follow-up studies, and experimental studies with a control group. Anemia can decrease school performance, productivity in adult life, quality of life, and the general income of affected individuals. Here we describe possible mechanisms underlying the effect of iron deficiency, with or without anemia, on childhood development. The high rate of anemia in this age group is a cause for concern. Moreover, anemia should be prevented in the first year of life to avoid long-term negative effects on individual development.

Emergency medicine and general practice

OpenAIRE

Abela, Gunther

2005-01-01

Emergency Medicine and Immediate Medical Care are relatively new specialties. In Malta, there is quite a considerable area of overlap between these specialties and general practice. Indeed, the family physician is confronted with some sort of medical emergency quite regularly. The brief of this article is to go through recent developments in Emergency Medicine as applied to General Practice. The areas considered are Basic Life Support, Head Injury, Asthma, Anaphylaxis, Community Acquired Pneu...

Prediction on long-term mean and mean square pollutant concentrations in an urban atmosphere

Energy Technology Data Exchange (ETDEWEB)

Kumar, S; Lamb, R G; Seinfeld, J H

1976-01-01

The general problem of predicting long-term average (say yearly) pollutant concentrations in an urban atmosphere is formulated. The pollutant concentration can be viewed as a random process, the complete description of which requires knowledge of its probability density function, which is unknown. The mean concentration is the first moment of the concentration distribution, and at present there exist a number of models for predicting the long-term mean concentration of an inert pollutant. The second moment, or mean square concentration, indicates additional features of the distribution, such as the level of fluctuations about the mean. In the paper a model proposed by Lamb for the long-term mean concentration is reviewed, and a new model for prediction of the long-term mean square concentration of an inert air pollutant is derived. The properties and uses of the model are discussed, and the equations defining the model are presented in a form for direct application to an urban area.

A study about the long-term stability of sedimentary rock

International Nuclear Information System (INIS)

Yoshino, Naoto; Miyanomae, Shun-ichi; Inoue, Hiroyuki; Nashimoto, Yutaka

2005-02-01

In this paper, following two issues were examined and estimated, (1) the influence of near field condition factor to the dynamical behavior of sedimentary soft rock, (2) the long term estimation of the dynamical behavior considering the condition of Horonobe area. As the study about the influence of near field condition factor to the dynamical behavior of sedimentary soft rock, the thermal factor was focused on and the laboratory tests using test pieces which were sampled in Horonobe area were carried out under the water temperature were 20 degrees and 80 degrees. As a result, the time dependence parameter in variable-compliance-type constitutive-equation could be obtained. And comparison between creep property under 20 degrees and 80 degrees was conducted. In addition, the general properties of sedimentary soft rock under several conditions were identified by the survey of the literature. And the way how to confirm the dynamical properties of sedimentary soft rock with in-situ test were presented. For the study on the short-term and long-term stability of rock surrounding buffer materials, numerical simulations were carried out assuming several conditions. The direction of disposal tunnels and the ratio of rock strength by initial stress were estimated to be the main factor affecting the short-term stability of rock. Time dependency of rock and the stiffness of buffer material were estimated to be the main factor affecting the long-term stability of rock. (author)

Long-term corrosion studies

International Nuclear Information System (INIS)

Gdowski, G.

1998-01-01

The scope of this activity is to assess the long-term corrosion properties of metallic materials under consideration for fabricating waste package containers. Three classes of metals are to be assessed: corrosion resistant, intermediate corrosion resistant, and corrosion allowance. Corrosion properties to be evaluated are general, pitting and crevice corrosion, stress-corrosion cracking, and galvanic corrosion. The performance of these materials will be investigated under conditions that are considered relevant to the potential emplacement site. Testing in four aqueous solutions, and vapor phases above them, and at two temperatures are planned for this activity. (The environmental conditions, test metals, and matrix are described in detail in Section 3.0.) The purpose and objective of this activity is to obtain the kinetic and mechanistic information on degradation of metallic alloys currently being considered for waste package containers. This information will be used to provide assistance to (1) waste package design (metal barrier selection) (E-20-90 to E-20-92), (2) waste package performance assessment activities (SIP-PA-2), (3) model development (E-20-75 to E-20-89). and (4) repository license application

Changing incentives for long-term gas contracts

International Nuclear Information System (INIS)

Bohi, D.R.

1992-01-01

There is much concern about the absence of long-term gas contracts with fixed price and quantity conditions, which until recent years was the standard way of doing business in the gas industry. These types of contracts performed a valuable service in the development of the gas industry, and there comparative absence today is sometimes thought to be one reason for the current malaise in the industry. One hears the argument that there must be some kind of 'market failure' that prevents buyers and sellers from entering into these long term arrangements, and recent changes in state and federal regulations are often cited as the cause of the problem. The purpose of the author's remarks is to argue that what is taken as a breakdown in the market may be simply a reaction to a decline in economic incentives to enter into long-term contracts with rigid price and quantity terms. This is, in other words, simply one more aspect of change in the gas business that Frank Heintz referred to in his opening remarks this morning. The author starts by giving a brief description of the motives for engaging in long-term contracts, and then describes how incentives to use long-term contracts have declined for both gas buyers and gas sellers. He concludes that the decline in the use of long-term contracts is not cause for regulatory concern, but a result of the continuing transformation of the gas business to one that more closely resembles other commodity markets

Long-term neurodevelopmental outcome after selective feticide in monochorionic pregnancies.

Science.gov (United States)

van Klink, Jmm; Koopman, H M; Middeldorp, J M; Klumper, F J; Rijken, M; Oepkes, D; Lopriore, E

2015-10-01

To assess the incidence of and risk factors for adverse long-term neurodevelopmental outcome in complicated monochorionic pregnancies treated with selective feticide at our centre between 2000 and 2011. Observational cohort study. National referral centre for fetal therapy (Leiden University Medical Centre, the Netherlands). Neurodevelopmental outcome was assessed in 74 long-term survivors. Children, at least 2 years of age, underwent an assessment of neurologic, motor and cognitive development using standardised psychometric tests and the parents completed a behavioural questionnaire. A composite outcome termed neurodevelopmental impairment including cerebral palsy (GMFCS II-V), cognitive and/or motor test score of Neurodevelopmental impairment was detected in 5/74 [6.8%, 95% confidence interval (CI), 1.1-12.5] of survivors. Overall adverse outcome, including perinatal mortality or neurodevelopmental impairment was 48/131 (36.6%). In multivariate analysis, parental educational level was associated with cognitive test scores (regression coefficient B 3.9, 95% CI 1.8-6.0). Behavioural problems were reported in 10/69 (14.5%). Adverse long-term outcome in survivor twins of complicated monochorionic pregnancies treated with selective feticide appears to be more prevalent than in the general population. Cognitive test scores were associated with parental educational level. Neurodevelopmental impairment after selective feticide was detected in 5/74 (6.8%, 95% CI 1.1-12.5) of survivors. © 2015 Royal College of Obstetricians and Gynaecologists.

Opening remarks for a panel discussion on short-term vs long-term procurement

International Nuclear Information System (INIS)

Courtenay, R.H.

1990-01-01

Long-term contracting in the late 1970's and early 1980's is blamed for some of the inequities that plague the uranium industry today. Utilities are obliged to pay prices far above prevailing levels and relatively low cost producers are forced to shut down while watching less efficient suppliers stay in business thanks to their long term supply agreements. Furthermore, it is argued that long-term contracts have contributed to supply instability by forcing the buildup of surplus inventories and by supporting excess incremental production by suppliers who have a baseload of long-term contracts. The depressed prices resulting from this oversupply are in turn jeopardizing future resource development and damaging supply reliability. In summary, the author's argument is that supply reliability will be greatly enhanced by the assurance of adequate primary supply from traditional sources such as Canada. This will not happen without long-term contracts. This conclusion may not be expected coming from a representative of Canada's largest uranium producer. But the final comment is less self serving. Many of the critics of long term contracts apparently expect a continuing and plentiful supply of East Bloc uranium to the spot market. A further question is to what extent East Bloc suppliers will eventually require long-term contracts in order to maintain production facilitates in economies that are no longer centrally planned, and where there is open competition for capital. Ultimately, reliability of supply from the non-traditional suppliers may also depend on long-term contracts

Social science in the context of the long term ecological research program

Science.gov (United States)

Ted L. Gragson; Morgan Grove

2006-01-01

This special issue of Society and Natural Resources brings the results of long-term ecological research with an explicit social dimension to the attention of the social scientific research community. Contributions are from the Baltimore Ecosystem Study LTER, the Central Arizona-Phoenix LTER, the Coweeta LTER and the Northern Temperate Lakes LTER. The range of practice...

High Hand Contamination Rates During Norovirus Outbreaks in Long-Term Care Facilities.

Science.gov (United States)

Park, Geun Woo; Williamson, Keenan J; DeBess, Emilio; Cieslak, Paul R; Gregoricus, Nicole; De Nardo, Elizabeth; Fricker, Christopher; Costantini, Verónica; Vinjé, Jan

2018-02-01

We examined norovirus contamination on hands of ill patients during 12 norovirus outbreaks in 12 long-term care facilities (LTCFs). The higher frequency and norovirus titers on hands of residents compared to hands of heathcare workers highlights the importance of adhering to appropriate hand hygiene practices during norovirus outbreaks in LTCFs. Infect Control Hosp Epidemiol 2018;39:219-221.

The role of the curriculum and other factors in determining the medium- to long-term attitude of the practicing dentist towards life-long learning.

LENUS (Irish Health Repository)

Polyzois, I

2010-05-01

To investigate the significance of the undergraduate dental curriculum on the medium- to long-term attitudes of the clinician to life-long learning, and to identify demographical and professional characteristics which may influence this attitude.

Restoring old-growth southern pine ecosystems: strategic lessons from long-term silvicultural research

Science.gov (United States)

Don C. Bragg; Michael G. Shelton; James M. Guldin

2008-01-01

The successful restoration of old-growth-like loblolly (Pinus taeda) and shortleaf (Pinus echinata) pine-dominated forests requires the integration of ecological information with long-term silvicultural research from places such as the Crossett Experimental Forest (CEF). Conventional management practices such as timber harvesting or competition control have supplied...

Field Performance Test of an Air-Cleaner with Photocatalysis-Plasma Synergistic Reactors for Practical and Long-Term Use

Directory of Open Access Journals (Sweden)

Tsuyoshi Ochiai

2014-10-01

Full Text Available A practical and long-term usable air-cleaner based on the synergy of photocatalysis and plasma treatments has been developed. A field test of the air-cleaner was carried out in an office smoking room. The results were compared to previously reported laboratory test results. Even after a treatment of 12,000 cigarettes-worth of tobacco smoke, the air-cleaner maintained high-level air-purification activity (98.9% ± 0.1% and 88% ± 1% removal of the total suspended particulate (TSP and total volatile organic compound (TVOC concentrations, respectively at single-pass conditions. Although the removal ratio of TSP concentrations was 98.6% ± 0.2%, the ratio of TVOC concentrations was 43.8% after a treatment of 21,900 cigarettes-worth of tobacco smoke in the field test. These results indicate the importance of suitable maintenance of the reactors in the air-cleaner during field use.

Definition of terms for practical superconductors

International Nuclear Information System (INIS)

Fickett, F.R.; Kaplan, S.B.; Powell, R.L.; Radebaugh, R.; Clark, A.F.

1980-01-01

The definitions of terms used in describing the phenomenology and measurement practices of practical superconductive materials are proposed. The definitions cover the subject categories of: 1, fundamental states and flux phenomena, 2, critical parameters, 3, fabrication, stabilization, and transient losses, and 4, Josephson phenomena. It is intended that these terms will become the basis for development of standard measurement practices and responses are invited. (author)

Definitions of terms for practical superconductors

International Nuclear Information System (INIS)

Read, D.T.; Ekin, J.W.; Powell, R.L.; Clark, A.F.

1979-01-01

The definitions of terms used in describing the phenomenology and measurement practices of practical superconductive materials are proposed. The definitions cover the subject categories of: (1) fundamental states and flux phenomena; (2) critical parameters; (3) fabrication, stabilization, and transient losses; and (4) Josephson phenomena. It is intended that these terms will become the basis for the development of standard measurement practices and responses are invited. (author)

Definitions of terms for practical superconductors

International Nuclear Information System (INIS)

Powell, R.; Clark, A.F.

1977-01-01

The definitions of terms used in describing the phenomenology and measurement practices of practical superconductive materials are proposed. The definitions cover the subject categories of: (1) fundamental states and flux phenomena, (2) critical parameters, (3) fabrication, stabilization, and transient losses, and (4) Josephson phenomena. It is intended that these terms become the basis for the development of standard measurement practices and responses are invited. (author)

Preeclampsia; short and long-term consequences for mother and neonate.

Science.gov (United States)

Bokslag, Anouk; van Weissenbruch, Mirjam; Mol, Ben Willem; de Groot, Christianne J M

2016-11-01

Preeclampsia is a common pregnancy specific disease, that presents with hypertension and a variety of organ failures, including malfunction of kidneys, liver and lungs. At present, the only definitive treatment of preeclampsia is end the pregnancy and deliver the neonate and placenta. For women with mild preeclampsia in the preterm phase of pregnancy, expectant management is generally indicated to improve fetal maturity, often requiring maternal medical treatment. Last decades, more evidence is available that the underlying mechanism of preeclampsia, endothelial disease, is not limited to pregnancy but increases cardiovascular risk in later life. In this review, we present the most recent insight in preeclampsia with focus on impact on the fetus, short and long-term outcome of offspring's, and long-term outcome of women with a history of preeclampsia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Long-term risks of kidney living donation

DEFF Research Database (Denmark)

Maggiore, Umberto; Budde, Klemens; Heemann, Uwe

2017-01-01

Two recent matched cohort studies from the USA and Norway published in 2014 have raised some concerns related to the long-term safety of kidney living donation. Further studies on the long-term risks of living donation have since been published. In this position paper, Developing Education Science...... and Care for Renal Transplantation in European States (DESCARTES) board members critically review the literature in an effort to summarize the current knowledge concerning long-term risks of kidney living donation to help physicians for decision-making purposes and for providing information...... to the prospective live donors. Long-term risk of end-stage renal disease (ESRD) can be partially foreseen by trying to identify donors at risk of developing ‘de novo’ kidney diseases during life post-donation and by predicting lifetime ESRD risk. However, lifetime risk may be difficult to assess in young donors...

Long-Term Research in Ecology and Evolution (LTREE): 2015 survey data.

Science.gov (United States)

Bradford, Mark A; Leiserowitz, Anthony; Feinberg, Geoffrey; Rosenthal, Seth A; Lau, Jennifer A

2017-11-01

To systematically assess views on contributions and future activities for long-term research in ecology and evolution (LTREE), we conducted and here provide data responses and associated metadata for a survey of ecological and evolutionary scientists. The survey objectives were to: (1) Identify and prioritize research questions that are important to address through long-term, ecological field experiments; and (2) understand the role that these experiments might play in generating and applying ecological and evolutionary knowledge. The survey was developed adhering to the standards of the American Association for Public Opinion Research. It was administered online using Qualtrics Survey Software. Survey creation was a multi-step process, with questions and format developed and then revised with, for example, input from an external advisory committee comprising senior and junior ecological and evolutionary researchers. The final questionnaire was released to ~100 colleagues to ensure functionality and then fielded 2 d later (January 7 th , 2015). Two professional societies distributed it to their membership, including the Ecological Society of America, and it was posted to three list serves. The questionnaire was available through February 8th 2015 and completed by 1,179 respondents. The distribution approach targeted practicing ecologists and evolutionary biologists in the U.S. Quantitative (both ordinal and categorical) closed-ended questions used a predefined set of response categories, facilitating direct comparison across all respondents. Qualitative, open-ended questions, provided respondents the opportunity to develop their own answers. We employed quantitative questions to score views on the extent to which long-term experimental research has contributed to understanding in ecology and evolutionary biology; its role compared to other approaches (e.g., short-term experiments); justifications for and caveats to long-term experiments; and the relative importance

Long-term effects of radiation

International Nuclear Information System (INIS)

Smith, J.; Smith, T.

1981-01-01

It is pointed out that sources of long-term damage from radiation are two-fold. People who have been exposed to doses of radiation from initial early fallout but have recovered from the acute effects may still suffer long-term damage from their exposure. Those who have not been exposed to early fallout may be exposed to delayed fallout, the hazards from which are almost exclusively from ingesting strontium, caesium and carbon isotopes present in food; the damage caused is relatively unimportant compared with that caused by the brief doses from initial radiation and early fallout. A brief discussion is presented of the distribution of delayed long-lived isotope fallout, and an outline is sketched of late biological effects, such as malignant disease, cataracts, retarded development, infertility and genetic effects. (U.K.)

A hands-on approach for fitting long-term survival models under the GAMLSS framework.

Science.gov (United States)

de Castro, Mário; Cancho, Vicente G; Rodrigues, Josemar

2010-02-01

In many data sets from clinical studies there are patients insusceptible to the occurrence of the event of interest. Survival models which ignore this fact are generally inadequate. The main goal of this paper is to describe an application of the generalized additive models for location, scale, and shape (GAMLSS) framework to the fitting of long-term survival models. In this work the number of competing causes of the event of interest follows the negative binomial distribution. In this way, some well known models found in the literature are characterized as particular cases of our proposal. The model is conveniently parameterized in terms of the cured fraction, which is then linked to covariates. We explore the use of the gamlss package in R as a powerful tool for inference in long-term survival models. The procedure is illustrated with a numerical example. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Spot-checks to measure general hygiene practice.

Science.gov (United States)

Sonego, Ina L; Mosler, Hans-Joachim

2016-01-01

A variety of hygiene behaviors are fundamental to the prevention of diarrhea. We used spot-checks in a survey of 761 households in Burundi to examine whether something we could call general hygiene practice is responsible for more specific hygiene behaviors, ranging from handwashing to sweeping the floor. Using structural equation modeling, we showed that clusters of hygiene behavior, such as primary caregivers' cleanliness and household cleanliness, explained the spot-check findings well. Within our model, general hygiene practice as overall concept explained the more specific clusters of hygiene behavior well. Furthermore, the higher general hygiene practice, the more likely children were to be categorized healthy (r = 0.46). General hygiene practice was correlated with commitment to hygiene (r = 0.52), indicating a strong association to psychosocial determinants. The results show that different hygiene behaviors co-occur regularly. Using spot-checks, the general hygiene practice of a household can be rated quickly and easily.

Tracheostomy for long-term ventilated patients: a postal survey of ICU practice in The Netherlands.

NARCIS (Netherlands)

Fikkers, B.G.; Fransen, G.A.J.; Hoeven, J.G. van der; Briede, I.S.; Hoogen, F.J.A. van den

2003-01-01

OBJECTIVE: To assess the frequency, timing, technique, and follow-up of tracheostomy for long-term ventilated patients in different intensive care units (ICUs) in The Netherlands. DESIGN AND SETTING: Postal questionnaire, survey on retrospective data. A questionnaire was sent to all ( n=63) ICUs

IMPACT OF EUROPEAN INTEGRATION PROCESSES ON THE NECESSITY OF LONG-TERM BUDGET PLANNING INTRODUCTION IN UKRAINE

Directory of Open Access Journals (Sweden)

Ganna Muzychenko

2017-12-01

Full Text Available The Association Agreement between Ukraine and the European Union was ratified in September 2014. Ukraine has undertaken to implement and enforce EU standards, including in the financial sphere, which are regulated by international law. The purpose of the study is to determine the impact of European integration processes on the necessity of the long-term budget forecasting process introduction into the budget process of Ukraine and the revelation of special budgetary rules regulated this process in the EU. The methodology. The list of requirements (budget procedures and rules for their introduction by law into the budget process of Ukraine was determined based on the generalization and systematization of normative legal acts that regulate the medium-term financial planning as the EU standard. The results showed that the long-term budget forecast developing procedure in the budget process will allow the government to timely identify the unfavourable trend in the state’s fiscal policy and introduce preventive measures, determine the full scale of economy’s and business’ reaction to the reforms’ introduction and new laws adoption, estimate fiscal space for fiscal policy implementation for coming years, take into consideration the budget forecast’s indicators during the annual adoption of budget decisions. The study defines the difference between the budget forecast and the planned budget: the forecast is for five years and more, the plan is for one year only; forecast indicators are not mandatory for implementation, they are only guidelines, and planned indicators are mandatory for implementation; the budget forecast is approved by the order of the Cabinet of Ministers of Ukraine and annually specified, the planned budget (for the current budget year is approved by the Verkhovna Rada of Ukraine by adopting the relevant law, amendments are an exception and also approved by law. The practical implementation. Governments of countries that

Patients' satisfaction with healthcare: comparing general practice ...

African Journals Online (AJOL)

Patients' satisfaction with healthcare: comparing general practice services in a tertiary and primary healthcare settings. ... Nigerian Health Journal ... This research compared the level of patients' satisfaction with general practice care delivered at physicians-manned General Outpatient clinics at tertiary and primary health ...

Yield gap analysis in long-term experiments with intensive rice cultivation

International Nuclear Information System (INIS)

Laureles, E.V.; Correa, T. Jr.; Buresh, R.J.

2007-01-01

The long-term continuous cropping experiment at IRRI is cultivated with three rice crops in a year, making it the world's most intensively cropped long-term rice experiment. The availability of comprehensive rice production records, compiled weather data, and tested crop models provides a means to evaluate long-term trends in measured and potential yields and yield gaps in this rice production system. Yield trends were assessed using the highest yielding cultivar in each cropping season from 1979 to 2005. Potential yield of the highest yielding cultivar in each season was determined using three rice models (ORYZA, TERM, and CERES) run with the actual transplanting and harvest dates for the cultivar. The yield gap was determined from the difference between the simulated potential grain yield and the measured grain yield. Measured and potential yields and the yield gap varied across seasons and years. Measured yields were higher in the dry season than in the early and late wet seasons. The yield gap tended to be higher in the wet season than in the dry season. Climatic parameters, particularly solar radiation, influenced the performance of rice cultivars. The relatively larger yield gaps in the late wet season than in the dry season were associated with increased spikelet sterility. The cumulative measured yield for the three annual rice crop was near 80 percent of the annual yield potential in years with best practices for fertilizer N and crop management. The long term trends suggest that effective timing and rates of N fertilization and effective control of diseases were critical in achieving 80 percent of the annual yield potential

Long-term complications and side effects of bariatric surgery: a systematic review

Directory of Open Access Journals (Sweden)

Alfonso Enrique Martínez-Núñez

2017-09-01

Full Text Available Background and objective: Bariatric surgery is a procedure that has gained popularity in the last decades as a treatment for obesity and is generally regarded as safe and effective in the short term, though the complications on the long term have been poorly described. We aim to review studies with long term follow-up reporting complications after a bariatric procedure. Method: A search was conducted on the data bases MEDLINE, EBSCO, Cochrane Library, and Google Scholar, and also scanning through references list in publications. We included cohort studies and clinical trials published from January 1st 2014 to April 15th 2017 with a follow up ≥ 5 years, retention rate above 50%, written in the following languages; English, Spanish, or Portuguese. We conducted qualitative bias assessment and analysis of heterogeneity. Result: Only four studies met the inclusion criteria, all of them were conducted with different bariatric procedures (vertical sleeve gastrectomy, laparoscopic sleeve gastrectomy, laparoscopic adjustable gastric banding, and billiopancreatic diversion with or without duodenal shift. Study design, outcome assessment, and complication definition were highly heterogeneous. The most frequent long term complications were gastroesophageal reflux disease, several nutritional deficits, incisional hernias, and failure to weight loss. Conclusions: There is insufficient evidence to ensure the quantity and severity of long-term complications of bariatric surgery.

Long-term induced agricultural intensification in China

DEFF Research Database (Denmark)

Teng, Shuqing; Svenning, Jens-Christian

2016-01-01

Understanding the dynamics of agricultural intensification has great implications for biodiversity conservation faced with increasing human population and food demand. How agricultural intensification evolves with human population growth is differently described by three theories, namely......, the Boserupian, Malthusian and induced intensification theories. The Malthusian theory suggests quick adoption of available techniques that increase human population, while the other two share one viewpoint that increased intensive level of agriculture is passively induced by population growth. Which theory has...... a prediction that matches long-term dynamics of agricultural intensification in history? Using historical land-use data spanning two thousand years, this study estimated the dynamic trajectories of four cultivation practices with different intensive levels in a part of China and assessed the three theories...

Long-term home care scheduling

DEFF Research Database (Denmark)

Gamst, Mette; Jensen, Thomas Sejr

In several countries, home care is provided for certain citizens living at home. The long-term home care scheduling problem is to generate work plans spanning several days such that a high quality of service is maintained and the overall cost is kept as low as possible. A solution to the problem...... provides detailed information on visits and visit times for each employee on each of the covered days. We propose a branch-and-price algorithm for the long-term home care scheduling problem. The pricing problem generates one-day plans for an employee, and the master problem merges the plans with respect...

What are the differences between long-term, short-term, and working memory?

OpenAIRE

Cowan, Nelson

2008-01-01

In the recent literature there has been considerable confusion about the three types of memory: long-term, short-term, and working memory. This chapter strives to reduce that confusion and makes up-to-date assessments of these types of memory. Long- and short-term memory could differ in two fundamental ways, with only short-term memory demonstrating (1) temporal decay and (2) chunk capacity limits. Both properties of short-term memory are still controversial but the current literature is rath...

Antibiotic treatment of exacerbations of COPD in general practice: long-term impact on healthrelated quality of life

Directory of Open Access Journals (Sweden)

Marc Miravitlles

2010-01-01

exacerbations.Conclusions: In COPD outpatients, treatment of exacerbations with moxifloxacin had a more favorable long-term effect on quality of life than amoxicillin/clavulanate.Keywords: COPD, exacerbations, moxifloxacin, amoxicillin/clavulanate, quality of life, SGRQ

Management of venous leg ulcers in general practice - a practical guideline.

Science.gov (United States)

Sinha, Sankar; Sreedharan, Sadhishaan

2014-09-01

Chronic venous leg ulcers are the most common wounds seen in general practice. Their management can be both challenging and time-consuming. To produce a short practical guideline incorporating the TIME concept and A2BC2D approach to help general practitioners and their practice nurses in delivering evidence-based initial care to patients with chronic venous leg ulcers. Most chronic venous leg ulcers can be managed effectively in the general practice setting by following the simple, evidence-based approach described in this article. Figure 1 provides a flow chart to aid in this process. Figure 2 illustrates the principles of management in general practice. Effective management of chronic ulcers involves the assessment of both the ulcer and the patient. The essential requirements of management are to debride the ulcer with appropriate precautions, choose dressings that maintain adequate moisture balance, apply graduated compression bandage after evaluation of the arterial circulation and address the patient's concerns, such as pain and offensive wound discharge.

Long-term hearing preservation in vestibular schwannoma

DEFF Research Database (Denmark)

Stangerup, Sven-Eric; Thomsen, Jens; Tos, Mirko

2010-01-01

The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas.......The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas....

Providing Extrinsic Reward for Test Performance Undermines Long-Term Memory Acquisition

Directory of Open Access Journals (Sweden)

Christof eKuhbandner

2016-02-01

Full Text Available Based on numerous studies showing that testing studied material can improve long-term retention more than restudying the same material, it is often suggested that the number of tests in education should be increased to enhance knowledge acquisition. However, testing in real-life educational settings often entails a high degree of extrinsic motivation of learners due to the common practice of placing important consequences on the outcome of a test. Such an effect on the motivation of learners may undermine the beneficial effects of testing on long-term memory because it has been shown that extrinsic motivation can reduce the quality of learning. To examine this issue, participants learned foreign language vocabulary words, followed by an immediate test in which one third of the words were tested and one third restudied. To manipulate extrinsic motivation during immediate testing, participants received either monetary reward contingent on test performance or no reward. After one week, memory for all words was tested. In the immediate test, reward reduced correct recall and increased commission errors, indicating that reward reduced the number of items that can benefit from successful retrieval. The results in the delayed test revealed that reward additionally reduced the gain received from successful retrieval because memory for initially successfully retrieved words was lower in the reward condition. However, testing was still more effective than restudying under reward conditions because reward undermined long-term memory for concurrently restudied material as well. These findings indicate that providing performance-contingent reward in a test can undermine long-term knowledge acquisition.

Providing Extrinsic Reward for Test Performance Undermines Long-Term Memory Acquisition.

Science.gov (United States)

Kuhbandner, Christof; Aslan, Alp; Emmerdinger, Kathrin; Murayama, Kou

2016-01-01

Based on numerous studies showing that testing studied material can improve long-term retention more than restudying the same material, it is often suggested that the number of tests in education should be increased to enhance knowledge acquisition. However, testing in real-life educational settings often entails a high degree of extrinsic motivation of learners due to the common practice of placing important consequences on the outcome of a test. Such an effect on the motivation of learners may undermine the beneficial effects of testing on long-term memory because it has been shown that extrinsic motivation can reduce the quality of learning. To examine this issue, participants learned foreign language vocabulary words, followed by an immediate test in which one-third of the words were tested and one-third restudied. To manipulate extrinsic motivation during immediate testing, participants received either monetary reward contingent on test performance or no reward. After 1 week, memory for all words was tested. In the immediate test, reward reduced correct recall and increased commission errors, indicating that reward reduced the number of items that can benefit from successful retrieval. The results in the delayed test revealed that reward additionally reduced the gain received from successful retrieval because memory for initially successfully retrieved words was lower in the reward condition. However, testing was still more effective than restudying under reward conditions because reward undermined long-term memory for concurrently restudied material as well. These findings indicate that providing performance-contingent reward in a test can undermine long-term knowledge acquisition.

Long-Term Patency of Lymphovenous Anastomoses: A Systematic Review.

Science.gov (United States)