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Sample records for greater quality-adjusted life

  1. The Quality Adjusted Life Year: A Total-Utility Perspective.

    Science.gov (United States)

    Firth, Steven J

    2018-04-01

    Given that a properly formed utilitarian response to healthcare distribution issues should evaluate cost effectiveness against the total utility increase, it follows that any utilitarian cost-effectiveness metric should be sensitive to increases in both individual and social utility afforded by a given intervention. Quality adjusted life year (QALY) based decisionmaking in healthcare cannot track increases in social utility, and as a result, the QALY cannot be considered a strict utilitarian response to issues of healthcare distribution. This article considers arguments against, and a possible defence of, the QALY as a utilitarian concept; in response, the article offers a similar - but properly formed - utilitarian metric called the (IALY). This article also advances a tool called the 'glee factor' (GF) on which the IALY may lean in a similar way to which the QALY leans on the Rosser Index.

  2. Impact of particulate air pollution on quality-adjusted life expectancy in Canada.

    Science.gov (United States)

    Coyle, Douglas; Stieb, Dave; Burnett, Richard T; DeCivita, Paul; Krewski, Daniel; Chen, Yue; Thun, Michael J

    Air pollution and premature death are important public health concerns. Analyses have repeatedly demonstrated that airborne particles are associated with increased mortality and estimates have been used to forecast the impact on life expectancy. In this analysis, we draw upon data from the American Cancer Society (ACS) cohort and literature on utility-based measures of quality of life in relation to health status to more fully quantify the effects of air pollution on mortality in terms of quality-adjusted life expectancy. The analysis was conducted within a decision analytic model using Monte Carlo simulation techniques. Outcomes were estimated based on projections of the Canadian population. A one-unit reduction in sulfate air pollution would yield a mean annual increase in Quality-Adjusted Life Years (QALYs) of 20,960, with gains being greater for individuals with lower educational status and for males compared to females. This suggests that the impact of reductions in sulfate air pollution on quality-adjusted life expectancy is substantial. Interpretation of the results is unclear. However, the potential gains in QALYs from reduced air pollutants can be contrasted to the costs of policies to bring about such reductions. Based on a tentative threshold for the value of health benefits, analysis suggests that an investment in Canada of over 1 billion dollars per annum would be an efficient use of resources if it could be demonstrated that this would reduce sulfate concentrations in ambient air by 1 microg/m(3). Further analysis can assess the efficiency of targeting such initiatives to communities that are most likely to benefit.

  3. Quality-adjusted life-years. Ethical implications for physicians and policymakers.

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    La Puma, J; Lawlor, E F

    1990-06-06

    Quality-adjusted life-years have been used in economic analyses as a measure of health outcomes, one that reflects both lives saved and patients' valuations of quality of life in alternative health states. The concept of "cost per quality-adjusted life year" as a guideline for resource allocation is founded on six ethical assumptions: quality of life can be accurately measured and used, utilitarianism is acceptable, equity and efficiency are compatible, projections of community preferences can substitute for individual preferences, the old have less "capacity to benefit" than the young, and physicians will not use quality-adjusted life-years as clinical maxims. Quality-adjusted life-years signal two shifts in the locus of control and the nature of the clinical encounter: first, formal expressions of community preferences and societal usefulness would counterbalance patient autonomy, and second, formal tools of resource allocation and applied decision analysis would counterbalance the use of clinical judgment. These shifts reflect and reinforce a new financial ethos in medical decision making. Presently using quality-adjusted life-years for health policy decisions is problematic and speculative; using quality-adjusted life-years at the bedside is dangerous.

  4. Quality Adjusted Life Years and Trade Off Exercises : exploring methodology and validity

    NARCIS (Netherlands)

    Verschuuren, Marieke

    2006-01-01

    Quality Adjusted Life Years (QALYs) are a popular outcome measure in cost-effectiveness analyses. QALYs are computed by multiplying follow-up or survival by a scaling factor reflecting health related quality of life, and as such capture quantity and quality gains simultaneously. Issues with regard

  5. Modeling Quality-Adjusted Life Expectancy Loss Resulting from Tobacco Use in the United States

    Science.gov (United States)

    Kaplan, Robert M.; Anderson, John P.; Kaplan, Cameron M.

    2007-01-01

    Purpose: To describe the development of a model for estimating the effects of tobacco use upon Quality Adjusted Life Years (QALYs) and to estimate the impact of tobacco use on health outcomes for the United States (US) population using the model. Method: We obtained estimates of tobacco consumption from 6 years of the National Health Interview…

  6. Impact of selected risk factors on quality-adjusted life expectancy in Denmark

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik; Juel, Knud; Davidsen, Michael

    2007-01-01

    AIMS: The construct quality-adjusted life years (QALYs) combines mortality and overall health status and can be used to quantify the impact of risk factors on population health. The purpose of the study was to estimate the impact of tobacco smoking, high alcohol consumption, physical inactivity...... Health Survey 2000, and Danish EQ-5D values. RESULTS: The quality-adjusted life expectancy of 25-year-olds was 10-11 QALYs shorter for heavy smokers than for those who never smoke. The difference in life expectancy was 9-10 years. Men and women with high alcohol consumption could expect to lose about 5...... and 3 QALYs, respectively. Sedentary persons could expect to have about 7 fewer QALYs than physically active persons. Obesity shortened QALYs by almost 3 for men and 6 for women. CONCLUSIONS: Smoking, high alcohol consumption, physical inactivity, and obesity strongly reduce life expectancy and health...

  7. The Social Distribution of Health: Estimating Quality-Adjusted Life Expectancy in England.

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    Love-Koh, James; Asaria, Miqdad; Cookson, Richard; Griffin, Susan

    2015-07-01

    To model the social distribution of quality-adjusted life expectancy (QALE) in England by combining survey data on health-related quality of life with administrative data on mortality. Health Survey for England data sets for 2010, 2011, and 2012 were pooled (n = 35,062) and used to model health-related quality of life as a function of sex, age, and socioeconomic status (SES). Office for National Statistics mortality rates were used to construct life tables for age-sex-SES groups. These quality-of-life and length-of-life estimates were then combined to predict QALE as a function of these characteristics. Missing data were imputed, and Monte-Carlo simulation was used to estimate standard errors. Sensitivity analysis was conducted to explore alternative regression models and measures of SES. Socioeconomic inequality in QALE at birth was estimated at 11.87 quality-adjusted life-years (QALYs), with a sex difference of 1 QALY. When the socioeconomic-sex subgroups are ranked by QALE, a differential of 10.97 QALYs is found between the most and least healthy quintile groups. This differential can be broken down into a life expectancy difference of 7.28 years and a quality-of-life adjustment of 3.69 years. The methods proposed in this article refine simple binary quality-adjustment measures such as the widely used disability-free life expectancy, providing a more accurate picture of overall health inequality in society than has hitherto been available. The predictions also lend themselves well to the task of evaluating the health inequality impact of interventions in the context of cost-effectiveness analysis. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Nimdet, Khachapon; Ngorsuraches, Surachat

    2015-10-05

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

  9. Quality-adjusted life years gained in patients aged over 65 years after total hip replacement

    DEFF Research Database (Denmark)

    Hørdam, Britta; Pedersen, P.U.; Søballe, Kjeld

    2011-01-01

    Background: Total hip replacement (THR) is an effective, but also cost-intensive health care procedure for the elderly. Because of demographic changes in Western Europe, THR-associated financial investment for health care has become a question of priorities in society. To provide a quantitative...... rationale for a discussion within Western European health care systems, we undertook a prospective assessment of the benefit of THR from the patients´ perspective and as measured by quality-adjusted life years (QALYs). Aim: To measure the difference in health related quality of life between an intervention...... treatment and telephone intervention. QALYs were calculated from measures of health-related quality of life using questionnaire SF-36. These scores were transformed to QALYs using a formula based on the method developed by Brazier (Brazier 1998). Results: Both the control and the intervention patients...

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

    Science.gov (United States)

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

    2014-01-01

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

  11. Utilitarianism and the measurement and aggregation of quality--adjusted life years.

    Science.gov (United States)

    Dolan, P

    2001-01-01

    It is widely accepted that one of the main objectives of government expenditure on health care is to generate health. Since health is a function of both length of life and quality of life, the quality-adjusted life-year (QALY) has been developed in an attempt to combine the value of these attributes into a single index number. The QALY approach--and particularly the decision rule that health care resources should be allocated so as to maximise the number of QALYs generated--has often been equated with the utilitarian philosophy of maximising 'the greatest happiness of the greatest number'. This paper considers the extent to which the measurement and aggregation of QALYs really is utilitarian by developing a new taxonomy in order to classify utilitarianism and the different aspects of the QALY approach. It is shown that the measurement of QALYs is consistent with a number of different moral positions and that QALYs do not have to be aggregated according to the maximisation rule. Therefore it is inappropriate to necessarily equate QALYs with utilitarianism. It is shown that much turns on what in principle the QALY represents and how in practice it can be operationalised. The paper highlights the category confusion that is often present here and suggests possible avenues for future theoretical and empirical research.

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

    Science.gov (United States)

    Bevan, Gwyn; Hollinghurst, Sandra

    2003-08-01

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

  13. Health inequalities in the Netherlands: trends in quality-adjusted life expectancy (QALE) by educational level.

    Science.gov (United States)

    Gheorghe, Maria; Wubulihasimu, Parida; Peters, Frederik; Nusselder, Wilma; Van Baal, Pieter H M

    2016-10-01

    Quality-adjusted life expectancy (QALE) has been proposed as a summary measure of population health because it encompasses multiple health domains as well as length of life. However, trends in QALE by education or other socio-economic measure have not yet been reported. This study investigates changes in QALE stratified by educational level for the Dutch population in the period 2001-2011. Using data from multiple sources, we estimated mortality rates and health-related quality of life (HRQoL) as functions of age, gender, calendar year and educational level. Subsequently, predictions from these regressions were combined for calculating QALE at ages 25 and 65. QALE changes were decomposed into effects of mortality and HRQoL. In 2001-2011, QALE increased for men and women at all educational levels, the largest increases being for highly educated resulting in a widening gap by education. In 2001, at age 25, the absolute QALE difference between the low and the highly educated was 7.4 healthy years (36.7 vs. 44.1) for men and 6.3 healthy years (39.5 vs. 45.8) for women. By 2011, the QALE difference increased to 8.1 healthy years (38.8 vs. 46.9) for men and to 7.1 healthy years (41.3 vs. 48.4) for women. Similar results were observed at age 65. Although the gap was largely attributable to widening inequalities in mortality, widening inequalities in HRQoL were also substantial. In the Netherlands, population health as measured by QALE has improved, but QALE inequalities have widened more than inequalities in life expectancy alone. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  14. Decomposing cross-country differences in quality adjusted life expectancy: the impact of value sets.

    Science.gov (United States)

    Heijink, Richard; van Baal, Pieter; Oppe, Mark; Koolman, Xander; Westert, Gert

    2011-06-23

    The validity, reliability and cross-country comparability of summary measures of population health (SMPH) have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and decompose international differences in health expectancy based on health-related quality of life (HRQoL). We focused on the impact of value set choice on cross-country variation. We calculated Quality Adjusted Life Expectancy (QALE) at age 20 for 15 countries in which EQ-5D population surveys had been conducted. We applied the Sullivan approach to combine the EQ-5D based HRQoL data with life tables from the Human Mortality Database. Mean HRQoL by country-gender-age was estimated using a parametric model. We used nonparametric bootstrap techniques to compute confidence intervals. QALE was then compared across the six country-specific time trade-off value sets that were available. Finally, three counterfactual estimates were generated in order to assess the contribution of mortality, health states and health-state values to cross-country differences in QALE. QALE at age 20 ranged from 33 years in Armenia to almost 61 years in Japan, using the UK value set. The value sets of the other five countries generated different estimates, up to seven years higher. The relative impact of choosing a different value set differed across country-gender strata between 2% and 20%. In 50% of the country-gender strata the ranking changed by two or more positions across value sets. The decomposition demonstrated a varying impact of health states, health-state values, and mortality on QALE differences across countries. The choice of the value set in SMPH may seriously affect cross-country comparisons of health expectancy, even across populations of similar levels of wealth and education. In our opinion, it is essential to get more insight into the drivers of differences in health-state values across populations. This

  15. Decomposing cross-country differences in quality adjusted life expectancy: the impact of value sets

    Directory of Open Access Journals (Sweden)

    Oppe Mark

    2011-06-01

    Full Text Available Abstract Background The validity, reliability and cross-country comparability of summary measures of population health (SMPH have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and decompose international differences in health expectancy based on health-related quality of life (HRQoL. We focused on the impact of value set choice on cross-country variation. Methods We calculated Quality Adjusted Life Expectancy (QALE at age 20 for 15 countries in which EQ-5D population surveys had been conducted. We applied the Sullivan approach to combine the EQ-5D based HRQoL data with life tables from the Human Mortality Database. Mean HRQoL by country-gender-age was estimated using a parametric model. We used nonparametric bootstrap techniques to compute confidence intervals. QALE was then compared across the six country-specific time trade-off value sets that were available. Finally, three counterfactual estimates were generated in order to assess the contribution of mortality, health states and health-state values to cross-country differences in QALE. Results QALE at age 20 ranged from 33 years in Armenia to almost 61 years in Japan, using the UK value set. The value sets of the other five countries generated different estimates, up to seven years higher. The relative impact of choosing a different value set differed across country-gender strata between 2% and 20%. In 50% of the country-gender strata the ranking changed by two or more positions across value sets. The decomposition demonstrated a varying impact of health states, health-state values, and mortality on QALE differences across countries. Conclusions The choice of the value set in SMPH may seriously affect cross-country comparisons of health expectancy, even across populations of similar levels of wealth and education. In our opinion, it is essential to get more insight into the drivers

  16. Regression estimators for generic health-related quality of life and quality-adjusted life years.

    Science.gov (United States)

    Basu, Anirban; Manca, Andrea

    2012-01-01

    To develop regression models for outcomes with truncated supports, such as health-related quality of life (HRQoL) data, and account for features typical of such data such as a skewed distribution, spikes at 1 or 0, and heteroskedasticity. Regression estimators based on features of the Beta distribution. First, both a single equation and a 2-part model are presented, along with estimation algorithms based on maximum-likelihood, quasi-likelihood, and Bayesian Markov-chain Monte Carlo methods. A novel Bayesian quasi-likelihood estimator is proposed. Second, a simulation exercise is presented to assess the performance of the proposed estimators against ordinary least squares (OLS) regression for a variety of HRQoL distributions that are encountered in practice. Finally, the performance of the proposed estimators is assessed by using them to quantify the treatment effect on QALYs in the EVALUATE hysterectomy trial. Overall model fit is studied using several goodness-of-fit tests such as Pearson's correlation test, link and reset tests, and a modified Hosmer-Lemeshow test. The simulation results indicate that the proposed methods are more robust in estimating covariate effects than OLS, especially when the effects are large or the HRQoL distribution has a large spike at 1. Quasi-likelihood techniques are more robust than maximum likelihood estimators. When applied to the EVALUATE trial, all but the maximum likelihood estimators produce unbiased estimates of the treatment effect. One and 2-part Beta regression models provide flexible approaches to regress the outcomes with truncated supports, such as HRQoL, on covariates, after accounting for many idiosyncratic features of the outcomes distribution. This work will provide applied researchers with a practical set of tools to model outcomes in cost-effectiveness analysis.

  17. Willingness to pay for a quality-adjusted life year: an evaluation of attitudes towards risk and preferences.

    Science.gov (United States)

    Martín-Fernández, Jesus; Polentinos-Castro, Elena; del Cura-González, Ma Isabel; Ariza-Cardiel, Gloria; Abraira, Victor; Gil-LaCruz, Ana Isabel; García-Pérez, Sonia

    2014-07-03

    This paper examines the Willingness to Pay (WTP) for a quality-adjusted life year (QALY) expressed by people who attended the healthcare system as well as the association of attitude towards risk and other personal characteristics with their response. Health-state preferences, measured by EuroQol (EQ-5D-3L), were combined with WTP for recovering a perfect health state. WTP was assessed using close-ended, iterative bidding, contingent valuation method. Data on demographic and socioeconomic characteristics, as well as usage of health services by the subjects were collected. The attitude towards risk was evaluated by collecting risky behaviors data, by the subject's self-evaluation, and through lottery games. Six hundred and sixty two subjects participated and 449 stated a utility inferior to 1. WTP/QALY ratios varied significantly when payments with personal money (mean €10,119; median €673) or through taxes (mean €28,187; median €915) were suggested. Family income, area income, higher education level, greater use of healthcare services, and the number of co-inhabitants were associated with greater WTP/QALY ratios. Age and female gender were associated with lower WTP/QALY ratios. Risk inclination was independently associated with a greater WTP/QALY when "out of pocket" payments were suggested. Clear discrepancies were demonstrated between linearity and neutrality towards risk assumptions and experimental results. WTP/QALY ratios vary noticeably based on demographic and socioeconomic characteristics of the subject, but also on their attitude towards risk. Knowing the expression of preferences by patients from this outcome measurement can be of interest for health service planning.

  18. Willingness to pay for a quality-adjusted life year: an evaluation of attitudes towards risk and preferences

    OpenAIRE

    Martín-Fernández, Jesus; Polentinos-Castro, Elena; del Cura-González, Ma Isabel; Ariza-Cardiel, Gloria; Abraira, Victor; Gil-LaCruz, Ana Isabel; García-Pérez, Sonia

    2014-01-01

    Background This paper examines the Willingness to Pay (WTP) for a quality-adjusted life year (QALY) expressed by people who attended the healthcare system as well as the association of attitude towards risk and other personal characteristics with their response. Methods Health-state preferences, measured by EuroQol (EQ-5D-3L), were combined with WTP for recovering a perfect health state. WTP was assessed using close-ended, iterative bidding, contingent valuation method. Data on demographic an...

  19. Long-Term Survival, Quality of Life, and Quality-Adjusted Survival in Critically Ill Patients With Cancer.

    Science.gov (United States)

    Normilio-Silva, Karina; de Figueiredo, Adelaide Cristina; Pedroso-de-Lima, Antonio Carlos; Tunes-da-Silva, Gisela; Nunes da Silva, Adriana; Delgado Dias Levites, Andresa; de-Simone, Ana Tereza; Lopes Safra, Patrícia; Zancani, Roberta; Tonini, Paula Camilla; Vasconcelos de Andrade E Silva, Ulysses; Buosi Silva, Thiago; Martins Giorgi, Juliana; Eluf-Neto, José; Costa, Anderson; Abrahão Hajjar, Ludhmila; Biasi Cavalcanti, Alexandre

    2016-07-01

    To assess the long-term survival, health-related quality of life, and quality-adjusted life years of cancer patients admitted to ICUs. Prospective cohort. Two cancer specialized ICUs in Brazil. A total of 792 participants. None. The health-related quality of life before ICU admission; at 15 days; and at 3, 6, 12, and 18 months was assessed with the EQ-5D-3L. In addition, the vital status was assessed at 24 months. The mean age of the subjects was 61.6 ± 14.3 years, 42.5% were female subjects and half were admitted after elective surgery. The mean Simplified Acute Physiology Score 3 was 47.4 ± 15.6. Survival at 12 and 18 months was 42.4% and 38.1%, respectively. The mean EQ-5D-3L utility measure before admission to the ICU was 0.47 ± 0.43, at 15 days it was 0.41 ± 0.44, at 90 days 0.56 ± 0.42, at 6 months 0.60 ± 0.41, at 12 months 0.67 ± 0.35, and at 18 months 0.67 ± 0.35. The probabilities for attaining 12 and 18 months of quality-adjusted survival were 30.1% and 19.1%, respectively. There were statistically significant differences in survival time and quality-adjusted life years according to all assessed baseline characteristics (ICU admission after elective surgery, emergency surgery, or medical admission; Simplified Acute Physiology Score 3; cancer extension; cancer status; previous surgery; previous chemotherapy; previous radiotherapy; performance status; and previous health-related quality of life). Only the previous health-related quality of life and performance status were associated with the health-related quality of life during the 18-month follow-up. Long-term survival, health-related quality of life, and quality-adjusted life year expectancy of cancer patients admitted to the ICU are limited. Nevertheless, these clinical outcomes exhibit wide variability among patients and are associated with simple characteristics present at the time of ICU admission, which may help healthcare professionals estimate patients

  20. Gender and ethnic health disparities among the elderly in rural Guangxi, China: estimating quality-adjusted life expectancy

    Directory of Open Access Journals (Sweden)

    Tai Zhang

    2016-11-01

    Full Text Available Background: Ethnic health inequalities for males and females among the elderly have not yet been verified in multicultural societies in developing countries. The aim of this study was to assess the extent of disparities in health expectancy among the elderly from different ethnic groups using quality-adjusted life expectancy. Design: A cross-sectional community-based survey was conducted. A total of 6,511 rural elderly individuals aged ≥60 years were selected from eight different ethnic groups in the Guangxi Zhuang Autonomous Region of China and assessed for health-related quality of life (HRQoL. The HRQoL utility value was combined with life expectancy at age 60 years (LE60 data by using Sullivan's method to estimate quality-adjusted life expectancy at age 60 years (QALE60 and loss in quality-adjusted life years (QALYs for each group. Results: Overall, LE60 and QALE60 for all ethnic groups were 20.9 and 18.0 years in men, respectively, and 24.2 and 20.3 years in women. The maximum gap in QALE60 between ethnic groups was 3.3 years in males and 4.6 years in females. The average loss in QALY was 2.9 years for men and 3.8 years for women. The correlation coefficient between LE60 and QALY lost was −0.53 in males and 0.12 in females. Conclusion: Women live longer than men, but they suffer more; men have a shorter life expectancy, but those who live longer are healthier. Attempts should be made to reduce suffering in the female elderly and improve longevity for men. Certain ethnic groups had low levels of QALE, needing special attention to improve their lifestyle and access to health care.

  1. The use of Quality-Adjusted Life Years in cost-effectiveness analyses in palliative care: Mapping the debate through an integrative review.

    Science.gov (United States)

    Wichmann, Anne B; Adang, Eddy Mm; Stalmeier, Peep Fm; Kristanti, Sinta; Van den Block, Lieve; Vernooij-Dassen, Myrra Jfj; Engels, Yvonne

    2017-04-01

    In cost-effectiveness analyses in healthcare, Quality-Adjusted Life Years are often used as outcome measure of effectiveness. However, there is an ongoing debate concerning the appropriateness of its use for decision-making in palliative care. To systematically map pros and cons of using the Quality-Adjusted Life Year to inform decisions on resource allocation among palliative care interventions, as brought forward in the debate, and to discuss the Quality-Adjusted Life Year's value for palliative care. The integrative review method of Whittemore and Knafl was followed. Theoretical arguments and empirical findings were mapped. A literature search was conducted in PubMed, EMBASE, and CINAHL, in which MeSH (Medical Subject Headings) terms were Palliative Care, Cost-Benefit Analysis, Quality of Life, and Quality-Adjusted Life Years. Three themes regarding the pros and cons were identified: (1) restrictions in life years gained, (2) conceptualization of quality of life and its measurement, including suggestions to adapt this, and (3) valuation and additivity of time, referring to changing valuation of time. The debate is recognized in empirical studies, but alternatives not yet applied. The Quality-Adjusted Life Year might be more valuable for palliative care if specific issues are taken into account. Despite restrictions in life years gained, Quality-Adjusted Life Years can be achieved in palliative care. However, in measuring quality of life, we recommend to-in addition to the EQ-5D- make use of quality of life or capability instruments specifically for palliative care. Also, we suggest exploring the possibility of integrating valuation of time in a non-linear way in the Quality-Adjusted Life Year.

  2. Prices over the Product Life Cycle: Implications for Quality-Adjustment and the Measurement of Inflation

    OpenAIRE

    Daniel Melser; Iqbal A. Syed

    2013-01-01

    The paper explores the extent to which products follow systematic pricing patterns over their life cycle and the impact this has on the measurement of inflation. Using a large US scanner data set on supermarket products and applying exible regression methods, we find that on average prices decline as items age. This life cycle price change is often attributed to quality difference in the construction of CPI as items are replaced due to disappearance and at sample rotations. This introduces a ...

  3. Impact of work-related cancers in Taiwan-Estimation with QALY (quality-adjusted life year) and healthcare costs.

    Science.gov (United States)

    Lee, Lukas Jyuhn-Hsiarn; Lin, Cheng-Kuan; Hung, Mei-Chuan; Wang, Jung-Der

    2016-12-01

    This study estimates the annual numbers of eight work-related cancers, total losses of quality-adjusted life years (QALYs), and lifetime healthcare expenditures that possibly could be saved by improving occupational health in Taiwan. Three databases were interlinked: the Taiwan Cancer Registry, the National Mortality Registry, and the National Health Insurance Research Database. Annual numbers of work-related cancers were estimated based on attributable fractions (AFs) abstracted from a literature review. The survival functions for eight cancers were estimated and extrapolated to lifetime using a semi-parametric method. A convenience sample of 8846 measurements of patients' quality of life with EQ-5D was collected for utility values and multiplied by survival functions to estimate quality-adjusted life expectancies (QALEs). The loss-of-QALE was obtained by subtracting the QALE of cancer from age- and sex-matched referents simulated from national vital statistics. The lifetime healthcare expenditures were estimated by multiplying the survival probability with mean monthly costs paid by the National Health Insurance for cancer diagnosis and treatment and summing this for the expected lifetime. A total of 3010 males and 726 females with eight work-related cancers were estimated in 2010. Among them, lung cancer ranked first in terms of QALY loss, with an annual total loss-of-QALE of 28,463 QALYs and total lifetime healthcare expenditures of US$36.6 million. Successful prevention of eight work-related cancers would not only avoid the occurrence of 3736 cases of cancer, but would also save more than US$70 million in healthcare costs and 46,750 QALYs for the Taiwan society in 2010.

  4. Willingness to pay for a quality-adjusted life year: in search of a standard.

    Science.gov (United States)

    Hirth, R A; Chernew, M E; Miller, E; Fendrick, A M; Weissert, W G

    2000-01-01

    Cost-benefit analysis (CBA) provides a clear decision rule: undertake an intervention if the monetary value of its benefits exceed its costs. However, due to a reluctance to characterize health benefits in monetary terms, users of cost-utility and cost-effectiveness analyses must rely on arbitrary standards (e.g., implied by the value-of-life literature and compared this value with arbitrary thresholds for cost-effectiveness that have come into common use. A literature search identified 42 estimates of the value of life that were appropriate for inclusion. These estimates were classified by method: human capital (HK), contingent valuation (CV), revealed preference/job risk (RP-JR) and revealed preference/non-occupational safety (RP-S), and by U.S. or non-U.S. origin. After converting these value-of-life estimates to 1997 U.S. dollars, the life expectancy of the study population, age-specific QALY weights, and a 3% real discount rate were used to calculate the implied value of a QALY. An ordinary least-squares regression of the value of a QALY on study type and national origin explained 28.4% of the variance across studies. Most of the explained variance was attributable to study type; national origin did not significantly affect the values. Median values by study type were $24,777 (HK estimates), $93,402 (RP-S estimates), $161,305 (CV estimates), and $428,286 (RP-JR estimates). With the exception of HK, these far exceed the "rules of thumb" that are frequently used to determine whether an intervention produces an acceptable increase in health benefits in exchange for incremental expenditures.

  5. Associations of Smoking, Physical Inactivity, Heavy Drinking, and Obesity with Quality-Adjusted Life Expectancy among US Adults with Depression.

    Science.gov (United States)

    Jia, Haomiao; Zack, Matthew M; Gottesman, Irving I; Thompson, William W

    2018-03-01

    To examine associations between four health behaviors (smoking, physical inactivity, heavy alcohol drinking, and obesity) and three health indices (health-related quality of life, life expectancy, and quality-adjusted life expectancy (QALE)) among US adults with depression. Data were obtained from the 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System data. The EuroQol five-dimensional questionnaire (EQ-5D) health preference scores were estimated on the basis of extrapolations from the Centers for Disease Control and Prevention's healthy days measures. Depression scores were estimated using the eight-item Patient Health Questionnaire. Life expectancy estimates were obtained from US life tables, and QALE was estimated from a weighted combination of the EQ-5D scores and the life expectancy estimates. Outcomes were summarized by depression status for the four health behaviors (smoking, physical inactivity, heavy alcohol drinking, and obesity). For depressed adults, current smokers and the physically inactive had significantly lower EQ-5D scores (0.040 and 0.171, respectively), shorter life expectancy (12.9 and 10.8 years, respectively), and substantially less QALE (8.6 and 10.9 years, respectively). For nondepressed adults, estimated effects were similar but smaller. Heavy alcohol drinking among depressed adults, paradoxically, was associated with higher EQ-5D scores but shorter life expectancy. Obesity was strongly associated with lower EQ-5D scores but only weakly associated with shorter life expectancy. Among depressed adults, physical inactivity and smoking were strongly associated with lower EQ-5D scores, life expectancy, and QALE, whereas obesity and heavy drinking were only weakly associated with these indices. These results suggest that reducing physical inactivity and smoking would improve health more among depressed adults. Copyright © 2018. Published by Elsevier Inc.

  6. Models of quality-adjusted life years when health varies over time

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Østerdal, Lars Peter Raahave

    2006-01-01

    Qualityadjusted life year (QALY) models are widely used for economic evaluation in the health care sector. In the first part of the paper, we establish an overview of QALY models where health varies over time and provide a theoretical analysis of model identification and parameter estimation from...... time tradeoff (TTO) and standard gamble (SG) scores. We investigate deterministic and probabilistic models and consider five different families of discounting functions in all. The second part of the paper discusses four issues recurrently debated in the literature. This discussion includes questioning...... of these two can be used to disentangle risk aversion from discounting. We find that caution must be taken when drawing conclusions from models with chronic health states to situations where health varies over time. One notable difference is that in the former case, risk aversion may be indistinguishable from...

  7. Reverse-total shoulder arthroplasty cost-effectiveness: A quality-adjusted life years comparison with total hip arthroplasty.

    Science.gov (United States)

    Bachman, Daniel; Nyland, John; Krupp, Ryan

    2016-02-18

    To compare reverse-total shoulder arthroplasty (RSA) cost-effectiveness with total hip arthroplasty cost-effectiveness. This study used a stochastic model and decision-making algorithm to compare the cost-effectiveness of RSA and total hip arthroplasty. Fifteen patients underwent pre-operative, and 3, 6, and 12 mo post-operative clinical examinations and Short Form-36 Health Survey completion. Short form-36 Health Survey subscale scores were converted to EuroQual Group Five Dimension Health Outcome scores and compared with historical data from age-matched patients who had undergone total hip arthroplasty. Quality-adjusted life year (QALY) improvements based on life expectancies were calculated. The cost/QALY was $3900 for total hip arthroplasty and $11100 for RSA. After adjusting the model to only include shoulder-specific physical function subscale items, the RSA QALY improved to 2.8 years, and its cost/QALY decreased to $8100. Based on industry accepted standards, cost/QALY estimates supported both RSA and total hip arthroplasty cost-effectiveness. Although total hip arthroplasty remains the quality of life improvement "gold standard" among arthroplasty procedures, cost/QALY estimates identified in this study support the growing use of RSA to improve patient quality of life.

  8. Exploring the willingness to pay for a quality-adjusted life-year in the state of Penang, Malaysia.

    Science.gov (United States)

    Shafie, Asrul Akmal; Lim, Yen Wei; Chua, Gin Nie; Hassali, Mohammed Azmi Ahmad

    2014-01-01

    The incremental cost-effectiveness ratio (ICER) is typically compared with a reference value to support the cost-effectiveness of a decision. One method for estimating this value is to estimate the willingness-to-pay (WTP) for a quality-adjusted life-year (QALY). This study was conducted to explore the WTP for a QALY in the Malaysian population. A cross-sectional, contingent valuation study was conducted in Penang, Malaysia. Respondents were selected from randomly chosen geographical grids of Penang. Respondents' sociodemographic information, qualities of life, and WTP for one additional QALY were collected using predesigned questionnaires in face-to-face interviews. WTP values were elicited using a double-bound dichotomous choice via a bidding game approach. The Heckman selection model was applied to the analysis of the mean WTP/QALY values, where the "protest zero" values, which may contribute to selection bias, were excluded. The mean value of WTP for an additional QALY gained was estimated to be MYR (Malaysian Ringgit) 29,080 (~USD 9,000). Key factors that affected the WTP include ethnicity and estimated monthly household income. The study findings suggested that the cost-effectiveness threshold value as studied in Penang, Malaysia was estimated to be MYR 29,080.

  9. Cost per QALY (quality-adjusted life year and lifetime cost of prolonged mechanical ventilation in Taiwan.

    Directory of Open Access Journals (Sweden)

    Mei-Chuan Hung

    Full Text Available INTRODUCTION: Patients who require prolonged mechanical ventilation (PMV are increasing and producing financial burdens worldwide. This study determines the cost per QALY (quality-adjusted life year, out-of-pocket expenses, and lifetime costs for PMV patients stratified by underlying diseases and cognition levels. METHODS: A nationwide sample of 50,481 patients with continual mechanical ventilation for more than 21 days was collected during 1997-2007. After stratifying the patients according to specific diagnoses, a latent class analysis (LCA was performed to categorise PMV patients with multiple co-morbidities into several homogeneous groups. The survival functions were estimated for individual groups using the Kaplan-Meier method and extrapolated to 300 months through a semi-parametric method. The survival functions were adjusted using an EQ-5D utility value derived from a convenience sample of 142 PMV patients to estimate quality-adjusted life expectancies (QALE. Another convenience sample of 165 patients was used to estimate the out-of-pocket expenses. The lifetime expenditures paid by the single-payer National Health Insurance (NHI system and patients' families were estimated by multiplying average monthly expenditures by the survival probabilities and summing the values over lifetime. RESULTS: PMV therapy costs more than 100,000 U.S. dollars (USD per QALY for all patients with poor cognition. For patients with partial cognition, PMV therapy costs less than 56,000 USD per QALY for those with liver cirrhosis, intracranial or spinal cord injuries, and 57,000-69,000 USD for patients with multiple co-morbidities under age of 65. The average lifetime cost of PMV was usually below 56,000 USD. The out-of-pocket expenses were often more than one-third of the total cost of treatment. CONCLUSIONS: PMV treatment for patients with poor cognition would cost more than 5 times Taiwan's GDP (gross domestic products, or less cost-effective. The out

  10. Population-Based Estimates of Decreases in Quality-Adjusted Life Expectancy Associated with Unhealthy Body Mass Index.

    Science.gov (United States)

    Jia, Haomiao; Zack, Matthew M; Thompson, William W

    2016-01-01

    Being classified as outside the normal range for body mass index (BMI) has been associated with increased risk for chronic health conditions, poor health-related quality of life (HRQOL), and premature death. To assess the impact of BMI on HRQOL and mortality, we compared quality-adjusted life expectancy (QALE) by BMI levels. We obtained HRQOL data from the 1993-2010 Behavioral Risk Factor Surveillance System and life table estimates from the National Center for Health Statistics national mortality files to estimate QALE among U.S. adults by BMI categories: underweight (BMI overweight (BMI 25.0-29.9 kg/m(2)), obese (BMI 30.0-34.9 kg/m(2)), and severely obese (BMI ≥35.0 kg/m(2)). In 2010 in the United States, the highest estimated QALE for adults at 18 years of age was 54.1 years for individuals classified as normal weight. The two lowest QALE estimates were for those classified as either underweight (48.9 years) or severely obese (48.2 years). For individuals who were overweight or obese, the QALE estimates fell between those classified as either normal weight (54.1 years) or severely obese (48.2 years). The difference in QALE between adults classified as normal weight and those classified as either overweight or obese was significantly higher among women than among men, irrespective of race/ethnicity. Using population-based data, we found significant differences in QALE loss by BMI category. These findings are valuable for setting national and state targets to reduce health risks associated with severe obesity, and could be used for cost-effectiveness evaluations of weight-reduction interventions.

  11. A multigene prognostic assay for selection of adjuvant chemotherapy in patients with T3, stage II colon cancer: impact on quality-adjusted life expectancy and costs.

    Science.gov (United States)

    Hornberger, John; Lyman, Gary H; Chien, Rebecca; Meropol, Neal J

    2012-12-01

    Uncertainty exists regarding appropriate and affordable use of adjuvant chemotherapy in stage II colon cancer (T3, proficient DNA mismatch repair). This study aimed to estimate the effectiveness and costs from a US societal perspective of a multigene recurrence score (RS) assay for patients recently diagnosed with stage II colon cancer (T3, proficient DNA mismatch repair) eligible for adjuvant chemotherapy. RS was compared with guideline-recommended clinicopathological factors (tumor stage, lymph nodes examined, tumor grade, and lymphovascular invasion) by using a state-transition (Markov) lifetime model. Data were obtained from published literature, a randomized controlled trial (QUick And Simple And Reliable) of adjuvant chemotherapy, and rates of chemotherapy use from the National Cooperative Cancer Network Colon/Rectum Cancer Outcomes study. Life-years, quality-adjusted life expectancy, and lifetime costs were examined. The RS is projected to reduce adjuvant chemotherapy use by 17% compared with current treatment patterns and to increase quality-adjusted life expectancy by an average of 0.035 years. Direct medical costs are expected to decrease by an average of $2971 per patient. The assay was cost saving for all subgroups of patients stratified by clinicopathologic factors. The most influential variables affecting treatment decisions were projected years of life remaining, recurrence score, and patients' disutilities associated with adjuvant chemotherapy. Use of the multigene RS to assess recurrence risk after surgery in stage II colon cancer (T3, proficient DNA mismatch repair) may reduce the use of adjuvant chemotherapy without decreasing quality-adjusted life expectancy and be cost saving from a societal perspective. These findings need to be validated in additional cohorts, including studies of clinical practice as assay use diffuses into nonacademic settings. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR

  12. A new methodology for cost-effectiveness studies of domestic radon remediation programmes: Quality-adjusted life-years gained within Primary Care Trusts in Central England

    International Nuclear Information System (INIS)

    Coskeran, Thomas; Denman, Antony; Phillips, Paul; Gillmore, Gavin; Tornberg, Roger

    2006-01-01

    Radon is a naturally occurring radioactive gas, high levels of which are associated with geological formations such as those found in Northamptonshire and North Oxfordshire in the UK. The UK's National Radiological Protection Board have designated both districts as radon Affected Areas. Radiation levels due to radon, therefore, exceed 200 Bq m -3 , the UK's domestic Action Level, in over one percent of domestic properties. Because of radon's radioactivity, exposure to the gas can potentially cause lung cancer, and has been linked to some 2000 deaths a year in the UK. Consequently, when radiation levels exceed the Action Level, remediation against radon's effects is recommended to householders. This study examines the cost-effectiveness of remediation measures in Northamptonshire and North Oxfordshire by estimating cost per quality-adjusted life-year gained in four Primary Care Trusts, organisations that play a key public health policy role in the UK's National Health Service. The study is the first to apply this approach to estimating the cost-effectiveness of radon remediation programmes. Central estimates of cost per quality-adjusted life-year in the four Primary Care Trusts range from Pounds 6143 to Pounds 10 323. These values, when assessed against generally accepted criteria, suggest the remediation programmes in the trusts were cost-effective. Policy suggestions based on the estimates, and designed to improve cost-effectiveness further, are proposed for the four Primary Care Trusts and the UK's National Health Service

  13. Effect of obesity on cost per quality-adjusted life years gained following anterior cervical discectomy and fusion in elective degenerative pathology.

    Science.gov (United States)

    Chotai, Silky; Sielatycki, J Alex; Parker, Scott L; Sivaganesan, Ahilan; Kay, Harrison L; Stonko, David P; Wick, Joseph B; McGirt, Matthew J; Devin, Clinton J

    2016-11-01

    Obese patients have greater comorbidities along with higher risk of complications and greater costs after spine surgery, which may result in increased cost and lower quality of life compared with their non-obese counterparts. The aim of the present study was to determine cost-utility following anterior cervical discectomy and fusion (ACDF) in obese patients. This study analyzed prospectively collected data. Patients undergoing elective ACDF for degenerative cervical pathology at a single academic institution were included in the study. Cost and quality-adjusted life years (QALYs) were the outcome measures. One- and two-year medical resource utilization, missed work, and health state values (QALYs) were assessed. Two-year resource use was multiplied by unit costs based on Medicare national payment amounts (direct cost). Patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Total cost (direct+indirect) was used to compute cost per QALY gained. Patients were defined as obese for body mass index (BMI) ≥35 based on the WHO definition of class II obesity. A subgroup analysis was conducted in morbidly obese patients (BMI≥40). There were significant improvements in pain (neck pain or arm pain), disability (Neck Disability Index), and quality of life (EuroQol-5D and Short Form-12) at 2 years after surgery (pdirect cost, indirect cost, and total cost between obese and non-obese patients at postoperative 1-year and 2-year follow-up. Mean 2-year direct cost for obese patients was $19,225±$8,065 and $17,635±$6,413 for non-obese patients (p=.14). There was no significant difference in the mean total 2-year cost between obese ($23,144±$9,216) and non-obese ($22,183±$10,564) patients (p=.48). Obese patients had a lower mean cumulative gain in QALYs versus non-obese patients at 2-years (0.34 vs. 0.42, p=.32). Two-year cost-utility in obese ($68,070/QALY) versus non-obese patients ($52,816/QALY) was not

  14. A systematic review of studies eliciting willingness-to-pay per quality-adjusted life year: does it justify CE threshold?

    Science.gov (United States)

    Nimdet, Khachapon; Chaiyakunapruk, Nathorn; Vichansavakul, Kittaya; Ngorsuraches, Surachat

    2015-01-01

    A number of studies have been conducted to estimate willingness to pay (WTP) per quality-adjusted life years (QALY) in patients or general population for various diseases. However, there has not been any systematic review summarizing the relationship between WTP per QALY and cost-effectiveness (CE) threshold based on World Health Organization (WHO) recommendation. To systematically review willingness-to-pay per quality-adjusted-life-year (WTP per QALY) literature, to compare WTP per QALY with Cost-effectiveness (CE) threshold recommended by WHO, and to determine potential influencing factors. We searched MEDLINE, EMBASE, Psyinfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Center of Research Dissemination (CRD), and EconLit from inception through 15 July 2014. To be included, studies have to estimate WTP per QALY in health-related issues using stated preference method. Two investigators independently reviewed each abstract, completed full-text reviews, and extracted information for included studies. We compared WTP per QALY to GDP per capita, analyzed, and summarized potential influencing factors. Out of 3,914 articles founded, 14 studies were included. Most studies (92.85%) used contingent valuation method, while only one study used discrete choice experiments. Sample size varied from 104 to 21,896 persons. The ratio between WTP per QALY and GDP per capita varied widely from 0.05 to 5.40, depending on scenario outcomes (e.g., whether it extended/saved life or improved quality of life), severity of hypothetical scenarios, duration of scenario, and source of funding. The average ratio of WTP per QALY and GDP per capita for extending life or saving life (2.03) was significantly higher than the average for improving quality of life (0.59) with the mean difference of 1.43 (95% CI, 1.81 to 1.06). This systematic review provides an overview summary of all studies estimating WTP per QALY studies. The variation of ratio of WTP per QALY and GDP per

  15. Eliciting the Monetary Value of a Quality-Adjusted Life Year in a Greek Outpatient Department in Times of Economic Austerity.

    Science.gov (United States)

    Mavrodi, A; Aletras, V; Spanou, A; Niakas, D

    2017-12-01

    Contingent valuation is widely used to determine individuals' willingness to pay (WTP) for a health gain. Our study aimed to elicit an empirical estimate of the monetary value of a quality-adjusted life year (QALY) in a Greek outpatient setting in times of economic austerity and assess the impact of patients' characteristics on their valuations. We used a questionnaire as a survey tool to determine the maximum WTP for a health gain of a hypothetical therapy and to evaluate patients' health-related quality of life (EuroQoL-5D-3L) and demographic and socioeconomic characteristics. EuroQoL tariffs were used to estimate health utilities. Mean WTP values were computed and ordinary least squares regressions performed on transformed Box-Cox and logarithmic dependent WTP per QALY variables to remedy observed skewness problems. Analyses were performed for 167 patients with utility values less than unity. Mean WTP per QALY reported was similar for both payment vehicles examined: payments made out-of-pocket (€2629) and payments made through new tax imposition (€2407). Regression results showed that higher net monthly family income was associated with higher WTP per QALY for both payment vehicles. Moreover, the presence of a chronic condition and higher level of education were associated with higher out-of-pocket WTP per QALY and WTP per QALY through taxes, respectively. The very low WTP per QALY estimates could be explained by the recent severe economic depression and austerity in Greece. In fact, family income was found to be a significant predictor of WTP per QALY. Since these estimates deviate significantly from the cost-effectiveness thresholds still employed in economic evaluations in this country, research should be undertaken promptly to further examine this important issue using a nationwide representative sample of the general population along with WTP and other methodologies.

  16. Disparities in total knee replacement: Population losses in quality-adjusted life years due to differential offer, acceptance, and complication rates for Black Americans.

    Science.gov (United States)

    Kerman, Hannah M; Smith, Savannah R; Smith, Karen C; Collins, Jamie E; Suter, Lisa G; Katz, Jeffrey N; Losina, Elena

    2018-01-24

    Total knee replacement (TKR) is an effective treatment for end-stage knee osteoarthritis (OA). American racial minorities undergo fewer TKRs than Whites. We estimated quality-adjusted life years (QALYs) lost for Black knee OA patients due to differences in TKR offer, acceptance, and complication rates. We used the Osteoarthritis Policy Model, a computer simulation of knee OA, to predict QALY outcomes for Black and White knee OA patients with and without TKR. We estimated per-person QALYs gained from TKR as the difference between QALYs with current TKR use and QALYs when no TKR was performed. We estimated average, per-person QALY losses in Blacks as the difference between QALYs gained with White rates of TKR and QALYs gained with Black rates of TKR. We calculated population-level QALY losses by multiplying per-person QALY losses by the number of persons with advanced knee OA. Finally, we estimated QALYs lost specifically due to lower TKR offer and acceptance and higher complications among Black knee OA patients. Black men and women gain 64,100 QALYs from current TKR use. With white offer and complications rates, they would gain an additional 72,000 QALYs. Because these additional gains are unrealized, we call this a loss of 72,000 QALYs. Black Americans lose 67,500 QALYs because of lower offer, 15,800 QALYs because of lower acceptance, and 2,600 QALYs because of higher complications. Black Americans lose 72,000 QALYs due to disparities in TKR offer and complication rates. Programs to decrease disparities in TKR use are urgently needed. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. Estimating the willingness to pay for a quality-adjusted life year in Thailand: does the context of health gain matter?

    Science.gov (United States)

    Thavorncharoensap, Montarat; Teerawattananon, Yot; Natanant, Sirin; Kulpeng, Wantanee; Yothasamut, Jomkwan; Werayingyong, Pitsaphun

    2013-01-01

    This study aims to elicit the value of the willingness to pay (WTP) for a quality-adjusted life year (QALY) and to examine the factors associated with the WTP for a QALY (WTP/QALY) value under the Thai health care setting. A community-based survey was conducted among 1191 randomly selected respondents. Each respondent was interviewed face-to-face to elicit his/her health state preference in each of three pairs of health conditions: (1) unilateral and bilateral blindness, (2) paraplegia and quadriplegia, and (3) mild and moderate allergies. A visual analog scale (VAS) and time trade off (TTO) were used as the eliciting methods. Subsequently, the respondents were asked about their WTP for the treatment and prevention of each pair of health conditions by using a bidding-game technique. With regards to treatment, the mean WTP for a QALY value (WTP/QALY(treatment)) estimated by the TTO method ranged from 59,000 to 285,000 baht (16.49 baht = US$1 purchasing power parity [PPP]). In contrast, the mean WTP for a QALY value in terms of prevention (WTP/QALY(prevention)) was significantly lower, ranging from 26,000 to 137,000 baht. Gender, household income, and hypothetical scenarios were also significant factors associated with the WTP/QALY values. The WTP/QALY values elicited in this study were approximately 0.4 to 2 times Thailand's 2008 GDP per capita. These values were in line with previous studies conducted in several different settings. This study's findings clearly support the opinion that a single ceiling threshold should not be used for the resource allocation of all types of interventions.

  18. The use of quality-adjusted life-years in the economic evaluation of health technologies in Spain: a review of the 1990-2009 literature.

    Science.gov (United States)

    Rodriguez, José Manuel; Paz, Silvia; Lizan, Luis; Gonzalez, Paloma

    2011-06-01

    To appraise economic evaluations of health technologies that included quality-adjusted life-years (QALYs) as an outcome measure conducted over the past 20 years in Spain. A systematic review of the literature was conducted. Economic evaluations that included QALYs as an outcome measure, conducted in Spain and published between January 1990 and December 2009 were identified. Primary and gray literature sources were reviewed. A total of 60 articles and 4 health technology assessment reports were included. Key findings were 1) the vast majority of articles (77.1%) referred to therapeutic interventions; 2) 63.2% dealt with pharmaceutical products and much fewer with preventive strategies, medical devices, or diagnostic interventions; 3) most evaluations referred to cardiovascular- (19.8%), respiratory- (16.3%), and cancer- (13.0%) related processes; 4) 80.3% were based on a theoretical model, most commonly Markov models (71.4%); 5) 67.3% adopted the National Health System perspective; 6) information on the methods used to describe the health states was given in 45.1% of studies; 7) 40.3% used the EuroQoL-5D to elicit preferences, whereas 66.1% gave no details on the methods applied to determine patients' choices; 8) it was possible to state who completed the questionnaires in only 17.7% of studies; 9) 77.1% of the interventions assessed were below the €30,000/QALY suggested affordable threshold in Spain. An increasing number of economic evaluations using QALYs had been conducted. Most of them relied on theoretical models. Several methodological issues remain unsolved. Great disparity exists regarding the reporting of the methods used to determine health states and utility values. Copyright © 2011. Published by Elsevier Inc.

  19. Estimating the willingness to pay for a quality-adjusted life year in Thailand: does the context of health gain matter?

    Directory of Open Access Journals (Sweden)

    Thavorncharoensap M

    2013-01-01

    Full Text Available Montarat Thavorncharoensap,1,2 Yot Teerawattananon,2 Sirin Natanant,2 Wantanee Kulpeng,2 Jomkwan Yothasamut,2 Pitsaphun Werayingyong21Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Thailand; 2Health Intervention and Technology Assessment Program (HITAP, Ministry of Public Health, ThailandBackground: This study aims to elicit the value of the willingness to pay (WTP for a quality-adjusted life year (QALY and to examine the factors associated with the WTP for a QALY (WTP/QALY value under the Thai health care setting.Methods: A community-based survey was conducted among 1191 randomly selected respondents. Each respondent was interviewed face-to-face to elicit his/her health state preference in each of three pairs of health conditions: (1 unilateral and bilateral blindness, (2 paraplegia and quadriplegia, and (3 mild and moderate allergies. A visual analog scale (VAS and time trade off (TTO were used as the eliciting methods. Subsequently, the respondents were asked about their WTP for the treatment and prevention of each pair of health conditions by using a bidding-game technique.Results: With regards to treatment, the mean WTP for a QALY value (WTP/QALYtreatment estimated by the TTO method ranged from 59,000 to 285,000 baht (16.49 baht = US$1 purchasing power parity [PPP]. In contrast, the mean WTP for a QALY value in terms of prevention (WTP/QALYprevention was significantly lower, ranging from 26,000 to 137,000 baht. Gender, household income, and hypothetical scenarios were also significant factors associated with the WTP/QALY values.Conclusion: The WTP/QALY values elicited in this study were approximately 0.4 to 2 times Thailand's 2008 GDP per capita. These values were in line with previous studies conducted in several different settings. This study's findings clearly support the opinion that a single ceiling threshold should not be used for the resource allocation of all types of interventions.Keywords: ceiling threshold

  20. Involving Members of the Public in Health Economics Research: Insights from Selecting Health States for Valuation to Estimate Quality-Adjusted Life-Year (QALY) Weights.

    Science.gov (United States)

    Goodwin, Elizabeth; Boddy, Kate; Tatnell, Lynn; Hawton, Annie

    2018-04-01

    Over recent years, public involvement in health research has expanded considerably. However, public involvement in designing and conducting health economics research is seldom reported. Here we describe the development, delivery and assessment of an approach for involving people in a clearly defined piece of health economics research: selecting health states for valuation in estimating quality-adjusted life-years (QALYs). This involvement formed part of a study to develop a condition-specific preference-based measure of health-related quality of life, the Multiple Sclerosis Impact Scale (MSIS-8D), and the work reported here relates to the identification of plausible, or realistic, health states for valuation. An Expert Panel of three people with multiple sclerosis (MS) was recruited from a local involvement network, and two health economists designed an interactive task that enabled the Panel to identify health states that were implausible, or unlikely to be experienced. Following some initial confusion over terminology, which was resolved by discussion with the Panel, the task worked well and can be adapted to select health states for valuation in the development of any preference-based measure. As part of the involvement process, five themes were identified by the Panel members and the researchers which summarised our experiences of public involvement in this health economics research example: proportionality, task design, prior involvement, protectiveness and partnerships. These are described in the paper, along with their practical implications for involving members of the public in health economics research. Our experience demonstrates how members of the public and health economists can work together to improve the validity of health economics research. Plain Language Summary It has become commonplace to involve members of the public in health service research. However, published reports of involving people in designing health economics research are rare. We

  1. Bleeding out the quality-adjusted life years: evaluating the burden of primary dysmenorrhea using time trade-off and willingness-to-pay methods

    NARCIS (Netherlands)

    Rencz, F.; Pentek, M.; Stalmeier, P.F.M.; Brodszky, V.; Ruzsa, G.; Gradvohl, E.; Baji, P.; Gulacsi, L.

    2017-01-01

    Primary dysmenorrhea (PD), or painful menstruation in the absence of identified uterine pathology, affects 5 to 9 in every 10 reproductive-aged women. Despite its high prevalence, just a few studies with very small patient numbers have focused on health-related quality of life impairment in PD. We

  2. Riesgo cardiovascular, calidad de Vida y años de vida ajustados por calidad: un estudio de caso Risco cardiovascular, qualidade de vida e anos de vida ajustados por qualidade: um estudo de caso Cardiovascular risk, quality of life and quality-adjusted years of life: a case report

    Directory of Open Access Journals (Sweden)

    Sandra Lorena Duque Henao

    2010-03-01

    ção dos pacientes em programa de promoção e prevenção de ECV está relacionada com redução no risco e melhoria na qualidade de vida.Objective: to determine the ratio cost-utility of cardiovascular diseases (CVD promotion and prevention programs in a health care providing institution in the city of Medellin (Colombia. Methodology: the preventive program was compared before and after with the conventional control scheme under the design of a quasi experimental study evaluation with a non equivalent control group. Between the studied groups’ differences of the following results were evaluated at the end of the first and second year: Framingham score, direct cost of the program, quality of life, health indexes and quality-adjusted years of life. Results: in the evaluated groups a statistically meaningful difference was found between the initial and final moments for the variables:Framingham score, direct cost of the program, quality of life, health indexes and quality-adjusted years of life. Conclusion: the participation of patients in CVD prevention and promotion programs is related with risk reduction and a better quality of life.

  3. On carrots and curiosity: eating fruit and vegetables is associated with greater flourishing in daily life.

    Science.gov (United States)

    Conner, Tamlin S; Brookie, Kate L; Richardson, Aimee C; Polak, Maria A

    2015-05-01

    Our aim was to determine whether eating fruit and vegetables (FV) is associated with other markers of well-being beyond happiness and life satisfaction. Towards this aim, we tested whether FV consumption is associated with greater eudaemonic well-being - a state of flourishing characterized by feelings of engagement, meaning, and purpose in life. We also tested associations with two eudaemonic behaviours - curiosity and creativity. Daily diary study across 13 days (micro-longitudinal, correlational design). A sample of 405 young adults (67% women; mean age 19.9 [SD 1.6] years) completed an Internet daily diary for 13 consecutive days. Each day, participants reported on their consumption of fruit, vegetables, sweets, and chips, as well as their eudaemonic well-being, curiosity, creativity, positive affect (PA), and negative affect. Between-person associations were analysed on aggregated data. Within-person associations were analysed using multilevel models controlling for weekday and weekend patterns. Fruit and vegetables consumption predicted greater eudaemonic well-being, curiosity, and creativity at the between- and within-person levels. Young adults who ate more FV reported higher average eudaemonic well-being, more intense feelings of curiosity, and greater creativity compared with young adults who ate less FV. On days when young adults ate more FV, they reported greater eudaemonic well-being, curiosity, and creativity compared with days when they ate less FV. FV consumption also predicted higher PA, which mostly did not account for the associations between FV and the other well-being variables. Few unhealthy foods (sweets, chips) were related to well-being except that consumption of sweets was associated with greater curiosity and PA at the within-person level. Lagged data analyses showed no carry-over effects of FV consumption onto next-day well-being (or vice versa). Although these patterns are strictly correlational, this study provides the first evidence

  4. Aproximación a los pesos de calidad de vida de los «años de vida ajustados por calidad» mediante el estado de salud autopercibido An approach to «quality-adjusted life years» quality of life weights from self-assessed health status

    Directory of Open Access Journals (Sweden)

    Anna García-Altés

    2006-12-01

    12 months had a greater negative impact on quality of life than did chronic diseases. Quality of life decreased as age increased, and increased as educational level increased. For the same disease and adjusted for age, sex, and educational level, quality of life weights were greater for 1993 and 2001 than for 1987. Conclusions: The proposed methodology allows quality of life weights to be calculated from health survey data, which has direct application in economic assessment, analysis of socioeconomic health inequalities, and health capital estimation.

  5. Aberrant clones: Birth order generates life history diversity in Greater Duckweed, Spirodela polyrhiza.

    Science.gov (United States)

    Mejbel, Hebah S; Simons, Andrew M

    2018-02-01

    Environmental unpredictability is known to result in the evolution of bet-hedging traits. Variable dormancy enhances survival through harsh conditions, and is widely cited as a diversification bet-hedging trait. The floating aquatic plant, Spirodela polyrhiza (Greater Duckweed), provides an opportunity to study diversification because although partially reliable seasonal cues exist, its growing season is subject to an unpredictable and literally "hard" termination when the surface water freezes, and overwinter survival depends on a switch from production of normal daughter fronds to production of dense, sinking "turions" prior to freeze-over. The problem for S. polyrhiza is that diversified dormancy behavior must be generated among clonally produced, genetically identical offspring. Variation in phenology has been observed in the field, but its sources are unknown. Here, we investigate sources of phenological variation in turion production , and test the hypothesis that diversification in turion phenology is generated within genetic lineages through effects of parental birth order. As expected, phenotypic plasticity to temperature is expressed along a thermal gradient; more interestingly, parental birth order was found to have a significant and strong effect on turion phenology: Turions are produced earlier by late birth-order parents. These results hold regardless of whether turion phenology is measured as first turion birth order, time to first turion, or turion frequency. This study addresses a question of current interest on potential mechanisms generating diversification, and suggests that consistent phenotypic differences across birth orders generate life history variation.

  6. Are Humor Styles of People With Dementia Linked to Greater Purpose in Life?

    Science.gov (United States)

    Mak, Wingyun; Sörensen, Silvia

    2018-01-27

    Little is known about humor and purpose in life in people with dementia. Although having a sense of humor is typically associated with positive psychological outcomes, recent evidence suggests that outcomes may vary depending on whether the humor being used is adaptive versus maladaptive. The goal of this study was to determine whether humor styles are predictive of purpose in life in people with dementia. Questionnaires were verbally administered to people with mild-to-moderate dementia to measure humor styles and purpose in life. Adaptive humor styles were associated with purpose in life whereas maladaptive humor styles were not. Having a sense of humor in dementia may be associated with a stronger sense of purpose in life, but it depends on the type of humor used. Results are discussed in the context of understanding the role of humor in the daily lives of people with dementia and implications for care. © 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.

  7. The Power of Life Histories: Moving Readers to Greater Acts of Empathy through Literature and Memoir

    Science.gov (United States)

    Lee, Valarie G.; Madden, Marjorie E.

    2016-01-01

    This paper argues that narratives, specifically literature and memoir, offer a way to build empathy and understanding by moving readers to deeper levels of text interpretation and critique. The paper examines a new literacy framework, Life Histories, that uses talk, collaboration, writing, and performance to understand the complex relationships…

  8. During early and mid-adolescence, greater mental toughness is related to increased sleep quality and quality of life.

    Science.gov (United States)

    Brand, Serge; Kalak, Nadeem; Gerber, Markus; Clough, Peter J; Lemola, Sakari; Pühse, Uwe; Holsboer-Trachsler, Edith

    2016-06-01

    The aim of this study was to explore the association between mental toughness, subjective sleep, physical activity, and quality of life during early and mid-adolescence. A total of 1475 participants (mean age = 13.4 years; range: 11-16 years) took part in the study. They completed questionnaires related to mental toughness, physical activity, subjective sleep, and quality of life. Greater mental toughness was related to more favorable quality of life and increased subjective sleep. Mental toughness was not related to physical activity. Increased mental toughness, favorable quality of life, and sleep are related during early and mid-adolescence. Against our expectations, mental toughness was not related to physical activity. © The Author(s) 2014.

  9. Do Quiet Areas Afford Greater Health-Related Quality of Life than Noisy Areas?

    Directory of Open Access Journals (Sweden)

    Kim N. Dirks

    2013-03-01

    Full Text Available People typically choose to live in quiet areas in order to safeguard their health and wellbeing. However, the benefits of living in quiet areas are relatively understudied compared to the burdens associated with living in noisy areas. Additionally, research is increasingly focusing on the relationship between the human response to noise and measures of health and wellbeing, complementing traditional dose-response approaches, and further elucidating the impact of noise and health by incorporating human factors as mediators and moderators. To further explore the benefits of living in quiet areas, we compared the results of health-related quality of life (HRQOL questionnaire datasets collected from households in localities differentiated by their soundscapes and population density: noisy city, quiet city, quiet rural, and noisy rural. The dose-response relationships between noise annoyance and HRQOL measures indicated an inverse relationship between the two. Additionally, quiet areas were found to have higher mean HRQOL domain scores than noisy areas. This research further supports the protection of quiet locales and ongoing noise abatement in noisy areas.

  10. Greater dyspnea is associated with lower health-related quality of life among European patients with COPD

    Directory of Open Access Journals (Sweden)

    Gruenberger JB

    2017-03-01

    number of emergency room visits (0.61 vs 0.40, P=0.030 were higher in patients with greater dyspnea.Conclusion: Many European patients with COPD continue to experience dyspnea despite treatment and at levels associated with notable impairments in the patients’ ability to function across a multitude of domains. These patients may benefit from more intense treatment of their symptoms. Keywords: COPD, dyspnea, health-related quality of life, activity impairment, symptoms

  11. HEADROOM BEYOND THE QUALITY- ADJUSTED LIFE-YEAR: THE CASE OF COMPLEX PEDIATRIC NEUROLOGY.

    Science.gov (United States)

    van Nimwegen, Kirsten J M; Lilford, Richard J; van der Wilt, Gert J; Grutters, Janneke P C

    2017-01-01

    The headroom method was introduced for the very early evaluation of the potential value of new technologies. It allows for establishing a ceiling price for technologies to still be cost-effective by combining the maximum effect a technology might yield, the maximum willingness-to-pay (WTP) for this effect, and potential downstream expenses and savings. Although the headroom method is QALY-based, not all innovations are expected to result in QALY gain. This study explores the feasibility and usefulness of the headroom method in the evaluation of technologies that are unlikely to result in QALY gain. This will be illustrated with the diagnostic trajectory of complex pediatric neurology (CPN). Our headroom analysis showed a large room for improvement in the current diagnostic trajectory of CPN in terms of diagnostic yield. Combining this with a maximum WTP value for an additional diagnosis and the potential downstream expenses and savings, resulted in a total headroom of €15,028. This indicates that a new technology in this particular diagnostic trajectory, might be cost-effective as long as its costs do not exceed €15,028. The headroom method seems a useful tool in the very early evaluation of medical technologies, also in cases when immediate QALY gain is unlikely. It allows for allocating healthcare resources to those technologies that are most promising. It should be kept in mind, however, that the headroom assumes an optimistic scenario, and for that reason cannot guarantee future cost-effectiveness. It might be most useful for ruling out those technologies that are unlikely to be cost-effective.

  12. Decomposing cross-country differences in Quality Adjusted Life Expectancy: The impact of value sets

    NARCIS (Netherlands)

    R. Heijink (Richard); P.H.M. Van Baal (Pieter); M. Oppe (Mark); A.H.E. Koolman (Xander); G. Westert (Gert)

    2011-01-01

    textabstractBackground: The validity, reliability and cross-country comparability of summary measures of population health (SMPH) have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and

  13. Decomposing cross-country differences in quality adjusted life expectancy: the impact of value sets.

    NARCIS (Netherlands)

    Heijink, R.; Baal, P. van; Oppe, M.; Koolman, X.; Westert, G.P.

    2011-01-01

    ABSTRACT: BACKGROUND: The validity, reliability and cross-country comparability of summary measures of population health (SMPH) have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and

  14. Decomposing cross-country differences in quality adjusted life expectancy : The impact of value sets

    NARCIS (Netherlands)

    Heijink, R.; Van Baal, P.; Oppe, M.; Koolman, X.; Westert, G.

    2011-01-01

    Background: The validity, reliability and cross-country comparability of summary measures of population health (SMPH) have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and decompose

  15. Residents of poor nations have a greater sense of meaning in life than residents of wealthy nations.

    Science.gov (United States)

    Oishi, Shigehiro; Diener, Ed

    2014-02-01

    Using Gallup World Poll data, we examined the role of societal wealth for meaning in life across 132 nations. Although life satisfaction was substantially higher in wealthy nations than in poor nations, meaning in life was higher in poor nations than in wealthy nations. In part, meaning in life was higher in poor nations because people in those nations were more religious. The mediating role of religiosity remained significant after we controlled for potential third variables, such as education, fertility rate, and individualism. As Frankl (1963) stated in Man's Search for Meaning, it appears that meaning can be attained even under objectively dire living conditions, and religiosity plays an important role in this search.

  16. Massage therapy during early postnatal life promotes greater lean mass and bone growth, mineralization, and strength in juvenile and young adult rats.

    Science.gov (United States)

    Chen, H; Miller, S; Shaw, J; Moyer-Mileur, L

    2009-01-01

    The objects of this study were to investigate the effects of massage therapy during early life on postnatal growth, body composition, and skeletal development in juvenile and young adult rats. Massage therapy was performed for 10 minutes daily from D6 to D10 of postnatal life in rat pups (MT, n=24). Body composition, bone area, mineral content, and bone mineral density were measured by dual energy X-ray absorptiometry (DXA); bone strength and intrinsic stiffness on femur shaft were tested by three-point bending; cortical and cancellous bone histomorphometric measurements were performed at D21 and D60. Results were compared to age- and gender-matched controls (C, n=24). D21 body weight, body length, lean mass, and bone area were significantly greater in the MT cohort. Greater bone mineral content was found in male MT rats; bone strength and intrinsic stiffness were greater in D60 MT groups. At D60 MT treatment promoted bone mineralization by increasing trabecular mineral apposition rate in male and endosteal mineral surface in females, and also improved micro-architecture by greater trabeculae width in males and decreasing trabecular separation in females. In summary, massage therapy during early life elicited immediate and prolonged anabolic effects on postnatal growth, lean mass and skeletal developmental in a gender-specific manner in juvenile and young adult rats.

  17. Estimating quality adjusted progression free survival of first-line treatments for EGFR mutation positive non small cell lung cancer patients in The Netherlands

    Directory of Open Access Journals (Sweden)

    Verduyn S

    2012-09-01

    Full Text Available Abstract Background Gefitinib, a tyrosine kinase inhibitor, is an effective treatment in advanced non-small cell lung cancer (NSCLC patients with an activating mutation in the epidermal growth factor receptor (EGFR. Randomised clinical trials showed a benefit in progression free survival for gefitinib versus doublet chemotherapy regimens in patients with an activated EGFR mutation (EGFR M+. From a patient perspective, progression free survival is important, but so is health-related quality of life. Therefore, this analysis evaluates the Quality Adjusted progression free survival of gefitinib versus three relevant doublet chemotherapies (gemcitabine/cisplatin (Gem/Cis; pemetrexed/cisplatin (Pem/Cis; paclitaxel/carboplatin (Pac/Carb in a Dutch health care setting in patients with EGFR M+ stage IIIB/IV NSCLC. This study uses progression free survival rather than overall survival for its time frame in order to better compare the treatments and to account for the influence that subsequent treatment lines would have on overall survival analysis. Methods Mean progression free survival for Pac/Carb was obtained by extrapolating the median progression free survival as reported in the Iressa-Pan-Asia Study (IPASS. Data from a network meta-analysis was used to estimate the mean progression free survival for therapies of interest relative to Pac/Carb. Adjustment for health-related quality of life was done by incorporating utilities for the Dutch population, obtained by converting FACT-L data (from IPASS to utility values and multiplying these with the mean progression free survival for each treatment arm to determine the Quality Adjusted progression free survival. Probabilistic sensitivity analysis was carried out to determine 95% credibility intervals. Results The Quality Adjusted progression free survival (PFS (mean, (95% credibility interval was 5.2 months (4.5; 5.8 for Gem/Cis, 5.3 months (4.6; 6.1 for Pem/Cis; 4.9 months (4.4; 5.5 for Pac/Carb and 8

  18. High-dose chemotherapy for patients with high-risk breast cancer: a clinical and economic assessment using a quality-adjusted survival analysis.

    Science.gov (United States)

    Marino, Patricia; Roché, Henri; Moatti, Jean-Paul

    2008-04-01

    The benefit of high-dose chemotherapy (HDC) has not been clearly demonstrated. It may offer disease-free survival improvement at the expense of major toxicity and increasing cost. We evaluated the trade-offs between toxicity, relapse, and costs using a quality-adjusted time without symptoms or toxicity (Q-TWiST) analysis. The analysis was conducted in the context of a randomized trial (PEGASE 01) evaluating the benefit of HDC for 314 patients with high-risk breast cancer. A Q-TWiST analysis was first performed to compare HDC with standard chemotherapy. We then used the results of this Q-TWiST analysis to inform a cost per quality-adjusted life-year (QALY) comparison between treatments. Q-TWiST durations were in favor of HDC, whatever the weighting coefficients used for the analysis. This benefit was significant when the weighting coefficient related to the time spent after relapse was low (0.78), HDC offered no benefit. For intermediate values, the results depended on the weighting coefficient attributed to the toxicity period. The incremental cost per QALY ranged from 12,691euro/QALY to 26,439euro/QALY, according to the coefficients used to weight toxicity and relapse. The benefits of HDC outweigh the burdens of treatment for a wide range of utility coefficients. Economic impact is not a barrier to HDC diffusion in this situation. Nevertheless, no significant benefit was demonstrated for a certain range of utility values.

  19. Palmoplantar psoriasis is associated with greater impairment of health-related quality of life compared to moderate-to-severe plaque psoriasis

    Science.gov (United States)

    Chung, Jina; Duffin, Kristina Callis; Takeshita, Junko; Shin, Daniel B.; Krueger, Gerald G.; Robertson, Andrew D.; Troxel, Andrea B.; Van Voorhees, Abby S.; Edson-Heredia, Emily; Gelfand, Joel M.

    2014-01-01

    Background The impact of palmoplantar psoriasis on health-related quality of life (QoL) is largely unknown. Objective To compare clinical characteristics and patient-reported outcomes between patients with palmoplantar psoriasis and moderate-to-severe plaque psoriasis. Methods We conducted a cross-sectional study of patients with plaque psoriasis (N=1,153) and palmoplantar psoriasis (N=66) currently receiving systemic or light treatment for psoriasis. Results Patients with palmoplantar psoriasis were more likely to report Dermatology Life Quality Index scores that correspond to at least a moderate impact on QoL (odds ratio [OR] 2.08; 95% confidence interval [CI], 1.20-3.61); problems with mobility (OR 1.98; 95% CI, 1.10-3.58), self-care (OR 3.12; 95% CI, 1.24-7.86), and usual activities (OR 2.47; 95% CI, 1.44-4.22) on the European Quality of Life-5 Dimensions questionnaire; and heavy topical prescription use of at least twice daily in the preceding week (OR 2.81; 95% CI, 1.63-4.85) than those with plaque psoriasis. Limitations Our assessment tools may not account for all dimensions of health-related QoL affected by palmoplantar disease, and these results may not be generalizable to patients with milder forms of psoriasis. Conclusion Patients with palmoplantar psoriasis suffer from greater health-related QoL impairment and are more likely to report heavy use of topical prescriptions than those with moderate-to-severe plaque psoriasis. PMID:24894455

  20. Assessment of cost of innovation versus the value of health gains associated with treatment of chronic hepatitis C in the United States: The quality-adjusted cost of care.

    Science.gov (United States)

    Younossi, Zobair M; Park, Haesuk; Dieterich, Douglas; Saab, Sammy; Ahmed, Aijaz; Gordon, Stuart C

    2016-10-01

    New direct-acting antiviral (DAA) therapy has dramatically increased cure rates for patients infected with hepatitis C virus (HCV), but has also substantially raised treatment costs. The aim of this analysis was to evaluate the therapeutic benefit and net costs (i.e. efficiency frontier) and the quality-adjusted cost of care associated with the evolution of treatment regimens for patients with HCV genotype 1 in the United States. A decision-analytic Markov model. Published literature and clinical trial data. Life Time. Third-party payer. This study compared four approved regimens in treatment-naïve genotype 1 chronic hepatitis C patients, including pegylated interferon and ribavirin (PR), first generation triple therapy (boceprevir + PR and telaprevir + PR), second generation triple therapy (sofosbuvir + PR and simeprevir + PR) and all-oral DAA regimens (ledipasvir/sofosbuvir and ombitasvir + paritaprevir/ritonavir + dasabuvir ± ribavirin). Quality-adjusted cost of care (QACC). QACC was defined as the increase in treatment cost minus the increase in the patient's quality-adjusted life years (QALYs) when valued at $50,000 per QALY. All-oral therapy improved the average sustained virologic response (SVR) rate to 96%, thereby offsetting the high drug acquisition cost of $85,714, which resulted in the highest benefit based on the efficiency frontier. Furthermore, while oral therapies increased HCV drug costs by $48,350, associated QALY gains decreased quality-adjusted cost of care by $14,120 compared to dual therapy. When the value of a QALY was varied from $100,000 to $300,000, the quality adjusted cost of care compared to dual therapy ranged from - $21,234 to - $107,861, - $89,007 to - $293,130, - $176,280 to - $500,599 for first generation triple, second generation triple, and all-oral therapies, respectively. Primary efficacy and safety measurements for drug regimens were sourced from clinical trials data rather than a real

  1. Monetary Value of Quality-Adjusted Life Years (QALY) among Patients with Cardiovascular Disease: a Willingness to Pay Study (WTP).

    Science.gov (United States)

    Moradi, Najmeh; Rashidian, Arash; Rasekh, Hamid Reza; Olyaeemanesh, Alireza; Foroughi, Mahnoosh; Mohammadi, Teymoor

    2017-01-01

    The aim of this study was to estimate the monetary value of a QALY among patients with heart disease and to identify its determinants. A cross-sectional survey was conducted through face-to-face interview on 196 patients with cardiovascular disease from two heart hospitals in Tehran, Iran, to estimate the value of QALY using disaggregated and aggregated approaches. The EuroQol-5 Dimension (EQ-5D) questionnaire, Visual Analogue Scale (VAS), Time Trade-Off (TTO) and contingent valuation WTP techniques were employed, first to elicit patients' preferences and then, to estimate WTP for QALY. The association of patients' characteristics with WTP for QALY, was assessed through Heckman selection model. The Mean willingness to pay per QALY, estimated by the disaggregated approach ranged from 2,799 to 3599 US dollars. It is higher than the values, estimated from aggregated methods (USD 2,256 to 3,137). However, in both approaches, the values were less than one Gross Domestic Product (GDP) per capita of Iran. Significant variables were: Current health state, education, age, marital status, number of comorbidities, and household's cost group. Our results challenge two major issues: the first, is a policy challenge which concerns the WHO recommendation to use less than 3 GDP per capita as a cost-effectiveness threshold value. The second, is an analytical challenge related to patients with zero QALY gain. More scrutiny is suggested on the issue of how patients with full health state valuation should be dealt with and what arbitrary value could be included in the estimation value of QALY when the disaggregated approach used.

  2. Effect of patient's life expectancy on the cost-effectiveness of treatment for ocular hypertension.

    Science.gov (United States)

    Kymes, Steven M; Plotzke, Michael R; Kass, Michael A; Boland, Michael V; Gordon, Mae O

    2010-05-01

    To assess the influence of expected life span on the cost-effectiveness of treating ocular hypertension to prevent primary open-angle glaucoma. We used a Markov simulation model to estimate the cost and benefit of ocular hypertension treatment over a person's remaining life. We examined the influence of age on the cost-effectiveness decision in 2 ways: (1) by evaluating specific age cohorts to assess the influence of age at the initiation of treatment; and (2) by evaluating the influence of a specific life span. At a willingness to pay $50,000/quality-adjusted life year to $100,000/quality-adjusted life year, treatment of people with a 2% or greater annual risk of developing glaucoma was cost-effective for people aged 45 years with a life expectancy of at least 18 remaining years. However, to be cost-effective, a person aged 55 years must have a life expectancy of 21 remaining years and someone aged 65 years must have a life expectancy of 23 remaining years. A person with ocular hypertension must have a life expectancy of at least 18 remaining years to justify treatment at a threshold of a 2% or greater annual risk of developing glaucoma. Persons at higher levels of risk require a life expectancy of 7 to 10 additional years to justify treatment.

  3. Perception of Life as Stressful, Not Biological Response to Stress, Is Associated with Greater Social Disability in Adults with Autism Spectrum Disorder

    Science.gov (United States)

    Bishop-Fitzpatrick, Lauren; Minshew, Nancy J.; Mazefsky, Carla A.; Eack, Shaun M.

    2017-01-01

    This study examined differences between adults with autism spectrum disorder (ASD; N = 40) and typical community volunteers (N = 25) on measures of stressful life events, perceived stress, and biological stress response (cardiovascular and cortisol reactivity) during a novel social stress task. Additional analyses examined the relationship between…

  4. Greater Independence in Activities of Daily Living is Associated with Higher Health-Related Quality of Life Scores in Nursing Home Residents with Dementia

    Directory of Open Access Journals (Sweden)

    Charice S. Chan

    2015-06-01

    Full Text Available Health-related quality of life (HRQL for nursing home residents is important, however, the concept of quality of life is broad, encompasses many domains and is difficult to assess in people with dementia. Basic activities of daily living (ADL are measured routinely in nursing homes using the Resident Assessment Instrument-Minimum Data Set Version 2.0 (RAI-MDS and Functional Independence Measure (FIM instrument. We examined the relationship between HRQL and ADL to assess the future possibility of ADL dependency level serving as a surrogate measure of HRQL in residents with dementia. To assess ADL, measures derived from the RAI-MDS and FIM data were gathered for 111 residents at the beginning of our study and at 6-month follow-up. Higher scores for independence in ADL were correlated with higher scores for a disease-specific HRQL measure, the Quality of Life—Alzheimer’s Disease Scale. Preliminary evidence suggests that FIM-assessed ADL is associated with HRQL for these residents. The associations of the dressing and toileting items with HRQL were particularly strong. This finding suggests the importance of ADL function in HRQL. The RAI-MDS ADL scales should be used with caution to evaluate HRQL.

  5. The impact of diabetes mellitus and other chronic medical conditions on health-related Quality of Life: Is the whole greater than the sum of its parts?

    Directory of Open Access Journals (Sweden)

    Fong Kok-Yong

    2005-01-01

    Full Text Available Abstract Background Diabetes mellitus (DM is an important public health concern, the impact of which is increased by the high prevalence of co-existing chronic medical conditions among subjects with DM. The aims of this study were therefore to (1 evaluate the impact of DM and co-existing chronic medical conditions on health-related quality of life (HRQoL (which could be additive, synergistic or subtractive; (2 to determine the extent to which the SF-6D (a single-index preference measure captures the multidimensional information provided by the SF-36 (a profile measure. Methods Using data from a cross-sectional, population-based survey of Chinese, Malay and Indians in Singapore, we developed 9 separate multiple linear regression models, with each SF-36 scale or SF-6D index score being the dependent variable for one model. The influence of DM and a second chronic medical condition (hypertension (HTN, heart disease (HD, musculoskeletal illnesses (MS and their interactions were studied after adjusting for the influence of potential confounding variables. Results Among 5,224 subjects, the prevalence of DM, HTN, HD and MS were 5.9%, 10.7%, 2.4% and 26.6% respectively. DM lowered SF-36 scores by more than 2 points on 3 SF-36 scales and lowered SF-6D scores by 0.03 points. Subjects with DM and HTN, DM and HD or DM and MS experienced further lowering of SF-36 scores exceeding 2 points on at least 6 scales and further lowering of SF-6D scores by 0.05, 0.08 and 0.10 points respectively. Generally, DM and co-existing medical conditions exerted additive effects on HRQoL, with the exception of DM and heart disease, where a subtractive effect was noted. SF-6D index scores generally reflected the patterns of influence of DM and chronic medical conditions on SF-36 scores. Conclusion DM and chronic medical conditions generally reduced HRQoL in this multiethnic general population in an additive, rather than synergistic or subtractive fashion. In this study, the SF

  6. Quality-adjusted cost of care: a meaningful way to measure growth in innovation cost versus the value of health gains.

    Science.gov (United States)

    Lakdawalla, Darius; Shafrin, Jason; Lucarelli, Claudio; Nicholson, Sean; Khan, Zeba M; Philipson, Tomas J

    2015-04-01

    Technology drives both health care spending and health improvement. Yet policy makers rarely see measures of cost growth that account for both effects. To fill this gap, we present the quality-adjusted cost of care, which illustrates cost growth net of growth in the value of health improvements, measured as survival gains multiplied by the value of survival. We applied the quality-adjusted cost of care to two cases. For colorectal cancer, drug cost per patient increased by $34,493 between 1998 and 2005 as a result of new drug launches, but value from offsetting health improvements netted a modest $1,377 increase in quality-adjusted cost of care. For multiple myeloma, new therapies increased treatment cost by $72,937 between 2004 and 2009, but offsetting health benefits lowered overall quality-adjusted cost of care by $67,863. However, patients with multiple myeloma on established first-line therapies saw costs rise without corresponding benefits. All three examples document rapid cost growth, but they provide starkly different answers to the question of whether society got what it paid for. Project HOPE—The People-to-People Health Foundation, Inc.

  7. Drugs Cleared Through The FDA's Expedited Review Offer Greater Gains Than Drugs Approved By Conventional Process.

    Science.gov (United States)

    Chambers, James D; Thorat, Teja; Wilkinson, Colby L; Neumann, Peter J

    2017-08-01

    We investigated whether drugs approved by the Food and Drug Administration (FDA) through expedited review have offered larger health gains, compared to drugs approved through conventional review processes. We identified published estimates of additional health gains (measured in quality-adjusted life-years, or QALYs) associated with drugs approved in the period 1999-2012 through expedited (seventy-six drugs) versus conventional (fifty-nine) review processes. We found that drugs in at least one expedited review program offered greater gains than drugs reviewed through conventional processes (0.182 versus 0.003 QALYs). We also found that, compared to drugs not included in the same program, greater gains were provided by drugs in the priority review (0.175 versus 0.007 QALYs), accelerated approval (0.370 versus 0.031 QALYs), and fast track (0.254 versus 0.014 QALYs) programs. Our analysis suggests that the FDA has prioritized drugs that offer the largest health gains. Project HOPE—The People-to-People Health Foundation, Inc.

  8. Greater autonomy at work

    NARCIS (Netherlands)

    Houtman, I.L.D.

    2004-01-01

    In the past 10 years, workers in the Netherlands increasingly report more decision-making power in their work. This is important for an economy in recession and where workers face greater work demands. It makes work more interesting, creates a healthier work environment, and provides opportunities

  9. Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester: repeated-measures and between-groups study of 'Living Life to the Full Interactive', 'Sleepio' and 'Breaking Free Online' at 'Self Help Services'.

    Science.gov (United States)

    Elison, Sarah; Ward, Jonathan; Williams, Chris; Espie, Colin; Davies, Glyn; Dugdale, Stephanie; Ragan, Kathryn; Chisnall, Leanne; Lidbetter, Nicky; Smith, Keith

    2017-07-20

    There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services. Therefore, this service evaluation reports on feasibility and outcomes from an eTherapy mental health service. 'Self Help Services', an Increasing Access to Psychological Therapies (IAPT) eTherapy service in Greater Manchester. 1068 service users referred to the service for secondary care for their mental health difficulties. Participants were triaged into one of three eTherapy programmes: 'Living Life to the Full Interactive' for low mood, stress and anxiety; 'Sleepio' for insomnia; and 'Breaking Free Online' for substance misuse, depending on clinical need. Standardised psychometric assessments of depression, anxiety and social functioning, collected as part of the IAPT Minimum Data Set, were conducted at baseline and post-treatment. Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive (depression CI 1.27 to 3.21, pmental health scores were found within all three groups (all pmental health difficulties (pmental health difficulties and suggest that eTherapies may be a useful addition to treatment offering in community-based services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Greater-confinement disposal

    International Nuclear Information System (INIS)

    Trevorrow, L.E.; Schubert, J.P.

    1989-01-01

    Greater-confinement disposal (GCD) is a general term for low-level waste (LLW) disposal technologies that employ natural and/or engineered barriers and provide a degree of confinement greater than that of shallow-land burial (SLB) but possibly less than that of a geologic repository. Thus GCD is associated with lower risk/hazard ratios than SLB. Although any number of disposal technologies might satisfy the definition of GCD, eight have been selected for consideration in this discussion. These technologies include: (1) earth-covered tumuli, (2) concrete structures, both above and below grade, (3) deep trenches, (4) augered shafts, (5) rock cavities, (6) abandoned mines, (7) high-integrity containers, and (8) hydrofracture. Each of these technologies employ several operations that are mature,however, some are at more advanced stages of development and demonstration than others. Each is defined and further described by information on design, advantages and disadvantages, special equipment requirements, and characteristic operations such as construction, waste emplacement, and closure

  11. More features, greater connectivity.

    Science.gov (United States)

    Hunt, Sarah

    2015-09-01

    Changes in our political infrastructure, the continuing frailties of our economy, and a stark growth in population, have greatly impacted upon the perceived stability of the NHS. Healthcare teams have had to adapt to these changes, and so too have the technologies upon which they rely to deliver first-class patient care. Here Sarah Hunt, marketing co-ordinator at Aid Call, assesses how the changing healthcare environment has affected one of its fundamental technologies - the nurse call system, argues the case for wireless such systems in terms of what the company claims is greater adaptability to changing needs, and considers the ever-wider range of features and functions available from today's nurse call equipment, particularly via connectivity with both mobile devices, and ancillaries ranging from enuresis sensors to staff attack alert 'badges'.

  12. Greater oil investment opportunities

    International Nuclear Information System (INIS)

    Arenas, Ismael Enrique

    1997-01-01

    Geologically speaking, Colombia is a very attractive country for the world oil community. According to this philosophy new and important steps are being taken to reinforce the oil sector: Expansion of the exploratory frontier by including a larger number of sedimentary areas, and the adoption of innovative contracting instruments. Colombia has to offer, Greater economic incentives for the exploration of new areas to expand the exploratory frontier, stimulation of exploration in areas with prospectivity for small fields. Companies may offer Ecopetrol a participation in production over and above royalties, without it's participating in the investments and costs of these fields, more favorable conditions for natural gas seeking projects, in comparison with those governing the terms for oil

  13. Exploring the spatial variation in quality-adjusted rental prices and identifying hot spots in Berlin’s residential property market

    DEFF Research Database (Denmark)

    Meulen, Philipp an de; Mitze, Timo Friedel

    2014-01-01

    In this work, we use residual values obtained from an estimated hedonic pricing model to assess the role of district-level neighbourhood effects for the spatial variation in quality-adjusted rental prices in Berlin between 2008 and 2013. By doing so, we also aim at identifying hot and cold spots ...... analysis (ESDA) toolbox, we finally pinpoint particular hot spots of the city’s residential property market associated with a significant spatial clustering of similar rental price values around individual observations....... proximity to the city centre compared to similar properties in Berlin’s periphery once we control for the properties’ physical characteristics. The observed temporal evolution of the rental price distribution between 2008 and 2013 thereby hints at an ongoing gentrification process in Germany’s capital...... associated with the current housing market boom. This visual impression is also confirmed by the application of quantile regressions for a correlation analysis between quality-adjusted rental price values and Berlin district-level characteristics obtained from the last census in 2011. Among other factors, we...

  14. Incremental cost per quality-adjusted life year gained? The need for alternative methods to evaluate medical interventions for ultra-rare disorders

    NARCIS (Netherlands)

    Schlander, Michael; Garattini, Silvio; Holm, Søren; Kolominsky-Rabas, Peter; Nord, Erik; Persson, Ulf; Postma, Maarten; Richardson, Jeff; Simoens, Steven; De Solà Morales, Oriol; Tolley, Keith; Toumi, Mondher

    2014-01-01

    Drugs for ultra-rare disorders (URDs) rank prominently among the most expensive medicines on a cost-per-patient basis. Many of them do not meet conventional standards for cost-effectiveness. In light of the high fixed cost of R&D, this challenge is inversely related to the prevalence of URDs. The

  15. Greater happiness for a greater number: Is that possible in Austria?

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2011-01-01

    textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the happiness of the great number could not be measured

  16. Greater happiness for a greater number: Is that possible? If so how? (Arabic)

    NARCIS (Netherlands)

    R. Veenhoven (Ruut); E. Samuel (Emad)

    2012-01-01

    textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time, the happiness of the great number could not be

  17. Greater happiness for a greater number: Is that possible in Germany?

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2009-01-01

    textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the Happiness of the great number could not be measured

  18. Differential time preferences for money and quality of life

    NARCIS (Netherlands)

    Parouty, M. B. Y.; Le, Hoa; Krooshof, D.; Postma, M. J.

    Background This study provides an empirical investigation into differential time preferences between money and quality of life. Thus far, time preference investigations in health have mostly involved life-years gained and lives saved. However, the quality-adjusted life-year, which is recommended by

  19. REGOSARC: Regorafenib versus placebo in doxorubicin-refractory soft-tissue sarcoma-A quality-adjusted time without symptoms of progression or toxicity analysis.

    Science.gov (United States)

    Berry, Vincent; Basson, Laurent; Bogart, Emilie; Mir, Olivier; Blay, Jean-Yves; Italiano, Antoine; Bertucci, François; Chevreau, Christine; Clisant-Delaine, Stéphanie; Liegl-Antzager, Bernadette; Tresch-Bruneel, Emmanuelle; Wallet, Jennifer; Taieb, Sophie; Decoupigny, Emilie; Le Cesne, Axel; Brodowicz, Thomas; Penel, Nicolas

    2017-06-15

    In a placebo-controlled, randomized phase 2 trial (ClinicalTrials.gov identifier NCT01900743), regorafenib improved progression-free survival (PFS) for patients with doxorubicin-pretreated advanced nonadipocytic sarcoma. A quality-adjusted time without symptoms of progression or toxicity (Q-TWiST) post hoc exploratory analysis was applied to provide an integrated measure of its clinical benefit. In the base-case analysis, each patient's overall survival (OS) was partitioned into 3 mutually exclusive health states: the time with a grade 3 or 4 adverse event (TOX), the time without symptoms of disease or grade 3 or 4 toxicity from treatment, and the time after tumor progression or relapse. The time spent in each state was weighted with a health-state utility associated with that state and was summed to calculate the Q-TWiST. The stability of the base-case analysis was explored with several sensitivity analyses. In nonadipocytic sarcoma, the PFS was (4.0 months [2.6-5.5 months] with regorafenib vs 1.0 month [0.9-1.8 months] with a placebo; hazard ratio, 0.36 [0.25-0.53]; P regorafenib and 9.0 months (6.8-12.5 months) with a placebo (hazard ratio, 0.67 [0.44-1.02]). With the classic definition of TOX (including all grade 3 and 4 clinical adverse events), the Q-TWiSTs were 8.0 months (7.0-9.0 months) with regorafenib and 5.7 months (4.9-6.4 months) with a placebo (P regorafenib significantly improved quality-adjusted survival in comparison with a placebo. Cancer 2017;123:2294-2302. © 2017 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2017 American Cancer Society.

  20. The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres.

    Science.gov (United States)

    Simoens, Steven; Dunselman, Gerard; Dirksen, Carmen; Hummelshoj, Lone; Bokor, Attila; Brandes, Iris; Brodszky, Valentin; Canis, Michel; Colombo, Giorgio Lorenzo; DeLeire, Thomas; Falcone, Tommaso; Graham, Barbara; Halis, Gülden; Horne, Andrew; Kanj, Omar; Kjer, Jens Jørgen; Kristensen, Jens; Lebovic, Dan; Mueller, Michael; Vigano, Paola; Wullschleger, Marcel; D'Hooghe, Thomas

    2012-05-01

    This study aimed to calculate costs and health-related quality of life of women with endometriosis-associated symptoms treated in referral centres. A prospective, multi-centre, questionnaire-based survey measured costs and quality of life in ambulatory care and in 12 tertiary care centres in 10 countries. The study enrolled women with a diagnosis of endometriosis and with at least one centre-specific contact related to endometriosis-associated symptoms in 2008. The main outcome measures were health care costs, costs of productivity loss, total costs and quality-adjusted life years. Predictors of costs were identified using regression analysis. Data analysis of 909 women demonstrated that the average annual total cost per woman was €9579 (95% confidence interval €8559-€10 599). Costs of productivity loss of €6298 per woman were double the health care costs of €3113 per woman. Health care costs were mainly due to surgery (29%), monitoring tests (19%) and hospitalization (18%) and physician visits (16%). Endometriosis-associated symptoms generated 0.809 quality-adjusted life years per woman. Decreased quality of life was the most important predictor of direct health care and total costs. Costs were greater with increasing severity of endometriosis, presence of pelvic pain, presence of infertility and a higher number of years since diagnosis. Our study invited women to report resource use based on endometriosis-associated symptoms only, rather than drawing on a control population of women without endometriosis. Our study showed that the economic burden associated with endometriosis treated in referral centres is high and is similar to other chronic diseases (diabetes, Crohn's disease, rheumatoid arthritis). It arises predominantly from productivity loss, and is predicted by decreased quality of life.

  1. Factors relating to readmission of term and near-term neonates in the first two weeks of life. Early Discharge Survey Group of the Health Professional Advisory Board of the Greater New York Chapter of the March of Dimes.

    Science.gov (United States)

    Brown, A K; Damus, K; Kim, M H; King, K; Harper, R; Campbell, D; Crowley, K A; Lakhani, M; Cohen-Addad, N; Kim, R; Harin, A

    1999-01-01

    A multisite study of term and near term infants readmitted in the first two weeks of life to 9 New York City area hospitals in 1995 was conducted to evaluate factors related to readmission, including length of newborn stay. Of the 30,884 infants born at the 9 study hospitals 391 newborns were readmitted. The major admission diagnoses were infection, 40.7%, hyperbilirubinemia, 39.1%, and feeding and/or gastrointestinal problems, 10.5%. In the first week, 65.1% of readmissions were for hyperbilirubinemia and 19.1% were for infection or suspected sepsis. In the second week, 67.8% of readmissions were for infection and 7.6% were for hyperbilirubinemia. Hyperbilirubinemia was the most frequent diagnosis for White and Asian infants, while infection was most frequent for African-American and Hispanic infants. Age at readmission was younger and the interval from discharge was shorter for infants with hyperbilirubinemia. Abnormalities which should have precluded early discharge included feeding difficulties, cyanotic congenital heart defects, hemolytic disease of the newborn, early jaundice or early high bilirubin levels. Attention to identification of infants at risk and programs such as lactation counseling and universal screening for bilirubin (with appropriate interpretation) prior to discharge could have reduced the necessity for readmission regardless of the newborn length of stay.

  2. The quality-of-life burden of knee osteoarthritis in New Zealand adults: A model-based evaluation.

    Directory of Open Access Journals (Sweden)

    J Haxby Abbott

    Full Text Available Knee osteoarthritis is a leading global cause of health-related quality of life loss. The aim of this project was to quantify health losses arising from knee osteoarthritis in New Zealand (NZ in terms of quality-adjusted life years (QALYs lost.The Osteoarthritis Policy Model (OAPol, a validated Monte Carlo computer simulation model, was used to estimate QALYs lost due to knee osteoarthritis in the NZ adult population aged 40-84 over their lifetimes from the base year of 2006 until death. Data were from the NZ Health Survey, NZ Burden of Diseases, NZ Census, and relevant literature. QALYs were derived from NZ EQ-5D value set 2. Sensitivity to health state valuation, disease and pain prevalence were assessed in secondary analyses.Based on NZ EQ-5D health state valuations, mean health losses due to knee osteoarthritis over people's lifetimes in NZ are 3.44 QALYs per person, corresponding to 467,240 QALYs across the adult population. Average estimated per person QALY losses are higher for non-Māori females (3.55 than Māori females (3.38, and higher for non-Māori males (3.34 than Māori males (2.60. The proportion of QALYs lost out of the total quality-adjusted life expectancy for those without knee osteoarthritis is similar across all subgroups, ranging from 20 to 23 percent.At both the individual and population levels, knee osteoarthritis is responsible for large lifetime QALY losses. QALY losses are higher for females than males due to greater prevalence of knee osteoarthritis and higher life expectancy, and lower for Māori than non-Māori due to lower life expectancy. Large health gains are potentially realisable from public health and policy measures aimed at decreasing incidence, progression, pain, and disability of osteoarthritis.

  3. [Autoerotic fatalities in Greater Dusseldorf].

    Science.gov (United States)

    Hartung, Benno; Hellen, Florence; Borchard, Nora; Huckenbeck, Wolfgang

    2011-01-01

    Autoerotic fatalities in the Greater Dusseldorf area correspond to the relevant medicolegal literature. Our results included exclusively young to middle-aged, usually single men who were found dead in their city apartments. Clothing and devices used showed a great variety. Women's or fetish clothing and complex shackling or hanging devices were disproportionately frequent. In most cases, death occurred due to hanging or ligature strangulation. There was no increased incidence of underlying psychiatric disorders. In most of the deceased no or at least no remarkable alcohol intoxication was found. Occasionally, it may be difficult to reliably differentiate autoerotic accidents, accidents occurring in connection with practices of bondage & discipline, dominance & submission (BDSM) from natural death, suicide or homicide.

  4. Planning for greater confinement disposal

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

    1985-01-01

    A report that provides guidance for planning for greater-confinement disposal (GCD) of low-level radioactive waste is being prepared. The report addresses procedures for selecting a GCD technology and provides information for implementing these procedures. The focus is on GCD; planning aspects common to GCD and shallow-land burial are covered by reference. Planning procedure topics covered include regulatory requirements, waste characterization, benefit-cost-risk assessment and pathway analysis methodologies, determination of need, waste-acceptance criteria, performance objectives, and comparative assessment of attributes that support these objectives. The major technologies covered include augered shafts, deep trenches, engineered structures, hydrofracture, improved waste forms, and high-integrity containers. Descriptive information is provided, and attributes that are relevant for risk assessment and operational requirements are given. 10 refs., 3 figs., 2 tabs

  5. Greater Emotional Empathy and Prosocial Behavior in Late Life

    OpenAIRE

    Sze, Jocelyn A.; Gyurak, Anett; Goodkind, Madeleine S.; Levenson, Robert W.

    2011-01-01

    Emotional empathy and prosocial behavior were assessed in older, middle-aged, and young adults. Participants watched two films depicting individuals in need, one uplifting and the other distressing. Physiological responses were monitored during the films and participants rated their levels of emotional empathy following each film. As a measure of prosocial behavior, participants were given an additional payment they could contribute to charities supporting the individuals in the films. Age-re...

  6. Waste management in Greater Vancouver

    Energy Technology Data Exchange (ETDEWEB)

    Carrusca, K. [Greater Vancouver Regional District, Burnaby, BC (Canada); Richter, R. [Montenay Inc., Vancouver, BC (Canada)]|[Veolia Environmental Services, Vancouver, BC (Canada)

    2006-07-01

    An outline of the Greater Vancouver Regional District (GVRD) waste-to-energy program was presented. The GVRD has an annual budget for solid waste management of $90 million. Energy recovery revenues from solid waste currently exceed $10 million. Over 1,660,00 tonnes of GVRD waste is recycled, and another 280,000 tonnes is converted from waste to energy. The GVRD waste-to-energy facility combines state-of-the-art combustion and air pollution control, and has processed over 5 million tonnes of municipal solid waste since it opened in 1988. Its central location minimizes haul distance, and it was originally sited to utilize steam through sales to a recycle paper mill. The facility has won several awards, including the Solid Waste Association of North America award for best facility in 1990. The facility focuses on continual improvement, and has installed a carbon injection system; an ammonia injection system; a flyash stabilization system; and heat capacity upgrades in addition to conducting continuous waste composition studies. Continuous air emissions monitoring is also conducted at the plant, which produces a very small percentage of the total air emissions in metropolitan Vancouver. The GVRD is now seeking options for the management of a further 500,000 tonnes per year of solid waste, and has received 23 submissions from a range of waste energy technologies which are now being evaluated. It was concluded that waste-to-energy plants can be located in densely populated metropolitan areas and provide a local disposal solution as well as a source of renewable energy. Other GVRD waste reduction policies were also reviewed. refs., tabs., figs.

  7. Ecology of greater sage-grouse in the Dakotas

    Science.gov (United States)

    Christopher C. Swanson

    2009-01-01

    Greater sage-grouse (Centrocercus urophasianus) populations and the sagebrush (Artemisia spp.) communities that they rely on have dramatically declined from historic levels. Moreover, information regarding sage-grouse annual life-history requirements at the eastern-most extension of sagebrush steppe communities is lacking....

  8. Greater trochanteric pain syndrome diagnosis and treatment.

    Science.gov (United States)

    Mallow, Michael; Nazarian, Levon N

    2014-05-01

    Lateral hip pain, or greater trochanteric pain syndrome, is a commonly seen condition; in this article, the relevant anatomy, epidemiology, and evaluation strategies of greater trochanteric pain syndrome are reviewed. Specific attention is focused on imaging of this syndrome and treatment techniques, including ultrasound-guided interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Socio-economic considerations of cleaning Greater Vancouver's air

    International Nuclear Information System (INIS)

    2005-08-01

    Socio-economic considerations of better air quality on the Greater Vancouver population and economy were discussed. The purpose of the study was to provide socio-economic information to staff and stakeholders of the Greater Vancouver Regional District (GVRD) who are participating in an Air Quality Management Plan (AQMP) development process and the Sustainable Region Initiative (SRI) process. The study incorporated the following methodologies: identification and review of Canadian, American, and European quantitative socio-economic, cost-benefit, cost effectiveness, competitiveness and health analyses of changes in air quality and measures to improve air quality; interviews with industry representatives in Greater Vancouver on competitiveness impacts of air quality changes and ways to improve air quality; and a qualitative analysis and discussion of secondary quantitative information that identifies and evaluates socio-economic impacts arising from changes in Greater Vancouver air quality. The study concluded that for the Greater Vancouver area, the qualitative analysis of an improvement in Greater Vancouver air quality shows positive socio-economic outcomes, as high positive economic efficiency impacts are expected along with good social quality of life impacts. 149 refs., 30 tabs., 6 appendices

  10. Simultaneous bilateral isolated greater trochanter fracture

    Directory of Open Access Journals (Sweden)

    Maruti Kambali

    2013-01-01

    Full Text Available A 48-year-old woman sustained simultaneous isolated bilateral greater trochanteric fracture, following a road traffic accident. The patient presented to us 1 month after the injury. She presented with complaints of pain in the left hip and inability to walk. Roentgenograms revealed displaced comminuted bilateral greater trochanter fractures. The fracture of the left greater trochanter was reduced and fixed internally using the tension band wiring technique. The greater trochanter fracture on the right side was asymptomatic and was managed conservatively. The patient regained full range of motion and use of her hips after a postoperative follow-up of 6 months. Isolated fractures of the greater trochanter are unusual injuries. Because of their relative rarity and the unsettled controversy regarding their etiology and pathogenesis, several methods of treatment have been advocated. Furthermore, the reports of this particular type of injury are not plentiful and the average textbook coverage afforded to this entity is limited. In our study we discuss the mechanism of injury and the various treatment options available.

  11. Greater trochanteric fracture with occult intertrochanteric extension.

    Science.gov (United States)

    Reiter, Michael; O'Brien, Seth D; Bui-Mansfield, Liem T; Alderete, Joseph

    2013-10-01

    Proximal femoral fractures are frequently encountered in the emergency department (ED). Prompt diagnosis is paramount as delay will exacerbate the already poor outcomes associated with these injuries. In cases where radiography is negative but clinical suspicion remains high, magnetic resonance imaging (MRI) is the study of choice as it has the capability to depict fractures which are occult on other imaging modalities. Awareness of a particular subset of proximal femoral fractures, namely greater trochanteric fractures, is vital for both radiologists and clinicians since it has been well documented that they invariably have an intertrochanteric component which may require surgical management. The detection of intertrochanteric or cervical extension of greater trochanteric fractures has been described utilizing MRI but is underestimated with both computed tomography (CT) and bone scan. Therefore, if MRI is unavailable or contraindicated, the diagnosis of an isolated greater trochanteric fracture should be met with caution. The importance of avoiding this potential pitfall is demonstrated in the following case of an elderly woman with hip pain and CT demonstrating an isolated greater trochanteric fracture who subsequently returned to the ED with a displaced intertrochanteric fracture.

  12. Butterfly valves: greater use in power plants

    International Nuclear Information System (INIS)

    McCoy, M.

    1975-01-01

    Improvements in butterfly valves, particularly in the areas of automatic control and leak tightness are described. The use of butterfly valves in nuclear power plants is discussed. These uses include service in component cooling, containment cooling, and containment isolation. The outlook for further improvements and greater uses is examined. (U.S.)

  13. Greater Somalia, the never-ending dream?

    DEFF Research Database (Denmark)

    Zoppi, Marco

    2015-01-01

    This paper provides an historical analysis of the concept of Greater Somalia, the nationalist project that advocates the political union of all Somali-speaking people, including those inhabiting areas in current Djibouti, Ethiopia and Kenya. The Somali territorial unification project of “lost...

  14. Setting the Greater Mekong Subregion - Development Analysis ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The funding will support the first stage of a two-stage research program in ... Inclusive development in basic education and health in Cambodia : final report ... New website will help record vital life events to improve access to services for all.

  15. Utilization of wind energy in greater Hanover

    International Nuclear Information System (INIS)

    Sahling, U.

    1993-01-01

    Since the beginning of the Eighties, the association of communities of Greater Hanover has dealt intensively with energy and ecopolitical questions in the scope of regional planning. Renewable energy sources play a dominant role in this context. This brochure is the third contribution to the subject ''Energy policy and environmental protection''. Experts as well as possibly interested parties are addressed especially. For all 8 contributions contained, separate entries have been recorded in this database. (BWI) [de

  16. Small cities face greater impact from automation

    OpenAIRE

    Frank, Morgan R.; Sun, Lijun; Cebrian, Manuel; Youn, Hyejin; Rahwan, Iyad

    2017-01-01

    The city has proven to be the most successful form of human agglomeration and provides wide employment opportunities for its dwellers. As advances in robotics and artificial intelligence revive concerns about the impact of automation on jobs, a question looms: How will automation affect employment in cities? Here, we provide a comparative picture of the impact of automation across U.S. urban areas. Small cities will undertake greater adjustments, such as worker displacement and job content su...

  17. The Greater Sekhukhune-CAPABILITY outreach project.

    Science.gov (United States)

    Gregersen, Nerine; Lampret, Julie; Lane, Tony; Christianson, Arnold

    2013-07-01

    The Greater Sekhukhune-CAPABILITY Outreach Project was undertaken in a rural district in Limpopo, South Africa, as part of the European Union-funded CAPABILITY programme to investigate approaches for capacity building for the translation of genetic knowledge into care and prevention of congenital disorders. Based on previous experience of a clinical genetic outreach programme in Limpopo, it aimed to initiate a district clinical genetic service in Greater Sekhukhune to gain knowledge and experience to assist in the implementation and development of medical genetic services in South Africa. Implementing the service in Greater Sekhukhune was impeded by a developing staff shortage in the province and pressure on the health service from the existing HIV/AIDS and TB epidemics. This situation underscores the need for health needs assessment for developing services for the care and prevention of congenital disorders in middle- and low-income countries. However, these impediments stimulated the pioneering of innovate ways to offer medical genetic services in these circumstances, including tele-teaching of nurses and doctors, using cellular phones to enhance clinical care and adapting and assessing the clinical utility of a laboratory test, QF-PCR, for use in the local circumstances.

  18. Operational technology for greater confinement disposal

    International Nuclear Information System (INIS)

    Dickman, P.T.; Vollmer, A.T.; Hunter, P.H.

    1984-12-01

    Procedures and methods for the design and operation of a greater confinement disposal facility using large-diameter boreholes are discussed. It is assumed that the facility would be located at an operating low-level waste disposal site and that only a small portion of the wastes received at the site would require greater confinement disposal. The document is organized into sections addressing: facility planning process; facility construction; waste loading and handling; radiological safety planning; operations procedures; and engineering cost studies. While primarily written for low-level waste management site operators and managers, a detailed economic assessment section is included that should assist planners in performing cost analyses. Economic assessments for both commercial and US government greater confinement disposal facilities are included. The estimated disposal costs range from $27 to $104 per cubic foot for a commercial facility and from $17 to $60 per cubic foot for a government facility. These costs are based on average site preparation, construction, and waste loading costs for both contact- and remote-handled wastes. 14 figures, 22 tables

  19. Greater Caregiving Risk, Better Infant Memory Performance?

    Science.gov (United States)

    Rifkin-Graboi, Anne; Quan, Jeffry; Richmond, Jenny; Goh, Shaun Kok Yew; Sim, Lit Wee; Chong, Yap Seng; Francois-Bureau, Jean; Chen, Helen; Qiu, Anqi

    2018-04-16

    Poor early life care often relates to cognitive difficulties. However, newer work suggests that in early-life, adversity may associate with enhanced or accelerated neurodevelopment. We examine associations between postnatal caregiving risks (i.e., higher self-reported postnatal-anxiety and lower observed maternal sensitivity) and infant relational memory (i.e. via deferred imitation and relational binding). Using subsamples of 67-181 infants (aged 433-477 post-conceptual days, or roughly five to seven months since birth) taking part in the GUSTO study, we found such postnatal caregiving risk significantly predictive of "better" performance on a relational binding task following a brief delay, after Bonferroni adjustments. Subsequent analyses suggest that the association between memory and these risks may specifically be apparent amongst infants spending at least 50% of their waking hours in the presence of their mothers. Our findings echo neuroimaging research concerning similar risk exposure and larger infant hippocampal volume, and likewise underscore the importance of considering developmental context in understanding early life experience. With this in mind, these findings caution against the use of cognitive outcomes as indices of experienced risk. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

  20. Search for greater stability in nuclear regulation

    International Nuclear Information System (INIS)

    Asselstine, J.K.

    1985-01-01

    The need for greater stability in nuclear regulation is discussed. Two possible approaches for dealing with the problems of new and rapidly changing regulatory requirements are discussed. The first approach relies on the more traditional licensing reform initiatives that have been considered off and on for the past decade. The second approach considers a new regulator philosophy aimed at the root causes of the proliferation of new safety requirements that have been imposed in recent years. For the past few years, the concepts of deregulation and regulatory reform have been in fashion in Washington, and the commercial nuclear power program has not remained unaffected. Many look to these concepts to provide greater stability in the regulatory program. The NRC, the nuclear industry and the administration have all been avidly pursuing regulatory reform initiatives, which take the form of both legislative and administrative proposals. Many of these proposals look to the future, and, if adopted, would have little impact on currently operating nuclear power plants or plants now under construction

  1. Greater Sudbury fuel efficient driving handbook

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-12-15

    Reducing the amount of fuel that people use for personal driving saves money, improves local air quality, and reduces personal contributions to climate change. This handbook was developed to be used as a tool for a fuel efficient driving pilot program in Greater Sudbury in 2009-2010. Specifically, the purpose of the handbook was to provide greater Sudbury drivers with information on how to drive and maintain their personal vehicles in order to maximize fuel efficiency. The handbook also provides tips for purchasing fuel efficient vehicles. It outlines the benefits of fuel maximization, with particular reference to reducing contributions to climate change; reducing emissions of air pollutants; safe driving; and money savings. Some tips for efficient driving are to avoid aggressive driving; use cruise control; plan trips; and remove excess weight. Tips for efficient winter driving are to avoid idling to warm up the engine; use a block heater; remove snow and ice; use snow tires; and check tire pressure. The importance of car maintenance and tire pressure was emphasized. The handbook also explains how fuel consumption ratings are developed by vehicle manufacturers. refs., figs.

  2. Women at greater risk of HIV infection.

    Science.gov (United States)

    Mahathir, M

    1997-04-01

    Although many people believe that mainly men get infected with HIV/AIDS, women are actually getting infected at a faster rate than men, especially in developing countries, and suffer more from the adverse impact of AIDS. As of mid-1996, the Joint UN Program on AIDS estimated that more than 10 million of the 25 million adults infected with HIV since the beginning of the epidemic are women. The proportion of HIV-positive women is growing, with almost half of the 7500 new infections daily occurring among women. 90% of HIV-positive women live in a developing country. In Asia-Pacific, 1.4 million women have been infected with HIV out of an estimated total 3.08 million adults from the late 1970s until late 1994. Biologically, women are more vulnerable than men to infection because of the greater mucus area exposed to HIV during penile penetration. Women under age 17 years are at even greater risk because they have an underdeveloped cervix and low vaginal mucus production. Concurrent sexually transmitted diseases increase the risk of HIV transmission. Women's risk is also related to their exposure to gender inequalities in society. The social and economic pressures of poverty exacerbate women's risk. Prevention programs are discussed.

  3. Small cities face greater impact from automation.

    Science.gov (United States)

    Frank, Morgan R; Sun, Lijun; Cebrian, Manuel; Youn, Hyejin; Rahwan, Iyad

    2018-02-01

    The city has proved to be the most successful form of human agglomeration and provides wide employment opportunities for its dwellers. As advances in robotics and artificial intelligence revive concerns about the impact of automation on jobs, a question looms: how will automation affect employment in cities? Here, we provide a comparative picture of the impact of automation across US urban areas. Small cities will undertake greater adjustments, such as worker displacement and job content substitutions. We demonstrate that large cities exhibit increased occupational and skill specialization due to increased abundance of managerial and technical professions. These occupations are not easily automatable, and, thus, reduce the potential impact of automation in large cities. Our results pass several robustness checks including potential errors in the estimation of occupational automation and subsampling of occupations. Our study provides the first empirical law connecting two societal forces: urban agglomeration and automation's impact on employment. © 2018 The Authors.

  4. Small cities face greater impact from automation

    Science.gov (United States)

    Sun, Lijun; Cebrian, Manuel; Rahwan, Iyad

    2018-01-01

    The city has proved to be the most successful form of human agglomeration and provides wide employment opportunities for its dwellers. As advances in robotics and artificial intelligence revive concerns about the impact of automation on jobs, a question looms: how will automation affect employment in cities? Here, we provide a comparative picture of the impact of automation across US urban areas. Small cities will undertake greater adjustments, such as worker displacement and job content substitutions. We demonstrate that large cities exhibit increased occupational and skill specialization due to increased abundance of managerial and technical professions. These occupations are not easily automatable, and, thus, reduce the potential impact of automation in large cities. Our results pass several robustness checks including potential errors in the estimation of occupational automation and subsampling of occupations. Our study provides the first empirical law connecting two societal forces: urban agglomeration and automation's impact on employment. PMID:29436514

  5. Planning for greater-confinement disposal

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

    1984-01-01

    This contribution is a progress report for preparation of a document that will summarize procedures and technical information needed to plan for and implement greater-confinement disposal (GCD) of low-level radioactive waste. Selection of a site and a facility design (Phase I), and construction, operation, and extended care (Phase II) will be covered in the document. This progress report is limited to Phase I. Phase I includes determination of the need for GCD, design alternatives, and selection of a site and facility design. Alternative designs considered are augered shafts, deep trenches, engineered structures, high-integrity containers, hydrofracture, and improved waste form. Design considerations and specifications, performance elements, cost elements, and comparative advantages and disadvantages of the different designs are covered. Procedures are discussed for establishing overall performance objectives and waste-acceptance criteria, and for comparative assessment of the performance and cost of the different alternatives. 16 references

  6. Greater confinement disposal of radioactive wastes

    International Nuclear Information System (INIS)

    Trevorrow, L.E.; Gilbert, T.L.; Luner, C.; Merry-Libby, P.A.; Meshkov, N.K.; Yu, C.

    1985-01-01

    Low-level radioactive waste (LLW) includes a broad spectrum of different radionuclide concentrations, half-lives, and hazards. Standard shallow-land burial practice can provide adequate protection of public health and safety for most LLW. A small volume fraction (approx. 1%) containing most of the activity inventory (approx. 90%) requires specific measures known as greater-confinement disposal (GCD). Different site characteristics and different waste characteristics - such as high radionuclide concentrations, long radionuclide half-lives, high radionuclide mobility, and physical or chemical characteristics that present exceptional hazards - lead to different GCD facility design requirements. Facility design alternatives considered for GCD include the augered shaft, deep trench, engineered structure, hydrofracture, improved waste form, and high-integrity container. Selection of an appropriate design must also consider the interplay between basic risk limits for protection of public health and safety, performance characteristics and objectives, costs, waste-acceptance criteria, waste characteristics, and site characteristics

  7. Planning for greater-confinement disposal

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

    1984-01-01

    This contribution is a progress report for preparation of a document that will summarize procedures and technical information needed to plan for and implement greater-confinement disposal (GCD) of low-level radioactive waste. Selection of a site and a facility design (Phase I), and construction, operation, and extended care (Phase II) will be covered in the document. This progress report is limited to Phase I. Phase I includes determination of the need for GCD, design alternatives, and selection of a site and facility design. Alternative designs considered are augered shafts, deep trenches, engineered structures, high-integrity containers, hydrofracture, and improved waste form. Design considerations and specifications, performance elements, cost elements, and comparative advantages and disadvantages of the different designs are covered. Procedures are discussed for establishing overall performance objecties and waste-acceptance criteria, and for comparative assessment of the performance and cost of the different alternatives. 16 refs

  8. The Greenlandic Life Script and Life Stories

    DEFF Research Database (Denmark)

    Zaragoza Scherman, Alejandra; Berntsen, Dorthe

    Adults older than 40 years remember a significantly greater amount of personal life events from their 15 - 30 years of age. This phenomenon is known as the reminiscence bump (Rubin, Rahal, & Poon, 1998). The reminiscence bump is highly populated by emotionally positive events (Rubin & Berntsen......, 2003), when cued by requests for important events. This dominance of positive events is not seen when cued by random words. Berntsen and Rubin (2004) presented a cultural explanation for the bump: cultural life script theory. Their theory claims that the bump for the life story can be explained...... by the life script; that is, culturally shared expectations about the order and timing of life events in an typical, idealized life course. According to the cultural life script theory, the life script is used as a guideline for the recall of autobiographical memories, which help construct personal life...

  9. Urban acid deposition in Greater Manchester

    Energy Technology Data Exchange (ETDEWEB)

    Lee, D.S.; Longhurst, J.W.S.; Gee, D.R.; Hare, S.E. (Manchester Polytechnic, Manchester (UK). Acid Rain Information Centre)

    1989-08-01

    Data are presented from a monitoring network of 18 bulk precipitation collectors and one wet-only collector in the urban area of Greater Manchester, in the north west of England. Weekly samples were analysed for all the major ions in precipitation along with gaseous nitrogen dioxide concentrations from diffusion tubes. Statistical analysis of the data shows significant spatial variation of non marine sulphate, nitrate, ammonium, acidity and calcium concentrations, and nitrogen dioxide concentrations. Calcium is thought to be responsible for the buffering of acidity and is of local origin. Wet deposition is the likely removal process for calcium in the atmosphere and probably by below cloud scavenging. Nitrate and ammonium concentrations and depositions show close spatial, temporal and statistical association. Examination of high simultaneous episodes of nitrate and ammonium deposition shows that these depositions cannot be explained in terms of trajectories and it is suggested that UK emissions of ammonia may be important. Statistical analysis of the relationships between nitrate and ammonium depositions, concentrations and precipitation amount suggest that ammonia from mesoscale sources reacts reversibly with nitric acid aerosol and is removed by below cloud scavenging. High episodes of the deposition of non marine sulphate are difficult to explain by trajectory analysis alone, perhaps suggesting local sources. In a comparison between wet deposition and bulk deposition, it was shown that only 15.2% of the non marine sulphur was dry deposited to the bulk precipitation collector. 63 refs., 86 figs., 31 tabs.

  10. Life Stories and Trauma

    DEFF Research Database (Denmark)

    Kongshøj, Inge Lise Lundsgaard; Bohn, Annette; Berntsen, Dorthe

    Research has shown a connection between Posttraumatic Stress Disorder (PTSD) and integration of traumatic experiences into the life story. Furthermore, empirical evidence suggests that life story formation begins in mid to late adolescence. Following these findings, the present study investigated...... whether experiencing trauma in youth was associated with a greater risk to integrate the trauma into the life story compared to adult traumatic exposure. Life stories were collected from 115 participants recruited via Amazon Mechanical Turk. Moreover, participants filled out questionnaires regarding...... often integrate the trauma into their life story? Results will be discussed in relation to theories of development of life stories and of PTSD....

  11. Indicators for human toxicity in Life Cycle Impact Assessment

    DEFF Research Database (Denmark)

    Krewitt, Wolfram; Pennington, David W.; Olsen, Stig Irving

    2002-01-01

    The main objectives of this task group under SETAC-Europe’s Second Working Group on Life Cycle Impact Assessment (LCIA-WIA2) were to identify and discuss the suitability of toxicological impact measures for human health for use in characterization in LCIA. The current state of the art of defining......, as well as potency. Quantitative severity-based indicators yield measures in terms of Years of Life Lost (YOLL), Disability Adjusted Life Years (DALY), Quality Adjusted Life Years (QALY) and other similar measures. DALYs and QALYs are examples of approaches that attempt to account for both years of life...... such as No Observed Effect Levels (NOEL). NOELs, and similar data, are determined in laboratory studies using rodents and are then extrapolated to more relevant human measures. Many examples also exist of measures and methods beyond potency-based indicators that attempt to account for differences in expected severity...

  12. Quality of life technologies

    DEFF Research Database (Denmark)

    Wac, Katarzyna; Fiordelli, M.; Gustarini, M.

    2015-01-01

    Inevitably, as basic human needs are assured in any developed society, differentiating factors for quality of life (QoL) relate to a greater capacity to make informed decisions across daily life activities, especially those related to health. The availability of powerful, personalized, and wearable...

  13. Forecasting the Effects of Obesity and Smoking on U.S. Life Expectancy

    Science.gov (United States)

    Stewart, Susan T.; Cutler, David M.; Rosen, Allison B.

    2015-01-01

    Background Although increases in obesity over the past 30 years have adversely affected the health of the U.S. population, there have been concomitant improvements in health because of reductions in smoking. Having a better understanding of the joint effects of these trends on longevity and quality of life will facilitate more efficient targeting of health care resources. Methods For each year from 2005 through 2020, we forecasted life expectancy and quality-adjusted life expectancy for a representative 18-year-old, assuming a continuation of past trends in smoking (based on data from the National Health Interview Survey for 1978 through 1979, 1990 through 1991, 1999 through 2001, and 2004 through 2006) and past trends in body-mass index (BMI) (based on data from the National Health and Nutrition Examination Survey for 1971 through 1975, 1988 through 1994, 1999 through 2002, and 2003 through 2006). The 2003 Medical Expenditure Panel Survey was used to examine the effects of smoking and BMI on health-related quality of life. Results The negative effects of increasing BMI overwhelmed the positive effects of declines in smoking in multiple scenarios. In the base case, increases in the remaining life expectancy of a typical 18-year-old are held back by 0.71 years or 0.91 quality-adjusted years between 2005 and 2020. If all U.S. adults became nonsmokers of normal weight by 2020, we forecast that the life expectancy of an 18-year-old would increase by 3.76 life-years or 5.16 quality-adjusted years. Conclusions If past obesity trends continue unchecked, the negative effects on the health of the U.S. population will increasingly outweigh the positive effects gained from declining smoking rates. Failure to address continued increases in obesity could result in an erosion of the pattern of steady gains in health observed since early in the 20th century. PMID:19955525

  14. Blood transfusion sampling and a greater role for error recovery.

    Science.gov (United States)

    Oldham, Jane

    Patient identification errors in pre-transfusion blood sampling ('wrong blood in tube') are a persistent area of risk. These errors can potentially result in life-threatening complications. Current measures to address root causes of incidents and near misses have not resolved this problem and there is a need to look afresh at this issue. PROJECT PURPOSE: This narrative review of the literature is part of a wider system-improvement project designed to explore and seek a better understanding of the factors that contribute to transfusion sampling error as a prerequisite to examining current and potential approaches to error reduction. A broad search of the literature was undertaken to identify themes relating to this phenomenon. KEY DISCOVERIES: Two key themes emerged from the literature. Firstly, despite multi-faceted causes of error, the consistent element is the ever-present potential for human error. Secondly, current focus on error prevention could potentially be augmented with greater attention to error recovery. Exploring ways in which clinical staff taking samples might learn how to better identify their own errors is proposed to add to current safety initiatives.

  15. Interculturalism and Physical Cultural Diversity in the Greater Toronto Area

    Directory of Open Access Journals (Sweden)

    Yuka Nakamura

    2017-06-01

    Full Text Available The Greater Toronto Area (GTA is one of the most multicultural communities in the world. Frequently, this description is based on ethnic, linguistic, and culinary diversity. Physical cultural diversity, such as different sports, martial arts, forms of dance, exercise systems, and other physical games and activities, remains ignored and understudied. Based on a living database of the GTA’s physical cultural diversity, this study identifies the trajectories of the lifecycle of activities that have been introduced into the GTA’s physical culture by immigrants. These pathways differ based on whether the activity is offered in a separate setting, where individuals may be participating with other immigrants of the same ethnocultural group, or mixed settings, where people are participating with people from outside of their ethnocultural group. We argue that the diversity and the lifecycle trajectories of physical cultural forms in the GTA serve as evidence of interculturalism and the contribution by immigrants to the social and cultural life of Canada.

  16. The Impact of Pandemic Influenza H1N1 on Health-Related Quality of Life: A Prospective Population-Based Study

    Science.gov (United States)

    van Hoek, Albert Jan; Underwood, Anthony; Jit, Mark; Miller, Elizabeth; Edmunds, W. John

    2011-01-01

    Background While the H1N1v influenza pandemic in 2009 was clinically mild, with a low case-fatality rate, the overall disease burden measured in quality-adjusted life years (QALY) lost has not been estimated. Such a measure would allow comparison with other diseases and assessment of the cost-effectiveness of pandemic control measures. Methods and Findings Cases of H1N1v confirmed by polymerase chain reaction (PCR) and PCR negative cases with similar influenza-like illness (ILI controls) in 7 regions of England were sent two questionnaires, one within a week of symptom onset and one two weeks later, requesting information on duration of illness, work loss and antiviral use together with EQ-5D questionnaires. Results were compared with those for seasonal influenza from a systematic literature review. A total QALY loss for the 2009 pandemic in England was calculated based on the estimated total clinical cases and reported deaths. A total of 655 questionnaires were sent and 296 (45%) returned. Symptoms and average illness duration were similar between confirmed cases and ILI controls (8.8 days and 8.7 days respectively). Days off work were greater for cases than ILI controls (7.3 and 4.9 days respectively, p = 0.003). The quality-adjusted life days lost was 2.92 for confirmed cases and 2.74 for ILI controls, with a reduction in QALY loss after prompt use of antivirals in confirmed cases. The overall QALY loss in the pandemic was estimated at 28,126 QALYs (22,267 discounted) of which 40% was due to deaths (24% with discounting). Conclusion Given the global public health significance of influenza, it is remarkable that no previous prospective study of the QALY loss of influenza using standardised and well validated methods has been performed. Although the QALY loss was minor for individual patients, the estimated total burden of influenza over the pandemic was substantial when compared to other infectious diseases. PMID:21399678

  17. End-of-Life Care Interventions: An Economic Analysis.

    Science.gov (United States)

    Pham, B; Krahn, M

    2014-01-01

    The annual cost of providing care for patients in their last year of life is estimated to account for approximately 9% of the Ontario health care budget. Access to integrated, comprehensive support and pain/symptom management appears to be inadequate and inequitable. To evaluate the cost-effectiveness of end-of-life (EoL) care interventions included in the EoL care mega-analysis. Multiple sources were used, including systematic reviews, linked health administration databases, survey data, planning documents, expert input, and additional literature searches. We conducted a literature review of cost-effectiveness studies to inform the primary economic analysis. We conducted the primary economic analysis and budget impact analysis for an Ontario cohort of decedents and their families and included interventions pertaining to team-based models of care, patient care planning discussions, educational interventions for patients and caregivers, and supportive interventions for informal caregivers. The time horizon was the last year of life. Costs were in 2013 Canadian dollars. Effectiveness measures included days at home, percentage dying at home, and quality-adjusted life-days. We developed a Markov model; model inputs were obtained from a cohort of Ontario decedents assembled from Institute for Clinical Evaluative Sciences databases and published literature. In-home palliative team care was cost-effective; it increased the chance of dying at home by 10%, increased the average number of days at home (6 days) and quality-adjusted life-days (0.5 days), and it reduced costs by approximately $4,400 per patient. Expanding in-home palliative team care to those currently not receiving such services (approximately 45,000 per year, at an annual cost of $76-108 million) is likely to improve quality of life, reduce the use of acute care resources, and save $191-$385 million in health care costs. Results for the other interventions were uncertain. The cost-effectiveness analysis was

  18. Tobacco retail outlet restrictions: health and cost impacts from multistate life-table modelling in a national population.

    Science.gov (United States)

    Pearson, Amber L; Cleghorn, Christine L; van der Deen, Frederieke S; Cobiac, Linda J; Kvizhinadze, Giorgi; Nghiem, Nhung; Blakely, Tony; Wilson, Nick

    2016-09-22

    Since there is some evidence that the density and distribution of tobacco retail outlets may influence smoking behaviours, we aimed to estimate the impacts of 4 tobacco outlet reduction interventions in a country with a smoke-free goal: New Zealand (NZ). A multistate life-table model of 16 tobacco-related diseases, using national data by sex, age and ethnicity, was used to estimate quality-adjusted life years (QALYs) gained and net costs over the remainder of the 2011 NZ population's lifetime. The outlet reduction interventions assumed that increased travel costs can be operationalised as equivalent to price increases in tobacco. All 4 modelled interventions led to reductions of >89% of current tobacco outlets after the 10-year phase-in process. The most effective intervention limited sales to half of liquor stores (and nowhere else) at 129 000 QALYs gained over the lifetime of the population (95% UI: 74 100 to 212 000, undiscounted). The per capita QALY gains were up to 5 times greater for Māori (indigenous population) compared to non-Māori. All interventions were cost-saving to the health system, with the largest saving for the liquor store only intervention: US$1.23 billion (95% UI: $0.70 to $2.00 billion, undiscounted). These tobacco outlet reductions reduced smoking prevalence, achieved health gains and saved health system costs. Effects would be larger if outlet reductions have additional spill-over effects (eg, smoking denormalisation). While these interventions were not as effective as tobacco tax increases (using the same model), these and other strategies could be combined to maximise health gain and to maximise cost-savings to the health system. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Influenza-like-illness and clinically diagnosed flu: disease burden, costs and quality of life for patients seeking ambulatory care or no professional care at all.

    Science.gov (United States)

    Bilcke, Joke; Coenen, Samuel; Beutels, Philippe

    2014-01-01

    This is one of the first studies to (1) describe the out-of-hospital burden of influenza-like-illness (ILI) and clinically diagnosed flu, also for patients not seeking professional medical care, (2) assess influential background characteristics, and (3) formally compare the burden of ILI in patients with and without a clinical diagnosis of flu. A general population sample with recent ILI experience was recruited during the 2011-2012 influenza season in Belgium. Half of the 2250 respondents sought professional medical care, reported more symptoms (especially more often fever), a longer duration of illness, more use of medication (especially antibiotics) and a higher direct medical cost than patients not seeking medical care. The disease and economic burden were similar for ambulatory ILI patients, irrespective of whether they received a clinical diagnosis of flu. On average, they experienced 5-6 symptoms over a 6-day period; required 1.6 physician visits and 86-91% took medication. An average episode amounted to €51-€53 in direct medical costs, 4 days of absence from work or school and the loss of 0.005 quality-adjusted life-years. Underlying illness led to greater costs and lower quality-of-life. The costs of ILI patients with clinically diagnosed flu tended to increase, while those of ILI patients without clinically diagnosed flu tended to decrease with age. Recently vaccinated persons experienced lower costs and a higher quality-of-life, but this was only the case for patients not seeking professional medical care. This information can be used directly to evaluate the implementation of cost-effective prevention and control measures for influenza. In particular to inform the evaluation of more widespread seasonal influenza vaccination, including in children, which is currently considered by many countries.

  20. Influenza-like-illness and clinically diagnosed flu: disease burden, costs and quality of life for patients seeking ambulatory care or no professional care at all.

    Directory of Open Access Journals (Sweden)

    Joke Bilcke

    Full Text Available This is one of the first studies to (1 describe the out-of-hospital burden of influenza-like-illness (ILI and clinically diagnosed flu, also for patients not seeking professional medical care, (2 assess influential background characteristics, and (3 formally compare the burden of ILI in patients with and without a clinical diagnosis of flu. A general population sample with recent ILI experience was recruited during the 2011-2012 influenza season in Belgium. Half of the 2250 respondents sought professional medical care, reported more symptoms (especially more often fever, a longer duration of illness, more use of medication (especially antibiotics and a higher direct medical cost than patients not seeking medical care. The disease and economic burden were similar for ambulatory ILI patients, irrespective of whether they received a clinical diagnosis of flu. On average, they experienced 5-6 symptoms over a 6-day period; required 1.6 physician visits and 86-91% took medication. An average episode amounted to €51-€53 in direct medical costs, 4 days of absence from work or school and the loss of 0.005 quality-adjusted life-years. Underlying illness led to greater costs and lower quality-of-life. The costs of ILI patients with clinically diagnosed flu tended to increase, while those of ILI patients without clinically diagnosed flu tended to decrease with age. Recently vaccinated persons experienced lower costs and a higher quality-of-life, but this was only the case for patients not seeking professional medical care. This information can be used directly to evaluate the implementation of cost-effective prevention and control measures for influenza. In particular to inform the evaluation of more widespread seasonal influenza vaccination, including in children, which is currently considered by many countries.

  1. Technical concept for a greater-confinement-disposal test facility

    International Nuclear Information System (INIS)

    Hunter, P.H.

    1982-01-01

    Greater confinement disposal (GCO) has been defined by the National Low-Level Waste Program as the disposal of low-level waste in such a manner as to provide greater containment of radiation, reduce potential for migration or dispersion or radionuclides, and provide greater protection from inadvertent human and biological intrusions in order to protect the public health and safety. This paper discusses: the need for GCD; definition of GCD; advantages and disadvantages of GCD; relative dose impacts of GCD versus shallow land disposal; types of waste compatible with GCD; objectives of GCD borehole demonstration test; engineering and technical issues; and factors affecting performance of the greater confinement disposal facility

  2. Life expectancy and education

    DEFF Research Database (Denmark)

    Hansen, Casper Worm; Strulik, Holger

    2017-01-01

    , we find that US states with higher mortality rates from cardiovascular disease prior to the 1970s experienced greater increases in adult life expectancy and higher education enrollment. Our estimates suggest that a one-standard deviation higher treatment intensity is associated with an increase...... in adult life expectancy of 0.37 years and 0.07–0.15 more years of higher education....

  3. Assessing Human Impacts on the Greater Akaki River, Ethiopia ...

    African Journals Online (AJOL)

    We assessed the impacts of human activities on the Greater Akaki River using physicochemical parameters and macroinvertebrate metrics. Physicochemical samples and macroinvertebrates were collected bimonthly from eight sites established on the Greater Akaki River from February 2006 to April 2006. Eleven metrics ...

  4. Comparative Education in Greater China: Contexts, Characteristics, Contrasts and Contributions.

    Science.gov (United States)

    Bray, Mark; Qin, Gui

    2001-01-01

    The evolution of comparative education in Greater China (mainland China, Taiwan, Hong Kong, and Macau) has been influenced by size, culture, political ideologies, standard of living, and colonialism. Similarities and differences in conceptions of comparative education are identified among the four components and between Greater China and other…

  5. Greater temperature sensitivity of plant phenology at colder sites

    DEFF Research Database (Denmark)

    Prevey, Janet; Vellend, Mark; Ruger, Nadja

    2017-01-01

    Warmer temperatures are accelerating the phenology of organisms around the world. Temperature sensitivity of phenology might be greater in colder, higher latitude sites than in warmer regions, in part because small changes in temperature constitute greater relative changes in thermal balance...

  6. Breeding of Greater and Lesser Flamingos at Sua Pan, Botswana ...

    African Journals Online (AJOL)

    to fledging was unknown owing to the rapid drying of the pan in late March 1999. No Greater Flamingo breeding was seen that season. Exceptional flooding during 1999–2000 produced highly favourable breeding conditions, with numbers of Greater and Lesser Flamingos breeding estimated to be 23 869 and 64 287 pairs, ...

  7. Surgical anatomy of greater occipital nerve and its relation to ...

    African Journals Online (AJOL)

    Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to study the anatomy of ...

  8. Surgical anatomy of greater occipital nerve and its relation to ...

    African Journals Online (AJOL)

    Nancy Mohamed El Sekily

    2014-08-19

    Aug 19, 2014 ... Abstract Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to ...

  9. INDUSTRIAL LAND DEVELOPMENT AND MANUFACTURING DECONCENTRATION IN GREATER JAKARTA

    NARCIS (Netherlands)

    Hudalah, Delik; Viantari, Dimitra; Firman, Tommy; Woltjer, Johan

    2013-01-01

    Industrial land development has become a key feature of urbanization in Greater Jakarta, one of the largest metropolitan areas in Southeast Asia. Following Suharto's market-oriented policy measures in the late 1980s, private developers have dominated the land development projects in Greater Jakarta.

  10. Strategies for Talent Management: Greater Philadelphia Companies in Action

    Science.gov (United States)

    Council for Adult and Experiential Learning (NJ1), 2008

    2008-01-01

    Human capital is one of the critical issues that impacts the Greater Philadelphia region's ability to grow and prosper. The CEO Council for Growth (CEO Council) is committed to ensuring a steady and talented supply of quality workers for this region. "Strategies for Talent Management: Greater Philadelphia Companies in Action" provides…

  11. Quality-Adjusted Cost Functions for Child-Care Centers.

    OpenAIRE

    Mocan, H Naci

    1995-01-01

    Using a newly compiled data set, this paper estimates multi- product translog cost functions for 399 child care centers from California, Colorado, Connecticut, and North Carolina. Quality of child care is controlled by a quality index, which has been shown to be positively related to child outcomes by previous research. Nonprofit centers that receive public money, either from the state or federal government, (which is tied to higher standards), have total variable costs that are 18 percent hi...

  12. Work Overload and Turnover Intention of Junior Auditors in Greater Jakarta, Indonesia

    OpenAIRE

    Andika Pradana; Imam Salehudin

    2015-01-01

    This paper aims to analyze how work overload influences turnover intentions of newly hired junior auditors in public accounting offices. Job satisfaction, work related stress and work life conflicts are used as mediating variables between work overload and turnover intention. This study employed 141 auditors from several accounting firms operating in the Greater Jakarta region. The sample was selected using purposive sampling. Three mediation hypotheses were tested using Structural Equation M...

  13. Fractures of the greater trochanter following total hip replacement.

    Science.gov (United States)

    Brun, Ole-Christian L; Maansson, Lukas

    2013-01-01

    We studied the incidence of greater trochanteric fractures at our department following THR. In all we examined 911 patients retrospectively and found the occurance of a greater trochanteric fracture to be 3%. Patients with fractures had significantly poorer outcome on Oxford Hip score, Pain VAS, Satisfaction VAS and EQ-5D compared to THR without fractures. Greater trochanteric fracture following THR is one of the most common complications following THR. It has previously been thought to have little impact on the overall outcome following THR, but our study suggests otherwise.

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

    Science.gov (United States)

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

    2013-10-29

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

  15. Prey selection by a reintroduced lion population in the Greater ...

    African Journals Online (AJOL)

    Prey selection by a reintroduced lion population in the Greater Makalali Conservancy, South Africa. Dave Druce, Heleen Genis, Jonathan Braak, Sophie Greatwood, Audrey Delsink, Ross Kettles, Luke Hunter, Rob Slotow ...

  16. LiveDiverse: Case study area, Greater Kruger South Africa

    CSIR Research Space (South Africa)

    Nortje, Karen

    2011-01-01

    Full Text Available Livelihoods and Biodiversity in Developing Countries Case study area: Greater Kruger, South Africa January 2011 Kolhapur, India Where are we? HARDSHIP LIVELIHOODS NATURE & BIODIVERSITY BELIEFS & CULTURAL PRACTISE threesansinv foursansinv onesansinv...

  17. Exploration of the Energy Efficiency of the Greater London Authority ...

    African Journals Online (AJOL)

    GLA Building/City Hall) ... Journal Home > Vol 11, No 2 (2007) > ... The Greater London Authority building was acclaimed as being energy efficient, with claims of 75 % reduction in its annual energy consumption compared to a high specification ...

  18. Molecular insights into the biology of Greater Sage-Grouse

    Science.gov (United States)

    Oyler-McCance, Sara J.; Quinn, Thomas W.

    2011-01-01

    Recent research on Greater Sage-Grouse (Centrocercus urophasianus) genetics has revealed some important findings. First, multiple paternity in broods is more prevalent than previously thought, and leks do not comprise kin groups. Second, the Greater Sage-Grouse is genetically distinct from the congeneric Gunnison sage-grouse (C. minimus). Third, the Lyon-Mono population in the Mono Basin, spanning the border between Nevada and California, has unique genetic characteristics. Fourth, the previous delineation of western (C. u. phaios) and eastern Greater Sage-Grouse (C. u. urophasianus) is not supported genetically. Fifth, two isolated populations in Washington show indications that genetic diversity has been lost due to population declines and isolation. This chapter examines the use of molecular genetics to understand the biology of Greater Sage-Grouse for the conservation and management of this species and put it into the context of avian ecology based on selected molecular studies.

  19. Greater saphenous vein anomaly and aneurysm with subsequent pulmonary embolism

    OpenAIRE

    Ma, Truong; Kornbau, Craig

    2017-01-01

    Abstract Venous aneurysms often present as painful masses. They can present either in the deep or superficial venous system. Deep venous system aneurysms have a greater risk of thromboembolism. Though rare, there have been case reports of superficial aneurysms and thrombus causing significant morbidity such as pulmonary embolism. We present a case of an anomalous greater saphenous vein connection with an aneurysm and thrombus resulting in a pulmonary embolism. This is the only reported case o...

  20. GREATER OMENTUM: MORPHOFUNCTIONAL CHARACTERISTICS AND CLINICAL SIGNIFICANCE IN PEDIATRICS

    Directory of Open Access Journals (Sweden)

    A.V. Nekrutov

    2007-01-01

    Full Text Available The review analyzes the structure organization and pathophysiological age specificities of the greater omentum, which determine its uniqueness and functional diversity in a child's organism. the article discusses protective functions of the organ, its role in the development of post operative complications of children, and the usage in children's reconstructive plastic surgery.Key words: greater omentum, omentitis, of post operative complications, children.

  1. Greater Occipital Nerve Treatment in the Management of Spontaneous Intracranial Hypotension Headache: A Case Report.

    Science.gov (United States)

    Niraj, G; Critchley, Peter; Kodivalasa, Mahesh; Dorgham, Mohammed

    2017-06-01

    Clinical presentation of spontaneous intracranial hypotension headache (SIHH) has similarities with postdural puncture headache (PDPH). Recommended treatment for both conditions is an epidural blood patch. Successful outcomes following greater occipital nerve blocks have been reported in the management of PDPH. We present the first report of greater occipital nerve treatment in SIHH. A 40-year-old male presented with a 2-year history of daily postural headaches having a significant impact on quality of life. Magnetic resonance imaging revealed bilateral convexity subdural collections. Post gadolinium scan revealed pachymeningeal enhancement with reduced pontomesencephalic angle below 50 degrees. The patient was offered an epidural blood patch and greater occipital nerve block with corticosteroids. The patient chose occipital nerve block. The patient reported significant short-term benefit lasting 4 months. Thereafter, the patient underwent pulsed radiofrequency treatment to bilateral greater occipital nerves. He reported significant benefit lasting 10 months. Greater occipital nerve treatment may have a role in management of SIHH. © 2017 American Headache Society.

  2. New summer areas and mixing of two greater sandhill crane populations in the Intermountain West

    Science.gov (United States)

    Collins, Daniel P.; Grisham, Blake A.; Conring, Courtenay M.; Knetter, Jeffrey M.; Conway, Warren C.; Carleton, Scott A.; Boggie, Matthew A.

    2016-01-01

    Population delineation throughout the annual life cycle for migratory birds is needed to formulate regional and national management and conservation strategies. Despite being well studied continentally, connectivity of sandhill crane Grus canadensis populations throughout the western portion of their North American range remains poorly described. Our objectives were to 1) use global positioning system satellite transmitter terminals to identify summer distributions for the Lower Colorado River Valley Population of greater sandhill cranes Grus canadensis tabida and 2) determine whether intermingling occurs among any of the western greater sandhill crane populations: Rocky Mountain Population, Lower Colorado River Valley Population, and Central Valley Population. Capture and marking occurred during winter and summer on private lands in California and Idaho as well as on two National Wildlife Refuges: Cibola and Sonny Bono Salton Sea National Wildlife Refuges. A majority of marked greater sandhill cranes summered in what is established Lower Colorado River Valley Population breeding areas in northeastern Nevada and southwestern Idaho. A handful of greater sandhill cranes summered outside of traditional breeding areas in west-central Idaho around Cascade Reservoir near Donnelly and Cascade, Idaho. For example, a greater sandhill crane colt captured near Donnelly in July 2014 survived to winter migration and moved south to areas associated with the Rocky Mountain Population. The integration of the greater sandhill crane colt captured near Donnelly provides the first evidence of potential intermingling between the Lower Colorado River Population and Rocky Mountain Population. We suggest continued marking and banding efforts of all three western populations of greater sandhill cranes will accurately delineate population boundaries and connectivity and inform management decisions for the three populations.

  3. Improving greater trochanteric reattachment with a novel cable plate system.

    Science.gov (United States)

    Baril, Yannick; Bourgeois, Yan; Brailovski, Vladimir; Duke, Kajsa; Laflamme, G Yves; Petit, Yvan

    2013-03-01

    Cable-grip systems are commonly used for greater trochanteric reattachment because they have provided the best fixation performance to date, even though they have a rather high complication rate. A novel reattachment system is proposed with the aim of improving fixation stability. It consists of a Y-shaped fixation plate combined with locking screws and superelastic cables to reduce cable loosening and limit greater trochanter movement. The novel system is compared with a commercially available reattachment system in terms of greater trochanter movement and cable tensions under different greater trochanteric abductor application angles. A factorial design of experiments was used including four independent variables: plate system, cable type, abductor application angle, and femur model. The test procedure included 50 cycles of simultaneous application of an abductor force on the greater trochanter and a hip force on the femoral head. The novel plate reduces the movements of a greater trochanter fragment within a single loading cycle up to 26%. Permanent degradation of the fixation (accumulated movement based on 50-cycle testing) is reduced up to 46%. The use of superelastic cables reduces tension loosening up to 24%. However this last improvement did not result in a significant reduction of the grater trochanter movement. The novel plate and cables present advantages over the commercially available greater trochanter reattachment system. The plate reduces movements generated by the hip abductor. The superelastic cables reduce cable loosening during cycling. Both of these positive effects could decrease the risks related to grater trochanter non-union. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

  4. Endovascular Thrombectomy for Ischemic Stroke Increases Disability-Free Survival, Quality of Life, and Life Expectancy and Reduces Cost

    Directory of Open Access Journals (Sweden)

    Bruce C. V. Campbell

    2017-12-01

    Full Text Available BackgroundEndovascular thrombectomy improves functional outcome in large vessel occlusion ischemic stroke. We examined disability, quality of life, survival and acute care costs in the EXTEND-IA trial, which used CT-perfusion imaging selection.MethodsLarge vessel ischemic stroke patients with favorable CT-perfusion were randomized to endovascular thrombectomy after alteplase versus alteplase-only. Clinical outcome was prospectively measured using 90-day modified Rankin scale (mRS. Individual patient expected survival and net difference in Disability/Quality-adjusted life years (DALY/QALY up to 15 years from stroke were modeled using age, sex, 90-day mRS, and utility scores. Level of care within the first 90 days was prospectively measured and used to estimate procedure and inpatient care costs (US$ reference year 2014.ResultsThere were 70 patients, 35 in each arm, mean age 69, median NIHSS 15 (IQR 12–19. The median (IQR disability-weighted utility score at 90 days was 0.65 (0.00–0.91 in the alteplase-only versus 0.91 (0.65–1.00 in the endovascular group (p = 0.005. Modeled life expectancy was greater in the endovascular versus alteplase-only group (median 15.6 versus 11.2 years, p = 0.02. The endovascular thrombectomy group had fewer simulated DALYs lost over 15 years [median (IQR 5.5 (3.2–8.7 versus 8.9 (4.7–13.8, p = 0.02] and more QALY gained [median (IQR 9.3 (4.2–13.1 versus 4.9 (0.3–8.5, p = 0.03]. Endovascular patients spent less time in hospital [median (IQR 5 (3–11 days versus 8 (5–14 days, p = 0.04] and rehabilitation [median (IQR 0 (0–28 versus 27 (0–65 days, p = 0.03]. The estimated inpatient costs in the first 90 days were less in the thrombectomy group (average US$15,689 versus US$30,569, p = 0.008 offsetting the costs of interhospital transport and the thrombectomy procedure (average US$10,515. The average saving per patient treated with thrombectomy was US$4

  5. Technical concept for a Greater Confinement Disposal test facility

    International Nuclear Information System (INIS)

    Hunter, P.H.

    1982-01-01

    For the past two years, Ford, Bacon and Davis has been performing technical services for the Department of Energy at the Nevada Test Site in specific development of defense low-level waste management concepts for greater confinement disposal concept with particular application to arid sites. The investigations have included the development of Criteria for Greater Confinement Disposal, NVO-234, which was published in May of 1981 and the draft of the technical concept for Greater Confinement Disposal, with the latest draft published in November 1981. The final draft of the technical concept and design specifications are expected to be published imminently. The document is prerequisite to the actual construction and implementation of the demonstration facility this fiscal year. The GCD Criteria Document, NVO-234 is considered to contain information complimentary and compatible with that being developed for the reserved section 10 CFR 61.51b of the NRCs proposed licensing rule for low level waste disposal facilities

  6. Expatriate job performance in Greater China: Does age matter?

    DEFF Research Database (Denmark)

    Selmer, Jan; Lauring, Jakob; Feng, Yunxia

    to expatriates in Chinese societies. It is possible that older business expatriates will receive more respect and be treated with more deference in a Chinese cultural context than their apparently younger colleagues. This may have a positive impact on expatriates’ job performance. To empirically test...... this presumption, business expatriates in Greater Chine were targeted by a survey. Controlling for the potential bias of a number of background variables, results indicate that contextual/managerial performance, including general managerial functions applied to the subsidiary in Greater China, had a positive...

  7. Absenteeism movement in Greater Poland in 1840–1902

    OpenAIRE

    Izabela Krasińska

    2013-01-01

    The article presents the origins and development of the idea of absenteeism in Greater Poland in the 19th century. The start date for the research is 1840, which is considered to be a breakthrough year in the history of an organized absenteeism movement in Greater Poland. It was due to the Association for the Suppression of the Use of Vodka (Towarzystwo ku Przytłumieniu Używania Wódki) in the Great Duchy of Posen that was then established in Kórnik. It was a secular organization that came int...

  8. Adjustment of Business Expatriates in Greater China: A Strategic Perspective

    DEFF Research Database (Denmark)

    Selmer, Jan

    2006-01-01

    Research has found that due to similarities, firms which have gained business experience elsewhere in Greater China may exhibit relatively better performance in mainland China. Hence, the experience of business expatriates could be of strategic importance for the expansion path of their firms...

  9. College Students with ADHD at Greater Risk for Sleep Disorders

    Science.gov (United States)

    Gaultney, Jane F.

    2014-01-01

    The pediatric literature indicates that children with ADHD are at greater risk for sleep problems, daytime sleepiness, and some sleep disorders than children with no diagnosed disability. It has not been determined whether this pattern holds true among emerging adults, and whether comorbid sleep disorders with ADHD predict GPA. The present study…

  10. The Easterlin Illusion: Economic growth does go with greater happiness

    NARCIS (Netherlands)

    R. Veenhoven (Ruut); F. Vergunst (Floris)

    2014-01-01

    markdownabstract__Abstract__ The 'Easterlin Paradox' holds that economic growth in nations does not buy greater happiness for the average citizen. This thesis was advanced in the 1970s on the basis of the then available data on happiness in nations. Later data have disproved most of the empirical

  11. Job-Sharing at the Greater Victoria Public Library.

    Science.gov (United States)

    Miller, Don

    1978-01-01

    Describes the problems associated with the management of part-time library employees and some solutions afforded by a job sharing arrangement in use at the Greater Victoria Public Library. This is a voluntary work arrangement, changing formerly full-time positions into multiple part-time positions. (JVP)

  12. Radiographic features of tuberculous osteitis in greater trochanter and lschium

    International Nuclear Information System (INIS)

    Hahm, So Hee; Lee, Ye Ri; Kim, Dong Jin; Sung, Ki Jun; Lim, Jong Nam

    1996-01-01

    To evaluate, if possible, the radiographic features of tuberculous osteitis in the greater trochanter and ischium, and to determine the cause of the lesions. We reterospectively reviewed the plain radiographic findings of 14 ptients with histologically proven tuberculous osteitis involving the greater trochanter and ischium. In each case, the following were analyzed:morphology of bone destruction, including cortical erosion;periosteal reaction;presence or abscence of calcific shadows in adjacent soft tissue. On the basis of an analysis of radiographic features and correlation of the anatomy with adjacent structures we attempted to determine causes. Of the 14 cases evaluated, 12 showed varrious degrees of extrinsic erosion on the outer cortical bone of the greater trochanter and ischium ; in two cases, bone destruction was so severe that the radiographic features of advanced perforated osteomyelitis were simulated. In addition to findings of bone destruction, in these twelve cases, the presence of sequestrum or calcific shadows was seen in adjacent soft tissue. Tuberculous osteitis in the greater trochanter and ischium showed the characteristic findings of chronic extrinsic erosion. On the basis of these findings we can suggest that these lesions result from an extrinsic pathophysiologic cause such as adjacent bursitis

  13. Radiographic features of tuberculous osteitis in greater trochanter and lschium

    Energy Technology Data Exchange (ETDEWEB)

    Hahm, So Hee; Lee, Ye Ri [Hanil Hospital Affiliated to KEPCO, Seoul (Korea, Republic of); Kim, Dong Jin; Sung, Ki Jun [Yonsei Univ. Wonju College of Medicine, Wonju (Korea, Republic of); Lim, Jong Nam [Konkuk Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-11-01

    To evaluate, if possible, the radiographic features of tuberculous osteitis in the greater trochanter and ischium, and to determine the cause of the lesions. We reterospectively reviewed the plain radiographic findings of 14 ptients with histologically proven tuberculous osteitis involving the greater trochanter and ischium. In each case, the following were analyzed:morphology of bone destruction, including cortical erosion;periosteal reaction;presence or abscence of calcific shadows in adjacent soft tissue. On the basis of an analysis of radiographic features and correlation of the anatomy with adjacent structures we attempted to determine causes. Of the 14 cases evaluated, 12 showed varrious degrees of extrinsic erosion on the outer cortical bone of the greater trochanter and ischium ; in two cases, bone destruction was so severe that the radiographic features of advanced perforated osteomyelitis were simulated. In addition to findings of bone destruction, in these twelve cases, the presence of sequestrum or calcific shadows was seen in adjacent soft tissue. Tuberculous osteitis in the greater trochanter and ischium showed the characteristic findings of chronic extrinsic erosion. On the basis of these findings we can suggest that these lesions result from an extrinsic pathophysiologic cause such as adjacent bursitis.

  14. Greater Confinement Disposal trench and borehole operations status

    International Nuclear Information System (INIS)

    Harley, J.P. Jr.; Wilhite, E.L.; Jaegge, W.J.

    1987-01-01

    Greater Confinement Disposal (GCD) facilities have been constructed within the operating burial ground at the Savannah River Plant (SRP) to dispose of the higher activity fraction of SRP low-level waste. GCD practices of waste segregation, packaging, emplacement below the root zone, and waste stabilization are being used in the demonstration. 2 refs., 2 figs., 2 tabs

  15. The Mesozoic-Cenozoic tectonic evolution of the Greater Caucasus

    NARCIS (Netherlands)

    Saintot, A.N.; Brunet, M.F.; Yakovlev, F.; Sébrier, M.; Stephenson, R.A.; Ershov, A.V.; Chalot-Prat, F.; McCann, T.

    2006-01-01

    The Greater Caucasus (GC) fold-and-thrust belt lies on the southern deformed edge of the Scythian Platform (SP) and results from the Cenoozoic structural inversion of a deep marine Mesozoic basin in response to the northward displacement of the Transcaucasus (lying south of the GC subsequent to the

  16. Introduction. China and the Challenges in Greater Middle East

    DEFF Research Database (Denmark)

    Sørensen, Camilla T. N.; Andersen, Lars Erslev; Jiang, Yang

    2016-01-01

    This collection of short papers is an outcome of an international conference entitled China and the Challenges in Greater Middle East, organized by the Danish Institute for International Studies and Copenhagen University on 10 November 2015. The conference sought answers to the following questions...

  17. On the Occurrence of Standardized Regression Coefficients Greater than One.

    Science.gov (United States)

    Deegan, John, Jr.

    1978-01-01

    It is demonstrated here that standardized regression coefficients greater than one can legitimately occur. Furthermore, the relationship between the occurrence of such coefficients and the extent of multicollinearity present among the set of predictor variables in an equation is examined. Comments on the interpretation of these coefficients are…

  18. The Educational Afterlife of Greater Britain, 1903-1914

    Science.gov (United States)

    Gardner, Philip

    2012-01-01

    Following its late nineteenth-century emergence as an important element within federalist thinking across the British Empire, the idea of Greater Britain lost much of its political force in the years following the Boer War. The concept however continued to retain considerable residual currency in other fields of Imperial debate, including those…

  19. Work Overload and Turnover Intention of Junior Auditors in Greater Jakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Andika Pradana

    2015-11-01

    Full Text Available This paper aims to analyze how work overload influences turnover intentions of newly hired junior auditors in public accounting offices. Job satisfaction, work related stress and work life conflicts are used as mediating variables between work overload and turnover intention. This study employed 141 auditors from several accounting firms operating in the Greater Jakarta region. The sample was selected using purposive sampling. Three mediation hypotheses were tested using Structural Equation Modeling (SEM. The results show that work overload has a significant effect on increasing turnover intention through both job satisfaction and work related stress. In comparison, work overload does not influence turnover intention through work life balance. This may be due to the nature of the respondents, in which a majority of the newly hired accountants employed in this study are unmarried.

  20. WORK OVERLOAD AND TURNOVER INTENTION OF JUNIOR AUDITORS IN GREATER JAKARTA, INDONESIA

    Directory of Open Access Journals (Sweden)

    Andika Pradana

    2015-11-01

    Full Text Available This paper aims to analyze how work overload influences turnover intentions of newly hired junior auditors in public accounting offices. Job satisfaction, work related stress and work life conflicts are used as mediating variables between work overload and turnover intention. This study employed 141 auditors from several accounting firms operating in the Greater Jakarta region. The sample was selected using purposive sampling. Three mediation hypotheses were tested using Structural Equation Modeling (SEM. The results show that work overload has a significant effect on increas- ing turnover intention through both job satisfaction and work related stress. In comparison, work overload does not influence turnover intention through work life balance. This may be due to the nature of the respondents, in which a majority of the newly hired accountants employed in this study are unmarried.

  1. Gratitude is associated with greater levels of protective factors and lower levels of risks in African American adolescents.

    Science.gov (United States)

    Ma, Mindy; Kibler, Jeffrey L; Sly, Kaye

    2013-10-01

    The literature suggests gratitude is associated with positive youth development. The current study examined the relationship between gratitude and protective/risk factors among African American youth. Adolescents (N = 389; 50.4% males) ages 12-14 completed measures of gratitude (moral affect and life-orientation), protective factors (e.g., academic and activity engagement, family relationship), and high-risk behaviors (e.g., sexual attitudes and behaviors, drug/alcohol use). Results indicated greater moral affect gratitude was the only variable significantly associated with greater academic interest, better academic performance, and more extra-curricular activity engagement. Greater moral affect and life-orientation gratitude both significantly correlated with positive family relationship. Greater life-orientation gratitude was the only variable significantly associated with abstinence from sexual intimacy, sexual intercourse, likelihood of engaging in sex during primary school, and abstinence from drug/alcohol use. The findings suggest that moral affect gratitude may enhance protective factors while life-orientation gratitude may buffer against high-risk behaviors among African American youth. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  2. Higher motivation - greater control? The effect of arousal on judgement.

    Science.gov (United States)

    Riemer, Hila; Viswanathan, Madhu

    2013-01-01

    This research examines control over the effect of arousal, a dimension of affect, on judgement. Past research shows that high processing motivation enhances control over the effects of affect on judgement. Isolating and studying arousal as opposed to valence, the other dimension of affect, and its effect on judgement, we identify boundary conditions for past findings. Drawing from the literature on processes by which arousal influences judgement, we demonstrate that the role of motivation is contingent upon the type of judgement task (i.e., memory- versus stimulus-based judgement). In stimulus-based judgement, individuals exert greater control over the effect of arousal on judgement under low compared to high motivation. In contrast, in memory-based judgement individuals exert greater control over the effect of arousal under high compared to low motivation. Theoretical implications and avenues for future research are discussed.

  3. Patient expectations predict greater pain relief with joint arthroplasty.

    Science.gov (United States)

    Gandhi, Rajiv; Davey, John Roderick; Mahomed, Nizar

    2009-08-01

    We examined the relationship between patient expectations of total joint arthroplasty and functional outcomes. We surveyed 1799 patients undergoing primary hip or knee arthroplasty for demographic data and Western Ontario McMaster University Osteoarthritis Index scores at baseline, 3 months, and 1 year of follow-up. Patient expectations were determined with 3 survey questions. The patients with the greatest expectations of surgery were younger, male, and had a lower body mass index. Linear regression modeling showed that a greater expectation of pain relief with surgery independently predicted greater reported pain relief at 1 year of follow-up, adjusted for all relevant covariates (P relief after joint arthroplasty is an important predictor of outcomes at 1 year.

  4. Torsion of the greater omentum: A rare preoperative diagnosis

    International Nuclear Information System (INIS)

    Tandon, Ankit Anil; Lim, Kian Soon

    2010-01-01

    Torsion of the greater omentum is a rare acute abdominal condition that is seldom diagnosed preoperatively. We report the characteristic computed tomography (CT) scan findings and the clinical implications of this unusual diagnosis in a 41-year-old man, who also had longstanding right inguinal hernia. Awareness of omental torsion as a differential diagnosis in the acute abdomen setting is necessary for correct patient management

  5. Ecological specialization and morphological diversification in Greater Antillean boas.

    Science.gov (United States)

    Reynolds, R Graham; Collar, David C; Pasachnik, Stesha A; Niemiller, Matthew L; Puente-Rolón, Alberto R; Revell, Liam J

    2016-08-01

    Colonization of islands can dramatically influence the evolutionary trajectories of organisms, with both deterministic and stochastic processes driving adaptation and diversification. Some island colonists evolve extremely large or small body sizes, presumably in response to unique ecological circumstances present on islands. One example of this phenomenon, the Greater Antillean boas, includes both small (<90 cm) and large (4 m) species occurring on the Greater Antilles and Bahamas, with some islands supporting pairs or trios of body-size divergent species. These boas have been shown to comprise a monophyletic radiation arising from a Miocene dispersal event to the Greater Antilles, though it is not known whether co-occurrence of small and large species is a result of dispersal or in situ evolution. Here, we provide the first comprehensive species phylogeny for this clade combined with morphometric and ecological data to show that small body size evolved repeatedly on separate islands in association with specialization in substrate use. Our results further suggest that microhabitat specialization is linked to increased rates of head shape diversification among specialists. Our findings show that ecological specialization following island colonization promotes morphological diversity through deterministic body size evolution and cranial morphological diversification that is contingent on island- and species-specific factors. © 2016 The Author(s). Evolution © 2016 The Society for the Study of Evolution.

  6. Moderate Baseline Vagal Tone Predicts Greater Prosociality in Children

    Science.gov (United States)

    Miller, Jonas G.; Kahle, Sarah; Hastings, Paul D.

    2016-01-01

    Vagal tone is widely believed to be an important physiological aspect of emotion regulation and associated positive behaviors. However, there is inconsistent evidence for relations between children’s baseline vagal tone and their helpful or prosocial responses to others (Hastings & Miller, 2014). Recent work in adults suggests a quadratic association (inverted U-shape curve) between baseline vagal tone and prosociality (Kogan et al., 2014). The present research examined whether this nonlinear association was evident in children. We found consistent evidence for a quadratic relation between vagal tone and prosociality across 3 samples of children using 6 different measures. Compared to low and high vagal tone, moderate vagal tone in early childhood concurrently predicted greater self-reported prosociality (Study 1), observed empathic concern in response to the distress of others and greater generosity toward less fortunate peers (Study 2), and longitudinally predicted greater self-, mother-, and teacher-reported prosociality 5.5 years later in middle childhood (Study 3). Taken together, our findings suggest that moderate vagal tone at rest represents a physiological preparedness or tendency to engage in different forms of prosociality across different contexts. Early moderate vagal tone may reflect an optimal balance of regulation and arousal that helps prepare children to sympathize, comfort, and share with others. PMID:27819463

  7. Absenteeism movement in Greater Poland in 1840–1902

    Directory of Open Access Journals (Sweden)

    Izabela Krasińska

    2013-12-01

    Full Text Available The article presents the origins and development of the idea of absenteeism in Greater Poland in the 19th century. The start date for the research is 1840, which is considered to be a breakthrough year in the history of an organized absenteeism movement in Greater Poland. It was due to the Association for the Suppression of the Use of Vodka (Towarzystwo ku Przytłumieniu Używania Wódki in the Great Duchy of Posen that was then established in Kórnik. It was a secular organization that came into being on an initiative of doctor De La Roch, who was a German surgeon of a French origin. However, as early as 1844, the idea of absenteeism raised an interest of catholic clergymen of Greater Poland with high ranking clergy such as Rev. Leon Michał Przyłuski, Archbishop of Gniezno and Rev. Jan Kanty Dąbrowski, Archbishop of Posen, and later on Archbishops Rev. Mieczysław Halka Ledóchowski and Rev. Florian Oksza Stablewski. They were fascinated with activities of Rev. Jan Nepomucen Fick, Parish Priest of Piekary Śląskie and several other priests on whose initiative a lot of church brotherhoods of so called holy continence were set up in Upper Silesia as early as the first half-year of 1844. It was due to Bishop Dąbrowski that 100 000 people took vows of absenteeism in 1844–1845, becoming members of brotherhoods of absenteeism. In turn, it was an initiative of Archbishop Przyłuski that Jesuit missionaries – Rev. Karol Bołoz Antoniewicz, Rev. Teofil Baczyński and Rev. Kamil Praszałowicz, arrived in Greater Poland from Galicia in 1852 to promote the idea of absenteeism. Starting from 1848, they were helping Silesian clergymen to spread absenteeism. Clergymen of Greater Poland were also active in secular absenteeism associations. They became involved in the workings of the Association for the Promotion of Absenteeism that was set up by Zygmunt Celichowski in Kórnik in 1887, and especially in the Jutrzenka Absenteeism Association

  8. The post-orgasmic prolactin increase following intercourse is greater than following masturbation and suggests greater satiety.

    Science.gov (United States)

    Brody, Stuart; Krüger, Tillmann H C

    2006-03-01

    Research indicates that prolactin increases following orgasm are involved in a feedback loop that serves to decrease arousal through inhibitory central dopaminergic and probably peripheral processes. The magnitude of post-orgasmic prolactin increase is thus a neurohormonal index of sexual satiety. Using data from three studies of men and women engaging in masturbation or penile-vaginal intercourse to orgasm in the laboratory, we report that for both sexes (adjusted for prolactin changes in a non-sexual control condition), the magnitude of prolactin increase following intercourse is 400% greater than that following masturbation. The results are interpreted as an indication of intercourse being more physiologically satisfying than masturbation, and discussed in light of prior research reporting greater physiological and psychological benefits associated with coitus than with any other sexual activities.

  9. Sexual predators, energy development, and conservation in greater Yellowstone.

    Science.gov (United States)

    Berger, Joel; Beckmann, Jon P

    2010-06-01

    In the United States, as elsewhere, a growing debate pits national energy policy and homeland security against biological conservation. In rural communities the extraction of fossil fuels is often encouraged because of the employment opportunities it offers, although the concomitant itinerant workforce is often associated with increased wildlife poaching. We explored possible positive and negative factors associated with energy extraction in the Greater Yellowstone Ecosystem (GYE), an area known for its national parks, intact biological diversity, and some of the New World's longest terrestrial migrations. Specifically, we asked whether counties with different economies-recreation (ski), agrarian (ranching or farming), and energy extractive (petroleum)-differed in healthcare (gauged by the abundance of hospital beds) and in the frequency of sexual predators. The absolute and relative frequency of registered sex offenders grew approximately two to three times faster in areas reliant on energy extraction. Healthcare among counties did not differ. The strong conflation of community dishevel, as reflected by in-migrant sexual predators, and ecological decay in Greater Yellowstone is consistent with patterns seen in similar systems from Ecuador to northern Canada, where social and environmental disarray exist around energy boomtowns. In our case, that groups (albeit with different aims) mobilized campaigns to help maintain the quality of rural livelihoods by protecting open space is a positive sign that conservation can matter, especially in the face of rampant and poorly executed energy extraction projects. Our findings further suggest that the public and industry need stronger regulatory action to instill greater vigilance when and where social factors and land conversion impact biological systems.

  10. Land cover mapping of Greater Mesoamerica using MODIS data

    Science.gov (United States)

    Giri, Chandra; Jenkins, Clinton N.

    2005-01-01

    A new land cover database of Greater Mesoamerica has been prepared using moderate resolution imaging spectroradiometer (MODIS, 500 m resolution) satellite data. Daily surface reflectance MODIS data and a suite of ancillary data were used in preparing the database by employing a decision tree classification approach. The new land cover data are an improvement over traditional advanced very high resolution radiometer (AVHRR) based land cover data in terms of both spatial and thematic details. The dominant land cover type in Greater Mesoamerica is forest (39%), followed by shrubland (30%) and cropland (22%). Country analysis shows forest as the dominant land cover type in Belize (62%), Cost Rica (52%), Guatemala (53%), Honduras (56%), Nicaragua (53%), and Panama (48%), cropland as the dominant land cover type in El Salvador (60.5%), and shrubland as the dominant land cover type in Mexico (37%). A three-step approach was used to assess the quality of the classified land cover data: (i) qualitative assessment provided good insight in identifying and correcting gross errors; (ii) correlation analysis of MODIS- and Landsat-derived land cover data revealed strong positive association for forest (r2 = 0.88), shrubland (r2 = 0.75), and cropland (r2 = 0.97) but weak positive association for grassland (r2 = 0.26); and (iii) an error matrix generated using unseen training data provided an overall accuracy of 77.3% with a Kappa coefficient of 0.73608. Overall, MODIS 500 m data and the methodology used were found to be quite useful for broad-scale land cover mapping of Greater Mesoamerica.

  11. Practicing more retrieval routes leads to greater memory retention.

    Science.gov (United States)

    Zheng, Jun; Zhang, Wei; Li, Tongtong; Liu, Zhaomin; Luo, Liang

    2016-09-01

    A wealth of research has shown that retrieval practice plays a significant role in improving memory retention. The current study focused on one simple yet rarely examined question: would repeated retrieval using two different retrieval routes or using the same retrieval route twice lead to greater long-term memory retention? Participants elaborately learned 22 Japanese-Chinese translation word pairs using two different mediators. Half an hour after the initial study phase, the participants completed two retrieval sessions using either one mediator (Tm1Tm1) or two different mediators (Tm1Tm2). On the final test, which was performed 1week after the retrieval practice phase, the participants received only the cue with a request to report the mediator (M1 or M2) followed by the target (Experiment 1) or only the mediator (M1 or M2) with a request to report the target (Experiment 2). The results of Experiment 1 indicated that the participants who practiced under the Tm1Tm2 condition exhibited greater target retention than those who practiced under the Tm1Tm1 condition. This difference in performance was due to the significant disadvantage in mediator retrieval and decoding of the unpracticed mediator under the Tm1Tm1 condition. Although mediators were provided to participants on the final test in Experiment 2, decoding of the unpracticed mediators remained less effective than decoding of the practiced mediators. We conclude that practicing multiple retrieval routes leads to greater memory retention than focusing on a single retrieval route. Thus, increasing retrieval variability during repeated retrieval practice indeed significantly improves long-term retention in a delay test. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Taino and African maternal heritage in the Greater Antilles.

    Science.gov (United States)

    Bukhari, Areej; Luis, Javier Rodriguez; Alfonso-Sanchez, Miguel A; Garcia-Bertrand, Ralph; Herrera, Rene J

    2017-12-30

    Notwithstanding the general interest and the geopolitical importance of the island countries in the Greater Antilles, little is known about the specific ancestral Native American and African populations that settled them. In an effort to alleviate this lacuna of information on the genetic constituents of the Greater Antilles, we comprehensively compared the mtDNA compositions of Cuba, Dominican Republic, Haiti, Jamaica and Puerto Rico. To accomplish this, the mtDNA HVRI and HVRII regions, as well as coding diagnostic sites, were assessed in the Haitian general population and compared to data from reference populations. The Taino maternal DNA is prominent in the ex-Spanish colonies (61.3%-22.0%) while it is basically non-existent in the ex-French and ex-English colonies of Haiti (0.0%) and Jamaica (0.5%), respectively. The most abundant Native American mtDNA haplogroups in the Greater Antilles are A2, B2 and C1. The African mtDNA component is almost fixed in Haiti (98.2%) and Jamaica (98.5%), and the frequencies of specific African haplogroups vary considerably among the five island nations. The strong persistence of Taino mtDNA in the ex-Spanish colonies (and especially in Puerto Rico), and its absence in the French and English excolonies is likely the result of different social norms regarding mixed marriages with Taino women during the early years after the first contact with Europeans. In addition, this article reports on the results of an integrative approach based on mtDNA analysis and demographic data that tests the hypothesis of a southward shift in raiding zones along the African west coast during the period encompassing the Transatlantic Slave Trade. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Education, implementation, and policy barriers to greater integration of palliative care: A literature review.

    Science.gov (United States)

    Aldridge, Melissa D; Hasselaar, Jeroen; Garralda, Eduardo; van der Eerden, Marlieke; Stevenson, David; McKendrick, Karen; Centeno, Carlos; Meier, Diane E

    2016-03-01

    Early integration of palliative care into the management of patients with serious disease has the potential to both improve quality of life of patients and families and reduce healthcare costs. Despite these benefits, significant barriers exist in the United States to the early integration of palliative care in the disease trajectory of individuals with serious illness. To provide an overview of the barriers to more widespread palliative care integration in the United States. A literature review using PubMed from 2005 to March 2015 augmented by primary data collected from 405 hospitals included in the Center to Advance Palliative Care's National Palliative Care Registry for years 2012 and 2013. We use the World Health Organization's Public Health Strategy for Palliative Care as a framework for analyzing barriers to palliative care integration. We identified key barriers to palliative care integration across three World Health Organization domains: (1) education domain: lack of adequate education/training and perception of palliative care as end-of-life care; (2) implementation domain: inadequate size of palliative medicine-trained workforce, challenge of identifying patients appropriate for palliative care referral, and need for culture change across settings; (3) policy domain: fragmented healthcare system, need for greater funding for research, lack of adequate reimbursement for palliative care, and regulatory barriers. We describe the key policy and educational opportunities in the United States to address and potentially overcome the barriers to greater integration of palliative care into the healthcare of Americans with serious illness. © The Author(s) 2015.

  14. Absorption spectrum of DNA for wavelengths greater than 300 nm

    International Nuclear Information System (INIS)

    Sutherland, J.C.; Griffin, K.P.

    1981-01-01

    Although DNA absorption at wavelengths greater than 300 nm is much weaker than that at shorter wavelengths, this absorption seems to be responsible for much of the biological damage caused by solar radiation of wavelengths less than 320 nm. Accurate measurement of the absorption spectrum of DNA above 300 nm is complicated by turbidity characteristic of concentrated solutions of DNA. We have measured the absorption spectra of DNA from calf thymus, Clostridium perfringens, Escherichia coli, Micrococcus luteus, salmon testis, and human placenta using procedures which separate optical density due to true absorption from that due to turbidity. Above 300 nm, the relative absorption of DNA increases as a function of guanine-cytosine content, presumably because the absorption of guanine is much greater than the absorption of adenine at these wavelengths. This result suggests that the photophysical processes which follow absorption of a long-wavelength photon may, on the average, differ from those induced by shorter-wavelength photons. It may also explain the lower quantum yield for the killing of cells by wavelengths above 300 nm compared to that by shorter wavelengths

  15. Black breast cancer survivors experience greater upper extremity disability.

    Science.gov (United States)

    Dean, Lorraine T; DeMichele, Angela; LeBlanc, Mously; Stephens-Shields, Alisa; Li, Susan Q; Colameco, Chris; Coursey, Morgan; Mao, Jun J

    2015-11-01

    Over one-third of breast cancer survivors experience upper extremity disability. Black women present with factors associated with greater upper extremity disability, including: increased body mass index (BMI), more advanced disease stage at diagnosis, and varying treatment type compared with Whites. No prior research has evaluated the relationship between race and upper extremity disability using validated tools and controlling for these factors. Data were drawn from a survey study among 610 women with stage I-III hormone receptor positive breast cancer. The disabilities of the arm, shoulder and hand (QuickDASH) is an 11-item self-administered questionnaire that has been validated for breast cancer survivors to assess global upper extremity function over the past 7 days. Linear regression and mediation analysis estimated the relationships between race, BMI and QuickDASH score, adjusting for demographics and treatment types. Black women (n = 98) had 7.3 points higher average QuickDASH scores than White (n = 512) women (p disability by 40 %. Even several years post-treatment, Black breast cancer survivors had greater upper extremity disability, which was partially mediated by higher BMIs. Close monitoring of high BMI Black women may be an important step in reducing disparities in cancer survivorship. More research is needed on the relationship between race, BMI, and upper extremity disability.

  16. Greater-confinement disposal of low-level radioactive wastes

    International Nuclear Information System (INIS)

    Trevorrow, L.E.; Gilbert, T.L.; Luner, C.; Merry-Libby, P.A.; Meshkov, N.K.; Yu, C.

    1985-01-01

    Low-level radioactive wastes include a broad spectrum of wastes that have different radionuclide concentrations, half-lives, and physical and chemical properties. Standard shallow-land burial practice can provide adequate protection of public health and safety for most low-level wastes, but a small volume fraction (about 1%) containing most of the activity inventory (approx.90%) requires specific measures known as ''greater-confinement disposal'' (GCD). Different site characteristics and different waste characteristics - such as high radionuclide concentrations, long radionuclide half-lives, high radionuclide mobility, and physical or chemical characteristics that present exceptional hazards - lead to different GCD facility design requirements. Facility design alternatives considered for GCD include the augered shaft, deep trench, engineered structure, hydrofracture, improved waste form, and high-integrity container. Selection of an appropriate design must also consider the interplay between basic risk limits for protection of public health and safety, performance characteristics and objectives, costs, waste-acceptance criteria, waste characteristics, and site characteristics. This paper presents an overview of the factors that must be considered in planning the application of methods proposed for providing greater confinement of low-level wastes. 27 refs

  17. Disorganized Attachment in Infancy Predicts Greater Amygdala Volume in Adulthood

    Science.gov (United States)

    Lyons-Ruth, K.; Pechtel, P.; Yoon, S.A.; Anderson, C.M.; Teicher, M.H.

    2016-01-01

    Early life stress in rodents is associated with increased amygdala volume in adulthood. In humans, the amygdala develops rapidly during the first two years of life. Thus, disturbed care during this period may be particularly important to amygdala development. In the context of a 30-year longitudinal study of impoverished, highly stressed families, we assessed whether disorganization of the attachment relationship in infancy was related to amygdala volume in adulthood. Amygdala volumes were assessed among 18 low-income young adults (8M/10F, 29.33±0.49 years) first observed in infancy (8.5±5.6 months) and followed longitudinally to age 29. In infancy (18.58±1.02 mos), both disorganized infant attachment behavior and disrupted maternal communication were assessed in the standard Strange Situation Procedure (SSP). Increased left amygdala volume in adulthood was associated with both maternal and infant components of disorganized attachment interactions at 18 months of age (overall r = .679, p attachment disturbance in adolescence, were not significantly related to left amygdala volume. Left amygdala volume was further associated with dissociation and limbic irritability in adulthood. Finally, left amygdala volume mediated the prediction from attachment disturbance in infancy to limbic irritability in adulthood. Results point to the likely importance of quality of early care for amygdala development in human children as well as in rodents. The long-term prediction found here suggests that the first two years of life may be an early sensitive period for amygdala development during which clinical intervention could have particularly important consequences for later child outcomes. PMID:27060720

  18. The Influence of Green Infrastructure on Urban Resilience in Greater London

    Science.gov (United States)

    Oh, Yukyung

    2017-04-01

    High population densities and diverse economic activities in urban areas create social issues as well as a range of environmental impacts including air pollution, soil contamination, loss of biodiversity and health problems (Alberti et al., 2003; Dobbs, Escobedo, & Zipperer, 2011; Grimm et al., 2008). The concept of urban resilience has been used for increasing the capacity of the entities and players to adapt to rapid changes, and urban green spaces play a crucial role in increasing urban resilience. Greater London has a good case for increasing urban green spaces and resilience under the London Plan. The relevance of urban open spaces and several socioeconomic indicators would provide researchers and policy makers with the information for managing green coverage. The correlation analysis of two quantitative data such as open space and socioeconomic data of Greater London was conducted with SPSS. The data for open spaces in Greater London was gained through Greenspace Information for Greater London. The data was converted from vector to raster in Geographic Information System (GIS), so as to calculate landscape metrics for open spaces in Greater London through a spatial pattern analysis program, FRAGSTATS 4.2. The socioeconomic data was obtained from "London Borough Profile", London Datastore. In addition, data on total carbon emissions from Industry and Commercial, Domestic, Transport, LULUCF Net Emissions, and per capita emissions were gained from UK local authority and regional carbon dioxide emissions national statistics: 2005-2014 released from Department of Energy and Climate Change. The indicators from open spaces are total area of open space and patch density or contagion of open spaces. The latter indicator allows to figure out the level of fragmentation of open spaces. The socioeconomic indicators cover number of jobs by workplace, jobs density, crime rates per thousand population, and several wellbeing indicators such as life satisfaction

  19. Picturing Life

    Directory of Open Access Journals (Sweden)

    Molly Bathje MS, OTR/L

    2013-08-01

    Full Text Available The cover art of the summer 2013 issue of The Open Journal of Occupational Therapy provided by Jonathan Darnall reflects his unique life perspective, current roles, and values. An exploration of Jon’s life experience reveals how creative arts, including photography, have positively influenced his life and inform OT practitioners about the benefits of photography as an intervention and an occupation.

  20. [Clinical Results of Endoscopic Treatment of Greater Trochanteric Pain Syndrome].

    Science.gov (United States)

    Zeman, P; Rafi, M; Skala, P; Zeman, J; Matějka, J; Pavelka, T

    2017-01-01

    PURPOSE OF THE STUDY This retrospective study aims to present short-term clinical outcomes of endoscopic treatment of patients with greater trochanteric pain syndrome (GTPS). MATERIAL AND METHODS The evaluated study population was composed of a total of 19 patients (16 women, 3 men) with the mean age of 47 years (19-63 years). In twelve cases the right hip joint was affected, in the remaining seven cases it was the left side. The retrospective evaluation was carried out only in patients with greater trochanteric pain syndrome caused by independent chronic trochanteric bursitis without the presence of m. gluteus medius tear not responding to at least 3 months of conservative treatment. In patients from the followed-up study population, endoscopic trochanteric bursectomy was performed alone or in combination with iliotibial band release. The clinical results were evaluated preoperatively and with a minimum follow-up period of 1 year after the surgery (mean 16 months). The Visual Analogue Scale (VAS) for assessment of pain and WOMAC (Western Ontario MacMaster) score were used. In both the evaluated criteria (VAS and WOMAC score) preoperative and postoperative results were compared. Moreover, duration of surgery and presence of postoperative complications were assessed. Statistical evaluation of clinical results was carried out by an independent statistician. In order to compare the parameter of WOMAC score and VAS pre- and post-operatively the Mann-Whitney Exact Test was used. The statistical significance was set at 0.05. RESULTS The preoperative VAS score ranged 5-9 (mean 7.6) and the postoperative VAS ranged 0-5 (mean 2.3). The WOMAC score ranged 56.3-69.7 (mean 64.2) preoperatively and 79.8-98.3 (mean 89.7) postoperatively. When both the evaluated parameters of VAS and WOMAC score were compared in time, a statistically significant improvement (ppain syndrome yields statistically significant improvement of clinical results with the concurrent minimum incidence of

  1. Strontium isotopic geochemistry of intrusive rocks, Puerto Rico, Greater Antilles

    International Nuclear Information System (INIS)

    Jones, L.M.; Kesler, S.E.

    1980-01-01

    The strontium isotope geochemistry is given for three Puerto Rican intrusive rocks: the granodioritic Morovis and San Lorenzo plutons and the Rio Blanco stock of quartz dioritic composition. The average calculated initial 87 Sr/ 86 Sr ratios are 0.70370, 0.70355 and 0.70408, respectively. In addition, the San Lorenzo data establish a whole-rock isochron of 71 +- 2 m.y., which agrees with the previously reported K-Ar age of 73 m.y. Similarity of most of the intrusive rocks in the Greater Antilles with respect to their strontium isotopic geochemistry regardless of their major element composition indicates that intrusive magmas with a wide range of composition can be derived from a single source material. The most likely source material, in view of the available isotopic data, is the mantle wedge overlying the subduction zone. (orig.)

  2. Slimness is associated with greater intercourse and lesser masturbation frequency.

    Science.gov (United States)

    Brody, Stuart

    2004-01-01

    I examined the relationship of recalled and diary recorded frequency of penile-vaginal intercourse (FSI), noncoital partnered sexual activity, and masturbation to measured waist and hip circumference in 120 healthy adults aged 19-38. Slimmer waist (in men and in the sexes combined) and slimmer hips (in men and women) were associated with greater FSI. Slimmer waist and hips were associated with rated importance of intercourse for men. Noncoital partnered sexual activity had a less consistent association with slimness. Slimmer waist and hips were associated with less masturbation (in men and in the sexes combined). I discuss the results in terms of differences between different sexual behaviors, attractiveness, emotional relatedness, physical sensitivity, sexual dysfunction, sociobiology, psychopharmacological aspects of excess fat and carbohydrate consumption, and implications for sex therapy.

  3. ADR characteristics and corporate governance in the Greater China region

    Directory of Open Access Journals (Sweden)

    Lee-Hsien Pan

    2012-04-01

    Full Text Available We examine the relationship between firm valuation and governance mechanisms, firm characteristics, and institutional factors of the American Depository Receipts (ADRs domiciled in the Greater China region. We find that China ADRs have the highest market-to-book value ratio followed by Hong Kong and Taiwan ADRs. It appears that Chinese firms with the poorest external governance environment stand to benefit the most from cross listing under the ADR programs. Listing in the U.S. that requires more stringent regulations and disclosure rules may strengthen the firms’ governance practices and thereby enhance their firm value. Among the internal governance mechanisms, institutional ownership and insider ownership are important for firm value.

  4. Greater confinement disposal program at the Savannah River Plant

    International Nuclear Information System (INIS)

    Cook, J.R.; Towler, O.A.; Peterson, D.L.; Johnson, G.M.; Helton, B.D.

    1984-01-01

    The first facility to demonstrate Greater Confinement Disposal (GCD) in a humid environment in the United States has been built and is operating at the Savannah River Plant. GCD practices of waste segregation, packaging, emplacement below the root zone, and waste stabilization are being used in the demonstration. Activity concentrations to select wastes for GCD are based on a study of SRP burial records, and are equal to or less than those for Class B waste in 10CFR61. The first disposal units to be constructed are 9-foot diameter, thirty-foot deep boreholes which will be used to dispose of wastes from production reactors, tritiated wastes, and selected wastes from off-site. In 1984 an engineered GCD trench will be constructed for disposal of boxed wastes and large bulky items. 2 figures, 1 table

  5. Greater Confinement Disposal Program at the Savannah River Plant

    International Nuclear Information System (INIS)

    Towler, O.A.; Cook, J.R.; Peterson, D.L.

    1983-01-01

    Plans for improved LLW disposal at the Savannah River Plant include Greater Confinement Disposal (GCD) for the higher activity fractions of this waste. GCD practices will include waste segregation, packaging, emplacement below the root zone, and stabilizing the emplacement with cement. Statistical review of SRP burial records showed that about 95% of the radioactivity is associated with only 5% of the waste volume. Trigger values determined in this study were compared with actual burials in 1982 to determine what GCD facilities would be needed for a demonstration to begin in Fall 1983. Facilities selected include 8-feet-diameter x 30-feet-deep boreholes to contain reactor scrap, tritiated waste, and selected wastes from offsite

  6. Evil genius? How dishonesty can lead to greater creativity.

    Science.gov (United States)

    Gino, Francesca; Wiltermuth, Scott S

    2014-04-01

    We propose that dishonest and creative behavior have something in common: They both involve breaking rules. Because of this shared feature, creativity may lead to dishonesty (as shown in prior work), and dishonesty may lead to creativity (the hypothesis we tested in this research). In five experiments, participants had the opportunity to behave dishonestly by overreporting their performance on various tasks. They then completed one or more tasks designed to measure creativity. Those who cheated were subsequently more creative than noncheaters, even when we accounted for individual differences in their creative ability (Experiment 1). Using random assignment, we confirmed that acting dishonestly leads to greater creativity in subsequent tasks (Experiments 2 and 3). The link between dishonesty and creativity is explained by a heightened feeling of being unconstrained by rules, as indicated by both mediation (Experiment 4) and moderation (Experiment 5).

  7. Use of renewable energy in the greater metropolitan area

    International Nuclear Information System (INIS)

    Arias Garcia, Rocio; Castro Gomez, Gustavo; Fallas Cordero, Kenneth; Grant Chaves, Samuel; Mendez Parrales, Tony; Parajeles Fernandez, Ivan

    2012-01-01

    A study is conducted on different renewable energy within the larger metropolitan area, selecting the most suitable for the area and the implementation for distributed generation. A research methodology is practiced type pretending gather the necessary information to make proposals selected of different type of energy. The geography of the greater metropolitan area is studied along with the different existing renewable energy: distributed generation, remote measurement of energy which is one of the elements of the concept of intelligent networks (Smart Grid) in the electricity sector, legislation of Costa Rica regarding the generation of renewable energy and environmental impact. An analysis of economic feasibility is covered for each of the proposals estimating current rates for leading distributors of a future value, concluding with the viability of projects for possible execution of the same. (author) [es

  8. The hydrogen village in the Greater Toronto Area (GTA)

    International Nuclear Information System (INIS)

    Kimmel, T.B.; Smith, R.

    2004-01-01

    'Full text:' A Hydrogen Village (H2V) is a public/private partnership with an objective to accelerate the commercialization of hydrogen and fuel cell technology in Canada and firmly position Canada as the international leader in this sector. The first Hydrogen Village is planned for the Greater Toronto Area (GTA) and will make use of existing hydrogen and fuel cell deployments to assist in its creation. This five year GTA Hydrogen Village program is planned to begin operations in 2004. The Hydrogen Village will demonstrate and deploy various hydrogen production and delivery techniques as well as fuel cells for stationary, transportation (mobile) and portable applications. This paper will provide an overview of the Hydrogen Village and identify the missions, objectives, members and progress within the H2V. (author)

  9. Age and Expatriate Job Performance in Greater China

    DEFF Research Database (Denmark)

    Selmer, Jan; Lauring, Jakob; Feng, Yunxia

    2009-01-01

    a positive impact on expatriates' job performance. Therefore, the purpose of this paper is toexamine the association between the age of business expatriates and their work performance in a Chinese cultural setting. Design/methodology/approach - Controlling for the potential bias of a number of background......, companies should not discriminate against older candidatesin expatriate selection for Greater China. Furthermore, older expatriates destined for a Chinesecultural context could be trained how to exploit their age advantage. Originality/value - In contrast to previous studies, this investigation attempts...... to match a certain personal characteristic of expatriates with a specific host culture. The results have implications for and contribute to the literature on expatriate selection as well as to the body of research on crosscultural training....

  10. The Greater Caucasus Glacier Inventory (Russia, Georgia and Azerbaijan)

    Science.gov (United States)

    Tielidze, Levan G.; Wheate, Roger D.

    2018-01-01

    There have been numerous studies of glaciers in the Greater Caucasus, but none that have generated a modern glacier database across the whole mountain range. Here, we present an updated and expanded glacier inventory at three time periods (1960, 1986, 2014) covering the entire Greater Caucasus. Large-scale topographic maps and satellite imagery (Corona, Landsat 5, Landsat 8 and ASTER) were used to conduct a remote-sensing survey of glacier change, and the 30 m resolution Advanced Spaceborne Thermal Emission and Reflection Radiometer Global Digital Elevation Model (ASTER GDEM; 17 November 2011) was used to determine the aspect, slope and height distribution of glaciers. Glacier margins were mapped manually and reveal that in 1960 the mountains contained 2349 glaciers with a total glacier surface area of 1674.9 ± 70.4 km2. By 1986, glacier surface area had decreased to 1482.1 ± 64.4 km2 (2209 glaciers), and by 2014 to 1193.2 ± 54.0 km2 (2020 glaciers). This represents a 28.8 ± 4.4 % (481 ± 21.2 km2) or 0.53 % yr-1 reduction in total glacier surface area between 1960 and 2014 and an increase in the rate of area loss since 1986 (0.69 % yr-1) compared to 1960-1986 (0.44 % yr-1). Glacier mean size decreased from 0.70 km2 in 1960 to 0.66 km2 in 1986 and to 0.57 km2 in 2014. This new glacier inventory has been submitted to the Global Land Ice Measurements from Space (GLIMS) database and can be used as a basis data set for future studies.

  11. Myiasis in Dogs in the Greater Accra Region of Ghana.

    Science.gov (United States)

    Johnson, Sherry A M; Gakuya, Daniel W; Mbuthia, Paul G; Mande, John D; Afakye, Kofi; Maingi, Ndichu

    2016-01-01

    Myiasis is the infestation of tissues of live vertebrate animals and humans with dipterous larvae. In sub-Saharan Africa, Cordylobia anthropohaga and Cordylobia rodhaini are known to be responsible for cutaneous myiasis in animals and humans. Human cases of myiasis, purportedly acquired in Ghana but diagnosed in other countries, have been reported; however, published data on its occurrence in animals in Ghana is unavailable. This study assessed the prevalence of canine myiasis among owned dogs in the Greater Accra region (GAR) of Ghana. A cross-sectional study was conducted in the Greater Accra region of Ghana, selected for being the region with the highest estimated population density of owned dogs. Physical examination and demographic characteristics of the study dogs were assessed. Management of the dogs was assessed through a questionnaire administered to the dog owners. A total of 392 owned dogs were sampled. Twenty-nine (7.4%) had cutaneous myiasis caused by C. rodhaini. In addition, one (0.2%) of the dogs had intestinal myiasis, with Dermatobia hominis as the offending larvae. Among the breeds of dogs with myiasis, the mongrel was most affected, with 24 (82.8%) out of the 29 cases. The mongrels, majority of which (24; 82.8%) were males, were left to roam freely in the community. Results from this study demonstrate that C. rodhaini and D. hominis are important causes of myiasis in owned dogs in the GAR of Ghana. Dogs could play a role in the spread of myiasis to humans, with its attendant public health implications.

  12. Economic and geographic factors affecting the development of Greater Baku

    Directory of Open Access Journals (Sweden)

    Vusat AFANDIYEV

    2014-12-01

    Full Text Available Globally, the responsible factors for the ongoing development of urbanization are the high speed of population growth, and the mass migration of humans to cities and large urban areas. In most countries, this process resulted in the emergence of ‘pseudo-urbanization’ which is difficult to be regulated. The purpose of the carried researches to determine the development priorities in the territory of Greater Baku – the capital city of the Republic of Azerbaijan; to define the problems that take place in this connection; and to develop ways of elimination of these problems. The reason of taking Baku as a research area is connected with some of the factors. Firstly, studies on Baku have been conducted based on the Soviet geographical and urban planning school and their methods for a long period. In this regard, it is necessary to carry out research in this field based on the principles adopted in most countries. Secondly, since 1992, the intensive accumulation of population in the territory of the capital city and the surrounding areas is being observed because of socio-economic problems. As a result, the process of pseudo-urbanization intensified, entailing a densely-populated area. Thirdly, low-rise buildings still continue to exist in the large areas within the territory of Baku, and they are not associated with the functional structure of the city. This situation creates many challenges, particularly in terms of density growth and effective use of the city’s territory. Finally, numerous new buildings have been constructed in the residential areas of Baku in recent years, and this may entailserious problems in water supply, energy provision, and utilities. The study is carried out referring to previous works of researchers, statistic data, and the results of the population census conducted in 1959-2009.The practical significance of the scientific work is that positive and negative factors affecting the further development of Greater Baku

  13. Greater learnability is not sufficient to produce cultural universals.

    Science.gov (United States)

    Rafferty, Anna N; Griffiths, Thomas L; Ettlinger, Marc

    2013-10-01

    Looking across human societies reveals regularities in the languages that people speak and the concepts that they use. One explanation that has been proposed for these "cultural universals" is differences in the ease with which people learn particular languages and concepts. A difference in learnability means that languages and concepts possessing a particular property are more likely to be accurately transmitted from one generation of learners to the next. Intuitively, this difference could allow languages and concepts that are more learnable to become more prevalent after multiple generations of cultural transmission. If this is the case, the prevalence of languages and concepts with particular properties can be explained simply by demonstrating empirically that they are more learnable. We evaluate this argument using mathematical analysis and behavioral experiments. Specifically, we provide two counter-examples that show how greater learnability need not result in a property becoming prevalent. First, more learnable languages and concepts can nonetheless be less likely to be produced spontaneously as a result of transmission failures. We simulated cultural transmission in the laboratory to show that this can occur for memory of distinctive items: these items are more likely to be remembered, but not generated spontaneously once they have been forgotten. Second, when there are many languages or concepts that lack the more learnable property, sheer numbers can swamp the benefit produced by greater learnability. We demonstrate this using a second series of experiments involving artificial language learning. Both of these counter-examples show that simply finding a learnability bias experimentally is not sufficient to explain why a particular property is prevalent in the languages or concepts used in human societies: explanations for cultural universals based on cultural transmission need to consider the full set of hypotheses a learner could entertain and all of

  14. Greater general startle reflex is associated with greater anxiety levels: a correlational study on 111 young women

    Directory of Open Access Journals (Sweden)

    Eleonora ePoli

    2015-02-01

    Full Text Available Startle eyeblink reflex is a valid non-invasive tool for studying attention, emotion and psychiatric disorders. In the absence of any experimental manipulation, the general (or baseline startle reflex shows a high inter-individual variability, which is often considered task-irrelevant and therefore normalized across participants. Unlike the above view, we hypothesized that greater general startle magnitude is related to participants’ higher anxiety level. 111 healthy young women, after completing the State-Trait Anxiety Inventory, were randomly administered 10 acoustic white noise probes (50 ms, 100 dBA acoustic level while integrated EMG from left and right orbicularis oculi was recorded. Results showed that participants with greater state anxiety levels exhibited larger startle reflex magnitude from the left eye (r109=0.23, p<0.05. Furthermore, individuals who perceived the acoustic probe as more aversive reported the largest anxiety scores (r109=0.28, p<0.05 and had the largest eyeblinks, especially in the left eye (r109 = 0.34, p<0.001. Results suggest that general startle may represent a valid tool for studying the neural excitability underlying anxiety and emotional dysfunction in neurological and mental disorders.

  15. More frequent vaginal orgasm is associated with experiencing greater excitement from deep vaginal stimulation.

    Science.gov (United States)

    Brody, Stuart; Klapilova, Katerina; Krejčová, Lucie

    2013-07-01

    Research indicated that: (i) vaginal orgasm (induced by penile-vaginal intercourse [PVI] without concurrent clitoral masturbation) consistency (vaginal orgasm consistency [VOC]; percentage of PVI occasions resulting in vaginal orgasm) is associated with mental attention to vaginal sensations during PVI, preference for a longer penis, and indices of psychological and physiological functioning, and (ii) clitoral, distal vaginal, and deep vaginal/cervical stimulation project via different peripheral nerves to different brain regions. The aim of this study is to examine the association of VOC with: (i) sexual arousability perceived from deep vaginal stimulation (compared with middle and shallow vaginal stimulation and clitoral stimulation), and (ii) whether vaginal stimulation was present during the woman's first masturbation. A sample of 75 Czech women (aged 18-36), provided details of recent VOC, site of genital stimulation during first masturbation, and their recent sexual arousability from the four genital sites. The association of VOC with: (i) sexual arousability perceived from the four genital sites and (ii) involvement of vaginal stimulation in first-ever masturbation. VOC was associated with greater sexual arousability from deep vaginal stimulation but not with sexual arousability from other genital sites. VOC was also associated with women's first masturbation incorporating (or being exclusively) vaginal stimulation. The findings suggest (i) stimulating the vagina during early life masturbation might indicate individual readiness for developing greater vaginal responsiveness, leading to adult greater VOC, and (ii) current sensitivity of deep vaginal and cervical regions is associated with VOC, which might be due to some combination of different neurophysiological projections of the deep regions and their greater responsiveness to penile stimulation. © 2013 International Society for Sexual Medicine.

  16. Life sciences

    Energy Technology Data Exchange (ETDEWEB)

    Day, L. (ed.)

    1991-04-01

    This document is the 1989--1990 Annual Report for the Life Sciences Divisions of the University of California/Lawrence Berkeley Laboratory. Specific progress reports are included for the Cell and Molecular Biology Division, the Research Medicine and Radiation Biophysics Division (including the Advanced Light Source Life Sciences Center), and the Chemical Biodynamics Division. 450 refs., 46 figs. (MHB)

  17. Life sciences

    International Nuclear Information System (INIS)

    Day, L.

    1991-04-01

    This document is the 1989--1990 Annual Report for the Life Sciences Divisions of the University of California/Lawrence Berkeley Laboratory. Specific progress reports are included for the Cell and Molecular Biology Division, the Research Medicine and Radiation Biophysics Division (including the Advanced Light Source Life Sciences Center), and the Chemical Biodynamics Division. 450 refs., 46 figs

  18. The Active Structure of the Greater Dead Sea Basin

    Science.gov (United States)

    Shamir, G.

    2002-12-01

    The Greater Dead Sea Basin (GDSB) is a 220km long depression situated along the southern section of the Dead Sea Transform (DST), between two structurally and gravitationally elevated points, Wadi Malih in the north and Paran fault zone in the south. In its center is the Dead Sea basin 'sensu strictu' (DSB), which has been described since the 1970s as a pull-apart basin at a left step-over along the DST. However, several observations, or their lack thereof, contradict this scheme, e.g. (i) It is not supported by recent seismological and geomorphic data; (ii) It does not explain the fault pattern and mixed sinistral and dextral offset along the DSB western boundary; (iii) It does not simply explain the presence of intense deformation outside the presumed fault step zone; (iv) It is inconsistent with the orientation of seismically active faults within the Dead Sea and Jericho Valley; (v) The length of the DSB exceeds the total offset along the Dead Sea Transform, while its subsidence is about the age of the DST. In this study, newly acquired and analyzed data (high resolution seismic reflection and earthquake relocation and fault plane solutions) has been integrated with previously published data (structural mapping, fracture orientation distribution, Bouguer anomaly maps, sinkhole distribution, geomorphic lineaments). The results show that the GDSB is dominated by two active fault systems, one trending NNE and showing normal-dextral motion, the other trending NW. These systems are identified by earthquake activity, seismic reflection observations, alignment of recent sinkholes, and distribution of Bouguer anomaly gradients. As a result, the intra-basin structure is of a series of rectangular blocks. The dextral slip component along NNE trending faults, the mixed sense of lateral offset along the western boundary of the DSB and temporal change in fracture orientation in the Jericho Valley suggest that the intra-basin blocks have rotated counterclockwise since the

  19. A new probabilistic seismic hazard assessment for greater Tokyo

    Science.gov (United States)

    Stein, R.S.; Toda, S.; Parsons, T.; Grunewald, E.; Blong, R.; Sparks, S.; Shah, H.; Kennedy, J.

    2006-01-01

    Tokyo and its outlying cities are home to one-quarter of Japan's 127 million people. Highly destructive earthquakes struck the capital in 1703, 1855 and 1923, the last of which took 105 000 lives. Fuelled by greater Tokyo's rich seismological record, but challenged by its magnificent complexity, our joint Japanese-US group carried out a new study of the capital's earthquake hazards. We used the prehistoric record of great earthquakes preserved by uplifted marine terraces and tsunami deposits (17 M???8 shocks in the past 7000 years), a newly digitized dataset of historical shaking (10 000 observations in the past 400 years), the dense modern seismic network (300 000 earthquakes in the past 30 years), and Japan's GeoNet array (150 GPS vectors in the past 10 years) to reinterpret the tectonic structure, identify active faults and their slip rates and estimate their earthquake frequency. We propose that a dislodged fragment of the Pacific plate is jammed between the Pacific, Philippine Sea and Eurasian plates beneath the Kanto plain on which Tokyo sits. We suggest that the Kanto fragment controls much of Tokyo's seismic behaviour for large earthquakes, including the damaging 1855 M???7.3 Ansei-Edo shock. On the basis of the frequency of earthquakes beneath greater Tokyo, events with magnitude and location similar to the M??? 7.3 Ansei-Edo event have a ca 20% likelihood in an average 30 year period. In contrast, our renewal (time-dependent) probability for the great M??? 7.9 plate boundary shocks such as struck in 1923 and 1703 is 0.5% for the next 30 years, with a time-averaged 30 year probability of ca 10%. The resulting net likelihood for severe shaking (ca 0.9g peak ground acceleration (PGA)) in Tokyo, Kawasaki and Yokohama for the next 30 years is ca 30%. The long historical record in Kanto also affords a rare opportunity to calculate the probability of shaking in an alternative manner exclusively from intensity observations. This approach permits robust estimates

  20. Real life cost and quality of life associated with continuous intraduodenal levodopa infusion compared with oral treatment in Parkinson patients

    DEFF Research Database (Denmark)

    Lundqvist, C.; Beiske, A. G.; Reiertsen, O.

    2014-01-01

    Advanced-stage Parkinson's disease (PD) strongly affects quality of life (QoL). Continuous intraduodenal administration of levodopa (IDL) is efficacious, but entails high costs. This study aims to estimate these costs in routine care. 10 patients with advanced-PD who switched from oral medication...... was the dominant cost during IDL (45 % of total costs), it represented only 6.4 % of the total for conventional treatment. IDL improves function but is not cost effective using recommended thresholds for cost/QALY in Norway.......Advanced-stage Parkinson's disease (PD) strongly affects quality of life (QoL). Continuous intraduodenal administration of levodopa (IDL) is efficacious, but entails high costs. This study aims to estimate these costs in routine care. 10 patients with advanced-PD who switched from oral medication...... to IDL were assessed at baseline, and subsequently at 3, 6, 9 and 12 months follow-up. We used the Unified PD Rating Scale (UPDRS) for function and 15D for Quality of Life (QoL). Costs were assessed using quarterly structured patient questionnaires and hospital registries. Costs per quality adjusted life...

  1. Scaling and allometry in the building geometries of Greater London

    Science.gov (United States)

    Batty, M.; Carvalho, R.; Hudson-Smith, A.; Milton, R.; Smith, D.; Steadman, P.

    2008-06-01

    Many aggregate distributions of urban activities such as city sizes reveal scaling but hardly any work exists on the properties of spatial distributions within individual cities, notwithstanding considerable knowledge about their fractal structure. We redress this here by examining scaling relationships in a world city using data on the geometric properties of individual buildings. We first summarise how power laws can be used to approximate the size distributions of buildings, in analogy to city-size distributions which have been widely studied as rank-size and lognormal distributions following Zipf [ Human Behavior and the Principle of Least Effort (Addison-Wesley, Cambridge, 1949)] and Gibrat [ Les Inégalités Économiques (Librarie du Recueil Sirey, Paris, 1931)]. We then extend this analysis to allometric relationships between buildings in terms of their different geometric size properties. We present some preliminary analysis of building heights from the Emporis database which suggests very strong scaling in world cities. The data base for Greater London is then introduced from which we extract 3.6 million buildings whose scaling properties we explore. We examine key allometric relationships between these different properties illustrating how building shape changes according to size, and we extend this analysis to the classification of buildings according to land use types. We conclude with an analysis of two-point correlation functions of building geometries which supports our non-spatial analysis of scaling.

  2. Comparing statistical tests for detecting soil contamination greater than background

    International Nuclear Information System (INIS)

    Hardin, J.W.; Gilbert, R.O.

    1993-12-01

    The Washington State Department of Ecology (WSDE) recently issued a report that provides guidance on statistical issues regarding investigation and cleanup of soil and groundwater contamination under the Model Toxics Control Act Cleanup Regulation. Included in the report are procedures for determining a background-based cleanup standard and for conducting a 3-step statistical test procedure to decide if a site is contaminated greater than the background standard. The guidance specifies that the State test should only be used if the background and site data are lognormally distributed. The guidance in WSDE allows for using alternative tests on a site-specific basis if prior approval is obtained from WSDE. This report presents the results of a Monte Carlo computer simulation study conducted to evaluate the performance of the State test and several alternative tests for various contamination scenarios (background and site data distributions). The primary test performance criteria are (1) the probability the test will indicate that a contaminated site is indeed contaminated, and (2) the probability that the test will indicate an uncontaminated site is contaminated. The simulation study was conducted assuming the background concentrations were from lognormal or Weibull distributions. The site data were drawn from distributions selected to represent various contamination scenarios. The statistical tests studied are the State test, t test, Satterthwaite's t test, five distribution-free tests, and several tandem tests (wherein two or more tests are conducted using the same data set)

  3. Distribution of grizzly bears in the Greater Yellowstone Ecosystem, 2004

    Science.gov (United States)

    Schwartz, C.C.; Haroldson, M.A.; Gunther, K.; Moody, D.

    2006-01-01

    The US Fish and Wildlife Service (USFWS) proposed delisting the Yellowstone grizzly bear (Ursus arctos horribilis) in November 2005. Part of that process required knowledge of the most current distribution of the species. Here, we update an earlier estimate of occupied range (1990–2000) with data through 2004. We used kernel estimators to develop distribution maps of occupied habitats based on initial sightings of unduplicated females (n = 481) with cubs of the year, locations of radiomarked bears (n = 170), and spatially unique locations of conflicts, confrontations, and mortalities (n = 1,075). Although each data set was constrained by potential sampling bias, together they provided insight into areas in the Greater Yellowstone Ecosystem (GYE) currently occupied by grizzly bears. The current distribution of 37,258 km2 (1990–2004) extends beyond the distribution map generated with data from 1990–2000 (34,416 km2 ). Range expansion is particularly evident in parts of the Caribou–Targhee National Forest in Idaho and north of Spanish Peaks on the Gallatin National Forest in Montana.

  4. Greater utilization of wood residue fuels through improved financial planning

    International Nuclear Information System (INIS)

    Billings, C.D.; Ziemke, M.C.; Stanford, R.

    1991-01-01

    Recent events have focused attention on the promotion of greater utilization of biomass fuel. Considerations include the need to reduce increases in global warming and also to improve ground level air quality by limiting the use of fossil fuels. However, despite all these important environmentally related considerations, economics remains the most important factor in the decision process used to determine the feasibility of using available renewable fuels instead of more convenient fossil fuels. In many areas of the Southeast, this decision process involves choosing between wood residue fuels such as bark, sawdust and shavings and presently plentiful natural gas. The primary candidate users of wood residue fuels are industries that use large amounts of heat and electric power and are located near centers of activity in the forest products industry such as sawmills, veneer mills and furniture factories. Given that such facilities both produce wood residues and need large amounts of heat and electricity, it is understandable that these firms are often major users of wood-fired furnaces and boilers. The authors have observed that poor or incomplete financial planning by the subject firms is a major barrier to economic utilization of inexpensive and widely available renewable fuels. In this paper, the authors suggest that wider usage of improved financial planning could double the present modest annual incidence of new commercial wood-fueled installation

  5. Greater commitment to the domestic violence training is required.

    Science.gov (United States)

    Leppäkoski, Tuija Helena; Flinck, Aune; Paavilainen, Eija

    2015-05-01

    Domestic violence (DV) is a major public health problem with high health and social costs. A solution to this multi-faceted problem requires that various help providers work together in an effective and optimal manner when dealing with different parties of DV. The objective of our research and development project (2008-2013) was to improve the preparedness of the social and healthcare professionals to manage DV. This article focuses on the evaluation of interprofessional education (IPE) to provide knowledge and skills for identifying and intervening in DV and to improve collaboration among social and health care professionals and other help providers at the local and regional level. The evaluation data were carried out with an internal evaluation. The evaluation data were collected from the participants orally and in the written form. The participants were satisfied with the content of the IPE programme itself and the teaching methods used. Participation in the training sessions could have been more active. Moreover, some of the people who had enrolled for the trainings could not attend all of them. IPE is a valuable way to develop intervening in DV. However, greater commitment to the training is required from not only the participants and their superiors but also from trustees.

  6. Greater confinement disposal program at the Savannah River Plant

    International Nuclear Information System (INIS)

    Towler, O.A.; Cook, J.R.; Peterson, D.L.; Reddick, J.A.

    1984-01-01

    A facility to demonstrate Greater Confinement Disposal (GCD) of low-level solid radioactive waste in a humid environment has been built and is operating at the Savannah River Plant (SRP). GCD practices of waste segregation into high and low activity concentrations, emplacement of waste below the root zone, waste stabilization, and capping are being used in the demonstration. Activity concentrations to select wastes for GCD are based on the volume/activity distribution of low-level solid wastes as obtained from SRP burial records, and are equal to or less than those for Class B waste in 10 CFR 61. The first disposal units constructed are twenty 9-ft-diam, 30-ft-deep boreholes. These holes will be used to dispose of wastes from the production reactors, tritiated wastes, and selected wastes from offsite. In 1984, construction will begin on an engineered GCD trench for disposal of boxed waste and large bulky items that meet the activity concentration criteria. 4 references, 5 figures, 2 tables

  7. Greater future global warming inferred from Earth's recent energy budget.

    Science.gov (United States)

    Brown, Patrick T; Caldeira, Ken

    2017-12-06

    Climate models provide the principal means of projecting global warming over the remainder of the twenty-first century but modelled estimates of warming vary by a factor of approximately two even under the same radiative forcing scenarios. Across-model relationships between currently observable attributes of the climate system and the simulated magnitude of future warming have the potential to inform projections. Here we show that robust across-model relationships exist between the global spatial patterns of several fundamental attributes of Earth's top-of-atmosphere energy budget and the magnitude of projected global warming. When we constrain the model projections with observations, we obtain greater means and narrower ranges of future global warming across the major radiative forcing scenarios, in general. In particular, we find that the observationally informed warming projection for the end of the twenty-first century for the steepest radiative forcing scenario is about 15 per cent warmer (+0.5 degrees Celsius) with a reduction of about a third in the two-standard-deviation spread (-1.2 degrees Celsius) relative to the raw model projections reported by the Intergovernmental Panel on Climate Change. Our results suggest that achieving any given global temperature stabilization target will require steeper greenhouse gas emissions reductions than previously calculated.

  8. [Reproductive health survey of young adults in greater Santiago].

    Science.gov (United States)

    Valenzuela, M S; Herold, J M; Morris, L; López, I M

    1992-01-01

    In 1988 a survey was carried out in order to obtain information on knowledge about reproduction, sexual activity, attitudes, and use of contraceptive methods among residents between 15 and 24 years of age in Greater Santiago. For this purpose, a multistage, self-weighted, non-replacement probability sample was chosen from the entire Santiago urban area. After 2,898 households were visited, 865 women and 800 men were selected and interviewed. For the interview, a questionnaire with 156 questions was developed; many questions were similar to those included in similar surveys in Brazil and Guatemala. The interviewers were professionals who had received prior training. Although 75% of the interviewees had attended sex education classes, they had erroneous ideas on various basic subjects. Sixty-nine percent of the women interviewed had undergone menarche before attending these classes. In addition, 35.4% of the women and 65.0% of the men had had sexual relations prior to marriage, and less than 20% had used any contraceptive method. More than 60% of the interviewees who had children had conceived them before marrying. These findings point up the necessity of offering sex education classes for children and young people, as well as facilitating their access to family planning services, in order to decrease the number of illegitimate and unwanted children that are born in Chile.

  9. Neural markers of a greater female responsiveness to social stimuli

    Directory of Open Access Journals (Sweden)

    Zani Alberto

    2008-06-01

    Full Text Available Abstract Background There is fMRI evidence that women are neurally predisposed to process infant laughter and crying. Other findings show that women might be more empathic and sensitive than men to emotional facial expressions. However, no gender difference in the brain responses to persons and unanimated scenes has hitherto been demonstrated. Results Twenty-four men and women viewed 220 images portraying persons or landscapes and ERPs were recorded from 128 sites. In women, but not in men, the N2 component (210–270 was much larger to persons than to scenes. swLORETA showed significant bilateral activation of FG (BA19/37 in both genders when viewing persons as opposed to scenes. Only women showed a source of activity in the STG and in the right MOG (extra-striate body area, EBA, and only men in the left parahippocampal area (PPA. Conclusion A significant gender difference was found in activation of the left and right STG (BA22 and the cingulate cortex for the subtractive condition women minus men, thus indicating that women might have a greater preference or interest for social stimuli (faces and persons.

  10. Vapour cloud explosion hazard greater with light feedstocks

    Energy Technology Data Exchange (ETDEWEB)

    Windebank, C.S.

    1980-03-03

    Because lighter chemical feedstocks such as propylene and butylenes are more reactive than LPG's they pose a greater risk of vapor cloud explosion, particularly during their transport. According to C.S. Windebank (Insurance Tech. Bur.), percussive unconfined vapor cloud explosions (PUVCE's) do not usually occur below the ten-ton threshold for saturated hydrocarbons but can occur well below this threshold in the case of unsaturated hydrocarbons such as propylene and butylenes. Boiling liquid expanding vapor explosions (BLEVE's) are more likely to be ''hot'' (i.e., the original explosion is associated with fire) than ''cold'' in the case of unsaturated hydrocarbons. No PUVCE or BLEVE incident has been reported in the UK. In the US, 16 out of 20 incidents recorded between 1970 and 1975 were related to chemical feedstocks, including propylene and butylenes, and only 4 were LPG-related. The average losses were $20 million per explosion. Between 1968 and 1978, 8% of LPG pipeline spillages led to explosions.

  11. Status on disposal of greater-than-Class C

    Energy Technology Data Exchange (ETDEWEB)

    Plummer, T.L.

    1995-12-31

    The Department of Energy (DOE) has developed a plan for the management and disposal of commercially generated greater-than-Class C (GTCC) low-level radioactive waste. The Low-Level Radioactive Waste Policy Amendments Act of 1985 made DOE responsible for disposal of GTCC waste. The act requires that GTCC waste be disposed in a Nuclear Regulatory Commission (NRC)-licensed facility. The NRC has amended 10 CFR 61 to express a preference for geologic disposal of GTCC waste. Based on reassessment studies, legislative guidance, and stakeholder involvement, a revised plan has been formulated to provide for total management of GTCC waste. The plan has four major thrusts: (1) plan for GTCC waste storage at the generator site until disposal is available, (2) establish storage for GTCC sealed sources posing health and safety risk to the public, (3) facilitate storage for other GTCC waste posing health and safety risk to the public, and (4) plan for co-disposal of GTCC waste in a geologic disposal site with similar waste types. The revised plan focuses on applying available resources to near- and long-term needs.

  12. Spontaneous, generalized lipidosis in captive greater horseshoe bats (Rhinolophus ferrumequinum).

    Science.gov (United States)

    Gozalo, Alfonso S; Schwiebert, Rebecca S; Metzner, Walter; Lawson, Gregory W

    2005-11-01

    During a routine 6-month quarantine period, 3 of 34 greater horseshoe bats (Rhinolophus ferrumequinum) captured in mainland China and transported to the United States for use in echolocation studies were found dead with no prior history of illness. All animals were in good body condition at the time of death. At necropsy, a large amount of white fat was found within the subcutis, especially in the sacrolumbar region. The liver, kidneys, and heart were diffusely tan in color. Microscopic examination revealed that hepatocytes throughout the liver were filled with lipid, and in some areas, lipid granulomas were present. renal lesions included moderate amounts of lipid in the cortical tubular epithelium and large amounts of protein and lipid within Bowman's capsules in the glomeruli. In addition, one bat had large lipid vacuoles diffusely distributed throughout the myocardium. The exact pathologic mechanism inducing the hepatic, renal, and cardiac lipidosis is unknown. The horseshoe bats were captured during hibernation and immediately transported to the United States. It is possible that the large amount of fat stored coupled with changes in photoperiod, lack of exercise, and/or the stress of captivity might have contributed to altering the normal metabolic processes, leading to anorexia and consequently lipidosis in these animals.

  13. Greater Vancouver's water supply receives ozone treatment

    Energy Technology Data Exchange (ETDEWEB)

    Crosby, J.; Singh, I.; Reil, D. D.; Neden, G.

    2000-10-01

    To improve the overall quality of the treated water delivered to the member municipalities of the Greater Vancouver Water District (GVWD), the GVWD implemented a phased drinking water quality improvement program. The phased treatment program is directed at attaining effective disinfection while minimizing the formation of chlorinated disinfection by-products. Accordingly, the current primary disinfection method of chlorination was reevaluated and an ozone primary disinfection without filtration was authorized. Ozonization provides increased protection against Giardia and Cryptosporidium and a decrease in the formation potential for disinfection by-products (DPBs). This paper describes the design for the ozonation facility at Coquitlam, construction of which began in 1998 and completed during the summer of 2000. The facility houses the liquid oxygen supply, ozone generation, cooling water, ozone injection, primary off-gas ozone destruct system, and provides a home for various office, electrical maintenance and diesel generating functions. The second site at Capilano is expected to start construction in the fall of 2000 and be completed late in 2002. Wit its kilometre long stainless steel ozone contactor and sidestream injector tower, the Coquitlam Ozonation Facility is the first ozone pressure injection system of its kind in North America. 1 tab., 2 figs.

  14. Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand.

    Directory of Open Access Journals (Sweden)

    Tony Blakely

    2015-07-01

    Full Text Available Countries are increasingly considering how to reduce or even end tobacco consumption, and raising tobacco taxes is a potential strategy to achieve these goals. We estimated the impacts on health, health inequalities, and health system costs of ongoing tobacco tax increases (10% annually from 2011 to 2031, compared to no tax increases from 2011 ["business as usual," BAU], in a country (New Zealand with large ethnic inequalities in smoking-related and noncommunicable disease (NCD burden.We modeled 16 tobacco-related diseases in parallel, using rich national data by sex, age, and ethnicity, to estimate undiscounted quality-adjusted life-years (QALYs gained and net health system costs over the remaining life of the 2011 population (n = 4.4 million. A total of 260,000 (95% uncertainty interval [UI]: 155,000-419,000 QALYs were gained among the 2011 cohort exposed to annual tobacco tax increases, compared to BAU, and cost savings were US$2,550 million (95% UI: US$1,480 to US$4,000. QALY gains and cost savings took 50 y to peak, owing to such factors as the price sensitivity of youth and young adult smokers. The QALY gains per capita were 3.7 times greater for Māori (indigenous population compared to non-Māori because of higher background smoking prevalence and price sensitivity in Māori. Health inequalities measured by differences in 45+ y-old standardized mortality rates between Māori and non-Māori were projected to be 2.31% (95% UI: 1.49% to 3.41% less in 2041 with ongoing tax rises, compared to BAU. Percentage reductions in inequalities in 2041 were maximal for 45-64-y-old women (3.01%. As with all such modeling, there were limitations pertaining to the model structure and input parameters.Ongoing tobacco tax increases deliver sizeable health gains and health sector cost savings and are likely to reduce health inequalities. However, if policy makers are to achieve more rapid reductions in the NCD burden and health inequalities, they will also

  15. Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand

    Science.gov (United States)

    Blakely, Tony; Cobiac, Linda J.; Cleghorn, Christine L.; Pearson, Amber L.; van der Deen, Frederieke S.; Kvizhinadze, Giorgi; Nghiem, Nhung; McLeod, Melissa; Wilson, Nick

    2015-01-01

    Background Countries are increasingly considering how to reduce or even end tobacco consumption, and raising tobacco taxes is a potential strategy to achieve these goals. We estimated the impacts on health, health inequalities, and health system costs of ongoing tobacco tax increases (10% annually from 2011 to 2031, compared to no tax increases from 2011 [“business as usual,” BAU]), in a country (New Zealand) with large ethnic inequalities in smoking-related and noncommunicable disease (NCD) burden. Methods and Findings We modeled 16 tobacco-related diseases in parallel, using rich national data by sex, age, and ethnicity, to estimate undiscounted quality-adjusted life-years (QALYs) gained and net health system costs over the remaining life of the 2011 population (n = 4.4 million). A total of 260,000 (95% uncertainty interval [UI]: 155,000–419,000) QALYs were gained among the 2011 cohort exposed to annual tobacco tax increases, compared to BAU, and cost savings were US$2,550 million (95% UI: US$1,480 to US$4,000). QALY gains and cost savings took 50 y to peak, owing to such factors as the price sensitivity of youth and young adult smokers. The QALY gains per capita were 3.7 times greater for Māori (indigenous population) compared to non-Māori because of higher background smoking prevalence and price sensitivity in Māori. Health inequalities measured by differences in 45+ y-old standardized mortality rates between Māori and non-Māori were projected to be 2.31% (95% UI: 1.49% to 3.41%) less in 2041 with ongoing tax rises, compared to BAU. Percentage reductions in inequalities in 2041 were maximal for 45–64-y-old women (3.01%). As with all such modeling, there were limitations pertaining to the model structure and input parameters. Conclusions Ongoing tobacco tax increases deliver sizeable health gains and health sector cost savings and are likely to reduce health inequalities. However, if policy makers are to achieve more rapid reductions in the NCD

  16. High myopia in Greater Beijing School Children in 2016.

    Directory of Open Access Journals (Sweden)

    Yin Guo

    Full Text Available To assess prevalence and associated factors of myopia and high myopia in schoolchildren in Greater Beijing.The school-based, cross-sectional Greater Beijing School Children Myopia study was carried out in the year 2016 in 54 schools randomly selected from 15 districts in Beijing. Non-cycloplegic auto-refractometry of the right eyes was performed.The study included 35,745 (99.4% out of 35,968 eligible pupils with a mean age of 12.6±3.4 years (range 6-18 years. Prevalence of myopia defined as myopic refractive error of ≥-0.50 diopters (D,≥-1D,≥-6D,≥-8D and ≥-10D was 70.9%(95% confidence intervals (CI:70.5,71.4, 60.9% (95%CI:60.4,61.4, 8.6%(95%CI:8.4,8.9, 2.2%(95%CI:2.0,2.4, and 0.3% (95%CI:0.3,0.4, respectively. The frequency of high myopia (≥-6D, ≥-8D, ≥-10D increased from 1.5% (95%CI:1.0,2.0, 0.4% (95%CI:0.1,0.6 and 0.1% (95%CI:0.00,0.02, respectively in 10-year-olds to 19.4% (95%CI:17.3,21.6, 5.2% (95%CI:4.0,6.4 and 0.9% (95%CI:0.4,1.5, respectively, in 18-year-olds. Mean refractive error in the 18-year-olds was -3.74±2.56D (median:-3.63D;range:-19.6D to + 6.25D. Higher prevalence of high myopia (≥-6D and ≥-8D was correlated (all P<0.001 with older age (OR:1.18, and 1.15, respectively, female gender (OR: 1.44 and 1.40, respectively, higher body mass index (OR: 1.02 and 1.03, respectively, taller body height (OR: 1.03 and 1.02, respectively, urban region of habitation (OR: 1.26 and 1.33, respectively and higher school type (OR:1.57 and 2.22, respectively. Prevalence of severe high myopia (≥-10D was associated only with older age (P<0.001; OR: 1.44; 95%CI: 1.31, 1.59 but not with any education-related parameter such as higher school type (P = 0.48, urban region of habitation (P = 0.07 or female gender (P = 0.37.In this most recent survey, prevalence of high myopia (≥-6D:19.4%;≥-8D:5.2%;≥-10D:0.9% in 18-year-old school children was higher than in previous surveys from mainland China. In contrast to minor high myopia

  17. Dietary breadth of grizzly bears in the Greater Yellowstone Ecosystem

    Science.gov (United States)

    Gunther, Kerry A.; Shoemaker, Rebecca; Frey, Kevin L.; Haroldson, Mark A.; Cain, Steven L.; van Manen, Frank T.; Fortin, Jennifer K.

    2014-01-01

    Grizzly bears (Ursus arctos) in the Greater Yellowstone Ecosystem (GYE) are opportunistic omnivores that eat a great diversity of plant and animal species. Changes in climate may affect regional vegetation, hydrology, insects, and fire regimes, likely influencing the abundance, range, and elevational distribution of the plants and animals consumed by GYE grizzly bears. Determining the dietary breadth of grizzly bears is important to document future changes in food resources and how those changes may affect the nutritional ecology of grizzlies. However, no synthesis exists of all foods consumed by grizzly bears in the GYE. We conducted a review of available literature and compiled a list of species consumed by grizzly bears in the GYE. We documented >266 species within 200 genera from 4 kingdoms, including 175 plant, 37 invertebrate, 34 mammal, 7 fungi, 7 bird, 4 fish, 1 amphibian, and 1 algae species as well as 1 soil type consumed by grizzly bears. The average energy values of the ungulates (6.8 kcal/g), trout (Oncorhynchus spp., 6.1 kcal/g), and small mammals (4.5 kcal/g) eaten by grizzlies were higher than those of the plants (3.0 kcal/g) and invertebrates (2.7 kcal/g) they consumed. The most frequently detected diet items were graminoids, ants (Formicidae), whitebark pine seeds (Pinus albicaulis), clover (Trifolium spp.), and dandelion (Taraxacum spp.). The most consistently used foods on a temporal basis were graminoids, ants, whitebark pine seeds, clover, elk (Cervus elaphus), thistle (Cirsium spp.), and horsetail (Equisetum spp.). Historically, garbage was a significant diet item for grizzlies until refuse dumps were closed. Use of forbs increased after garbage was no longer readily available. The list of foods we compiled will help managers of grizzly bears and their habitat document future changes in grizzly bear food habits and how bears respond to changing food resources.

  18. Predictability of Seasonal Rainfall over the Greater Horn of Africa

    Science.gov (United States)

    Ngaina, J. N.

    2016-12-01

    The El Nino-Southern Oscillation (ENSO) is a primary mode of climate variability in the Greater of Africa (GHA). The expected impacts of climate variability and change on water, agriculture, and food resources in GHA underscore the importance of reliable and accurate seasonal climate predictions. The study evaluated different model selection criteria which included the Coefficient of determination (R2), Akaike's Information Criterion (AIC), Bayesian Information Criterion (BIC), and the Fisher information approximation (FIA). A forecast scheme based on the optimal model was developed to predict the October-November-December (OND) and March-April-May (MAM) rainfall. The predictability of GHA rainfall based on ENSO was quantified based on composite analysis, correlations and contingency tables. A test for field-significance considering the properties of finiteness and interdependence of the spatial grid was applied to avoid correlations by chance. The study identified FIA as the optimal model selection criterion. However, complex model selection criteria (FIA followed by BIC) performed better compared to simple approach (R2 and AIC). Notably, operational seasonal rainfall predictions over the GHA makes of simple model selection procedures e.g. R2. Rainfall is modestly predictable based on ENSO during OND and MAM seasons. El Nino typically leads to wetter conditions during OND and drier conditions during MAM. The correlations of ENSO indices with rainfall are statistically significant for OND and MAM seasons. Analysis based on contingency tables shows higher predictability of OND rainfall with the use of ENSO indices derived from the Pacific and Indian Oceans sea surfaces showing significant improvement during OND season. The predictability based on ENSO for OND rainfall is robust on a decadal scale compared to MAM. An ENSO-based scheme based on an optimal model selection criterion can thus provide skillful rainfall predictions over GHA. This study concludes that the

  19. Greater effort increases perceived value in an invertebrate.

    Science.gov (United States)

    Czaczkes, Tomer J; Brandstetter, Birgit; di Stefano, Isabella; Heinze, Jürgen

    2018-05-01

    Expending effort is generally considered to be undesirable. However, both humans and vertebrates will work for a reward they could also get for free. Moreover, cues associated with high-effort rewards are preferred to low-effort associated cues. Many explanations for these counterintuitive findings have been suggested, including cognitive dissonance (self-justification) or a greater contrast in state (e.g., energy or frustration level) before and after an effort-linked reward. Here, we test whether effort expenditure also increases perceived value in ants, using both classical cue-association methods and pheromone deposition, which correlates with perceived value. In 2 separate experimental setups, we show that pheromone deposition is higher toward the reward that requires more effort: 47% more pheromone deposition was performed for rewards reached via a vertical runway (high effort) compared with ones reached via a horizontal runway (low effort), and deposition rates were 28% higher on rough (high effort) versus smooth (low effort) runways. Using traditional cue-association methods, 63% of ants trained on different surface roughness, and 70% of ants trained on different runway elevations, preferred the high-effort related cues on a Y maze. Finally, pheromone deposition to feeders requiring memorization of one path bifurcation was up to 29% higher than to an identical feeder requiring no learning. Our results suggest that effort affects value perception in ants. This effect may stem from a cognitive process, which monitors the change in a generalized hedonic state before and after reward. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  20. Greater trochanter pain syndrome: A descriptive MR imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Klontzas, Michail E., E-mail: miklontzas@gmail.com; Karantanas, Apostolos H., E-mail: akarantanas@gmail.com

    2014-10-15

    Objective: Greater trochanter pain syndrome (GTPS) is a diverse clinical entity caused by a variety of underlying conditions. We sought to explore the impact of (1) hip morphology, namely the center-edge angle (CEa) and femoral neck-shaft (NSa) angle, (2) hip abductor tendon degeneration, (3) the dimensions of peritrochanteric edema and (4) bursitis, on the presence of GTPS, using MR imaging. Materials and methods: The presence of pain was prospectively assessed blindly by the senior author. CEa and NSa were blindly measured in 174 hip MR examinations, after completion of the clinical evaluation by another evaluator. The existence and dimensions of T2 hyperintensity of the peritrochanteric soft tissues, the existence and dimensions of bursae, as well as degeneration and tearing of gluteus tendons were also recorded. Results: Out of 174 examinations, 91 displayed peritrochanteric edema (group A) and 34 bursitis, all with peritrochanteric edema (group B). A number of 78 patients from both A and B groups, showed gluteus medius tendon degeneration and one tendon tear. CEa of groups A and B were 6° higher than those of normals (group C, P = 0.0038). The mean age of normals was 16.6 years less than in group A and 19.8 years less than in group B (P < 0.0001). Bursitis was associated with pain with a negative predictive value of 97% (P = 0.0003). Conclusion: Acetabular morphology is associated with GTPS and the absence of bursitis was proved to be clinically relevant. Peritrochanteric edema alone was not associated with local pain.

  1. Greater trochanter pain syndrome: A descriptive MR imaging study

    International Nuclear Information System (INIS)

    Klontzas, Michail E.; Karantanas, Apostolos H.

    2014-01-01

    Objective: Greater trochanter pain syndrome (GTPS) is a diverse clinical entity caused by a variety of underlying conditions. We sought to explore the impact of (1) hip morphology, namely the center-edge angle (CEa) and femoral neck-shaft (NSa) angle, (2) hip abductor tendon degeneration, (3) the dimensions of peritrochanteric edema and (4) bursitis, on the presence of GTPS, using MR imaging. Materials and methods: The presence of pain was prospectively assessed blindly by the senior author. CEa and NSa were blindly measured in 174 hip MR examinations, after completion of the clinical evaluation by another evaluator. The existence and dimensions of T2 hyperintensity of the peritrochanteric soft tissues, the existence and dimensions of bursae, as well as degeneration and tearing of gluteus tendons were also recorded. Results: Out of 174 examinations, 91 displayed peritrochanteric edema (group A) and 34 bursitis, all with peritrochanteric edema (group B). A number of 78 patients from both A and B groups, showed gluteus medius tendon degeneration and one tendon tear. CEa of groups A and B were 6° higher than those of normals (group C, P = 0.0038). The mean age of normals was 16.6 years less than in group A and 19.8 years less than in group B (P < 0.0001). Bursitis was associated with pain with a negative predictive value of 97% (P = 0.0003). Conclusion: Acetabular morphology is associated with GTPS and the absence of bursitis was proved to be clinically relevant. Peritrochanteric edema alone was not associated with local pain

  2. Reserves in western basins: Part 1, Greater Green River basin

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-01

    This study characterizes an extremely large gas resource located in low permeability, overpressured sandstone reservoirs located below 8,000 feet drill depth in the Greater Green River basin, Wyoming. Total in place resource is estimated at 1,968 Tcf. Via application of geologic, engineering and economic criteria, the portion of this resource potentially recoverable as reserves is estimated. Those volumes estimated include probable, possible and potential categories and total 33 Tcf as a mean estimate of recoverable gas for all plays considered in the basin. Five plays (formations) were included in this study and each was separately analyzed in terms of its overpressured, tight gas resource, established productive characteristics and future reserves potential based on a constant $2/Mcf wellhead gas price scenario. A scheme has been developed to break the overall resource estimate down into components that can be considered as differing technical and economic challenges that must be overcome in order to exploit such resources: in other words, to convert those resources to economically recoverable reserves. Total recoverable reserves estimates of 33 Tcf do not include the existing production from overpressured tight reservoirs in the basin. These have estimated ultimate recovery of approximately 1.6 Tcf, or a per well average recovery of 2.3 Bcf. Due to the fact that considerable pay thicknesses can be present, wells can be economic despite limited drainage areas. It is typical for significant bypassed gas to be present at inter-well locations because drainage areas are commonly less than regulatory well spacing requirements.

  3. Deviance and resistance: Malaria elimination in the greater Mekong subregion.

    Science.gov (United States)

    Lyttleton, Chris

    2016-02-01

    Malaria elimination rather than control is increasingly globally endorsed, requiring new approaches wherein success is not measured by timely treatment of presenting cases but eradicating all presence of infection. This shift has gained urgency as resistance to artemisinin-combination therapies spreads in the Greater Mekong Sub-region (GMS) posing a threat to global health security. In the GMS, endemic malaria persists in forested border areas and elimination will require calibrated approaches to remove remaining pockets of residual infection. A new public health strategy called 'positive deviance' is being used to improve health promotion and community outreach in some of these zones. However, outbreaks sparked by alternative understandings of appropriate behaviour expose the unpredictable nature of 'border malaria' and difficulties eradication faces. Using a recent spike in infections allegedly linked to luxury timber trade in Thai borderlands, this article suggests that opportunities for market engagement can cause people to see 'deviance' as a means to material advancement in ways that increase disease vulnerability. A malaria outbreak in Ubon Ratchathani was investigated during two-week field-visit in November 2014 as part of longer project researching border malaria in Thai provinces. Qualitative data were collected in four villages in Ubon's three most-affected districts. Discussions with villagers focused primarily on changing livelihoods, experience with malaria, and rosewood cutting. Informants included ten men and two women who had recently overnighted in the nearby forest. Data from health officials and villagers are used to frame Ubon's rise in malaria transmission within moral and behavioural responses to expanding commodity supply-chains. The article argues that elimination strategies in the GMS must contend with volatile outbreaks among border populations wherein 'infectiousness' and 'resistance' are not simply pathogen characteristics but also

  4. Interspecific nest parasitism by chukar on greater sage-grouse

    Science.gov (United States)

    Fearon, Michelle L.; Coates, Peter S.

    2014-01-01

    Nest parasitism occurs when a female bird lays eggs in the nest of another and the host incubates the eggs and may provide some form of parental care for the offspring (Lyon and Eadie 1991). Precocial birds (e.g., Galliformes and Anseriformes) are typically facultative nest parasites of both their own and other species (Lyon and Eadie 1991). This behavior increases a female’s reproductive success when she parasitizes other nests while simultaneously raising her own offspring. Both interspecific and conspecific nest parasitism have been well documented in several families of the order Galliformes, particularly the Phasianidae (Lyon and Eadie 1991, Geffen and Yom-Tov 2001, Krakauer and Kimball 2009). The Chukar (Alectoris chukar) has been widely introduced as a game bird to western North America from Eurasia and is now well established within the Great Basin from northeastern California east to Utah and north to Idaho and Oregon (Christensen 1996). Over much of this range the Chukar occurs with other phasianids, including the native Greater Sage-Grouse (Centrocercus urophasianus), within sagebrush (Artemisia spp.) steppe (Christensen 1996, Schroeder et al. 1999, Connelly et al. 2000). Chukar typically exploit a broader range of habitats than do sage-grouse, but both species use the same species of sagebrush and other shrubs for nesting cover (Christensen 1996, Schroeder et al. 1999). Chukar are known to parasitize nests of other individuals of their own species (Geffen and Yom-Tov 2001), but we are unaware of reported evidence that Chukar may parasitize nests of sage-grouse. Here we describe a case of a Chukar parasitizing a sage-grouse nest in the sagebrush steppe of western Nevada.

  5. Extraterrestrial Life

    Science.gov (United States)

    Klein, M. J.

    1993-01-01

    Extraterrestrial Intelligence is intelligent life that developed somewhere other than the earth. Such life has not yet been discovered. However, scientific research, including astronomy, biology, planetary science and studies of fossils here on earth have led many scientists to conclude that such life may exist on planets orbiting at least some of the hundreds of billions of stars in our Milky Way Galaxy. Today, some researchers are trying to find evidence for extraterrestrial intelligence. This effort is often called SETI, which stands for Search for Extraterrestrial Intelligence. SETI researchers decided that looking for evidence of their technology might be the best way to discover other intelligent life in the Galaxy. They decided to use large radio telescopes to search the sky over a wide range of radio frequencies...

  6. Views That Are Shared With Others Are Expressed With Greater Confidence and Greater Fluency Independent of Any Social Influence.

    Science.gov (United States)

    Koriat, Asher; Adiv, Shiri; Schwarz, Norbert

    2016-05-01

    Research on group influence has yielded a prototypical majority effect (PME): Majority views are endorsed faster and with greater confidence than minority views, with the difference increasing with majority size. The PME was attributed to conformity pressure enhancing confidence in consensual views and causing inhibition in venturing deviant opinions. Our results, however, indicate that PME for binary choices can arise from the process underlying confidence and latency independent of social influence. PME was demonstrated for tasks and conditions that are stripped of social relevance; it was observed in within-individual analyses in contrasting the individual's more frequent and less frequent responses to the same item, and was found for the predictions of others' responses. A self-consistency model, which assumes that choice and confidence are based on the sampling of representations from a commonly shared pool of representations, yielded a PME for confidence and latency. Behavioral implications of the results are discussed. © 2015 by the Society for Personality and Social Psychology, Inc.

  7. Psychiatry: life events and social support in late life depression

    Directory of Open Access Journals (Sweden)

    Clóvis Alexandrino-Silva

    2011-01-01

    Full Text Available OBJECTIVES: To examine the association of life events and social support in the broadly defined category of depression in late life. INTRODUCTION: Negative life events and lack of social support are associated with depression in the elderly. Currently, there are limited studies examining the association between life events, social support and late-life depression in Brazil. METHODS: We estimated the frequency of late-life depression within a household community sample of 367 subjects aged 60 years or greater with associated factors. ''Old age symptomatic depression'' was defined using the Composite International Diagnostic Interview 1.1 tool. This diagnostic category included only late-life symptoms and consisted of the diagnoses of depression and dysthymia as well as a subsyndromal definition of depression, termed ''late subthreshold depression''. Social support and life events were assessed using the Comprehensive Assessment and Referral Evaluation (SHORT-CARE inventory. RESULTS: ''Old age symptomatic depression'' occurred in 18.8% of the patients in the tested sample. In univariate analyses, this condition was associated with female gender, lifetime anxiety disorder and living alone. In multivariate models, ''old age symptomatic depression'' was associated with a perceived lack of social support in men and life events in women. DISCUSSION: Social support and life events were determined to be associated with late-life depression, but it is important to keep in mind the differences between genders. Also, further exploration of the role of lifetime anxiety disorder in late-life depression may be of future importance. CONCLUSIONS: We believe that this study helps to provide insight into the role of psychosocial factors in late-life depression.

  8. The outcome of endoscopy for recalcitrant greater trochanteric pain syndrome.

    Science.gov (United States)

    Drummond, James; Fary, Camdon; Tran, Phong

    2016-11-01

    Greater trochanteric pain syndrome (GTPS), previously referred as trochanteric bursitis, is a debilitating condition characterised by chronic lateral hip pain. The syndrome is thought to relate to gluteal tendinopathy, with most cases responding to non-operative treatment. A number of open and endoscopic surgical techniques targeting the iliotibial band, trochanteric bursa and gluteal tendons have, however, been described for severe recalcitrant cases. We report the outcomes of one such endoscopic approach here. We retrospectively reviewed 49 patients (57 operations) who had undergone endoscopic longitudinal vertical iliotibial band release and trochanteric bursectomy. Inclusion criteria included diagnosed GTPS with a minimum of six months of non-operative treatment. Exclusion criteria included concomitant intra- or extra-articular hip pathology and previous hip surgery including total hip arthroplasty. Outcomes were assessed using the Visual Analogue Scale, Oxford hip Score and International Hip Outcome Tool (iHOT-33). The series included 42 females and 7 males with a mean age of 65.0 years (26.7-88.6). Mean follow-up time was 20.7 months (5.3-41.2). Eight patients had full thickness gluteal tendon tears, of which 7 were repaired. Adjuvant PRP was injected intraoperatively in 38 of 57 operations (67.2 %). At follow-up, overall mean Visual Analogue Scale values had decreased from 7.8 to 2.8 (p < 0.001), Oxford hip Scores had increased from 20.4 to 37.3 (p < 0.001) and iHOT-33 scores had increased from 23.8 to 70.2 (p < 0.001). Of the 57 operations performed, patients reported feeling very satisfied with the surgical outcome in 28 operations (49.1 %), satisfied in 17 operations (29.8 %) and less than satisfied in 12 operations (21.1 %). While the majority of patients with GTPS will improve with non-operative management, endoscopic iliotibial band release, trochanteric bursectomy and gluteal tendon repair is a safe and effective treatment for severe

  9. Malaria in the Greater Mekong Subregion: Heterogeneity and Complexity

    Science.gov (United States)

    Cui, Liwang; Yan, Guiyun; Sattabongkot, Jetsumon; Cao, Yaming; Chen, Bin; Chen, Xiaoguang; Fan, Qi; Fang, Qiang; Jongwutiwes, Somchai; Parker, Daniel; Sirichaisinthop, Jeeraphat; Kyaw, Myat Phone; Su, Xin-zhuan; Yang, Henglin; Yang, Zhaoqing; Wang, Baomin; Xu, Jianwei; Zheng, Bin; Zhong, Daibin; Zhou, Guofa

    2011-01-01

    The Greater Mekong Subregion (GMS), comprised of six countries including Cambodia, China's Yunnan Province, Lao PDR, Myanmar (Burma), Thailand and Vietnam, is one of the most threatening foci of malaria. Since the initiation of the WHO's Mekong Malaria Program a decade ago, malaria situation in the GMS has greatly improved, reflected in the continuous decline in annual malaria incidence and deaths. However, as many nations are moving towards malaria elimination, the GMS nations still face great challenges. Malaria epidemiology in this region exhibits enormous geographical heterogeneity with Myanmar and Cambodia remaining high-burden countries. Within each country, malaria distribution is also patchy, exemplified by ‘border malaria’ and ‘forest malaria’ with high transmission occurring along international borders and in forests or forest fringes, respectively. ‘Border malaria’ is extremely difficult to monitor, and frequent malaria introductions by migratory human populations constitute a major threat to neighboring, malaria-eliminating countries. Therefore, coordination between neighboring countries is essential for malaria elimination from the entire region. In addition to these operational difficulties, malaria control in the GMS also encounters several technological challenges. Contemporary malaria control measures rely heavily on effective chemotherapy and insecticide control of vector mosquitoes. However, the spread of multidrug resistance and potential emergence of artemisinin resistance in Plasmodium falciparum make resistance management a high priority in the GMS. This situation is further worsened by the circulation of counterfeit and substandard artemisinin-related drugs. In most endemic areas of the GMS, P. falciparum and P. vivax coexist, and in recent malaria control history, P. vivax has demonstrated remarkable resilience to control measures. Deployment of the only registered drug (primaquine) for the radical cure of vivax malaria is

  10. Greater sage-grouse population trends across Wyoming

    Science.gov (United States)

    Edmunds, David; Aldridge, Cameron L.; O'Donnell, Michael; Monroe, Adrian

    2018-01-01

    The scale at which analyses are performed can have an effect on model results and often one scale does not accurately describe the ecological phenomena of interest (e.g., population trends) for wide-ranging species: yet, most ecological studies are performed at a single, arbitrary scale. To best determine local and regional trends for greater sage-grouse (Centrocercus urophasianus) in Wyoming, USA, we modeled density-independent and -dependent population growth across multiple spatial scales relevant to management and conservation (Core Areas [habitat encompassing approximately 83% of the sage-grouse population on ∼24% of surface area in Wyoming], local Working Groups [7 regional areas for which groups of local experts are tasked with implementing Wyoming's statewide sage-grouse conservation plan at the local level], Core Area status (Core Area vs. Non-Core Area) by Working Groups, and Core Areas by Working Groups). Our goal was to determine the influence of fine-scale population trends (Core Areas) on larger-scale populations (Working Group Areas). We modeled the natural log of change in population size ( peak M lek counts) by time to calculate the finite rate of population growth (λ) for each population of interest from 1993 to 2015. We found that in general when Core Area status (Core Area vs. Non-Core Area) was investigated by Working Group Area, the 2 populations trended similarly and agreed with the overall trend of the Working Group Area. However, at the finer scale where Core Areas were analyzed separately, Core Areas within the same Working Group Area often trended differently and a few large Core Areas could influence the overall Working Group Area trend and mask trends occurring in smaller Core Areas. Relatively close fine-scale populations of sage-grouse can trend differently, indicating that large-scale trends may not accurately depict what is occurring across the landscape (e.g., local effects of gas and oil fields may be masked by increasing

  11. Self-mastery among Chinese Older Adults in the Greater Chicago Area

    Directory of Open Access Journals (Sweden)

    Xinqi Dong

    2014-09-01

    Full Text Available Background: Self-mastery is an important psychological resource to cope with stressful situations. However, we have limited understanding of self-mastery among minority aging populations. Objective: This study aims to examine the presence and levels of self-mastery among U.S. Chinese older adults. Methods: Data were drawn from the PINE study, a population-based survey of U.S. Chinese older adults in the Greater Chicago area. Guided by a community-based participatory research approach, a total of 3,159 Chinese older adults aged 60 and above were surveyed. A Chinese version of the Self-Mastery Scale was used to assess self-mastery. Results: Out of the 7-item Chinese Self-Mastery Scale, approximately 42.8% to 87.5% of Chinese older adults experienced some degree of self-mastery in their lives. Older adults with no formal education and the oldest-old aged 85 and over had the lowest level of self-mastery in our study. A higher mastery level was associated with being married, having fewer children, better self-reported health status, better quality of life, and positive health changes. Conclusion: Although self-mastery is commonly experienced among the Chinese aging population in the Greater Chicago area, specific subgroups are still vulnerable. Future longitudinal studies are needed to improve the understanding of risk factors and outcomes associated with self-mastery among Chinese older adults.

  12. Physics of the Life Sciences

    CERN Document Server

    Newman, Jay

    2008-01-01

    Originally developed for the author's course at Union College, this text is designed for life science students who need to understand the connections of fundamental physics to modern biology and medicine. Almost all areas of modern life sciences integrally involve physics in both experimental techniques and in basic understanding of structure and function. Physics of the Life Sciences is not a watered-down, algebra-based engineering physics book with sections on relevant biomedical topics added as an afterthought. This authoritative and engaging text, which is designed to be covered in a two-semester course, was written with a thoroughgoing commitment to the needs and interests of life science students. Although covering most of the standard topics in introductory physics in a more or less traditional sequence, the author gives added weight and space to concepts and applications of greater relevance to the life sciences. Students benefit from occasional sidebars using calculus to derive fundamental relations,...

  13. Recognising life

    DEFF Research Database (Denmark)

    Nissen, Morten

    2013-01-01

    ’ – that the contemporary discursive pragmatics of more or less pharmaceutical life practices still include forms of transcendence – and by the wish to fertilize the field of bio-politics with the indexical inter-subjectivity of the concept of ideology, as derived from an antiessentialist reading of Hegelian......–Marxist traditions. The analysis unfolds as an ideology critique that reconstructs, and seeks ways to overcome, particular forms of recognition that are identifiable in the data and in the field of drug practices, and how these form part of the constitution of singular collectives and participants – in these life...

  14. Life Cycle Thinking in Impact Assessment

    DEFF Research Database (Denmark)

    Bidstrup, Morten

    2015-01-01

    It has been advocated that life cycle thinking (LCT) should be applied in impact assessment (IA) to a greater extent, since some development proposals pose a risk of significant impacts throughout the interconnected activities of product systems. Multiple authors have proposed the usage of life...

  15. Ged® Completers' Perceptions of College Readiness and Social Capital: Linking Adult Literacy to a Greater Quality of Life

    Science.gov (United States)

    Lott, Donalyn; O'Dell, Jade

    2014-01-01

    This study examined the efficacy of general education development (GED®) acquisition and GED® completers' perceptions of college readiness and social capital using a quantitative methodology. Also, the study used a descriptive, cross-sectional research design framed by the social capital theoretical perspective. The conceptual framework developed…

  16. One life

    Directory of Open Access Journals (Sweden)

    Demkova E.E.

    2016-06-01

    Full Text Available It is not easy to care for a special needs child. Especially, it is easy to understand parents’ worries about their grown up children. Living in one’s own family or supported living in the community are much more preferable than the options the state can offer. The author — a mother of a young woman with autism — contemplates about possibilities for independent living for a person with special needs after their parents are gone. She is confident that teaching a child skills for independent living is not less important than giving them school education. The author illustrates her thoughts with real examples of support for adults with disabilities in their independent life or life in a foster family in a city, as well in rural areas.

  17. Pumping life

    DEFF Research Database (Denmark)

    Sitsel, Oleg; Dach, Ingrid; Hoffmann, Robert Daniel

    2012-01-01

    The name PUMPKIN may suggest a research centre focused on American Halloween traditions or the investigation of the growth of vegetables – however this would be misleading. Researchers at PUMPKIN, short for Centre for Membrane Pumps in Cells and Disease, are in fact interested in a large family o......’. Here we illustrate that the pumping of ions means nothing less than the pumping of life....

  18. EXTRA LIFE

    Directory of Open Access Journals (Sweden)

    Ruth S. Contreras Espinosa

    2016-02-01

    Full Text Available El creciente número de personas jugando videojuegos significa que estos están teniendo un efecto innegable sobre nuestra cultura. Este efecto es claramente visible en una aceptación general. Los videojuegos también han cambiado la forma en que muchas otras formas de medios de comunicación, se producen y consumen. Los videojuegos tienen una influencia creciente en nuestra cultura, y en "EXTRA LIFE" diferentes autores expresan sus opiniones sobre este nuevo medio. EXTRA LIFE Abstract The increasing number of people playing video games means that they are having an undeniable effect on culture. This effect is clearly visible in the increasing mainstream acceptance of aspects of gaming culture. Video games have also changed the way that many other forms of media, are produced and consumed. Video games have an increasing influence on our culture,  and in "EXTRA LIFE" diferent authors have voiced their opinions on this new media. Keywords: Video games; culture; effects; games.

  19. Relation Between Hertz Stress-Life Exponent, Ball-Race Conformity, and Ball Bearing Life

    Science.gov (United States)

    Zaretsky, Erwin V.; Poplawski, Joseph V.; Root, Lawrence E.

    2008-01-01

    ANSI/ABMA and ISO standards based on Lundberg-Palmgren bearing life theory are normalized for ball bearings having inner- and outerrace conformities of 52 percent (0.52) and made from pre-1940 bearing steel. The Lundberg-Palmgren theory incorporates an inverse 9th power relation between Hertz stress and fatigue life for ball bearings. The effect of race conformity on ball set life independent of race life is not incorporated into the Lundberg-Palmgren theory. In addition, post-1960 vacuum-processed bearing steel exhibits a 12th power relation between Hertz stress and life. The work reported extends the previous work of Zaretsky, Poplawski, and Root to calculate changes in bearing life--that includes the life of the ball set--caused by race conformity, Hertz stress-life exponent, ball bearing type and bearing series. The bearing fatigue life in actual application will usually be equal to or greater than that calculated using the ANSI/ABMA and ISO standards that incorporate the Lundberg-Palmgren theory. The relative fatigue life of an individual race is more sensitive to changes in race conformity for Hertz stress-life exponent n of 12 than where n = 9. However, when the effects are combined to predict actual bearing life for a specified set of conditions and bearing geometry, the predicted life of the bearing will be greater for a value of n = 12 than n = 9.

  20. Greater Expectations

    Science.gov (United States)

    McCloskey, Patrick J.

    2006-01-01

    Julius Bennett was once a disinterested student destined to become a dropout. Then he enrolled in Amistad Academy, an academically focused charter middle school intent on narrowing the achievement gap between urban and suburban kids located in New Haven, Connecticut. Now Julius is making plans for college. In this article the author details the…

  1. Greater Melbourne.

    Science.gov (United States)

    Wulff, M; Burke, T; Newton, P

    1986-03-01

    With more than a quarter of its population born overseas, Melbourne, Australia, is rapidly changing from an all-white British outpost to a multicultural, multilingual community. Since the "white" Australian policy was abandoned after World War II, 3 million immigrants from 100 different countries have moved to Australia. Most of the immigrants come from New Zealand, Rhodesia, South Africa, Britain, Ireland, Greece, Turkey, Yugoslavia, Poland, and Indochina. Melbourne is Australia's 2nd largest city and houses 1 out of 5 Australians. Its 1984 population was 2,888,400. Melbourne's housing pattern consists of subdivisions; 75% of the population live in detached houses. Between 1954 and 1961 Melbourne grew at an annual rate of 3.5%; its growth rate between 1961 and 1971 still averaged 2.5%. In the 1970s the growth rate slowed to 1.4%. Metropolitan Melbourne has no central government but is divided into 56 councils and 8 regions. Both Australia's and Melbourne's fertility rates are high compared to the rest of the developed world, partly because of their younger age structure. 41% of Melbourne's population was under age 24 in 1981. Single-person households are growing faster than any other type. 71% of the housing is owner-occupied; in 1981 the median sized dwelling had 5.2 rooms. Public housing only accounts for 2.6% of all dwellings. Fewer students graduate from high school in Australia than in other developed countries, and fewer graduates pursue higher education. Melbourne's suburban sprawl promotes private car travel. In 1980 Melbourne contained more than 28,000 retail establishments and 4200 restaurants and hotels. Industry accounts for 30% of employment, and services account for another 30%. Its largest industries are motor vehicles, clothing, and footware. Although unemployment reached 10% after the 1973 energy crisis, by 1985 it was down to 6%.

  2. Defining health-related quality of life for young wheelchair users: A qualitative health economics study.

    Directory of Open Access Journals (Sweden)

    Nathan Bray

    Full Text Available Wheelchairs for children with impaired mobility provide health, developmental and psychosocial benefits, however there is limited understanding of how mobility aids affect the health-related quality of life of children with impaired mobility. Preference-based health-related quality of life outcome measures are used to calculate quality-adjusted life years; an important concept in health economics. The aim of this research was to understand how young wheelchair users and their parents define health-related quality of life in relation to mobility impairment and wheelchair use.The sampling frame was children with impaired mobility (≤18 years who use a wheelchair and their parents. Data were collected through semi-structured face-to-face interviews conducted in participants' homes. Qualitative framework analysis was used to analyse the interview transcripts. An a priori thematic coding framework was developed. Emerging codes were grouped into categories, and refined into analytical themes. The data were used to build an understanding of how children with impaired mobility define health-related quality of life in relation to mobility impairment, and to assess the applicability of two standard measures of health-related quality of life.Eleven children with impaired mobility and 24 parents were interviewed across 27 interviews. Participants defined mobility-related quality of life through three distinct but interrelated concepts: 1 participation and positive experiences; 2 self-worth and feeling fulfilled; 3 health and functioning. A good degree of consensus was found between child and parent responses, although there was some evidence to suggest a shift in perception of mobility-related quality of life with child age.Young wheelchair users define health-related quality of life in a distinct way as a result of their mobility impairment and adaptation use. Generic, preference-based measures of health-related quality of life lack sensitivity in this

  3. Greater number of group identifications is associated with healthier behaviour: Evidence from a Scottish community sample.

    Science.gov (United States)

    Sani, Fabio; Madhok, Vishnu; Norbury, Michael; Dugard, Pat; Wakefield, Juliet R H

    2015-09-01

    This paper investigates the interplay between group identification (i.e., the extent to which one has a sense of belonging to a social group, coupled with a sense of commonality with in-group members) and four types of health behaviour, namely physical exercise, smoking, drinking, and diet. Specifically, we propose a positive relationship between one's number of group identifications and healthy behaviour. This study is based on the Scottish portion of the data obtained for Wave 1 of the two-wave cross-national Health in Groups project. Totally 1,824 patients from five Scottish general practitioner (GP) surgeries completed the Wave 1 questionnaire in their homes. Participants completed measures of group identification, group contact, health behaviours, and demographic variables. Results demonstrate that the greater the number of social groups with which one identifies, the healthier one's behaviour on any of the four health dimensions considered. We believe our results are due to the fact that group identification will generally (1) enhance one's sense of meaning in life, thereby leading one to take more care of oneself, (2) increase one's sense of responsibility towards other in-group members, thereby enhancing one's motivation to be healthy in order to fulfil those responsibilities, and (3) increase compliance with healthy group behavioural norms. Taken together, these processes amply overcompensate for the fact that some groups with which people may identify can actually prescribe unhealthy behaviours. © 2014 The British Psychological Society.

  4. Are passive smoking, air pollution and obesity a greater mortality risk than major radiation incidents?

    Directory of Open Access Journals (Sweden)

    Smith Jim T

    2007-04-01

    Full Text Available Abstract Background Following a nuclear incident, the communication and perception of radiation risk becomes a (perhaps the major public health issue. In response to such incidents it is therefore crucial to communicate radiation health risks in the context of other more common environmental and lifestyle risk factors. This study compares the risk of mortality from past radiation exposures (to people who survived the Hiroshima and Nagasaki atomic bombs and those exposed after the Chernobyl accident with risks arising from air pollution, obesity and passive and active smoking. Methods A comparative assessment of mortality risks from ionising radiation was carried out by estimating radiation risks for realistic exposure scenarios and assessing those risks in comparison with risks from air pollution, obesity and passive and active smoking. Results The mortality risk to populations exposed to radiation from the Chernobyl accident may be no higher than that for other more common risk factors such as air pollution or passive smoking. Radiation exposures experienced by the most exposed group of survivors of Hiroshima and Nagasaki led to an average loss of life expectancy significantly lower than that caused by severe obesity or active smoking. Conclusion Population-averaged risks from exposures following major radiation incidents are clearly significant, but may be no greater than those from other much more common environmental and lifestyle factors. This comparative analysis, whilst highlighting inevitable uncertainties in risk quantification and comparison, helps place the potential consequences of radiation exposures in the context of other public health risks.

  5. Maternal PTSD associates with greater glucocorticoid sensitivity in offspring of Holocaust survivors.

    Science.gov (United States)

    Lehrner, Amy; Bierer, Linda M; Passarelli, Vincent; Pratchett, Laura C; Flory, Janine D; Bader, Heather N; Harris, Iris R; Bedi, Aarti; Daskalakis, Nikolaos P; Makotkine, Iouri; Yehuda, Rachel

    2014-02-01

    Intergenerational effects of trauma have been observed clinically in a wide range of populations, and parental PTSD has been associated with an increased risk for psychopathology in offspring. In studies of Holocaust survivor offspring, parental PTSD, and particularly maternal PTSD, has been associated with increased risk for PTSD, low basal urinary cortisol excretion and enhanced cortisol suppression in response to dexamethasone. Such findings implicate maternally derived glucocorticoid programming in the intergenerational transmission of trauma-related consequences, potentially resulting from in utero influences or early life experiences. This study investigated the relative influence of Holocaust exposure and PTSD in mothers and fathers on glucocorticoid sensitivity in offspring. Eighty Holocaust offspring and 15 offspring of non-exposed Jewish parents completed evaluations and provided blood and urine samples. Glucocorticoid sensitivity was evaluated using the lysozyme suppression test (LST), an in vitro measure of glucocorticoid receptor sensitivity in a peripheral tissue, the dexamethasone suppression test (DST), and 24-h urinary cortisol excretion. Maternal PTSD was associated with greater glucocorticoid sensitivity in offspring across all three measures of glucocorticoid function. An interaction of maternal and paternal PTSD on the DST and 24-h urinary cortisol showed an effect of decreased glucocorticoid sensitivity in offspring with paternal, but not maternal, PTSD. Although indirect, these findings are consistent with the hypothesis that epigenetic programming may be involved in the intergenerational transmission of trauma-related effects on glucocorticoid regulation. Published by Elsevier Ltd.

  6. Clean air benefits and costs in the GVRD [Greater Vancouver Regional District

    International Nuclear Information System (INIS)

    Gislason, G.; Martin, J.; Williams, D.; Caton, B.; Rich, J.; Rojak, S.; Robinson, J.; Stuermer, A. von

    1994-01-01

    Air pollution is a major concern in the Greater Vancouver Regional District in British Columbia. An analysis was conducted to assess the costs and benefits of an innovative plan to reduce the emissions of five primary pollutants in the GVRD: nitrogen oxides (NOx), sulfur oxides (SOx), volatile organic compounds (VOCs), particulates, and CO. The study adopts a damage function approach in which the benefits of reduced emissions are given by the averted damages to human health, crops, and so on. Under a base case scenario, motor vehicle emission controls and additional measures proposed in the region's air quality management plan (AQMP) are projected to lead to emission reductions of 873,000 tonnes in the GVRD by the year 2020, compared to the emission level projected without intervention. The AQMP is projected to avert over its life some 2,800 premature deaths, 33,000 emergency room visits, 13 million restricted activity days, and 5 million symptoms. Crop losses due to ozone are projected to decrease by 1-4%/y over the next several decades due to the AQMP. Damage averted to materials and property per tonne of pollutant reduced ranges from $30 for VOC to $180 for particulates. Under base-case conservative assumptions, the AQMP generates $5.4 billion in benefits and $3.8 billion in costs, nearly 2/3 of which are paid by the industrial and commercial sectors. 1 tab

  7. Life lessons.

    Science.gov (United States)

    Nitschke, Jonathan R

    2015-01-01

    Reminiscing about his younger self: "I mean I can't very well just 86 [in American slang, to "86" is to eject, remove, or discard someone or something, J.R.N.] this guy from my life. On the other hand, if through some as yet undeveloped technology I were to run into him today, how comfortable would I feel about lending him money, or for that matter even stepping down the street to have a beer and talk over old times?" - Thomas Pynchon, Slow Learner.

  8. Linking well-being with cultural revitalization for greater cognitive justice in conservation: lessons from Venezuela in Canaima National Park

    Directory of Open Access Journals (Sweden)

    Iokiñe Rodriguez

    2017-12-01

    Full Text Available Across the globe, conservation policies have often suppressed nonscientific forms of knowledge and ways of knowing nature, along with the social practices of the groups that are informed by such knowledge. Reversing this process of epistemic supremacy is crucial both for achieving greater cognitive justice in conservation areas and ensuring that conservation aims are achieved. Doing so, however, is not an easy task. In situations of cultural violence, hidden environmental knowledge is not easily made visible unless adequate conditions for it to emerge are created. I show that one way forward is by conservation engaging with the well-being agendas of indigenous people, in particular, with the construction of their life plans. This discussion is illustrated through a case study in Canaima National Park, Venezuela, where over the last 20 years, social-ecological research has been studying existing conflicts over the use of fire while supporting the development of Pemon (the indigenous peoples in this area Life Plans. Assisting in the development of life plans through participatory historical reconstructions, territorial self-demarcation processes, and facilitation of community reflexivity about its social-ecological changes and desired future has been decisive for the Pemon, and has revealed fire management knowledge that challenges conventional explanations of landscape change that simplistically place the blame for such changes on the local use of fire. This local knowledge, combined with results from studies of Pemon fire regimes, fire behavior ecology, and paleoecological research, now informs a counter narrative of landscape change that is influencing a shift in environmental discourse and policy-making toward an intercultural fire management approach. By documenting how social-ecological research has engaged with the Pemon Life Plan processes, I show the important role that cultural revitalization plays in making hidden and silenced local

  9. Quantifying the Driving Forces of Informal Urbanization in the Western Part of the Greater Cairo Metropolitan Region

    Directory of Open Access Journals (Sweden)

    Taher Osman

    2016-06-01

    Full Text Available This paper discusses the driving forces (DFs of informal urbanization (IU in the greater Cairo metropolitan region (GCMR using the Analytic Hierarchy Process (AHP. The IU patterns in the GCMR have been extremely influenced by seven DFs: geographical characteristics, availability of life facilities, economic incentives, land demand and supply, population increase, administrative function, and development plans. This research found that these forces vary significantly in how they influence urban growth in the three study sectors, namely, the middle, north, and south areas in the western part of the GCMR. The forces with the highest influence were economic incentives in the middle sector, population increase in the north sector, and the administrative function in the south sector. Due to the lower availability of buildable land in the middle sector, the land demand and supply force had a lesser influence in this sector compared to in the north and south sectors. The development plans force had medium influence in all sectors. The geographical characteristics force had little influence in both the middle and the north sectors, but higher influence than economic incentives, availability of life facilities, and development plans in the south sector. Because of the spatial variances in life facilities organizations in the GCMR, the life facilities availability force had little effect on IU in the south sector.

  10. Quality of life of inoperable non-small cell lung carcinoma

    International Nuclear Information System (INIS)

    Minet, P.; Chevalier, P.; Gras, A.; Dejardin-Closon, M.T.; Bartsch, P.; Raets, D.; Lennes, G.

    1987-01-01

    Eighty one patients with inoperable non-small cell lung carcinoma (NSCLC) were entered in a randomized phase II trial comparing split-dose irradiation alone to combined treatment radiotherapy and polychemotherapy (C.A.P. + V.D.S.). The quality of life and the survival of the patients were studied. The authors have defined three classes of quality of life responses based on the time elapsed before the performance status index drops. A higher quality of life failure rate was observed in the combined treatment group (p non-significant) but the time elapsed before the Karnofsky index drops is longer in the combined treatment group for the quality of life 'no change' subgroup (p = 0.15). Survival and quality adjusted survival are similar in both treatment groups. The same conclusion holds for retrospective stratified treatment groups. The authors conclude that as far as the quality of life is concerned, polychemotherapy combined with the particular split-dose irradiation schedule used is an effective treatment of inoperable NSCLC. (Auth.)

  11. Global life satisfaction predicts ambulatory affect, stress, and cortisol in daily life in working adults.

    Science.gov (United States)

    Smyth, Joshua M; Zawadzki, Matthew J; Juth, Vanessa; Sciamanna, Christopher N

    2017-04-01

    Global life satisfaction has been linked with long-term health advantages, yet how life satisfaction impacts the trajectory of long-term health is unclear. This paper examines one such possible mechanism-that greater life satisfaction confers momentary benefits in daily life that accumulate over time. A community sample of working adults (n = 115) completed a measure of life satisfaction and then three subsequent days of ecological momentary assessment surveys (6 times/day) measuring affect (i.e., emotional valence, arousal), and perceived stress, and also provided salivary cortisol samples. Multilevel models indicated that people with higher (vs. lower) levels of life satisfaction reported better momentary affect, less stress, marginally lower momentary levels and significantly altered diurnal slopes of cortisol. Findings suggest individuals with high global life satisfaction have advantageous daily experiences, providing initial evidence for potential mechanisms through which global life satisfaction may help explain long-term health benefits.

  12. Carryover effects and climatic conditions influence the postfledging survival of greater sage-grouse

    Science.gov (United States)

    Blomberg, Erik J.; Sedinger, James S.; Gibson, Daniel; Coates, Peter S.; Casazza, Michael L.

    2014-01-01

    Prebreeding survival is an important life history component that affects both parental fitness and population persistence. In birds, prebreeding can be separated into pre- and postfledging periods; carryover effects from the prefledging period may influence postfledging survival. We investigated effects of body condition at fledging, and climatic variation, on postfledging survival of radio-marked greater sage-grouse (Centrocercus urophasianus) in the Great Basin Desert of the western United States. We hypothesized that body condition would influence postfledging survival as a carryover effect from the prefledging period, and we predicted that climatic variation may mediate this carryover effect or, alternatively, would act directly on survival during the postfledging period. Individual body condition had a strong positive effect on postfledging survival of juvenile females, suggesting carryover effects from the prefledging period. Females in the upper 25th percentile of body condition scores had a postfledging survival probability more than twice that (Φ = 0.51 ± 0.06 SE) of females in the bottom 25th percentile (Φ = 0.21 ± 0.05 SE). A similar effect could not be detected for males. We also found evidence for temperature and precipitation effects on monthly survival rates of both sexes. After controlling for site-level variation, postfledging survival was nearly twice as great following the coolest and wettest growing season (Φ = 0.77 ± 0.05 SE) compared with the hottest and driest growing season (Φ = 0.39 ± 0.05 SE). We found no relationships between individual body condition and temperature or precipitation, suggesting that carryover effects operated independently of background climatic variation. The temperature and precipitation effects we observed likely produced a direct effect on mortality risk during the postfledging period. Conservation actions that focus on improving prefledging habitat for sage-grouse may have indirect benefits

  13. Personel and life coaching

    DEFF Research Database (Denmark)

    Spaten, Ole Michael

    2018-01-01

    Personal coaching and life-coaching psychology is for assisting individuals clarify values, visions and meaning of life, through a systematic process in which the coach facilitates improvement of satisfying and fruitful life experiences and achievement of personal life goals....

  14. Preferences and actual chemotherapy decision-making in the greater plains collaborative breast cancer study.

    Science.gov (United States)

    Berger, Ann M; Buzalko, Russell J; Kupzyk, Kevin A; Gardner, Bret J; Djalilova, Dilorom M; Otte, Julie L

    2017-12-01

    There is renewed interest in identifying breast cancer patients' participation in decision-making about adjuvant chemotherapy. There is a gap in the literature regarding the impact of these decisions on quality of life (QOL) and quality of care (QOC). Our aims were to determine similarities and differences in how patients diagnosed with breast cancer preferred to make decisions with providers about cancer treatment, to examine the patient's recall of her role when the decision was made about chemotherapy and to determine how preferred and actual roles, as well as congruence between them, relate to QOL and perceived QOC. Greater Plains Collaborative clinical data research network of PCORnet conducted the 'Share Thoughts on Breast Cancer' survey among women 12-18 months post-diagnosis at eight sites in seven Midwestern United States. Patients recalled their preferred and actual treatment decision-making roles and three new shared decision-making (SDM) variables were created. Patients completed QOL and QOC measurements. Correlations and t-tests were used. Of 1235 returned surveys, 873 (full sample) and 329 (subsample who received chemotherapy) were used. About one-half of women in both the full (50.7%) and subsample (49.8%,) preferred SDM with providers about treatment decisions, but only 41.2% (full) and 42.6% (subsample) reported experiencing SDM. Significant differences were found between preferred versus actual roles in the full (p decision-making variables with QOL, but there was an association with QOC. The subsample's decision-making variables related to several QOL scales and QOC items, with a more patient-centered decision than originally preferred related to higher physical and social/family well-being, overall QOL and QOC. Patients benefit from providers' efforts to identify patient preferences, encourage an active role in SDM, and tailor decision making to their desired choice.

  15. Contraception knowledge and attitudes: truths and myths among African Australian teenage mothers in Greater Melbourne, Australia.

    Science.gov (United States)

    Ngum Chi Watts, Mimmie C; Liamputtong, Pranee; Carolan, Mary

    2014-08-01

    To discuss the contraception knowledge, attitudes and beliefs of African Australian teenagers and women with a refugee background in Melbourne. The numbers of African Australian persons continue to increase, with a significant proportion being refugee women and children. Attitudes and behaviours towards contraception in this group continue to be influenced by culture, family and beliefs. This study is based on qualitative research that was underpinned by intersectionality theory, cultural competency and phenomenology. Sixteen teenagers and women who had experienced teenage pregnancy in Greater Melbourne, Australia, were interviewed. In-depth interviews were conducted with the sixteen African Australian teenagers and women. Following data collection, data were transcribed verbatim, and coded, and key themes identified and analysed using thematic analysis. Knowledge of contraception among this group of migrants was low and filled with myths. Attitudes towards contraception use were insufficient and influenced by beliefs and external factors such as partner, family and community attitudes towards contraception. Migration status and other instabilities in the lives of these participants all intersected to shape their health beliefs and contraception decision-making. Refugee teenage mothers' knowledge of contraception was low and their attitude towards contraceptive use was poor. Myths and external factors continued to influence teenagers' and women's attitudes towards contraceptives. The events and life experiences of African Australian teenagers/women, culture, and family and community influences should be taken into consideration when providing healthcare services and sexual health education to this migrant group. Service providers should consider the multiple intersections in the lives of these women when delivering healthcare services and information to them. © 2013 John Wiley & Sons Ltd.

  16. Demography and viability of the largest population of greater one-horned rhinoceros in Nepal

    Directory of Open Access Journals (Sweden)

    Naresh Subedi

    2017-10-01

    Full Text Available Megaherbivores are characterized by slow life history traits which when coupled with human exploitation makes them vulnerable to local extinctions. An understanding of key demographic parameters assists in guiding management interventions to ensure their recovery and persistence over the longer term. We monitored 110 (30 calves, 80 young and adults individually known greater one-horned rhinoceros (Rhinoceros unicornis for seven years in Chitwan National Park, Nepal (2009–15. Using known fate model with staggered entry design in program MARK we estimated annual calf survival at 0.765 ± 0.026 SE and that of remaining older age groups between 0.96 and 0.985. Both genders exhibited a typical Type I survivorship curve. The population consisted of 62% adults, 13% sub-adults and 26% juveniles and calves (dependent animals. The adult sex ratio (female: male was 1.23 ± 0.09 SE and dependent: cow ratio was 0.636 ± 0.03 SE. Age at first calving was 7.91 years ± 0.31 SE. Shorter inter-calving intervals were observed for young adults compared to old adults. Overall inter-calving interval was 41.28 months ± 2.33 SE. Chitwan rhino population grew at a maximum realized rate of r = 0.051 ± 0.005 SE. PHVA results showed that low level continuous poaching increased extinction probability compared to high but intermittent poaching episodes. An increase in annual poaching of over six females and 12 males over the current average of 5.5 rhinos per year, coupled with habitat degradation, caused by the alien invasive Mikania micrantha resulted in high extinction risks. Annually upto 13 rhinos (8 males and 5 females from Chitwan can be used for reintroduction and supplementation of rhinoceros across their current and historic range.

  17. [The construction of life profiles by social class in Chile].

    Science.gov (United States)

    Torres, C

    1989-11-01

    The author develops a series of life profiles for men and women living in the Greater Santiago area of Chile over the past 25 years. These profiles, which are based on the concept of life expectancy at birth, illustrate the length of time individuals take to go through such life cycle stages as education, employment, unemployment, and retirement. The concept is used to analyze changes in the life profile over time and how these differ by class. (SUMMARY IN ENG)

  18. Predictors of life disability in trichotillomania.

    Science.gov (United States)

    Tung, Esther S; Flessner, Christopher A; Grant, Jon E; Keuthen, Nancy J

    2015-01-01

    Limited research has investigated disability and functional impairment in trichotillomania (TTM) subjects. This study examined the relationships between hair pulling (HP) style and severity and disability while controlling for mood severity. Disability was measured in individual life areas (work, social, and family/home life) instead of as a total disability score as in previous studies. One hundred fifty three adult hair pullers completed several structured interviews and self-report instruments. HP style and severity, as well as depression, anxiety, and stress were correlated with work, social, and family/home life impairment on the Sheehan Disability Scale (SDS). Multiple regression analyses were performed to determine significant predictors of life impairment. Depressive severity was a significant predictor for all SDS life areas. In addition, interference/avoidance associated with HP was a predictor for work and social life disability. Distress from HP was a significant predictor of social and family/home life disability. Focused HP score and anxiety were significant predictors of family/home life disability. As expected, depression in hair pullers predicted disability across life domains. Avoiding work and social situations can seriously impair functioning in those life domains. Severity of distress and worry about HP may be most elevated in social situations with friends and family and thus predict impairment in those areas. Finally, since HP often occurs at home, time spent in focused hair pulling would have a greater negative impact on family and home responsibilities than social and work life. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. An empiric estimate of the value of life: updating the renal dialysis cost-effectiveness standard.

    Science.gov (United States)

    Lee, Chris P; Chertow, Glenn M; Zenios, Stefanos A

    2009-01-01

    Proposals to make decisions about coverage of new technology by comparing the technology's incremental cost-effectiveness with the traditional benchmark of dialysis imply that the incremental cost-effectiveness ratio of dialysis is seen a proxy for the value of a statistical year of life. The frequently used ratio for dialysis has, however, not been updated to reflect more recently available data on dialysis. We developed a computer simulation model for the end-stage renal disease population and compared cost, life expectancy, and quality adjusted life expectancy of current dialysis practice relative to three less costly alternatives and to no dialysis. We estimated incremental cost-effectiveness ratios for these alternatives relative to the next least costly alternative and no dialysis and analyzed the population distribution of the ratios. Model parameters and costs were estimated using data from the Medicare population and a large integrated health-care delivery system between 1996 and 2003. The sensitivity of results to model assumptions was tested using 38 scenarios of one-way sensitivity analysis, where parameters informing the cost, utility, mortality and morbidity, etc. components of the model were by perturbed +/-50%. The incremental cost-effectiveness ratio of dialysis of current practice relative to the next least costly alternative is on average $129,090 per quality-adjusted life-year (QALY) ($61,294 per year), but its distribution within the population is wide; the interquartile range is $71,890 per QALY, while the 1st and 99th percentiles are $65,496 and $488,360 per QALY, respectively. Higher incremental cost-effectiveness ratios were associated with older age and more comorbid conditions. Sensitivity to model parameters was comparatively small, with most of the scenarios leading to a change of less than 10% in the ratio. The value of a statistical year of life implied by dialysis practice currently averages $129,090 per QALY ($61,294 per year), but

  20. Qualidade de vida e medidas de utilidade: parâmetros clínicos para as tomadas de decisão em saúde Quality of life and utility measures: clinical parameters for decision-making in health

    Directory of Open Access Journals (Sweden)

    Alessandro Gonçalves Campolina

    2006-02-01

    Full Text Available In recent decades, the international scientific community has become increasingly interested in the concept of quality of life. One of the most important implications of the focus on quality of life is a shift from "cure" to "a guarantee of a better life" as a health care goal, as well as the inclusion of individuals' preferences for certain health states in the decision-making process associated with treatments, diagnostic strategies, and health spending. This is especially important as the prevalence of chronic diseases increases as a result of the aging of the population. This piece describes the main concepts and applications related to this new health paradigm, including quality of life itself, utility measures, quality-adjusted life years (QALYs, and health decision analysis.

  1. When Product Life Cycle Meets Customer Activity Cycle

    DEFF Research Database (Denmark)

    Tan, Adrian Ronald

    2007-01-01

    Manufacturing companies have traditionally focused their efforts on designing, developing and producing products to offer on the market. Today global competition and demands for greater company responsibility of products throughout their entire life cycle are driving manufacturing companies to sh...

  2. Greater-than-Class C low-level radioactive waste characterization. Appendix A-2: Timing of greater-than-Class C low-level radioactive waste from nuclear power plants

    International Nuclear Information System (INIS)

    Steinke, W.F.

    1994-09-01

    Planning for the storage or disposal of greater-than-Class C low-level radioactive waste (GTCC LLW) requires characterization of that waste. Timing, or the date the waste will require storage or disposal, is an integral aspect of that planning. The majority of GTCC LLW is generated by nuclear power plants, and the length of time a reactor remains operational directly affects the amount of GTCC waste expected from that reactor. This report uses data from existing literature to develop high, base, and low case estimates for the number of plants expected to experience (a) early shutdown, (b) 40-year operation, or (c) life extension to 60-year operation. The discussion includes possible effects of advanced light water reactor technology on future GTCC LLW generation. However, the main focus of this study is timing for shutdown of current technology reactors that are under construction or operating

  3. The Value Function with Life Satisfaction Data

    DEFF Research Database (Denmark)

    Kanninen, Ohto; Mahler, Daniel Gerszon

    2017-01-01

    evaluated with life satisfaction. We nd that the mapping from changes in earnings to life satisfaction mimics the predicted S-curve remarkably well when the reference point is generated from individuals' past earnings. This nding is robust to a large set of alternative specications. In congruence...... with experimental evidence, we nd that earnings losses have around 2 times greater impact on life satisfaction than earnings gains. We emphasize that the S-curve we nd need not be causal, since the changes in earnings were based on observational data. However, we can rule out that certain other factors produced...

  4. Active convergence between the Lesser and Greater Caucasus in Georgia: Constraints on the tectonic evolution of the Lesser-Greater Caucasus continental collision

    Science.gov (United States)

    Sokhadze, G.; Floyd, M.; Godoladze, T.; King, R.; Cowgill, E. S.; Javakhishvili, Z.; Hahubia, G.; Reilinger, R.

    2018-01-01

    We present and interpret newly determined site motions derived from GPS observations made from 2008 through 2016 in the Republic of Georgia, which constrain the rate and locus of active shortening in the Lesser-Greater Caucasus continental collision zone. Observation sites are located along two ∼160 km-long profiles crossing the Lesser-Greater Caucasus boundary zone: one crossing the Rioni Basin in western Georgia and the other crossing further east near the longitude of Tbilisi. Convergence across the Rioni Basin Profile occurs along the southern margin of the Greater Caucasus, near the surface trace of the north-dipping Main Caucasus Thrust Fault (MCTF) system, and is consistent with strain accumulation on the fault that generated the 1991 MW6.9 Racha earthquake. In contrast, convergence along the Tbilisi Profile occurs near Tbilisi and the northern boundary of the Lesser Caucasus (near the south-dipping Lesser Caucasus Thrust Fault), approximately 50-70 km south of the MCTF, which is inactive within the resolution of geodetic observations (< ± 0.5 mm/yr) at the location of the Tbilisi Profile. We suggest that the southward offset of convergence along strike of the range is related to the incipient collision of the Lesser-Greater Caucasus, and closing of the intervening Kura Basin, which is most advanced along this segment of the collision zone. The identification of active shortening near Tbilisi requires a reevaluation of seismic hazards in this area.

  5. The mortality effect of ship-related fine particulate matter in the Sydney greater metropolitan region of NSW, Australia.

    Science.gov (United States)

    Broome, Richard A; Cope, Martin E; Goldsworthy, Brett; Goldsworthy, Laurie; Emmerson, Kathryn; Jegasothy, Edward; Morgan, Geoffrey G

    2016-02-01

    This study investigates the mortality effect of primary and secondary PM2.5 related to ship exhaust in the Sydney greater metropolitan region of Australia. A detailed inventory of ship exhaust emissions was used to model a) the 2010/11 concentration of ship-related PM2.5 across the region, and b) the reduction in PM2.5 concentration that would occur if ships used distillate fuel with a 0.1% sulfur content at berth or within 300 km of Sydney. The annual loss of life attributable to 2010/11 levels of ship-related PM2.5 and the improvement in survival associated with use of low-sulfur fuel were estimated from the modelled concentrations. In 2010/11, approximately 1.9% of the region-wide annual average population weighted-mean concentration of all natural and human-made PM2.5 was attributable to ship exhaust, and up to 9.4% at suburbs close to ports. An estimated 220 years of life were lost by people who died in 2010/11 as a result of ship exhaust-related exposure (95% CIβ: 140-290, where CIβ is the uncertainty in the concentration-response coefficient only). Use of 0.1% sulfur fuel at berth would reduce the population weighted-mean concentration of PM2.5 related to ship exhaust by 25% and result in a gain of 390 life-years over a twenty year period (95% CIβ: 260-520). Use of 0.1% sulfur fuel within 300 km of Sydney would reduce the concentration by 56% and result in a gain of 920 life-years over twenty years (95% CIβ: 600-1200). Ship exhaust is an important source of human exposure to PM2.5 in the Sydney greater metropolitan region. This assessment supports intervention to reduce ship emissions in the GMR. Local strategies to limit the sulfur content of fuel would reduce exposure and will become increasingly beneficial as the shipping industry expands. A requirement for use of 0.1% sulfur fuel by ships within 300 km of Sydney would provide more than twice the mortality benefit of a requirement for ships to use 0.1% sulfur fuel at berth. Copyright © 2015 Elsevier

  6. Conditional survival is greater than overall survival at diagnosis in patients with osteosarcoma and Ewing's sarcoma.

    Science.gov (United States)

    Miller, Benjamin J; Lynch, Charles F; Buckwalter, Joseph A

    2013-11-01

    Conditional survival is a measure of the risk of mortality given that a patient has survived a defined period of time. These estimates are clinically helpful, but have not been reported previously for osteosarcoma or Ewing's sarcoma. We determined the conditional survival of patients with osteosarcoma and Ewing's sarcoma given survival of 1 or more years. We used the Surveillance, Epidemiology, and End Results (SEER) Program database to investigate cases of osteosarcoma and Ewing's sarcoma in patients younger than 40 years from 1973 to 2009. The SEER Program is managed by the National Cancer Institute and provides survival data gathered from population-based cancer registries. We used an actuarial life table analysis to determine any cancer cause-specific 5-year survival estimates conditional on 1 to 5 years of survival after diagnosis. We performed a similar analysis to determine 20-year survival from the time of diagnosis. The estimated 5-year survival improved each year after diagnosis. For local/regional osteosarcoma, the 5-year survival improved from 74.8% at baseline to 91.4% at 5 years-meaning that if a patient with localized osteosarcoma lives for 5 years, the chance of living for another 5 years is 91.4%. Similarly, the 5-year survivals for local/regional Ewing's sarcoma improved from 72.9% at baseline to 92.5% at 5 years, for metastatic osteosarcoma 35.5% at baseline to 85.4% at 5 years, and for metastatic Ewing's sarcoma 31.7% at baseline to 83.6% at 5 years. The likelihood of 20-year cause-specific survival from the time of diagnosis in osteosarcoma and Ewing's sarcoma was almost 90% or greater after 10 years of survival, suggesting that while most patients will remain disease-free indefinitely, some experience cancer-related complications years after presumed eradication. The 5-year survival estimates of osteosarcoma and Ewing's sarcoma improve with each additional year of patient survival. Knowledge of a changing risk profile is useful in counseling

  7. [Death is also life].

    Science.gov (United States)

    Belliard, F

    1985-01-01

    A nurse at the Center for Voluntary Pregnancy Interruption and Contraception in Angers, which receives 30 abortion requests each week, describes psychological aspects of nursing care for abortion patients. Abortion patients statistically are most likely to be married women around 27 years old with husbands aged 31 on average and with 2 children. Abortions are done under local anesthesia, so that there is no hiatus between the time "before" and that "after" the procedure. Women speak about their moral and physical suffering; their choice is respected by the staff. Despite the regret or mild depression that may follow an abortion, most women experience the greatest difficulty before the procedure and feel primarily relieved afterwards. Nursing work with abortion patients consists in being open to them and accompanying them for a few hours. The patients' comfort and postabortion morbidity depend largely on the reception and understanding they are given by the staff. After the procedure, the topic of contraception is discussed with the patient. Abortion and contraception cannot be dissociated because fertility regulation involves greater well-being for all members of the family. The abortion center is a place of life in which women and couples take responsibility for their sexuality and begin again. It is important not to impose beliefs or feelings about sexuality on the patient. A training which encouraged reflection on the grand problems of life and death as well as understanding of emotions, sentiments, and reactions would be helpful in gaining self knowledge and in living through events such as abortion. A meeting with a psychiatrist every 3 weeks is arranged for all staff members who desire it in order to maintain their emotional balance and work out troubling situations encountered at work. The work at the abortion center is 1 of listening and gaining the patient's confidence in order to dedramatize the abortion and permit the woman and the couple to elect an

  8. An Atypical “Hourglass” Stomach Due to the Presence of an Unusual Incisure at the Greater Curvature

    Directory of Open Access Journals (Sweden)

    Satheesha Nayak B

    2017-05-01

    Full Text Available Shape and position of the stomach can vary greatly with or without any physiological disturbances. However some of its rare shapes may result in the formation of volvulus or may increase the risk of gastric ulcer. Variant shapes of the stomach may be of congenital occurrence or are acquired later on in life. We report here an atypical form of hourglass stomach. The stomach in the present case exhibited 2 distinct pouches. The two pouches were formed due to the presence of an unusually deep notch at the greater curvature. Both the pouches communicated with the distal end of the esophagus. This variation is possibly of congenital origin and may lead to radiological misinterpretations

  9. Nesting success and resource selection of Greater Sage-Grouse [chapter 8

    Science.gov (United States)

    Nicholas W. Kaczor; Kent C. Jensen; Robert W. Klaver; Mark A. Rumble; Katie M. Herman-Brunson; Christopher C. Swanson

    2011-01-01

    Declines of Greater Sage-Grouse (Centrocercus urophasianus) in South Dakota are a concern because further population declines may lead to isolation from populations in Wyoming and Montana. Furthermore, little information exists about reproductive ecology and resource selection of sage grouse on the eastern edge of their distribution. We investigated Greater Sage-Grouse...

  10. Greater sage-grouse apparent nest productivity and chick survival in Carbon County, Wyoming

    Science.gov (United States)

    Leslie A. Schreiber; Christopher P. Hansen; Mark A. Rumble; Joshua J. Millspaugh; Frank R. Thompson; R. Scott Gamo; Jon W. Kehmeier; Nate Wojik

    2016-01-01

    Greater sage-grouse Centrocercus urophasianus populations across North America have been declining due to degradation and fragmentation of sagebrush habitat. As part of a study quantifying greater sage-grouse demographics prior to construction of a wind energy facility, we estimated apparent net nest productivity and survival rate of chicks associated with...

  11. Hierarchical population structure in greater sage-grouse provides insight into management boundary delineation

    Science.gov (United States)

    Todd B. Cross; David E. Naugle; John C. Carlson; Michael K. Schwartz

    2016-01-01

    Understanding population structure is important for guiding ongoing conservation and restoration efforts. The greater sage-grouse (Centrocercus urophasianus) is a species of concern distributed across 1.2 million km2 of western North America. We genotyped 1499 greater sagegrouse from 297 leks across Montana, North Dakota and South Dakota using a 15 locus...

  12. Resource selection during brood-rearing by Greater Sage-Grouse [chapter 12

    Science.gov (United States)

    Nicholas W. Kaczor; Katie M. Herman-Brunson; Kent C. Jensen; Mark A. Rumble; Robert W. Klaver; Christopher C. Swanson

    2011-01-01

    Understanding population dynamics and resource selection is crucial in developing wildlife resource management plans for sensitive species such as Greater Sage-Grouse (Centrocercus urophasianus). Little is known about sage grouse habitats on the eastern edge of their range. We investigated resource selection of Greater Sage-Grouse during brood- rearing in North and...

  13. Constraints facing the implementation of the greater New Orleans urban water plan

    NARCIS (Netherlands)

    Visschedijk, A.; Van de Ven, F.H.M.

    2015-01-01

    On September 6th of last year the Greater New Orleans Urban Water Plan (UWP) was presented. A comprehensive plan which addresses flooding caused by heavy rainfall and soil subsidence caused by excessive drainage. Every year parts of the Greater New Orleans Area flood due to severe rainfall events in

  14. Observations of territorial breeding common ravens caching eggs of greater sage-grouse

    Science.gov (United States)

    Howe, Kristy B.; Coates, Peter S.

    2015-01-01

    Previous investigations using continuous video monitoring of greater sage-grouse Centrocercus urophasianus nests have unambiguously identified common ravens Corvus corax as an important egg predator within the western United States. The quantity of greater sage-grouse eggs an individual common raven consumes during the nesting period and the extent to which common ravens actively hunt greater sage-grouse nests are largely unknown. However, some evidence suggests that territorial breeding common ravens, rather than nonbreeding transients, are most likely responsible for nest depredations. We describe greater sage-grouse egg depredation observations obtained opportunistically from three common raven nests located in Idaho and Nevada where depredated greater sage-grouse eggs were found at or in the immediate vicinity of the nest site, including the caching of eggs in nearby rock crevices. We opportunistically monitored these nests by counting and removing depredated eggs and shell fragments from the nest sites during each visit to determine the extent to which the common raven pairs preyed on greater sage-grouse eggs. To our knowledge, our observations represent the first evidence that breeding, territorial pairs of common ravens cache greater sage-grouse eggs and are capable of depredating multiple greater sage-grouse nests.

  15. Managing Daily Life

    Science.gov (United States)

    ... Duchenne / Managing Daily Life Print Email Managing Daily Life Environmental accessibility As the person with Duchenne starts ... such as wider doorways and ramps, can make life easier once the person with Duchenne cannot climb ...

  16. Hospitals with greater diversities of physiologically complex procedures do not achieve greater surgical growth in a market with stable numbers of such procedures.

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H; Lubarsky, David A

    2018-05-01

    Although having a large diversity of types of procedures has a substantial operational impact on the surgical suites of hospitals, the strategic importance is unknown. In the current study, we used longitudinal data for all hospitals and patient ages in the State of Florida to evaluate whether hospitals with greater diversity of types of physiologically complex major therapeutic procedures (PCMTP) also had greater rates of surgical growth. Observational cohort study. 1479 combinations of hospitals in the State of Florida and fiscal years, 2008-2015. The types of International Classification of Diseases, Ninth revision, Clinical Modification (ICD-9-CM) procedures studied were PCMT, defined as: a) major therapeutic procedure; b) >7 American Society of Anesthesiologists base units; and c) performed during a hospitalization with a Diagnosis Related Group with a mean length of stay ≥4.0days. The number of procedures of each type of PCMTP commonly performed at each hospital was calculated by taking 1/Herfindahl index (i.e., sum of the squares of the proportions of all procedures of each type of PCMTP). Over the 8 successive years studied, there was no change in the number of PCMTP being performed (Kendall's τ b =-0.014±0.017 [standard error], P=0.44; N=1479 hospital×years). Busier and larger hospitals commonly performed more types of PCMTP, respectively categorized based on performed PCMTP (τ=0.606±0.017, P<0.0001) or hospital beds (τ=0.524±0.017, P<0.0001). There was no association between greater diversity of types of PCMTP commonly performed and greater annual growth in numbers of PCMTP (τ=0.002±0.019, P=0.91; N=1295 hospital×years). Conclusions were the same with multiple sensitivity analyses. Post hoc, it was recognized that hospitals performing a greater diversity of PCMTP were more similar to the aggregate of other hospitals within the same health district (τ=0.550±0.017, P<0.0001). During a period with no overall growth in PCMTP, hospitals with

  17. Thought Suppression and Meaning in Life: A Longitudinal Investigation

    Science.gov (United States)

    Krause, Neal

    2007-01-01

    The purpose of this study is to see if older adults who experience problems with thought suppression tend to encounter greater difficulty deriving a sense of meaning in life. Data from a longitudinal nationwide survey of older people (N = 988) indicate that greater difficulty with thought suppression is associated with a decline in meaning over…

  18. Evidence for an association between post-fledging dispersal and microsatellite multilocus heterozygosity in a large population of greater flamingos.

    Directory of Open Access Journals (Sweden)

    Mark A F Gillingham

    Full Text Available Dispersal can be divided into three stages: departure, transience and settlement. Despite the fact that theoretical studies have emphasized the importance of heterozygosity on dispersal strategies, empirical evidence of its effect on different stages of dispersal is lacking. Here, using multi-event capture-mark-recapture models, we show a negative association between microsatellite multilocus heterozygosity (MLH; 10 loci; n = 1023 and post-fledging dispersal propensity for greater flamingos, Phoenicopterus roseus, born in southern France. We propose that the negative effects of inbreeding depression affects competitive ability and therefore more homozygous individuals are more likely to disperse because they are less able to compete within the highly saturated natal site. Finally, a model with the effect of MLH on propensity of post-fledgling dispersers to disperse to the long-distance sites of Africa was equivalent to the null model, suggesting that MLH had low to no effect on dispersal distance. Variations in individual genetic quality thus result in context-dependent heterogeneity in dispersal strategies at each stage of dispersal. Our results have important implications on fitness since sites visited early in life are known to influence site selection later on in life and future survival.

  19. Reconstructing the paleogeography and subduction geodynamics of Greater India: how to apply Ockham's Razor?

    Science.gov (United States)

    Van Hinsbergen, D. J. J.; Li, S.; Lippert, P. C.; Huang, W.; Advokaat, E. L.; Spakman, W.

    2017-12-01

    Key in understanding the geodynamics governing subduction and orogeny is reconstructing the paleogeography of `Greater India', the Indian plate lithosphere that subducted since Tibetan Himalayan continental crustal collision with Asia. Here, we discuss how the principle of Ockham's Razor, favoring the simplest scenario as the most likely, may apply to three perspectives on Greater India's paleogeography. We follow recent constraints suggesting a 58 Ma initial collision and update the kinematic restoration of intra-Asian shortening with a recently proposed Indochina extrusion model that reconciles long-debated large and small estimates of Indochina extrusion. The reconstruction is tested against Tibetan paleomagnetic rotation data, and against seismic tomographic constraints on paleo-subduction zone locations. The resulting restoration shows 1000-1200 km of post-collisional intra-Asian shortening, leaving a 2600-3400 km wide Greater India. Ockham's Razor from a paleogeographic, sediment provenance perspective would prefer a fully continental Greater India, although these sediments may also source from the Paleocene-Eocene west Indian orogen unrelated to the India-Asia collision. Ockham's Razor applied from a kinematic, paleomagnetic perspective, prefers major Cretaceous extension and `Greater India Basin' opening within Greater India, but data uncertainty may speculatively allow for minimal extension. Finally, from a geodynamic perspective, assuming a fully continental Greater India would require that the highest subduction rates recorded in the Phanerozoic would have been driven by a subduction of a lithosphere-crust assemblage more buoyant than the mantle, which seems physically improbable. Ockhams Razor thereby isolates the Greater India Basin hypothesis as the only scenario sustainable from all perspectives. Finally, we infer that the old pre-collisional lithosphere rapidly entered the lower mantle sustaining high subduction rates, whilst post

  20. Rolling Bearing Life Prediction, Theory, and Application

    Science.gov (United States)

    Zaretsky, Erwin V.

    2016-01-01

    life results using the Lundberg- Palmgren equations with life adjustment factors to predict bearing life. That is, they had lives equal to or greater than that predicted. The Lundberg-Palmgren model was used to predict the life of a commercial turboprop gearbox. The life prediction was compared with the field lives of 64 gearboxes. From these results, the roller bearing lives exhibited a load-life exponent of 5.2, which correlated with the Zaretsky model. The use of the ANSI/ABMA and ISO standards load-life exponent of 10/3 to predict roller bearing life is not reflective of modern roller bearings and will underpredict bearing lives.

  1. Use of locking plates for fixation of the greater trochanter in patients with hip replacement

    Directory of Open Access Journals (Sweden)

    Allison K. Tetreault, BA

    2016-12-01

    Conclusions: Locking plate technology is a successful method of fixation of the greater trochanter in patients with THA. Postoperative trochanteric pain and reoperation for hardware-related issues remain a challenge.

  2. GLOBALIZATION OF ECONOMY AND GREATER CYCLES OF THE TOTAL REGIONAL PRODUCT, INFLATION AND UNEMPLOYMENT

    Directory of Open Access Journals (Sweden)

    V.A. Belkin

    2009-06-01

    Full Text Available The process of synchronization of greater and small waves of real gross national product of the USA and a total regional product of the Chelyabinsk area is shown on the materials of economic statistics. The conclusion about defining influence of dynamics of real gross national product of the USA on the basic macroeconomic parameters of the Chelyabinsk area owing to high dependence of its economy on export of metal products is done from here. It is evidently shown, that the modern world economic crisis quite keeps within the theory of greater cycles of an economic conjuncture of N.D. Kondratyev. To greater cycles of a total regional product of the Chelyabinsk area there correspond return greater cycles of inflation and unemployment.

  3. Haemangiopericytoma of greater omentum. A rare cause of acute abdominal pain.

    Science.gov (United States)

    Bovino, A; Basso, L; Di Giacomo, G; Codacci Pisanelli, M; Basile, U; De Toma, G

    2003-12-01

    Haemangiopericytoma (HPT) is a rare neoplasm that can occur in any part of the human body. In this report, we describe the case of a patient with sudden severe upper abdominal pain caused by primary HPT in the greater omentum.

  4. Gas, Oil, and Water Production from Jonah, Pinedale, Greater Wamsutter, and Stagecoach Draw Fields in the Greater Green River Basin, Wyoming

    Science.gov (United States)

    Nelson, Philip H.; Ewald, Shauna M.; Santus, Stephen L.; Trainor, Patrick K.

    2010-01-01

    Gas, oil, and water production data were compiled from selected wells in four gas fields in rocks of Late Cretaceous age in southwestern Wyoming. This study is one of a series of reports examining fluid production from tight-gas reservoirs, which are characterized by low permeability, low porosity, and the presence of clay minerals in pore space. Production from each well is represented by two samples spaced five years apart, the first sample typically taken two years after commencement of production. For each producing interval, summary diagrams of oil versus gas and water versus gas production show fluid production rates, the change in rates during five years, the water-gas and oil-gas ratios, and the fluid type. These diagrams permit well-to-well and field-to-field comparisons. Fields producing water at low rates (water dissolved in gas in the reservoir) can be distinguished from fields producing water at moderate or high rates, and the water-gas ratios are quantified. The ranges of first-sample gas rates in Pinedale field and Jonah field are quite similar, and the average gas production rate for the second sample, taken five years later, is about one-half that of the first sample for both fields. Water rates are generally substantially higher in Pinedale than in Jonah, and water-gas ratios in Pinedale are roughly a factor of ten greater in Pinedale than in Jonah. Gas and water production rates from each field are fairly well grouped, indicating that Pinedale and Jonah fields are fairly cohesive gas-water systems. Pinedale field appears to be remarkably uniform in its flow behavior with time. Jonah field, which is internally faulted, exhibits a small spread in first-sample production rates. In the Greater Wamsutter field, gas production from the upper part of the Almond Formation is greater than from the main part of the Almond. Some wells in the main and the combined (upper and main parts) Almond show increases in water production with time, whereas increases

  5. Velocity Drives Greater Power Observed During Back Squat Using Cluster Sets.

    Science.gov (United States)

    Oliver, Jonathan M; Kreutzer, Andreas; Jenke, Shane C; Phillips, Melody D; Mitchell, Joel B; Jones, Margaret T

    2016-01-01

    This investigation compared the kinetics and kinematics of cluster sets (CLU) and traditional sets (TRD) during back squat in trained (RT) and untrained (UT) men. Twenty-four participants (RT = 12, 25 ± 1 year, 179.1 ± 2.2 cm, 84.6 ± 2.1 kg; UT = 12, 25 ± 1 year, 180.1 ± 1.8 cm, 85.4 ± 3.8 kg) performed TRD (4 × 10, 120-second rest) and CLU (4 × (2 × 5) 30 seconds between clusters; 90 seconds between sets) with 70% one repetition maximum, randomly. Kinematics and kinetics were sampled through force plate and linear position transducers. Resistance-trained produced greater overall force, velocity, and power; however, similar patterns were observed in all variables when comparing conditions. Cluster sets produced significantly greater force in isolated repetitions in sets 1-3, while consistently producing greater force due to a required reduction in load during set 4 resulting in greater total volume load (CLU, 3302.4 ± 102.7 kg; TRD, 3274.8 ± 102.8 kg). Velocity loss was lessened in CLU resulting in significantly higher velocities in sets 2 through 4. Furthermore, higher velocities were produced by CLU during later repetitions of each set. Cluster sets produced greater power output for an increasing number of repetitions in each set (set 1, 5 repetitions; sets 2 and 3, 6 repetitions; set 4, 8 repetitions), and the difference between conditions increased over subsequent sets. Time under tension increased over each set and was greater in TRD. This study demonstrates greater power output is driven by greater velocity when back squatting during CLU; therefore, velocity may be a useful measure by which to assess power.

  6. On Graceful Spider Graphs with at Most Four Legs of Lengths Greater than One

    Directory of Open Access Journals (Sweden)

    A. Panpa

    2016-01-01

    Full Text Available A graceful labeling of a tree T with n edges is a bijection f:V(T→{0,1,2,…,n} such that {|f(u-f(v|:uv∈E(T} equal to {1,2,…,n}. A spider graph is a tree with at most one vertex of degree greater than 2. We show that all spider graphs with at most four legs of lengths greater than one admit graceful labeling.

  7. Effects of sexual dimorphism and landscape composition on the trophic behavior of Greater Prairie-Chicken.

    Directory of Open Access Journals (Sweden)

    Beatriz Blanco-Fontao

    Full Text Available Partitioning of ecological niche is expected in lekking species that show marked sexual size dimorphism as a consequence of sex-specific ecological constraints. However, niche partitioning is uncertain in species with moderate sexual dimorphism. In addition, the ecological niche of a species may also be affected by landscape composition; particularly, agricultural fragmentation may greatly influence the trophic behavior of herbivores. We studied trophic niche variation in Greater Prairie-Chickens (Tympanuchus cupido, a grouse species that shows moderate sex-dimorphism. Greater Prairie-Chickens are native to tallgrass prairies of North America, although populations persist in less natural mosaics of cropland and native habitats. We used stable isotope analysis of carbon and nitrogen in blood, claws and feathers to assess seasonal differences in trophic niche breadth and individual specialization between male and female Greater Prairie-Chickens, and between birds living in continuous and fragmented landscapes. We found that females showed broader niches and higher individual specialization than males, especially in winter and autumn. However, differences between females and males were smaller in spring when birds converge at leks, suggesting that females and males may exhibit similar feeding behaviors during the lekking period. In addition, we found that birds living in native prairies showed greater annual trophic variability than conspecifics in agricultural mosaic landscapes. Native habitats may provide greater dietary diversity, resulting in greater diversity of feeding strategies.

  8. Arab Youth in Canada: Acculturation, Enculturation, Social Support, and Life Satisfaction

    Science.gov (United States)

    Paterson, Ashley D.; Hakim-Larson, Julie

    2012-01-01

    Results from 98 Arab youth in Canada showed that having a positive Arab culture orientation was related to greater family life satisfaction with family social support as a mediator. A positive European Canadian orientation was related to greater school life satisfaction, but this relation was not mediated by friend social support. Implications for…

  9. Parenthood and Life Satisfaction in Germany

    Directory of Open Access Journals (Sweden)

    Matthias Pollmann-Schult

    2013-03-01

    Full Text Available This article examines the association between parenthood and life satisfaction. It focuses on the question to which extent parental life satisfaction is influenced by individual and familial context. The empirical study is based on the data from the first wave of the German Family Panel (pairfam. All in all, the analyses show that although parents are less satisfied with their leisure time, their social contacts and their relationship, they are nonetheless more satisfied with their life in general than their childless peers. Increased life satisfaction is observed in particular in the first years following the birth of a child. The satisfaction of parents is, however, dependent upon different contextual factors. Parents in the medium and higher income ranges report a comparatively high degree of life satisfaction, whereas only a weak association is observed between parenthood and life satisfaction among low-income persons. Moreover, the life satisfaction of mothers, but not of fathers, varies with their employment status. For instance, only non-employed and part-time employed mothers report a greater life satisfaction than childless women. Finally, fathers whose family formation was presumably unplanned record no higher level of satisfaction than men without children.

  10. Greater decision-making competence is associated with greater expected-value sensitivity, but not overall risk taking: an examination of concurrent validity.

    Science.gov (United States)

    Parker, Andrew M; Weller, Joshua A

    2015-01-01

    Decision-making competence reflects individual differences in the susceptibility to committing decision-making errors, measured using tasks common from behavioral decision research (e.g., framing effects, under/overconfidence, following decision rules). Prior research demonstrates that those with higher decision-making competence report lower incidence of health-risking and antisocial behaviors, but there has been less focus on intermediate processes that may impact real-world decisions, and, in particular, those implicated by normative models. Here we test the associations between measures of youth decision-making competence (Y-DMC) and one such process, the degree to which individuals make choices consistent with maximizing expected value (EV). Using a task involving hypothetical gambles, we find that greater EV sensitivity is associated with greater Y-DMC. Higher Y-DMC scores are associated with (a) choosing risky options when EV favors those options and (b) avoiding risky options when EV favors a certain option. This relationship is stronger for gambles that involved potential losses. The results suggest that Y-DMC captures decision processes consistent with standard normative evaluations of risky decisions.

  11. Greater decision-making competence is associated with greater expected-value sensitivity, but not overall risk taking: An examination of concurrent validity

    Directory of Open Access Journals (Sweden)

    Andrew M Parker

    2015-05-01

    Full Text Available Decision-making competence reflects individual differences in the susceptibility to decision-making errors, measured using tasks common from behavioral decision research (e.g., framing effects, under/overconfidence, following decision rules. Prior research demonstrates that those with higher decision-making competence report lower incidence of health-risking and antisocial behaviors, but there has been less focus on intermediate mechanisms that may impact real-world decisions, and, in particular, those implicated by normative models. Here we test the associations between measures of youth decision-making competence (Y-DMC and one such mechanism, the degree to which individuals make choices consistent with maximizing expected value (EV. Using a task involving hypothetical gambles, we find that greater EV sensitivity is associated with greater Y-DMC. Higher Y-DMC scores are associated with (a choosing risky options when expected value favors those options and (b avoiding risky options when expected value favors a certain option. This relationship is stronger for gambles that involved potential losses. The results suggest that Y-DMC captures decision processes consistent with standard normative evaluations of risky decisions.

  12. Sonography of greater trochanteric pain syndrome and the rarity of primary bursitis.

    Science.gov (United States)

    Long, Suzanne S; Surrey, David E; Nazarian, Levon N

    2013-11-01

    Greater trochanteric pain syndrome is a common condition with clinical features of pain and tenderness at the lateral aspect of the hip. Diagnosing the origin of greater trochanteric pain is important because the treatment varies depending on the cause. We hypothesized that sonographic evaluation of sources for greater trochanteric pain syndrome would show that bursitis was not the most commonly encountered abnormality. We performed a retrospective review of musculoskeletal sonographic examinations performed at our institution over a 6-year period for greater trochanteric pain syndrome; completed a tabulation of the sonographic findings; and assessed the prevalence of trochanteric bursitis, gluteal tendon abnormalities, iliotibial band abnormalities, or a combination of findings. Prevalence of abnormal findings, associations of bursitis, gluteal tendinosis, gluteal tendon tears, and iliotibial band abnormalities were calculated. The final study population consisted of 877 unique patients: 602 women, 275 men; average age, 54 years; and age range, 15-87 years). Of the 877 patients with greater trochanteric pain, 700 (79.8%) did not have bursitis on ultrasound. A minority of patients (177, 20.2%) had trochanteric bursitis. Of the 877 patients with greater trochanteric pain, 438 (49.9%) had gluteal tendinosis, four (0.5%) had gluteal tendon tears, and 250 (28.5%) had a thickened iliotibial band. The cause of greater trochanteric pain syndrome is usually some combination of pathology involving the gluteus medius and gluteus minimus tendons as well as the iliotibial band. Bursitis is present in only the minority of patients. These findings have implications for treatment of this common condition.

  13. Trabecular microstructure and surface changes in the greater tuberosity in rotator cuff tears

    International Nuclear Information System (INIS)

    Jiang, Yebin; Zhao, Jenny; Ouyang, Xiaolong; Genant, Harry K.; Holsbeeck, Marnix T. van; Flynn, Michael J.

    2002-01-01

    Abstract Objective. When planning surgery in patients with rotator cuff tear, strength of bone at the tendon insertion and trabecular bone structure in the greater tuberosity are usually taken into consideration. We investigated radiographic changes in bone structure of the greater tuberosity in rotator cuff tears.Design. Twenty-two human cadaveric shoulders from subjects ranging from 55 to 75 years of age were obtained. The integrity of the rotator cuff was examined by sonography to determine if it is intact without any tear, or torn partially or completely. The humeral head was sectioned in 3 mm thick coronal slab sections and microradiographed. After digitization of the microradiographs and imaging processing with in-house semi-automated image processing software tools developed using software interfaces on a Sun workstation, the trabecular histomorphometrical structural parameters and connectivity in the greater tuberosity were quantified. The degenerative changes on the surface of the greater tuberosity were interpreted blindly by 2 independent readers.Results. Among the 22 shoulder specimens, the rotator cuff was found intact in 10 shoulders, partially in 7 and fully torn in 5. Statistically significant loss in apparent trabecular bone volume fraction, number of trabecular nodes, and number of trabecular branches, and a statistically significant increase in apparent trabecular separation and number of trabecular free ends were found in the greater tuberosity of the shoulders with tears. The loss was greater in association with full tear than in partial tear. Thickening of the cortical margin of the enthesis, irregularity of its surface, and calcification beyond the tidemark were observed in 2 (20%) shoulders with intact rotator cuff, in 6 (86%) shoulders with partial tear, and in 5 (100%) shoulders with full tear.Conclusions. Rotator cuff tears are associated with degenerative changes on the bone surface and with disuse osteopenia of the greater tuberosity

  14. Population momentum across vertebrate life histories

    Science.gov (United States)

    Koons, D.N.; Grand, J.B.; Arnold, J.M.

    2006-01-01

    Population abundance is critically important in conservation, management, and demographic theory. Thus, to better understand how perturbations to the life history affect long-term population size, we examined population momentum for four vertebrate classes with different life history strategies. In a series of demographic experiments we show that population momentum generally has a larger effect on long-term population size for organisms with long generation times than for organisms with short generation times. However, patterns between population momentum and generation time varied across taxonomic groups and according to the life history parameter that was changed. Our findings indicate that momentum may be an especially important aspect of population dynamics for long-lived vertebrates, and deserves greater attention in life history studies. Further, we discuss the importance of population momentum in natural resource management, pest control, and conservation arenas. ?? 2006 Elsevier B.V. All rights reserved.

  15. Defending definitions of life.

    Science.gov (United States)

    Mix, Lucas John

    2015-01-01

    Over the past 10 years, it has become unpopular to talk about definitions of life, under the assumption that attempts at a precise definition are counterproductive. Recent attempts have failed to meet strict philosophical criteria for definitions and have failed to reach consensus. I argue that provisional definitions are necessary for clear communications. Our current knowledge of biology justifies a number of universal claims about the category of life. Whether or not "life" represents a natural category, it maps to a number of important, observable processes. Given the importance of those processes and the extent of our knowledge, plural explicit definitions of life (and related categories) will be necessary for progress in astrobiology and origin-of-life studies as well as biology in general. I propose concrete categories related to, but not necessarily coextensive with, life for clear communication and hypothesis formation: Woese life, Darwin life, Haldane life.

  16. Spousal similarity in life satisfaction before and after divorce.

    Science.gov (United States)

    Wortman, Jessica; Lucas, Richard E

    2016-04-01

    Previous research has explored possible origins of individual differences in subjective well-being, focusing largely on stable, internal characteristics of traits as predictors of life satisfaction (Diener & Lucas, 1999). Although past work has demonstrated that life satisfaction is largely stable over the life span, other evidence has also demonstrated the lasting impact of life events. In this study, we use married couples as a test of the impact of life circumstances on life satisfaction, focusing on similarity in life satisfaction before and after divorce. If life satisfaction is impacted by shared life circumstances, married couples (who share life circumstances) should show greater similarity in life satisfaction before divorce than after. We tested this possibility using a dyadic latent-state-trait model that examined cross-spouse similarity in the stable and changing components of life satisfaction. Using a nationally representative panel study from Germany (Wagner, Frick & Schupp, 2007), we showed that similarity declined substantially following divorce. This suggests that life satisfaction is related to shared life circumstances. (c) 2016 APA, all rights reserved).

  17. Criteria and technical concept for demonstrating greater confinement disposal of radioactive wastes at Arid Western Sites

    International Nuclear Information System (INIS)

    Hunter, P.H.

    1981-01-01

    This report summarizes the work of two documents; the Criteria for Greater Confinement of Radioactive Wastes at Arid Western Sites, NVO-234, March 1981, (within this report, referred to as the GCDF Criteria Document); and the Draft Technical Concept for a Test of Greater Confinement Disposal of Radioactive Waste in Unsaturated Media at the Nevada Test Site, FBDU-343-004, June 1981, (referred within this report as the Technical Concept for the GCDF). For the past two years, Ford, Bacon and Davis has been performing technical services for the Department of Energy at the Nevada Test Site in development of defense low-level waste management concepts, including the greater confinement disposal concept with particular application to arid sites. The investigations have included the development of Criteria for Greater Confinement Disposal, NVO-234, which we published in May of this year; then the draft for the technical concept for greater confinement disposal, published in June; leading up to the point where we are now. The final technical concept and design specifications should be published imminently. The document is prerequisite to the actual construction and implementation of the demonstration facility this fiscal year

  18. Application of a Uniform Price Quality Adjusted Discount Auction for Assigning Surface Warfare Officer Retention Bonuses

    Science.gov (United States)

    2012-03-01

    O4 19.5% 14.7% Married 65.0% 61.8% Unmarried 35.0% 38.2% *2010 DoD Demographics Report D. ESTIMATION OF THE PARAMETERS The study uses the...120 $240 $360 $480 0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 B id ( in $ 1 ,0 0 0 ’s ) Quality Score Bid vs Quality Score 27 VI

  19. Constructing Quality Adjusted Price Indexes: a Comparison of Hedonic and Discrete Choice Models

    OpenAIRE

    N. Jonker

    2001-01-01

    The Boskin report (1996) concluded that the US consumer price index (CPI) overestimated the inflation by 1.1 percentage points. This was due to several measurement errors in the CPI. One of them is called quality change bias. In this paper two methods are compared which can be used to eliminate quality change bias, namely the hedonic method and a method based on the use of discrete choice models. The underlying micro-economic fundations of the two methods are compared as well as their empiric...

  20. High Decision Latitude at Work Combined with Traumatic Life Events in Private Life is Associated with Reduced Sleep Quality: Results from the GAZEL Study

    Directory of Open Access Journals (Sweden)

    Nadya Dich

    2018-04-01

    Full Text Available Psychosocial stress, both at work and at home, plays a role in sleep disturbances. Theoretical models of stress underscore the cumulative effect of stress from different domains in affecting health and well-being. However, previous research has not considered how work stress and stress in private life might interact to affect sleep. The study investigated potential synergistic effects of work stress and traumatic events in private life on sleep quality. Participants ('N' = 6552, average baseline age = 52 were a subset of the French GAZEL cohort who were working in 1999. Work stress was operationalized as high job demands and low decision latitude. These working conditions were self-reported in 1999 (study baseline. Traumatic events in the past 12 months were reported in 2000. Sleep quality was assessed in 2000 as disturbed sleep in the past 12 months, and current sleep problems was indexed by the sleep subscale of the Nottingham Health Profile questionnaire. The results showed that recent events interacted with decision latitude, but not job demands, in predicting sleep quality. However, contrary to our expectations, it was 'high' and not low decision latitude at work that amplified the negative association between stressful events and sleep quality. Adjusted for baseline health, individuals with highest numbers of events and highest levels of decision latitude were at highest risk for impaired sleep. These results challenge the idea that high decision latitude always serves as a protective factor, and underscore the necessity for considering a broader life context when studying stress in a particular domain of life.

  1. Greater-than-Class C low-level radioactive waste characterization. Appendix E-4: Packaging factors for greater-than-Class C low-level radioactive waste

    International Nuclear Information System (INIS)

    Quinn, G.; Grant, P.; Winberg, M.; Williams, K.

    1994-09-01

    This report estimates packaging factors for several waste types that are potential greater-than-Class C (GTCC) low-level radioactive waste (LLW). The packaging factor is defined as the volume of a GTCC LLW disposal container divided by the as-generated or ''unpackaged'' volume of the waste loaded into the disposal container. Packaging factors reflect any processes that reduce or increase an original unpackaged volume of GTCC LLW, the volume inside a waste container not occupied by the waste, and the volume of the waste container itself. Three values are developed that represent (a) the base case or most likely value for a packaging factor, (b) a high case packaging factor that corresponds to the largest anticipated disposal volume of waste, and (c) a low case packaging factor for the smallest volume expected. GTCC LLW is placed in three categories for evaluation in this report: activated metals, sealed sources, and all other waste

  2. Hormones, herbal preparations and nutriceuticals for a better life after the menopause: part II.

    Science.gov (United States)

    Comhaire, F H; Depypere, H T

    2015-06-01

    Long-term estrogen replacement therapy with estrogen has benefits for many postmenopausal women. However, some women prefer non-steroidal substitution with herbal preparations. The effectivity against vasomotor symptoms has been evidenced for the extracts of pine bark, of linseed and of Lepidium meyenii (Maca), whereas there is controversy about the effectiveness of genistein-rich soy extract. The extracts of cruciferous vegetables such as Broccoli and of linseed induce changes in the metabolism of estrogens, and antioxidants may reverse altered epigenetic DNA methylation, possibly reducing the risk of breast cancer or its recurrence. Indirect evidence from the literature and from clinical trials supports that a nutriceutical composed of plant extracts, low-dose vitamins and minerals may improve the quality of life by delaying certain age-related diseases. On the basis of epidemiologic studies, physiopathological considerations and controlled prospectieve trials, it is suggested that transdermal substitution therapy with estradiol together with nutriceutical food supplementation may increase the number of quality-adjusted life years of postmenopausal women, but complementary, large-scale, prospective trials are still needed.

  3. Cost Effectiveness of a Weight Management Program Implemented in the Worksite: Translation of Fuel Your Life.

    Science.gov (United States)

    Corso, Phaedra S; Ingels, Justin B; Padilla, Heather M; Zuercher, Heather; DeJoy, David M; Vandenberg, Robert J; Wilson, Mark G

    2018-04-18

    Conduct a cost-effectiveness analysis of the Fuel Your Life (FYL) program dissemination. Employees were recruited from three workplaces randomly assigned to one of the conditions: telephone coaching, small group coaching, and self-study. Costs were collected prospectively during the efficacy trial. The main outcome measures of interest were weight loss and quality-adjusted life years (QALYs). The phone condition was most costly ($601-$589/employee) and the self-study condition was least costly ($145-$143/employee). For weight loss, delivering FYL through the small group condition was no more effective, yet more expensive, than the self-study delivery. For QALYs, the group delivery of FYL was in an acceptable cost-effectiveness range ($22,400/QALY) relative to self-study (95% CI: $10,600/QALY - dominated). Prevention programs require adaptation at the local level and significantly affect the cost, effectiveness, and cost effectiveness of the program.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0.

  4. Quality of life and time to death: have the health gains of preventive interventions been underestimated?

    Science.gov (United States)

    Gheorghe, Maria; Brouwer, Werner B F; van Baal, Pieter H M

    2015-04-01

    This article explores the implications of the relation between quality of life (QoL) and time to death (TTD) for economic evaluations of preventive interventions. By using health survey data on QoL for the general Dutch population linked to the mortality registry, we quantify the magnitude of this relationship. For addressing specific features of the nonstandard QoL distribution such as boundness, skewness, and heteroscedasticity, we modeled QoL using a generalized additive model for location, scale, and shape (GAMLSS) with a β inflated outcome distribution. Our empirical results indicate that QoL decreases when approaching death, suggesting that there is a strong relationship between TTD and QoL. Predictions of different regression models revealed that ignoring this relationship results in an underestimation of the quality-adjusted life year (QALY) gains for preventive interventions. The underestimation ranged between 3% and 7% and depended on age, the number of years gained from the intervention, and the discount rate used. © The Author(s) 2014.

  5. The independent contribution of executive functions to health related quality of life in older women

    Directory of Open Access Journals (Sweden)

    Marra Carlo A

    2010-04-01

    Full Text Available Abstract Background Cognition is a multidimensional construct and to our knowledge, no previous studies have examined the independent contribution of specific domains of cognition to health related quality of life. To determine whether executive functions are independently associated with health related quality of life assessed using Quality Adjusted Life Years (QALYs calculated from the EuroQol EQ-5D (EQ-5D in older women after adjusting for known covariates, including global cognition. Therefore, we conducted a secondary analysis of community-dwelling older women aged 65-75 years who participated in a 12-month randomized controlled trial of resistance training. We assessed global cognition using the Mini-Mental State Examination (MMSE and executive functions using the: 1 Stroop Test; 2 Trail Making Test (Part B and 3 Digits Verbal Span Backwards Test. We calculated QALYs from the EQ-5D administered at baseline, 6 months and 12 months. Results Our multivariate linear regression model demonstrated the specific executive processes of set shifting and working memory, as measured by Trail Making Test (Part B and Digits Verbal Span Backward Test (p Conclusions Our study highlights the specific executive processes of set shifting and working memory were independently associated with QALYs -- a measure of health related quality of life. Given that executive functions explain variability in QALYs, clinicians may need to consider assessing executive functions when measuring health related quality of life. Further, the EQ-5D may be used to track changes in health status over time and serve as a screening tool for clinicians. Trial Registration ClinicalTrials.gov Identifier: NCT00426881.

  6. Overview of Milestone E activities, greater confinement than shallow land burial

    International Nuclear Information System (INIS)

    Mezga, L.J.

    1981-01-01

    In summary, the objective of Milestone E is to provide the technology and documentation needed to open a site providing greater confinement than shallow land burial. To that end, ORNL has prepared a technical position paper defining greater confinement disposal, options for achieving it, and the need for this disposal technology. In order to meet the objective of the milestones, the LLWMP evaluated the full range of options to shallow land burial and decided to focus on a combination of greater depth solidification containment and engineered barriers. The program identified a series of research needs and then focused program efforts on resolving those needs. These tasks are proceeding on schedule at this time but budget reductions may have an impact on our ability to maintain the schedule

  7. Can genetically based clines in plant defence explain greater herbivory at higher latitudes?

    Science.gov (United States)

    Anstett, Daniel N; Ahern, Jeffrey R; Glinos, Julia; Nawar, Nabanita; Salminen, Juha-Pekka; Johnson, Marc T J

    2015-12-01

    Greater plant defence is predicted to evolve at lower latitudes in response to increased herbivore pressure. However, recent studies question the generality of this pattern. In this study, we tested for genetically based latitudinal clines in resistance to herbivores and underlying defence traits of Oenothera biennis. We grew plants from 137 populations from across the entire native range of O. biennis. Populations from lower latitudes showed greater resistance to multiple specialist and generalist herbivores. These patterns were associated with an increase in total phenolics at lower latitudes. A significant proportion of the phenolics were driven by the concentrations of two major ellagitannins, which exhibited opposing latitudinal clines. Our analyses suggest that these findings are unlikely to be explained by local adaptation of herbivore populations or genetic variation in phenology. Rather greater herbivory at high latitudes can be explained by latitudinal clines in the evolution of plant defences. © 2015 John Wiley & Sons Ltd/CNRS.

  8. Gender differences in commuting behavior: Women's greater sensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Olmo Sanchez, M.I.; Maeso Gonzalez, E.

    2016-07-01

    Women's greater sensitivity to changes in their environment is one of the most distinguishing features between both genders. This article raises women's greater sensitivity to the different variables which influence their commuting modal choice. In order to do this, gender gaps detected in the choice of means of transport in commuting trips with respect to the decision factors such as age, education level, driver's license, private transport access; location, household size and net income, are quantified.The results show a greater female sensitivity to the different variables that affect their modal choice, which helps to better understand the different mobility patterns and it is useful for planning measures favoring sustainable mobility policies and equity. (Author)

  9. Prevention of depression and anxiety in later life: design of a randomized controlled trial for the clinical and economic evaluation of a life-review intervention

    Directory of Open Access Journals (Sweden)

    Smit Filip

    2009-07-01

    Full Text Available Abstract Background Depressive and anxiety symptoms in older adults could develop into significant health problems with detrimental effects on quality of life and a possibly poor prognosis. Therefore, there is a need for preventive interventions which are at once effective, acceptable and economic affordable. Methods and design This paper describes the design of a study evaluating "The stories we live by", a preventive life-review group intervention, which was recently developed for adults of 55 years and over with depressive and anxiety symptoms. Both clinical and economic effectiveness will be evaluated in a pragmatic randomized controlled trial. The participants in the intervention condition will receive the 8-session preventive intervention. The participants in the control condition will have access to usual care. Clinical end-terms are depressive and anxiety symptoms, current major depressive episode, quality of life and positive mental health post-treatment (3 months after baseline and at follow-ups (6 and 12 months after baseline. Additional goals of this study are to identify groups for whom the intervention is particularly effective and to identify the therapeutic pathways that are vital in inducing clinical change. This will be done by analyzing if treatment response is moderated by demographics, personality, past major depressive episodes, important life events and chronically disease, and mediated by reminiscence functions, perceived control, automatic positive thoughts and meaning in life. Finally the cost-effectiveness of the intervention relative to care as usual will be assessed by computing incremental costs per case of depression and anxiety avoided (cost-effectiveness and per quality adjusted life year (QALY (cost utility. Discussion It is expected that both the life-review intervention and its evaluation will contribute to the existing body of knowledge in several ways. First, the intervention is unique in linking life

  10. Greater physiological and behavioral effects of interrupted stress pattern compared to daily restraint stress in rats.

    Directory of Open Access Journals (Sweden)

    Wei Zhang

    Full Text Available Repeated stress can trigger a range of psychiatric disorders, including anxiety. The propensity to develop abnormal behaviors after repeated stress is related to the severity, frequency and number of stressors. However, the pattern of stress exposure may contribute to the impact of stress. In addition, the anxiogenic nature of repeated stress exposure can be moderated by the degree of coping that occurs, and can be reflected in homotypic habituation to the repeated stress. However, expectations are not clear when a pattern of stress presentation is utilized that diminishes habituation. The purpose of these experiments is to test whether interrupted stress exposure decreases homotypic habituation and leads to greater effects on anxiety-like behavior in adult male rats. We found that repeated interrupted restraint stress resulted in less overall homotypic habituation compared to repeated daily restraint stress. This was demonstrated by greater production of fecal boli and greater corticosterone response to restraint. Furthermore, interrupted restraint stress resulted in a lower body weight and greater adrenal gland weight than daily restraint stress, and greater anxiety-like behavior in the elevated plus maze. Control experiments demonstrated that these effects of the interrupted pattern could not be explained by differences in the total number of stress exposures, differences in the total number of days that the stress periods encompased, nor could it be explained as a result of only the stress exposures after an interruption from stress. These experiments demonstrate that the pattern of stress exposure is a significant determinant of the effects of repeated stress, and that interrupted stress exposure that decreases habituation can have larger effects than a greater number of daily stress exposures. Differences in the pattern of stress exposure are therefore an important factor to consider when predicting the severity of the effects of repeated

  11. MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Andrew; Van der Vliet, Andrew [Regional Imaging Border, Albury, NSW (Australia); Zadow, Steven [Dr Jones and Partners Medical Imaging, Adelaide, SA (Australia)

    2007-07-15

    Greater trochanteric pain syndrome is commonly due to gluteus minimus or medius injury rather than trochanteric bursitis. Gluteal tendinopathy most frequently occurs in late-middle aged females. In this pictorial review the pertinent MRI and US anatomy of the gluteal tendon insertions on the greater trochanter and the adjacent bursae are reviewed. The direct (peritendinitis, tendinosis, partial and complete tear) and indirect (bursal fluid, bony changes and fatty atrophy) MRI signs of gluteal tendon injury are illustrated. The key sonographic findings of gluteal tendinopathy are also discussed. (orig.)

  12. Population dynamics of Greater Scaup breeding on the Yukon-Kuskokwim Delta, Alaska

    Science.gov (United States)

    Flint, Paul L.; Grand, J. Barry; Fondell, Thomas F.; Morse, Julie A.

    2006-01-01

    Populations of greater scaup (Aythya marila) remained relatively stable during a period when populations of lesser scaup (A. affinis) have declined from historic levels. To assist in describing these differences in population trends, from 1991 through 2000, we studied the survival, nesting ecology, and productivity of greater scaup on the Yukon-Kuskokwim Delta (Y-K Delta), Alaska, to develop a model of population dynamics. We located nests, radio-marked females for renesting studies, estimated duckling survival, and leg-banded females to examine nest site fidelity and annual survival.

  13. BILATERAL ANTERIOR DISLOCATION OF SHOULDER WITH GREATER TUBEROSITY FRACTURE DUE TO HYPONATREMIA : A RARE PRESENTATION

    Directory of Open Access Journals (Sweden)

    Sivananda

    2015-01-01

    Full Text Available We here report a rare presentation of bilateral anterior dislocation of shoulder with associated fracture of greater tuberosity in a 38 year old male due to minor trauma which he sustained secondary to hyponatremia induced irritability. There was no associ ated rotator cuff tear which is often associated with BADS which makes this presentation unique. Unilateral dislocation of shoulder is a common condition which is frequently encountered in emergency trauma department. Anterior dislocation is more common th an posterior dislocation. However, simultaneous bilateral shoulder dislocations are usually posterior. Bilateral anterior dislocations with fractures of the greater tuberosity are even rarer and are usually associated with trauma or seizures

  14. Excerpt from Trans-Americanity: Subaltern Modernities, Global Coloniality, and the Cultures of Greater Mexico

    Directory of Open Access Journals (Sweden)

    José David Saldívar

    2012-06-01

    Full Text Available José David Saldívar’s work, excerpted from Trans-Americanity: Subaltern Modernities, Global Coloniality, and the Cultures of Greater Mexico, focuses on Américo Paredes, whom he refers to as a “proto-Chicano.” Here he discusses Paredes’s columns written from Asia for the United States Army magazine Stars and Stripes and how his experience in Asia between 1945 and 1950 crossed with and informed his evolving viewpoint on US–Mexican borderlands and his “outernationalist” envisioning of a “Greater Mexico.”

  15. Violence, abuse, alcohol and drug use, and sexual behaviors in street children of Greater Cairo and Alexandria, Egypt.

    Science.gov (United States)

    Nada, Khaled H; Suliman, El Daw A

    2010-07-01

    To measure the prevalence of HIV/AIDS risk behaviors and related factors in a large, probability-based sample of boys and girls aged 12-17 years living on the streets of Egypt's largest urban centers of Greater Cairo and Alexandria. Time-location sampling (TLS) was used to recruit a cross-sectional sample of street children. Procedures entailed using key informants and field observation to create a sampling frame of locations at predetermined time intervals of the day, where street children congregate in the two cities, selecting a random sample of time-locations from the complete list, and intercepting children in the selected time-locations to assess eligibility and conduct interviews. Interviews gathered basic demographic information, life events on the street (including violence, abuse, forced sex), sexual and drug use behaviors, and HIV/AIDS knowledge. A total of 857 street children were enrolled in the two cities, with an age, sex, and time-location composition matching the sampling frame. The majority of these children had faced harassment or abuse (93%) typically by police and other street children, had used drugs (62%), and, among the older adolescents, were sexually active (67%). Among the sexually active 15-17-year-olds, most reported multiple partners (54%) and never using condoms (52%). Most girls (53% in Greater Cairo and 90% in Alexandria) had experienced sexual abuse. The majority of street children experienced more than one of these risks. Overlaps with populations at highest risk for HIV were substantial, namely men who have sex with men, commercial sex workers, and injection drug users. Our study using a randomized TLS approach produced a rigorous, diverse, probability-based sample of street children and documented very high levels of multiple concurrent risks. Our findings strongly advocate for multiple services including those addressing HIV and STI prevention and care, substance use, shelters, and sensitization of authorities to the plight of

  16. Interseasonal movements of greater sage-grouse, migratory behavior, and an assessment of the core regions concept in Wyoming

    Science.gov (United States)

    Fedy, Bradley C.; Aldridge, Cameron L.; Doherty, Kevin E.; O'Donnell, Michael S.; Beck, Jeffrey L.; Bedrosian, Bryan; Holloran, Matthew J.; Johnson, Gregory D.; Kaczor, Nicholas W.; Kirol, Christopher P.; Mandich, Cheryl A.; Marshall, David; McKee, Gwyn; Olson, Chad; Swanson, Christopher C.; Walker, Brett L.

    2012-01-01

    Animals can require different habitat types throughout their annual cycles. When considering habitat prioritization, we need to explicitly consider habitat requirements throughout the annual cycle, particularly for species of conservation concern. Understanding annual habitat requirements begins with quantifying how far individuals move across landscapes between key life stages to access required habitats. We quantified individual interseasonal movements for greater sage-grouse (Centrocercus urophasianus; hereafter sage-grouse) using radio-telemetry spanning the majority of the species distribution in Wyoming. Sage-grouse are currently a candidate for listing under the United States Endangered Species Act and Wyoming is predicted to remain a stronghold for the species. Sage-grouse use distinct seasonal habitats throughout their annual cycle for breeding, brood rearing, and wintering. Average movement distances in Wyoming from nest sites to summer-late brood-rearing locations were 8.1 km (SE = 0.3 km; n = 828 individuals) and the average subsequent distances moved from summer sites to winter locations were 17.3 km (SE = 0.5 km; n = 607 individuals). Average nest-to-winter movements were 14.4 km (SE = 0.6 km; n = 434 individuals). We documented remarkable variation in the extent of movement distances both within and among sites across Wyoming, with some individuals remaining year-round in the same vicinity and others moving over 50 km between life stages. Our results suggest defining any of our populations as migratory or non-migratory is innappropriate as individual strategies vary widely. We compared movement distances of birds marked using Global Positioning System (GPS) and very high frequency (VHF) radio marking techniques and found no evidence that the heavier GPS radios limited movement. Furthermore, we examined the capacity of the sage-grouse core regions concept to capture seasonal locations. As expected, we found the core regions approach, which was

  17. Architecture is Life... ...Life is Architecture

    OpenAIRE

    Snider, David E

    2001-01-01

    When thinking about architecture, I cannot help but think about my life and the things that have affected my life. How does the environment around us effect the daily decisions we make? How do the experiences throughout our life impact who we are and who we become? The people and surroundings we choose will ultimately decide the type of people we become. When we select our surroundings we are in turn selecting our ideal community. Everyone is trying to achieve community in some sense, from in...

  18. Satisfaction with life and food-related life in Ecuadorian older adults.

    Science.gov (United States)

    Schnettler, Berta; Lobos, Germán; Lapo, María Del Carmen; Adasme-Berríos, Cristian; Hueche, Clementina

    2017-02-01

    To distinguish typologies of seniors according to their levels of satisfaction with life and food-related life, and to characterize them according to the importance assigned to family, health-related aspects, eating habits, nutritional status and sociodemographic characteristics. A survey was administered to a non-probabilistic sample of 817 seniors aged 60 years and over, of both genders, resident in urban and rural zones of the province of Guayas, Ecuador. The instrument included: Satisfaction with Life Scale (SWLS), Satisfaction with Food-related Life (SWFL), the Health-related Quality of Life Index (HRQOL-4) and the Family Importance Scale (FIS). Eating habits, sociodemographic variables, approximate weight and height were asked about. A cluster analysis was used to distinguish three typologies that differed significantly in the scores on the SWLS, SWFL, FIS, number of days with mental health problems, self-perception of health status, body mass index, eating habits and zone of residence. Two typologies presented high levels of satisfaction with life and food-related life, although the variables associated with overall well-being and in the food domain were different in each typology. The results suggest that high levels of satisfaction with life and food-related life in Ecuadorian seniors are associated with both healthful eating habits and having lunch in company, fewer mental health problems and greater importance assigned to family.

  19. Go4Life

    Medline Plus

    Full Text Available ... This item has been hidden Go4Life Exercises — Building Strength Play all Try some of these Go4Life exercises to improve your strength! Stronger muscles can make it easier to do ...

  20. Life cycle assessment (LCA)

    DEFF Research Database (Denmark)

    Thrane, Mikkel; Schmidt, Jannick Andresen

    2004-01-01

    The chapter introduces Life Cycle Assessment (LCA) and its application according to the ISO 1404043 standards.......The chapter introduces Life Cycle Assessment (LCA) and its application according to the ISO 1404043 standards....

  1. Go4Life

    Medline Plus

    Full Text Available ... useful upper body exercise from Go4Life, the Overhead Arm Raise. CC 3:10 Play next Play now Go4Life Exercise--Hand Grip - Duration: 3 minutes, 10 seconds. National Institute ...

  2. YOUR LIFE@CERN

    CERN Multimedia

    Guinot, Genevieve

    2016-01-01

    Balancing work and home life, getting support for your family and thriving in an inclusive and respectful workplace: find out more about the support structures in place to enhance your working life@CERN!

  3. Go4Life

    Medline Plus

    Full Text Available ... more This item has been hidden Go4Life Exercises — Balance Play all Try some of these Go4Life exercises to improve your balance! Balance is important because it can help reduce ...

  4. Cost and quality of life of overlooked eye care needs of children

    Directory of Open Access Journals (Sweden)

    Malvankar-Mehta MS

    2018-02-01

    Full Text Available Monali S Malvankar-Mehta,1,2 Ryan Wilson,3 Erik Leci,3 Kelly Hatch,4 Sapna Sharan1 1Department of Ophthalmology, Ivey Eye Institute, St. Joseph’s Hospital, 2Department of Epidemiology and Biostatistics, 3Schulich School of Medicine and Dentistry, 4Allyn & Betty Taylor Library, Natural Sciences Centre, The University of Western Ontario, London, ON, Canada Background: The objective of this research was to conduct a systematic review and cost analysis to summarize, from the Ministry of Health perspective, the costs families might incur because of their child’s prescription for refractive errors and amblyopia correction.Methods: Databases including MEDLINE, Embase, BIOSIS, CINAHL, HEED, ISI Web of Science, and the Cochrane Library as well as the gray literature were searched. Systematic review was conducted using EPPI-Reviewer 4. Percentage difference in cost of glasses and patches per patient per various diagnoses were computed. The cost of glasses and patches was projected over a 5-year time horizon. Cost-utility analysis was performed.Results: In total, 302 records were retrieved from multiple databases and an additional 48 records were identified through gray literature search. From these, a total of 14 studies (10,388 subjects were eligible for quantitative analysis. The cost of glasses increased significantly for congenital cataract patients to US$1,820, esotropia patients to US$840, myopes to US$411, amblyopes (mixed to US$916, anisometropes to US$521, and patients with strabismus to US$728 over a 5-year period making them unaffordable for low-income families. Incremental cost of glasses of congenital cataract patients with delayed treatment was computed to be US$1,690 per health utility gained. Incremental cost of glasses for high refractive error was US$93 per health utility gained in non-compliant children. For amblyopia patients, incremental cost of glasses per quality-adjusted life years gained was US$3,638.Conclusion: Cost of

  5. Do ewes born with a male co-twin have greater longevity with lambing over time?

    Science.gov (United States)

    Based on a recent analysis of historical records, ewes born co-twin to a ram had greater lifetime reproductive performance than ewes born co-twin to a ewe. We are interested in determining what component(s) of lifetime reproductive performance may be associated with a ewe’s co-twin sex. As an initi...

  6. Affordability Assessment to Implement Light Rail Transit (LRT for Greater Yogyakarta

    Directory of Open Access Journals (Sweden)

    Anjang Nugroho

    2015-06-01

    Full Text Available The high population density and the increasing visitors in Yogyakarta aggravate the traffic congestion problem. BRT (Bus Rapid Transit services, Trans Jogja has not managed to solve this problem yet. Introducing Light Rail Transit (LRT has been considered as one of the solutions to restrain the congestion in Greater Yogyakarta. As the first indication that the LRT can be built in Greater Yogyakarta, the transportation affordability index was used to understand whether the LRT tariff was affordable. That tariff was calculated based on government policy in determining railway tariff. The forecasted potential passengers and LRT route have been analyzed as the previous steps to get LRT tariff. Potential passenger was forecasted from gravity mode, and the proposed LRT route was chosen using Multi Criteria Decision Analysis (MCDA. The existing transportation affordability index was calculated for comparison analysis using the percentage of the expenditures for transportation made by monthly income of each household. The result showed that the LRT for Greater Yogyakarta was the most affordable transport mode compared to the Trans Jogja Bus and motorcycle. The affordability index of Tram Jogja for people having average income was 10.66% while another people with bottom quartile income was 13.56%. Keywords: Greater Yogyakarta, LRT, affordability.

  7. Secure equality and greater-than tests with sublinear online complexity

    DEFF Research Database (Denmark)

    Lipmaa, Helger; Toft, Tomas

    2013-01-01

    Secure multiparty computation (MPC) allows multiple parties to evaluate functions without disclosing the private inputs. Secure comparisons (testing equality and greater-than) are important primitives required by many MPC applications. We propose two equality tests for ℓ-bit values with O(1) online...

  8. Climate influences on whitebark pine mortality from mountain pine beetle in the Greater Yellowstone Ecosystem

    Science.gov (United States)

    Polly C. Buotte; Jeffrey A. Hicke; Haiganoush K. Preisler; John T. Abatzoglou; Kenneth F. Raffa; Jesse A. Logan

    2016-01-01

    Extensive mortality of whitebark pine, beginning in the early to mid-2000s, occurred in the Greater Yellowstone Ecosystem (GYE) of the western USA, primarily from mountain pine beetle but also from other threats such as white pine blister rust. The climatic drivers of this recent mortality and the potential for future whitebark pine mortality from mountain pine beetle...

  9. Hearing and evasive behavior in the greater wax moth, Galleria mellonella (Pyralidae)

    DEFF Research Database (Denmark)

    Skals, Niels; Surlykke, Annemarie

    2000-01-01

    Greater wax moths (Galleria mellonella L., Pyraloidea) use ultrasound sensitive ears to detect clicking conspeci®cs and echolocating bats. Pyralid ears have four sensory cells, A1±4. The audiogram of G. mellonella has best frequency at 60 kHz with a threshold around 47 dB sound pressure level. A1...

  10. Landscape restoration for greater sage-grouse: implications for multiscale planning and monitoring

    Science.gov (United States)

    Michael J. Wisdom; Mary M. Rowland; Miles A. Hemstrom; Barbara C. Wales

    2005-01-01

    Habitats and populations of greater sage-grouse (Centrocercus urophasianus) have declined throughout western North America in response to a myriad of detrimental land uses. Successful restoration of this species' habitat, therefore, is of keen interest to Federal land agencies who oversee management of most remaining habitat. To illustrate the...

  11. Monitoring white pine blister rust infection and mortality in whitebark pine in the Greater Yellowstone ecosystem

    Science.gov (United States)

    Cathie Jean; Erin Shanahan; Rob Daley; Gregg DeNitto; Dan Reinhart; Chuck Schwartz

    2011-01-01

    There is a critical need for information on the status and trend of whitebark pine (Pinus albicaulis) in the Greater Yellowstone Ecosystem (GYE). Concerns over the combined effects of white pine blister rust (WPBR, Cronartium ribicola), mountain pine beetle (MPB, Dendroctonus ponderosae), and climate change prompted an interagency working group to design and implement...

  12. Does Greater Autonomy Improve School Performance? Evidence from a Regression Discontinuity Analysis in Chicago

    Science.gov (United States)

    Steinberg, Matthew P.

    2014-01-01

    School districts throughout the United States are increasingly providing greater autonomy to local public (non-charter) school principals. In 2005-06, Chicago Public Schools initiated the Autonomous Management and Performance Schools program, granting academic, programmatic, and operational freedoms to select principals. This paper provides…

  13. Microhabitat selection of brood-rearing sites by greater sage-grouse in Carbon County, Wyoming

    Science.gov (United States)

    Leslie A. Schreiber; Christopher P. Hansen; Mark A. Rumble; Joshua J. Millspaugh; R. Scott Gamo; Jon W. Kehmeier; Nate Wojcik

    2015-01-01

    Declines in Greater Sage-Grouse (Centrocercus urophasianus, hereafter sage-grouse) populations could be attributed to low chick survival, which may be influenced by the availability of food and cover at sites used by females rearing broods. Habitat attributes important to broods may vary regionally; thus, it is necessary to understand factors affecting...

  14. Greater sage-grouse winter habitat use on the eastern edge of their range

    Science.gov (United States)

    Christopher C. Swanson; Mark A. Rumble; Nicholas W. Kaczor; Robert W. Klaver; Katie M. Herman-Brunson; Jonathan A. Jenks; Kent C. Jensen

    2013-01-01

    Greater sage-grouse (Centrocercus urophasianus) at the western edge of the Dakotas occur in the transition zone between sagebrush and grassland communities. These mixed sagebrush (Artemisia sp.) and grasslands differ from those habitats that comprise the central portions of the sage-grouse range; yet, no information is available on winter habitat selection within this...

  15. Restoration handbook for sagebrush steppe ecosystems with emphasis on greater sage-grouse habitat - Part 1

    Science.gov (United States)

    David A. Pyke; Jeanne C. Chambers; Mike Pellant; Steven T. Knick; Richard F. Miller; Jeffrey L. Beck; Paul S. Doescher; Eugene W. Schupp; Bruce A. Roundy; Mark Brunson; James D. McIver

    2015-01-01

    Sagebrush steppe ecosystems in the United States currently occur on only about one-half of their historical land area because of changes in land use, urban growth, and degradation of land, including invasions of non-native plants. The existence of many animal species depends on the existence of sagebrush steppe habitat. The greater sage-grouse (Centrocercus...

  16. Lek ecology of male greater sage-grouse in Carbon County, Wyoming

    Science.gov (United States)

    Aleshia Lynn Fremgen

    2014-01-01

    Greater sage-grouse (Centrocercus urophasianus, hereafter "sage-grouse") have experienced range-wide population declines for several decades, and as a result they were considered warranted for listing under the Endangered Species Act in 2010. Therefore, wildlife managers need to understand how sage-grouse breeding behavior influences long-term reproductive...

  17. Evaluating lek occupancy of greater sage-grouse in relation to landscape cultivation in the Dakotas

    Science.gov (United States)

    Smith, Joe T.; Flake, Lester D.; Higgins, Kenneth F.; Kobriger, Gerald D.; Homer, Collin G.

    2005-01-01

    Greater Sage-Grouse (Centrocercus urophasianus) have been declining in many states and provinces of North America, and North and South Dakota hold no exception to these declines. We studied effects of cultivated land on Greater Sage-Grouse lek abandonment in North and South Dakota. Landscape-level data were assessed using satellite imagery within a geographic information system. Comparisons were made of 1972-1976 and 1999-2000 percent cultivated and noncultivated land. These comparisons were made between land uses surrounding active leks versus inactive leks, active leks versus random locations, and abandoned regions versus active regions. The 1999-2000 imagery illustrated that percent cultivated land was greater near abandoned leks (4-km buffers) than near active leks in North Dakota or random sites, but this did not hold true in South Dakota. Comparison of an extensive region of abandoned leks with a region of active leks in North Dakota illustrated a similar increase as well as dispersion of cultivation within the abandoned region. However, 1972-1976 imagery revealed that this relationship between percentage of cultivated land and lek activity in North Dakota has been static over the last 30 years. Thus, if the decline of Greater Sage-Grouse is the result of cultivated land infringements, it occurred prior to 1972 in North Dakota.

  18. Nutritional status of alcoholics in Peri-urban areas of the greater ...

    African Journals Online (AJOL)

    Alcoholism is a common problem in developing countries. Epidemiological studies on the relationship among excessive alcohol consumption, malnutrition and anaemia are inconclusive. The present study examined the association between alcohol intake and nutritional status of alcoholics in the Greater Accra Region of ...

  19. Higher Education's Influence on the Confessional Practices of Roman Catholic Laity in the Greater Miami Area

    Science.gov (United States)

    Ferrari, Joseph L.

    2013-01-01

    This qualitative phenomenological study of 20 Roman Catholic laypersons in the Greater Miami area investigated the phenomenon of transformation of confessional practice as a result of the undergraduate educational experience. By searching for meaning in each individual's story, two themes or factors and six sub themes emerged. The themes were…

  20. Greater support and debriefing may help student midwives to process traumatic birth experiences

    OpenAIRE

    Kitson-Reynolds, Ellen

    2015-01-01

    Implications for practice and researchIncorporating resilience training and a multidisciplinary debriefing approach within clinical and academic environments would develop a culture of support and compassion for the workforce and ultimately effective care for women using maternity services. Further research surrounding the effectiveness of resilience education for student midwives is required to elicit greater understanding of the effect on woman-centred care.

  1. Advancing grate-firing for greater environmental impacts and efficiency for decentralized biomass/wastes combustion

    DEFF Research Database (Denmark)

    Yin, Chungen; Li, Shuangshuang

    2017-01-01

    to well suit decentralized biomass and municipal/industrial wastes combustion. This paper discusses with concrete examples how to advance grate-firing for greater efficiency and environmental impacts, e.g., use of advanced secondary air system, flue gas recycling and optimized grate assembly, which...

  2. Optimal wildlife management in the greater Yellowstone ecosystem: A spatiotemporal model of disease risk

    Science.gov (United States)

    South of Yellowstone National Park there are twenty-three sites where elk herds are provided supplementary feeding during the winter and spring months. Supplementary feeding of elk in the Greater Yellowstone Ecosystem (GYE) has been practiced since the early twentieth century, but the practice has b...

  3. DOD Financial Management: Greater Visibility Needed to Better Assess Audit Readiness for Property, Plant, and Equipment

    Science.gov (United States)

    2016-05-01

    with U.S. generally accepted accounting principles and establish and maintain effective internal control over financial reporting and compliance with... Accountability Office Highlights of GAO-16-383, a report to congressional committees May 2016 DOD FINANCIAL MANAGEMENT Greater Visibility... Accounting Standards Advisory Board FIAR Financial Improvement and Audit Readiness IUS internal-use software NDAA National Defense Authorization Act

  4. Higher Pretransplantation Hemoglobin A1c Is Associated With Greater Risk of Posttransplant Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Jung-Im Shin

    2017-11-01

    Discussion: Higher pretransplantation HbA1c above 5.4% is independently associated with greater risk of PTDM among kidney transplant recipients. A continuous relationship between pretransplantation HbA1c and risk of PTDM suggests that increased risk starts at HbA1c levels well below current thresholds for prediabetes.

  5. Single versus double row suture anchor fixation for greater tuberosity fractures - a biomechanical study.

    Science.gov (United States)

    Seppel, Gernot; Saier, Tim; Martetschläger, Frank; Plath, Johannes E; Guevara-Alvarez, Alberto; Henschel, Julia; Winkler, Martin; Augat, Peter; Imhoff, Andreas B; Buchmann, Stefan

    2017-12-01

    Fractures of the humeral greater tuberosity (GT) are a frequent injury progressively treated with arthroscopic suture anchor repair. Yet, no biomechanical study has been performed comparing fixation strength of arthroscopic single- (SR) vs. double row (DR) fixation. Standardized fractures of the greater tuberosity were created in 12 fresh frozen proximal humeri. After random assignation to the SR or DR group the fixed humeri were tested applying cyclic loading to the supraspinatus and infraspinatus tendon. Load to failure and fragment displacement were assessed by means of an electrodynamic material testing machine using an optical tracking system. Load to failure values were higher in the DR group (649 N; ±176) than in the SR group (490 N; ±145) however without statistical significance (p = .12). In greater tuberosity displacement of 3-5 mm surgical treatment is recommended. The fixing constructs in this study did not reach displacement landmarks of 3 or 5 mm before construct failure as shown in previous studies. Thus the applied traction force (N) at 1 mm displacement was analyzed. In the SR group the load at 1 mm displacement was 277 N; ±46 compared to 260 N; ±62 in the DR group (p = .65). The results suggest that both techniques are viable options for refixation of greater tuberosity fractures. Laboratory study.

  6. Continued warming could transform Greater Yellowstone fire regimes by mid-21st century

    Science.gov (United States)

    Anthony L. Westerling; Monica G. Turner; Erica A. H. Smithwick; William H. Romme; Michael G. Ryan

    2011-01-01

    Climate change is likely to alter wildfire regimes, but the magnitude and timing of potential climate-driven changes in regional fire regimes are not well understood. We considered how the occurrence, size, and spatial location of large fires might respond to climate projections in the Greater Yellowstone ecosystem (GYE) (Wyoming), a large wildland ecosystem dominated...

  7. Circumpolar variation in morphological characteristics of Greater White-fronted Geese Anser albifrons

    Science.gov (United States)

    Ely, Craig R.; Fox, A.D.; Alisauskas, R.T.; Andreev, A.; Bromley, R.G.; Degtyarev, Andrei G.; Ebbinge, B.; Gurtovaya, E.N.; Kerbes, R.; Kondratyev, Alexander V.; Kostin, I.; Krechmar, A.V.; Litvin, K.E.; Miyabayashi, Y.; Moou, J.H.; Oates, R.M.; Orthmeyer, D.L.; Sabano, Yutaka; Simpson, S.G.; Solovieva, D.V.; Spindler, Michael A.; Syroechkovsky, Y.V.; Takekawa, John Y.; Walsh, A.

    2005-01-01

    Capsule: Greater White-fronted Geese show significant variation in body size from sampling locations throughout their circumpolar breeding range. Aims: To determine the degree of geographical variation in body size of Greater White-fronted Geese and identify factors contributing to any apparent patterns in variation. Methods: Structural measures of >3000 geese from 16 breeding areas throughout the Holarctic breeding range of the species were compared statistically. Results: Palearctic forms varied clinally, and increased in size from the smallest forms on the Kanin and Taimyr peninsulas in western Eurasia to the largest forms breeding in the Anadyr Lowlands of eastern Chukotka. Clinal variation was less apparent in the Nearctic, as both the smallest form in the Nearctic and the largest form overall (the Tule Goose) were from different breeding areas in Alaska. The Tule Goose was 25% larger than the smallest form. Birds from Greenland (A. a. flavirostris) were the second largest, although only slightly larger than geese from several North American populations. Body size was not correlated with breeding latitude but was positively correlated with temperature on the breeding grounds, breeding habitat, and migration distance. Body mass of Greater White-fronted Geese from all populations remained relatively constant during the period of wing moult. Morphological distinctness of eastern and western Palearctic forms concurs with earlier findings of complete range disjunction. Conclusions: Patterns of morphological variation in Greater White-fronted Geese across the Holarctic can be generally attributed to adaptation to variable breeding environments, migration requirements, and phylo-geographical histories. 

  8. Greater Engagement among Members of Gay-Straight Alliances: Individual and Structural Contributors

    Science.gov (United States)

    Poteat, V. Paul; Heck, Nicholas C.; Yoshikawa, Hirokazu; Calzo, Jerel P.

    2016-01-01

    Using youth program models to frame the study of Gay-Straight Alliances (GSAs), we identified individual and structural predictors of greater engagement in these settings with a cross-sectional sample of 295 youth in 33 GSAs from the 2014 Massachusetts GSA Network Survey (69% LGBQ, 68% cisgender female, 68% White, M[subscript age] =16.07).…

  9. Using epiphytic macrolichen communities for biomonitoring ammonia in forests of the greater Sierra Nevada, California

    Science.gov (United States)

    Sarah Jovan; Bruce. Mccune

    2006-01-01

    Chronic, excessive nitrogen deposition is potentially an important ecological threat to forests of the greater Sierra Nevada in California. We developed a model for ammonia bioindication, a major nitrogen pollutant in the region, using epiphytic macrolichens. We used non-metric multidimensional scaling to extract gradients in lichen community composition from surveys...

  10. Minister wants age balance to play greater role in redundancy selection

    NARCIS (Netherlands)

    Grünell, M.

    2004-01-01

    In May 2004, the Dutch Minister of Social Affairs proposed changes to the statutory rules on selection for redundancy, with less emphasis on the last in, first out seniority-based principle and a greater focus on distributing the redundancies between employees of different ages. The social partners

  11. Holistic Analysis of the Urban Water Systems in Greater Cincinnati Region

    Science.gov (United States)

    Urban water and wastewater systems with two utilities in Greater Cincinnati region were evaluated as a case study to elucidates a bigger picture of a typical centralized urban water system. Two different integrated assessment metrics were used to analyze the same system. LCA an...

  12. Evidence for radiations of cheilanthoid ferns in the Greater Cape Floristic Region

    DEFF Research Database (Denmark)

    Eiserhardt, Wolf L.; Rohwer, Jens G.; Russell, Stephen J.

    2011-01-01

    The Greater Cape Floristic Region (GCFR) of southern Africa is characterised by large, endemic radiations of flowering plants, the so-called ‘Cape Clades’, but it is unknown whether such radiations are also found in non-angiosperms. We hypothesise that GCFR-endemic lineages exist in the xeric...

  13. Greater-than-Class-C Low-Level Waste Data Base user's manual

    International Nuclear Information System (INIS)

    1992-07-01

    The Greater-than-Class-C Low-level Waste (GTCC LLW) Data Base characterizes GTCC LLW using low, base, and high cases for three different scenarios: unpackaged, packaged, and concentration averages. The GTCC LLW Data Base can be used to project future volumes and radionuclide activities. This manual provides instructions for users of the GTCC LLW Data Base

  14. Greater sage-grouse as an umbrella species for sagebrush-associated vertebrates.

    Science.gov (United States)

    Mary M. Rowland; Michael J. Wisdom; Lowell Suring; Cara W. Meinke

    2006-01-01

    Widespread degradation of the sagebrush ecosystem in the western United States, including the invasion of cheatgrass, has prompted resource managers to consider a variety of approaches to restore and conserve habitats for sagebrush-associated species. One such approach involves the use of greater sage-grouse, a species of prominent conservation interest, as an umbrella...

  15. Integrating Ethics into International Business Teaching: Challenges and Methodologies in the Greater China Context

    Science.gov (United States)

    Whitla, Paul

    2011-01-01

    This paper examines the process of integrating ethics into the teaching of international business within the Greater China region. An example of how ethics is integrated into a required undergraduate international business course at a Hong Kong based university is presented. The contextual challenges of developing a course for use in the Greater…

  16. Environmental Impacts of Wind Power Development on the Population Biology of Greater Prairie-Chickens

    Energy Technology Data Exchange (ETDEWEB)

    Sandercock, Brett K. [Kansas State Univ., Manhattan, KS (United States)

    2013-05-22

    This report summarizes the results of a seven-year, DOE-funded research project, conducted by researchers from Kansas State University and the National Wind Coordinating Collaborative, to assess the effects of wind energy development in Kansas on the population and reproduction of greater prairie chickens.

  17. Conservation of greater sage-grouse- a synthesis of current trends and future management

    Science.gov (United States)

    Connelly, John W.; Knick, Steven T.; Braun, Clait E.; Baker, William L.; Beever, Erik A.; Christiansen, Thomas J.; Doherty, Kevin E.; Garton, Edward O.; Hagen, Christian A.; Hanser, Steven E.; Johnson, Douglas H.; Leu, Matthias; Miller, Richard F.; Naugle, David E.; Oyler-McCance, Sara J.; Pyke, David A.; Reese, Kerry P.; Schroeder, Michael A.; Stiver, San J.; Walker, Brett L.; Wisdorn, Michael J.

    2011-01-01

    Recent analyses of Greater Sage-Grouse (Centrocercus urophasianus) populations indicate substantial declines in many areas but relatively stable populations in other portions of the species? range. Sagebrush (Artemisia spp.) habitats neces-sary to support sage-grouse are being burned by large wildfires, invaded by nonnative plants, and developed for energy resources (gas, oil, and wind). Management on public lands, which con-tain 70% of sagebrush habitats, has changed over the last 30 years from large sagebrush control projects directed at enhancing livestock grazing to a greater emphasis on projects that often attempt to improve or restore ecological integrity. Never-theless, the mandate to manage public lands to provide traditional consumptive uses as well as recreation and wilderness values is not likely to change in the near future. Consequently, demand and use of resources contained in sagebrush land-scapes plus the associated infrastructure to sup-port increasing human populations in the western United States will continue to challenge efforts to conserve Greater Sage-Grouse. The continued widespread distribution of sage-grouse, albeit at very low densities in some areas, coupled with large areas of important sagebrush habitat that are relatively unaffected by the human footprint, sug-gest that Greater Sage-Grouse populations may be able to persist into the future. We summarize the status of sage-grouse populations and habitats, provide a synthesis of major threats and chal-lenges to conservation of sage-grouse, and suggest a roadmap to attaining conservation goals.

  18. A Formalization of the Greater Fools Theory with Dynamic Epistemic Logic

    DEFF Research Database (Denmark)

    van Lee, Hanna Sofie

    2017-01-01

    The greater fools explanation of financial bubbles says that traders are willing to pay more for an asset than they deem it worth, because they anticipate they might be able to sell it to someone else for an even higher price. As agents’ beliefs about other agents’ beliefs are at the heart...

  19. Data requirements of GREAT-ER: Modelling and validation using LAS in four UK catchments

    International Nuclear Information System (INIS)

    Price, Oliver R.; Munday, Dawn K.; Whelan, Mick J.; Holt, Martin S.; Fox, Katharine K.; Morris, Gerard; Young, Andrew R.

    2009-01-01

    Higher-tier environmental risk assessments on 'down-the-drain' chemicals in river networks can be conducted using models such as GREAT-ER (Geography-referenced Regional Exposure Assessment Tool for European Rivers). It is important these models are evaluated and their sensitivities to input variables understood. This study had two primary objectives: evaluate GREAT-ER model performance, comparing simulated modelled predictions for LAS (linear alkylbenzene sulphonate) with measured concentrations, for four rivers in the UK, and investigate model sensitivity to input variables. We demonstrate that the GREAT-ER model is very sensitive to variability in river discharges. However it is insensitive to the form of distributions used to describe chemical usage and removal rate in sewage treatment plants (STPs). It is concluded that more effort should be directed towards improving empirical estimates of effluent load and reducing uncertainty associated with usage and removal rates in STPs. Simulations could be improved by incorporating the effect of river depth on dissipation rates. - Validation of GREAT-ER.

  20. Data requirements of GREAT-ER: Modelling and validation using LAS in four UK catchments

    Energy Technology Data Exchange (ETDEWEB)

    Price, Oliver R., E-mail: oliver.price@unilever.co [Safety and Environmental Assurance Centre, Unilever, Colworth Science Park, Sharnbrook, Bedfordshire MK44 1LQ (United Kingdom); Munday, Dawn K. [Safety and Environmental Assurance Centre, Unilever, Colworth Science Park, Sharnbrook, Bedfordshire MK44 1LQ (United Kingdom); Whelan, Mick J. [Department of Natural Resources, School of Applied Sciences, Cranfield University, College Road, Cranfield, Bedfordshire MK43 0AL (United Kingdom); Holt, Martin S. [ECETOC, Ave van Nieuwenhuyse 4, Box 6, B-1160 Brussels (Belgium); Fox, Katharine K. [85 Park Road West, Birkenhead, Merseyside CH43 8SQ (United Kingdom); Morris, Gerard [Environment Agency, Phoenix House, Global Avenue, Leeds LS11 8PG (United Kingdom); Young, Andrew R. [Wallingford HydroSolutions Ltd, Maclean building, Crowmarsh Gifford, Wallingford, Oxon OX10 8BB (United Kingdom)

    2009-10-15

    Higher-tier environmental risk assessments on 'down-the-drain' chemicals in river networks can be conducted using models such as GREAT-ER (Geography-referenced Regional Exposure Assessment Tool for European Rivers). It is important these models are evaluated and their sensitivities to input variables understood. This study had two primary objectives: evaluate GREAT-ER model performance, comparing simulated modelled predictions for LAS (linear alkylbenzene sulphonate) with measured concentrations, for four rivers in the UK, and investigate model sensitivity to input variables. We demonstrate that the GREAT-ER model is very sensitive to variability in river discharges. However it is insensitive to the form of distributions used to describe chemical usage and removal rate in sewage treatment plants (STPs). It is concluded that more effort should be directed towards improving empirical estimates of effluent load and reducing uncertainty associated with usage and removal rates in STPs. Simulations could be improved by incorporating the effect of river depth on dissipation rates. - Validation of GREAT-ER.

  1. End of Life Issues

    Science.gov (United States)

    Planning for the end of life can be difficult. But by deciding what end-of-life care best suits your needs when you are healthy, you can ... right choices when the time comes. End-of-life planning usually includes making choices about the following: ...

  2. Chinese Student Life.

    Science.gov (United States)

    Braswell, James; Boone, Jerry N.

    1991-01-01

    Places life of university students in China in context of Tiananmen Square and Cultural Revolution, with implications of serving them as students in the United States. Presents basic facts of student life in China. Although the emphasis is on college life, some attention is paid to earlier student experiences as well. (Author/NB)

  3. Go4Life

    Medline Plus

    Full Text Available ... Go4Life Exercises — Stretching Play all Try some of these Go4Life exercises to improve your flexibility! 2:48 ... Exercises — Building Strength Play all Try some of these Go4Life exercises to improve your strength! Stronger muscles ...

  4. Life Cycle Management

    DEFF Research Database (Denmark)

    Bey, Niki

    2018-01-01

    This chapter gives an overview of Life Cycle Management (LCM)—a discipline that deals with the managerial tasks related to practicing sustainable development in an organisation . Just as Life Cycle Assessment, LCM advocates the life cycle perspective , and it applies this perspective in decision...

  5. Go4Life

    Medline Plus

    Full Text Available ... some of these Go4Life exercises to improve your flexibility! 2:48 Play next Play now Go4Life Exercise-- ... 17,679 views Exercise your upper body at work like Linda with Go4Life's Wall Pushups. CC 1: ...

  6. Work–Life Interventions

    OpenAIRE

    He Lu Calvin Ong; Senthu Jeyaraj

    2014-01-01

    Despite disparities in the conceptualization of work–life balance (WLB) and work–life harmony (WLH) in the literature, there remains no evidence till date to validate these differences. Furthermore, there are currently no insights that shed light on the relationship between work–life initiatives and key business strategies of contemporary organizations. Hence, the current study investigated the differences between the ...

  7. Life in other planets

    International Nuclear Information System (INIS)

    Ghosh, S.N.

    1977-01-01

    Speculations of life on other planets in space are discussed. The life history of a star in terms of the high temperature fusion reactions taking place in it, is outlined. The phenomenon of gases escaping from planetary atmospheres which destroys life on them is explained. Solar radiation effects, pulsar detection etc. are briefly touched upon. (K.B.)

  8. Life in other planets

    Energy Technology Data Exchange (ETDEWEB)

    Ghosh, S N [Calcutta Univ. (India). Dept. of Applied Physics

    1977-12-01

    Speculations of life on other planets in space are discussed. The life history of a star in terms of the high-temperature fusion reactions taking place in it is outlined. The phenomenon of gases escaping from planetary atmospheres which destroys life on them is explained. Solar radiation effects, pulsar detection, etc., are briefly touched upon.

  9. Quality of Life

    Science.gov (United States)

    Military Child Education DSN: (315) 477-9422 COMM: (808) 477-9422 Individual Contacts Branch Chief, Quality Directory Media Inquiries Home : Resources : Quality of Life J102 Quality of Life and Military Child Education Branch PACOM Quality of Life and Education Facebook Page | USPACOM SAPR 24/7 Emergency Lines and

  10. Sagebrush, greater sage-grouse, and the occurrence and importance of forbs

    Science.gov (United States)

    Pennington, Victoria E.; Schlaepfer, Daniel R.; Beck, Jeffrey L.; Bradford, John B.; Palmquist, Kyle A.; Lauenroth, William K.

    2016-01-01

    Big sagebrush (Artemisia tridentata Nutt.) ecosystems provide habitat for sagebrush-obligate wildlife species such as the Greater Sage-Grouse (Centrocercus urophasianus). The understory of big sagebrush plant communities is composed of grasses and forbs that are important sources of cover and food for wildlife. The grass component is well described in the literature, but the composition, abundance, and habitat role of forbs in these communities is largely unknown. Our objective was to synthesize information about forbs and their importance to Greater Sage-Grouse diets and habitats, how rangeland management practices affect forbs, and how forbs respond to changes in temperature and precipitation. We also sought to identify research gaps and needs concerning forbs in big sagebrush plant communities. We searched for relevant literature including journal articles and state and federal agency reports. Our results indicated that in the spring and summer, Greater Sage-Grouse diets consist of forbs (particularly species in the Asteraceae family), arthropods, and lesser amounts of sagebrush. The diets transition to sagebrush in fall and winter. Forbs provide cover for Greater Sage-Grouse individuals at their lekking, nesting, and brood-rearing sites, and the species has a positive relationship with arthropod presence. The effect of grazing on native forbs may be compounded by invasion of nonnative species and differs depending on grazing intensity. The effect of fire on forbs varies greatly and may depend on time elapsed since burning. In addition, chemical and mechanical treatments affect annual and perennial forbs differently. Temperature and precipitation influence forb phenology, biomass, and abundance differently among species. Our review identified several uncertainties and research needs about forbs in big sagebrush ecosystems. First, in many cases the literature about forbs is reported only at the genus or functional type level. Second, information about forb

  11. Variability modifies life satisfaction's association with mortality risk in older adults

    Science.gov (United States)

    Boehm, Julia K.; Winning, Ashley; Segerstrom, Suzanne; Kubzansky, Laura D.

    2015-01-01

    Life satisfaction is associated with greater longevity, but its variability across time has not been examined relative to longevity. We investigated whether mean levels of life satisfaction across time, variability in life satisfaction across time, and their interaction were associated with mortality over 9 years of follow-up. Participants were 4,458 Australians initially ≥50 years old. During the follow-up, 546 people died. Adjusting for age, greater mean life satisfaction was associated with reduced risk and greater variability in life satisfaction was associated with increased risk of mortality. These findings were qualified by a significant interaction such that individuals with low mean satisfaction and high variability in satisfaction had the greatest risk of mortality over the follow-up period. In combination with mean levels of life satisfaction, variability in life satisfaction is relevant for mortality risk among older adults. Considering intraindividual variability provides additional insight into associations between psychological characteristics and health. PMID:26048888

  12. Predicting Greater Prairie-Chicken Lek Site Suitability to Inform Conservation Actions.

    Directory of Open Access Journals (Sweden)

    Torre J Hovick

    Full Text Available The demands of a growing human population dictates that expansion of energy infrastructure, roads, and other development frequently takes place in native rangelands. Particularly, transmission lines and roads commonly divide rural landscapes and increase fragmentation. This has direct and indirect consequences on native wildlife that can be mitigated through thoughtful planning and proactive approaches to identifying areas of high conservation priority. We used nine years (2003-2011 of Greater Prairie-Chicken (Tympanuchus cupido lek locations totaling 870 unique leks sites in Kansas and seven geographic information system (GIS layers describing land cover, topography, and anthropogenic structures to model habitat suitability across the state. The models obtained had low omission rates (0.81, indicating high model performance and reliability of predicted habitat suitability for Greater Prairie-Chickens. We found that elevation was the most influential in predicting lek locations, contributing three times more predictive power than any other variable. However, models were improved by the addition of land cover and anthropogenic features (transmission lines, roads, and oil and gas structures. Overall, our analysis provides a hierarchal understanding of Greater Prairie-Chicken habitat suitability that is broadly based on geomorphological features followed by land cover suitability. We found that when land features and vegetation cover are suitable for Greater Prairie-Chickens, fragmentation by anthropogenic sources such as roadways and transmission lines are a concern. Therefore, it is our recommendation that future human development in Kansas avoid areas that our models identified as highly suitable for Greater Prairie-Chickens and focus development on land cover types that are of lower conservation concern.

  13. MR Neurography of Greater Occipital Nerve Neuropathy: Initial Experience in Patients with Migraine.

    Science.gov (United States)

    Hwang, L; Dessouky, R; Xi, Y; Amirlak, B; Chhabra, A

    2017-11-01

    MR imaging of peripheral nerves (MR neurography) allows improved assessment of nerve anatomy and pathology. The objective of this study was to evaluate patients with unilateral occipital neuralgia using MR neurography and to assess the differences in greater occipital nerve signal and size between the symptomatic and asymptomatic sides. In this case-control evaluation using MR neurography, bilateral greater occipital nerve caliber, signal intensity, signal-to-noise ratios, and contrast-to-noise ratios were determined by 2 observers. Among 18 subjects with unilateral occipital migraines, the average greater occipital nerve diameter for the symptomatic side was significantly greater at 1.77 ± 0.4 mm than for the asymptomatic side at 1.29 ± 0.25 mm ( P = .001). The difference in nerve signal intensity between the symptomatic and asymptomatic sides was statistically significant at 269.06 ± 170.93 and 222.44 ± 170.46, respectively ( P = .043). The signal-to-noise ratios on the symptomatic side were higher at 15.79 ± 4.59 compared with the asymptomatic nerve at 14.02 ± 5.23 ( P = .009). Contrast-to-noise ratios were significantly higher on the symptomatic side than on the asymptomatic side at 2.57 ± 4.89 and -1.26 ± 5.02, respectively ( P = .004). Intraobserver performance was good to excellent (intraclass coefficient correlation, 0.68-0.93), and interobserver performance was fair to excellent (intraclass coefficient correlation, 0.54-0.81). MR neurography can be reliably used for the diagnosis of greater occipital nerve neuropathy in patients with unilateral occipital migraines with a good correlation of imaging findings to the clinical presentation. © 2017 by American Journal of Neuroradiology.

  14. Managing occupations in everyday life for people with advanced cancer at home

    DEFF Research Database (Denmark)

    Peoples, Hanne; Brandt, Åse; Wæhrens, Eva Elisabet Ejlersen

    “Everyday life under change” and two sub-categories 1) Appling strategies to manage occupations in everyday life and 2) Preserving a meaningful everyday life. Significance: The findings suggest that people with advanced cancer, to a greater extent, should be supported in exploring familiar as well as new...

  15. SIMPLE LIFE AND RELIGION

    Directory of Open Access Journals (Sweden)

    Ahmet YILDIRIM

    2014-07-01

    Full Text Available Individuals in terms of the economy in which we live is one of the most important phenomenon of the century. This phenomenon present itself as the only determinant of people's lives by entering almost makes itself felt. The mo st obvious objective needs of the economy by triggering motive is to induce people to consume . Consumer culture pervades all aspects of the situation are people . Therefore, these people have the blessing of culture , beauty and value all in the name of w hatever is consumed. This is way out of the siege of moral and religious values we have is to go back again . Referred by local cultural and religious values, based on today increasingly come to the fore and the Muslim way of life appears to be close to th e plain / lean preferred by many people life has been a way of life. Even the simple life , a way of life in the Western world , a conception of life , a philosophy, a movement as it has become widely accepted. Here in determining the Muslim way of life Pr ophet. Prophet (sa lived the kind of life a very important model, sample, and determining which direction is known. Religious values, which is the carrier of the prophets, sent to the society they have always been examples and models. Because every aspect of human life, his life style and the surrounding area has a feature. We also value his life that he has unknowingly and without learning and skills and to understand it is not possible to live our religion . We also our presentation, we mainly of Islam o utlook on life and predicted life - style, including the Prophet of Islam 's (sa simple life to scrutinize and lifestyle issues related to reveal , in short Islam's how life has embraced and the Prophet. Prophet's will try to find answers to questions reg arding how to live.

  16. The economic value of innovative treatments over the product life cycle: the case of targeted trastuzumab therapy for breast cancer.

    Science.gov (United States)

    Garrison, Louis P; Veenstra, David L

    2009-01-01

    Pharmacoeconomic analyses typically project the expected cost-effectiveness of a new product for a specific indication. This analysis develops a dynamic life-cycle model to conduct a multi-indication evaluation using the case of trastuzumab licensed in the United States for both early-stage and metastatic (or late-stage) human epidermal growth factor receptor 2 (HER2)-positive breast cancer therapy (early breast cancer [EBC]; metastatic breast cancer [MBC]), approved in 2006 and 1998, respectively. This dynamic model combined information on expected incremental cost-utility ratios for specific indications with an epidemiologically based projection of utilization by indication over the product life cycle-from 1998 to 2016. Net economic value was estimated as the cumulative quality-adjusted life years (QALYs) gained over the life cycle multiplied by a societal valuation of health gains ($/QALY) minus cumulative net direct treatment costs. Sensitivity analyses were performed under a range of assumptions. We projected that the annual number of EBC patients receiving trastuzumab will be more than three times that of MBC by 2016, in part because adjuvant treatment reduces the future incidence of MBC. Over this life cycle, the estimated overall incremental cost-effectiveness ratio (ICER) was $35,590/QALY with a total of 432,547 discounted QALYs gained. Under sensitivity analyses, the overall ICER varied from $21,000 to $53,000/QALY, and the projected net economic value resulting from trastuzumab treatment ranged from $6.2 billion to $49.5 billion. Average ICERs for multi-indication compounds can increase or decrease over the product life cycle. In this example, the projected overall life-cycle ICER for trastuzumab was less than one half of that in the initial indication. This dynamic perspective-versus the usual static one-highlights the interdependence of drug development decisions and investment incentives, raising important reimbursement policy issues.

  17. Impact of work-life imbalance on job satisfaction and quality of life among hospital nurses in Japan

    Science.gov (United States)

    MAKABE, Sachiko; TAKAGAI, Junko; ASANUMA, Yoshihiro; OHTOMO, Kazuo; KIMURA, Yutaka

    2014-01-01

    This study investigated the status of work-life imbalance among hospital nurses in Japan and impact of work-life imbalance on job satisfaction and quality of life. A cross-sectional survey of 1,202 nurses (81% response rate) was conducted in three Japanese acute care hospitals. Participants were divided into four groups for actual work-life balance (Group A: 50/50, including other lower working proportion groups [e.g., 40/50]; Group B: 60/40; Group C: 70/30; and Group D: 80/20, including other higher working proportion groups [e.g., 90/10]). We also asked participants about desired work-life balance, and private and work-related perspectives. Satisfactions (job, private life, and work-life balance), quality of life, and stress-coping ability were also measured. All data were compared among the four groups. Most nurses sensed that they had a greater proportion of working life than private life, and had a work-life imbalance. Actual WLB did not fit compared to desired WLB. When the actual working proportion greatly exceeds the private life proportion, nurses’ health could be in danger, and they may resign due to lower job satisfaction and QOL. Simultaneous progress by both management and individual nurses is necessary to improve work-life imbalance. PMID:25475095

  18. Impact of work-life imbalance on job satisfaction and quality of life among hospital nurses in Japan.

    Science.gov (United States)

    Makabe, Sachiko; Takagai, Junko; Asanuma, Yoshihiro; Ohtomo, Kazuo; Kimura, Yutaka

    2015-01-01

    This study investigated the status of work-life imbalance among hospital nurses in Japan and impact of work-life imbalance on job satisfaction and quality of life. A cross-sectional survey of 1,202 nurses (81% response rate) was conducted in three Japanese acute care hospitals. Participants were divided into four groups for actual work-life balance (Group A: 50/50, including other lower working proportion groups [e.g., 40/50]; Group B: 60/40; Group C: 70/30; and Group D: 80/20, including other higher working proportion groups [e.g., 90/10]). We also asked participants about desired work-life balance, and private and work-related perspectives. Satisfactions (job, private life, and work-life balance), quality of life, and stress-coping ability were also measured. All data were compared among the four groups. Most nurses sensed that they had a greater proportion of working life than private life, and had a work-life imbalance. Actual WLB did not fit compared to desired WLB. When the actual working proportion greatly exceeds the private life proportion, nurses' health could be in danger, and they may resign due to lower job satisfaction and QOL. Simultaneous progress by both management and individual nurses is necessary to improve work-life imbalance.

  19. NPP service life management

    International Nuclear Information System (INIS)

    Elagin, Yu.P.

    2001-01-01

    Problems of NPP service life management and service life prolongation are reviewed. Methods for the prolongation of the French NPP service life are discussed, priority directions of nuclear block service life management in regard to aging in the context of the European program of investigation into the materials aging are identified. Questions of the provision of the 60 years service life of the Mihama 1 block (Japan) and decision of the problem of the control equipment aging in Great Britain are discussed. Situation with the prolongation of licenses on the NPP operation in the USA and Spain is considered [ru

  20. High energy density, long life energy storage capacitor dielectric system

    International Nuclear Information System (INIS)

    Nichols, D.H.; Wilson, S.R.

    1977-01-01

    The evolution of energy storage dielectric systems shows a dramatic improvement in life and joule density, culminating in a 50% to 300% life improvement of polypropylene film-paper-phthalate ester over paper-castor oil depending on service. The physical and electrical drawbacks of castor oil are not present in the new system, allowing the capacitor designer to utilize the superior insulation resistance, dielectric strength, and corona resistance to full advantage. The result is longer life for equal joule density or greater joule density for equal life. Field service proof of the film-Geconol system superiority is based on 5 megajoule in operation and 16 megajoule on order

  1. Waste Management Facilities Cost Information report for Greater-Than-Class C and DOE equivalent special case waste

    Energy Technology Data Exchange (ETDEWEB)

    Feizollahi, F.; Shropshire, D.

    1993-07-01

    This Waste Management Facility Cost Information (WMFCI) report for Greater-Than-Class C low-level waste (GTCC LLW) and DOE equivalent special case waste contains preconceptual designs and planning level life-cycle cost (PLCC) estimates for treatment, storage, and disposal facilities needed for management of GTCC LLW and DOE equivalent waste. The report contains information on 16 facilities (referred to as cost modules). These facilities are treatment facility front-end and back-end support functions (administration support, and receiving, preparation, and shipping cost modules); seven treatment concepts (incineration, metal melting, shredding/compaction, solidification, vitrification, metal sizing and decontamination, and wet/air oxidation cost modules); two storage concepts (enclosed vault and silo); disposal facility front-end functions (disposal receiving and inspection cost module); and four disposal concepts (shallow-land, engineered shallow-land, intermediate depth, and deep geological cost modules). Data in this report allow the user to develop PLCC estimates for various waste management options. A procedure to guide the U.S. Department of Energy (DOE) and its contractor personnel in the use of estimating data is also included in this report.

  2. Waste Management Facilities Cost Information report for Greater-Than-Class C and DOE equivalent special case waste

    International Nuclear Information System (INIS)

    Feizollahi, F.; Shropshire, D.

    1993-07-01

    This Waste Management Facility Cost Information (WMFCI) report for Greater-Than-Class C low-level waste (GTCC LLW) and DOE equivalent special case waste contains preconceptual designs and planning level life-cycle cost (PLCC) estimates for treatment, storage, and disposal facilities needed for management of GTCC LLW and DOE equivalent waste. The report contains information on 16 facilities (referred to as cost modules). These facilities are treatment facility front-end and back-end support functions (administration support, and receiving, preparation, and shipping cost modules); seven treatment concepts (incineration, metal melting, shredding/compaction, solidification, vitrification, metal sizing and decontamination, and wet/air oxidation cost modules); two storage concepts (enclosed vault and silo); disposal facility front-end functions (disposal receiving and inspection cost module); and four disposal concepts (shallow-land, engineered shallow-land, intermediate depth, and deep geological cost modules). Data in this report allow the user to develop PLCC estimates for various waste management options. A procedure to guide the U.S. Department of Energy (DOE) and its contractor personnel in the use of estimating data is also included in this report

  3. Whitebark pine, population density, and home-range size of grizzly bears in the greater yellowstone ecosystem.

    Science.gov (United States)

    Bjornlie, Daniel D; Van Manen, Frank T; Ebinger, Michael R; Haroldson, Mark A; Thompson, Daniel J; Costello, Cecily M

    2014-01-01

    Changes in life history traits of species can be an important indicator of potential factors influencing populations. For grizzly bears (Ursus arctos) in the Greater Yellowstone Ecosystem (GYE), recent decline of whitebark pine (WBP; Pinus albicaulis), an important fall food resource, has been paired with a slowing of population growth following two decades of robust population increase. These observations have raised questions whether resource decline or density-dependent processes may be associated with changes in population growth. Distinguishing these effects based on changes in demographic rates can be difficult. However, unlike the parallel demographic responses expected from both decreasing food availability and increasing population density, we hypothesized opposing behavioral responses of grizzly bears with regard to changes in home-range size. We used the dynamic changes in food resources and population density of grizzly bears as a natural experiment to examine hypotheses regarding these potentially competing influences on grizzly bear home-range size. We found that home-range size did not increase during the period of whitebark pine decline and was not related to proportion of whitebark pine in home ranges. However, female home-range size was negatively associated with an index of population density. Our data indicate that home-range size of grizzly bears in the GYE is not associated with availability of WBP, and, for female grizzly bears, increasing population density may constrain home-range size.

  4. Whitebark pine, population density, and home-range size of grizzly bears in the greater yellowstone ecosystem.

    Directory of Open Access Journals (Sweden)

    Daniel D Bjornlie

    Full Text Available Changes in life history traits of species can be an important indicator of potential factors influencing populations. For grizzly bears (Ursus arctos in the Greater Yellowstone Ecosystem (GYE, recent decline of whitebark pine (WBP; Pinus albicaulis, an important fall food resource, has been paired with a slowing of population growth following two decades of robust population increase. These observations have raised questions whether resource decline or density-dependent processes may be associated with changes in population growth. Distinguishing these effects based on changes in demographic rates can be difficult. However, unlike the parallel demographic responses expected from both decreasing food availability and increasing population density, we hypothesized opposing behavioral responses of grizzly bears with regard to changes in home-range size. We used the dynamic changes in food resources and population density of grizzly bears as a natural experiment to examine hypotheses regarding these potentially competing influences on grizzly bear home-range size. We found that home-range size did not increase during the period of whitebark pine decline and was not related to proportion of whitebark pine in home ranges. However, female home-range size was negatively associated with an index of population density. Our data indicate that home-range size of grizzly bears in the GYE is not associated with availability of WBP, and, for female grizzly bears, increasing population density may constrain home-range size.

  5. Whitebark pine, population density, and home-range size of grizzly bears in the greater Yellowstone ecosystem

    Science.gov (United States)

    Bjornlie, Daniel D.; van Manen, Frank T.; Ebinger, Michael R.; Haroldson, Mark A.; Thompson, Daniel J.; Costello, Cecily M.

    2014-01-01

    Changes in life history traits of species can be an important indicator of potential factors influencing populations. For grizzly bears (Ursus arctos) in the Greater Yellowstone Ecosystem (GYE), recent decline of whitebark pine (WBP; Pinus albicaulis), an important fall food resource, has been paired with a slowing of population growth following two decades of robust population increase. These observations have raised questions whether resource decline or density-dependent processes may be associated with changes in population growth. Distinguishing these effects based on changes in demographic rates can be difficult. However, unlike the parallel demographic responses expected from both decreasing food availability and increasing population density, we hypothesized opposing behavioral responses of grizzly bears with regard to changes in home-range size. We used the dynamic changes in food resources and population density of grizzly bears as a natural experiment to examine hypotheses regarding these potentially competing influences on grizzly bear home-range size. We found that home-range size did not increase during the period of whitebark pine decline and was not related to proportion of whitebark pine in home ranges. However, female home-range size was negatively associated with an index of population density. Our data indicate that home-range size of grizzly bears in the GYE is not associated with availability of WBP, and, for female grizzly bears, increasing population density may constrain home-range size.

  6. Backyard Living – Integrative Policies Towards Migrant Workers: Housing Microfinance in Greater Ho Chi Minh City, Vietnam

    Directory of Open Access Journals (Sweden)

    Martin Noltze

    2008-01-01

    Full Text Available The urban agglomeration of the Vietnamese southeast industrial driving force Ho Chi Minh City (HCMC has become the most outstanding benefi ciary of the remarkable economic growth and foreign investments in the Vietnamese economy since the start of a comprehensive economic reform process in the mid 1980s. The notable development towards the foremost economic centre led to a high influx of migrant workers. In the course of an ongoing expansion process towards a megacity of tomorrow, the defi cient provision of adequate housing remains one of the most challenging problems of rural migrants in Greater HCMC. However, a future-oriented sustainable megacity concept is strongly dependent on the successful integration of migrants into the urban society. Within this context, the housing market is considered to be a key aspect of comprehensive urban planning. Hereby, housing microfinance (HMF will be presented as an alternative housing finance scheme meeting the demand of a noteworthy number of poor and low-income people. Thereby HMF can do both: focus on specifi c needs of migrants with respect to their current life situation and enhance its outreach to a potential target group.

  7. Life is pretty meaningful.

    Science.gov (United States)

    Heintzelman, Samantha J; King, Laura A

    2014-09-01

    The human experience of meaning in life is widely viewed as a cornerstone of well-being and a central human motivation. Self-reports of meaning in life relate to a host of important functional outcomes. Psychologists have portrayed meaning in life as simultaneously chronically lacking in human life as well as playing an important role in survival. Examining the growing literature on meaning in life, we address the question "How meaningful is life, in general?" We review possible answers from various psychological sources, some of which anticipate that meaning in life should be low and others that it should be high. Summaries of epidemiological data and research using two self-report measures of meaning in life suggest that life is pretty meaningful. Diverse samples rate themselves significantly above the midpoint on self-reports of meaning in life. We suggest that if meaning in life plays a role in adaptation, it must be commonplace, as our analysis suggests. (c) 2014 APA, all rights reserved.

  8. Evaluating quality of life and cost implications of prophylactic radiotherapy in mesothelioma: Health economic analysis of the SMART trial.

    Science.gov (United States)

    Stewart, Samuel Alan; Clive, Amelia O; Maskell, Nick A; Penz, Erika

    2018-01-01

    The SMART trial is a UK-based, multicentre RCT comparing prophylactic radiotherapy and symptom-based (deferred) radiotherapy in 203 patients with Malignant Pleural Mesothelioma who had undergone large bore pleural interventions. Using costs and quality of life data collected alongside the clinical trial, we will estimate the cost-effectiveness of prophylactic radiotherapy compared to deferred radiotherapy over a 1-year period. Healthcare utilization and costs were captured during the trial. Utility weights produced by the EQ-5D questionnaire were used to determine quality-adjusted life-years (QALY) gained. The incremental cost-effectiveness ratio was calculated over the one-year trial period. Costs were similar in the immediate and deferred radiotherapy groups: £5480.40 (SD = £7040; n = 102) and £5461.40 (SD = £7770; n = 101) respectively. There was also no difference in QALY: 0.498 (95% CI: [0.45, 0.547]) in the prophylactic radiotherapy group versus 0.525 (95% CI: [0.471, 0.580]) in the deferred group. At a willingness to pay threshold of £30,000/QALY there was only a 24% chance that prophylactic radiotherapy was cost-effective compared to deferred radiotherapy. There was no significant effect of prophylactic radiotherapy on quality of life in the intervention group, nor was there any discernable decrease in healthcare costs. There is little evidence to suggest that prophylactic radiotherapy is a cost-effective intervention in this population. ISRCTN72767336 with ISRCTN.

  9. Real-Life Treatment Paradigms Show Adalimumab Is Cost-Effective for the Management of Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Candace L. Beilman

    2016-01-01

    Full Text Available Background. Adalimumab is effective for the maintenance of remission in patients with moderate-to-severe ulcerative colitis (UC. Currently, biologic therapies are used in cases where patients fail conventional medical therapies. If biologic therapies are not available, patients often choose to remain in an unwell state rather than undergo colectomy. Objective. The aim of the study was to evaluate the cost-effectiveness of adalimumab in patients with UC where adalimumab was readily available compared to not available. Methods. A previously validated Markov model was used to simulate disease progression of patients with UC who are corticosteroid-dependent and/or did not respond to thiopurine therapy. Utility scores and transition probabilities between health states were determined by using data from randomized controlled trials and real-life observational studies. Costs were obtained from the Ontario Case Costing Initiative and the Alberta Health Schedule of Medical Benefits. Results. The incremental cost-effectiveness ratios for readily available adalimumab treatment of UC were $40,000 and $59,000 per quality-adjusted life year, compared with ongoing medical therapy in an unwell state, at 5-year and 10-year treatment time horizons, respectively. Conclusion. Considering real-life patient preferences to avoid colectomy, adalimumab is cost-effective according to a willingness-to-pay threshold of $80,000 for treatment of UC.

  10. Best Practice Life Expectancy

    DEFF Research Database (Denmark)

    Medford, Anthony

    2017-01-01

    been reported previously by various authors. Though remarkable, this is simply an empirical observation. Objective: We examine best-practice life expectancy more formally by using extreme value theory. Methods: Extreme value distributions are fit to the time series (1900 to 2012) of maximum life......Background: Whereas the rise in human life expectancy has been extensively studied, the evolution of maximum life expectancies, i.e., the rise in best-practice life expectancy in a group of populations, has not been examined to the same extent. The linear rise in best-practice life expectancy has...... expectancies at birth and age 65, for both sexes, using data from the Human Mortality Database and the United Nations. Conclusions: Generalized extreme value distributions offer a theoretically justified way to model best-practice life expectancies. Using this framework one can straightforwardly obtain...

  11. Self-Organization, Urban Transformation, and Spatial Planning in Greater Jakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Yovi Dzulhijjah Rahmawati

    2015-09-01

    Full Text Available Penelitian ini bertujuan untuk mengidentifikasi peran sistem perencanaan tata ruang dalam menghadapi proses perorganisasian diri, sebagaimana dibuktikan oleh transformasi perkotaan yang kompleks di wilayah Jakarta. Wilayah Jakarta adalah salah satu wilayah megapolitan di Asia Tenggara yang mengalami proses transformasi yang cepat. Sangat disayangkan bahwa sistem perencanaan tata ruang yang ada sekarang di wilayah Jakarta belum mampu merespon transformasi kota secara non-linier. Kekurangan ini terbukti dari ketidaksinkronan antara dokumen-dokumen perencanaan tata ruang dan perubahan tata guna lahan perkotaan yang diperkuat dengan proses pengorganisasian diri. Perbedaan antara situasi empiris dan dokumen-dokumen perencanaan tata ruang yang ada telah menghasilkan ketidakcocokan antara sistem perencanaan tata ruang dengan sistem tata ruang di wilayah Jakarta. Ketidakcocokan ini terjadi karena sistem perencanaan tata ruang saat ini tidak mempertimbangkan ketidakpastian di masa depan. Situasi ini mengindikasikan adanya ‘fuzziness’ dalam implementasi sistem dan proses perencanaan tata ruang, sementara transformasi perkotaan telah berkembang sedemikian kompleksnya dan membutuhkan respon yang cepat dan tepat. Untuk dapat merespon ketidakcocokan ini, sistem perencanaan tata ruang di wilayah Jakarta harus lebih memperhatikan sistem perkotaan yang berkembang dalam proses yang tidak linear.Kata kunci. Pengorganisasian diri, transformasi perkotaan, ketidaklinieran, sistem perencanaan, Megapolitan Jakarta. This study aimed to identify the role of spatial planning in facing self-organizing processes as evidenced by a complex urban transformation in Greater Jakarta. Greater Jakarta is one of the mega urban-regions in Southeast Asia that are undergoing a rapid urban transformation process. This urban transformation has been developing through a non-linear transition. Unfortunately, the current spatial planning system in Greater Jakarta is not yet adequately

  12. Ultrasound-Guided Intermediate Site Greater Occipital Nerve Infiltration: A Technical Feasibility Study.

    Science.gov (United States)

    Zipfel, Jonathan; Kastler, Adrian; Tatu, Laurent; Behr, Julien; Kechidi, Rachid; Kastler, Bruno

    2016-01-01

    Two studies recently reported that computed tomography (CT) guided infiltration of the greater occipital nerve at its intermediate site allows a high efficacy rate with long-lasting pain relief following procedure in occipital neuralgia and in various craniofacial pain syndromes. The purpose of our study was to evaluate the technical feasibility and safety of ultrasound-guided intermediate site greater occipital nerve infiltration. Retrospective study. This study was conducted at the imaging department of a 1,409 bed university hospital. Local institutional review board approval was obtained and written consent was waived. In this retrospective study, 12 patients suffering from refractory occipital neuralgia or craniofacial pain syndromes were included between April and October 2014. They underwent a total of 21 ultrasound-guided infiltrations. Infiltration of the greater occipital nerve was performed at the intermediate site of the greater occipital nerve, at its first bend between obliqus capitis inferior and semispinalis capitis muscles with local anestetics and cortivazol. Technical success was defined as satisfactory diffusion of added iodinated contrast media in the fatty space between these muscles depicted on control CT scan. We also reported first data of immediate block test efficacy and initial clinical efficacy at 7 days, one month, and 3 months, defined by a decrease of at least 50% of visual analog scale (VAS) scores. Technical success rate was 95.24%. Patients suffered from right unilateral occipital neuralgia in 3 cases, left unilateral occipital neuralgia in 2 cases, bilateral occipital neuralgia in 2 cases, migraine in one case, cervicogenic headache in one case, tension-type headache in 2 cases, and cluster headache in one case. Block test efficacy was found in 93.3% (14/15) cases. Clinical efficacy was found in 80% of cases at 7 days, in 66.7% of cases at one month and in 60% of cases at 3 months. No major complications were noted. Some of the

  13. Using IT to Assess IT: Towards Greater Authenticity in Summative Performance Assessment

    Science.gov (United States)

    Newhouse, C. Paul

    2011-01-01

    An applied Information Technology (IT) course that is assessed using pen and paper may sound incongruous but it is symptomatic of the state of high-stakes assessment in jurisdictions such as Western Australia. Whereas technology has permeated most aspects of modern life, including schooling, and more has been demanded of education systems in terms…

  14. Study of Medical Ethics Areas of Concern in the Greater San Antonio Area

    Science.gov (United States)

    2006-06-01

    3 4 5 nosocomial infections 1 2 3 4 5 failure to provide patient education 1 2 3 4 5 failure to appropriately address patterns of substandard care 1 2...Modified Delphi Study 58 94 maternal /fetal issues at threshold of viability 95 end of life clarification to families about having directives 96 lab

  15. Greater Equality: The Hidden Key to Better Health and Higher Scores

    Science.gov (United States)

    Wilkinson, Richard; Pickett, Kate

    2011-01-01

    There are now many studies of income inequality and health that compare countries, American states, or other large regions, and the majority of these studies show that more egalitarian societies tend to be healthier. Inequality is associated with lower life expectancy, higher rates of infant mortality, shorter height, poor self-reported health,…

  16. A Future Market Reduces Bubbles but Allows Greater Profit for More Sophisticated Traders

    NARCIS (Netherlands)

    Noussair, C.N.; Tucker, S.; Xu, Yilong

    2014-01-01

    We study the effect of the addition of a futures market, in which contracts maturing in the last period of the life of the asset can be traded. Our experiment has two treatments, one in which a spot market operates on its own, and a second treatment in which a spot and futures market are active

  17. Life conditions of Sicilian centenarians.

    Science.gov (United States)

    Receputo, G; Rapisarda, R; Mazzoleni, G; Fornaro, D; Tomasello, F B; Di Stefano, S; Savia, S; Cilmi, V; Malacuarnera, M

    1996-01-01

    Aim of the study was at furnishing a description of the socio-economic reality of Sicilian centenarians. Informations were taken from the records of Italian Multicentric Study on Centenarians. Randomly selected 28 centenarians (8 males, 20 females), in the age range 100-108 years from Eastern Sicily were examined. The following average socioeconomic profile of the centenarians was established: they are widows or widowers with 4 children; have primary education, mediocre socioeconomic conditions, have worked in the fields or had been housewives; their hobbies were before gardening or embroidering and sewing and now is watching TV; they live in their own salubrious 4 roomed house in small center in the hills. These observations reveal that the social and intellectual quality of life is better in cases of centenarian subjects living at home, in their family environment, surrounded by their children and grandchildren as they receive greater affection and physical care than those living in old peoples' homes.

  18. The radiological impact on the Greater London population of postulated accidental releases from the Sizewell PWR

    CERN Document Server

    Kelly, G N; Charles, D; Hemming, C R

    1983-01-01

    This report contains an assessment of the radiological impact on the Greater London population of postulated accidental releases from the Sizewell PWR. Three of the degraded core accident releases postulated by the CEGB are analysed. The consequences, conditional upon each release, are evaluated in terms of the health impact on the exposed population and the impact of countermeasures taken to limit the exposure. Consideration is given to the risk to the Greater London population as a whole and to individuals within it. The consequences are evaluated using the NRPB code MARC (Methodology for Assessing Radiological Consequences). The results presented in this report are all conditional upon the occurrence of each release. In assessing the significance of the results, due account must be taken of the frequency with which such releases may be predicted to occur.

  19. Solid waste workers and livelihood strategies in Greater Port-au-Prince, Haiti

    International Nuclear Information System (INIS)

    Noel, Claudel

    2010-01-01

    The solid waste management industry in Haiti is comprised of a formal and an informal sector. Many basic activities in the solid waste management sector are being carried out within the context of profound poverty, which exposes the failure of the socioeconomic and political system to provide sufficient job opportunities for the urban population. This paper examines the involvement of workers in the solid waste management industry in Greater Port-au-Prince and the implications for livelihood strategies. The findings revealed that the Greater Port-au-Prince solid waste management system is very inclusive with respect to age, while highly segregated with regard to gender. In terms of earning capacity, the results showed that workers hired by the State agencies were the most economically vulnerable group as more than 50% of them fell below the official nominal minimum wage. This paper calls for better salary scales and work compensation for the solid waste workers.

  20. Obese Hypertensive Men Have Lower Circulating Proatrial Natriuretic Peptide Concentrations Despite Greater Left Atrial Size

    DEFF Research Database (Denmark)

    Asferg, Camilla L; Andersen, Ulrik B; Linneberg, Allan

    2018-01-01

    BACKGROUND: Obese persons have lower circulating natriuretic peptide (NP) concentrations. It has been proposed that this natriuretic handicap plays a role in obesity-related hypertension. In contrast, hypertensive patients with left atrial enlargement have higher circulating NP concentrations....... On this background, we investigated whether obese hypertensive men could have lower circulating NP concentrations despite evidence of pressure-induced greater left atrial size. METHODS: We examined 98 obese men (body mass index [BMI] ≥ 30.0 kg/m2) and 27 lean normotensive men (BMI 20.0-24.9 kg/m2). All men were...... using echocardiography, and we measured fasting serum concentrations of midregional proatrial NP (MR-proANP). RESULTS: Of the 98 obese men, 62 had hypertension and 36 were normotensive. The obese hypertensive men had greater left atrial size (mean ± SD: 28.7 ± 6.0 ml/m2) compared with the lean...

  1. Call to action: Better care, better health, and greater value in college health.

    Science.gov (United States)

    Ciotoli, Carlo; Smith, Allison J; Keeling, Richard P

    2018-03-05

    It is time for action by leaders across higher education to strengthen quality improvement (QI) in college health, in pursuit of better care, better health, and increased value - goals closely linked to students' learning and success. The size and importance of the college student population; the connections between wellbeing, and therefore QI, and student success; the need for improved standards and greater accountability; and the positive contributions of QI to employee satisfaction and professionalism all warrant a widespread commitment to building greater capacity and capability for QI in college health. This report aims to inspire, motivate, and challenge college health professionals and their colleagues, campus leaders, and national entities to take both immediate and sustainable steps to bring QI to the forefront of college health practice - and, by doing so, to elevate care, health, and value of college health as a key pathway to advancing student success.

  2. A greater voice for academic health sciences libraries: the Association of Academic Health Sciences Libraries' vision.

    Science.gov (United States)

    Bunting, Alison

    2003-04-01

    The founders of the Association of Academic Health Sciences Libraries (AAHSL) envisioned the development of a professional organization that would provide a greater voice for academic health sciences libraries, facilitate cooperation and communication with the Association of American Medical Colleges, and create a forum for identifying problems and solutions that are common to academic health sciences libraries. This article focuses on the fulfillment of the "greater voice" vision by describing action and leadership by AAHSL and its members on issues that directly influenced the role of academic health sciences libraries. These include AAHSL's participation in the work that led to the publication of the landmark report, Academic Information in the Academic Health Sciences Center: Roles for the Library in Information Management; its contributions to the recommendations of the Physicians for the Twenty-first Century: The GPEP Report; and the joint publication with the Medical Library Association of Challenge to Action: Planning and Evaluation Guidelines for Academic Health Sciences Libraries.

  3. A novel form of spontaneous tool use displayed by several captive greater vasa parrots (Coracopsis vasa).

    Science.gov (United States)

    Lambert, Megan L; Seed, Amanda M; Slocombe, Katie E

    2015-12-01

    Parrots are frequently cited for their sophisticated problem-solving abilities, but cases of habitual tool use among psittacines are scarce. We report the first evidence, to our knowledge, of tool use by greater vasa parrots (Coracopsis vasa). Several members of a captive population spontaneously adopted a novel tool-using technique by using pebbles and date pits either (i) to scrape on the inner surface of seashells, subsequently licking the resulting calcium powder from the tool, or (ii) as a wedge to break off smaller pieces of the shell for ingestion. Tool use occurred most frequently just prior to the breeding season, during which time numerous instances of tool transfer were also documented. These observations provide new insights into the tool-using capabilities of parrots and highlight the greater vasa parrot as a species of interest for studies of physical cognition. © 2015 The Author(s).

  4. Aerobic fitness is associated with greater white matter integrity in children

    Directory of Open Access Journals (Sweden)

    Laura eChaddock-Heyman

    2014-08-01

    Full Text Available Aerobic fitness has been found to play a positive role in brain and cognitive health of children. Yet, many of the neural biomarkers related to aerobic fitness remain unknown. Here, using diffusion tensor imaging (DTI, we demonstrated that higher aerobic fitness was related to greater estimates of white matter microstructure in children. Higher fit 9- and 10-year-old children showed greater fractional anisotropy (FA in sections of the corpus callosum, corona radiata, and superior longitudinal fasciculus, compared to lower fit children. The FA effects were primarily characterized by aerobic fitness differences in radial diffusivity (RD, thereby raising the possibility that estimates of myelination may vary as a function of individual differences in fitness during childhood. White matter structure may be another potential neural mechanism of aerobic fitness that assists in efficient communication between gray matter regions as well as the integration of regions into networks.

  5. Advancing U.S. Strategic Communication through Greater Civilian-Military Coordination and Integration

    Science.gov (United States)

    2012-06-01

    WARFIGHTING SCHOOL ADVANCING U.S. STRATEGIC COMMUNICATION THROUGH GREATER CIVILIAN-MILITARY COORDINATION AND INTERGRATION by Wendy A. Kolls U.S... products synchronized with the actions of all instruments of national power." Department af Defense Dictionary of Military and Associated Terms...the "British street," the "American street," and the "Israeli street.ŗ Selling "Brand America" If the " product " was America, then the thinking in

  6. The complete mitochondrial DNA genome of a greater horseshoe bat subspecies, Rhinolophus ferrumequinum quelpartis (Chiroptera: Rhinolophidae).

    Science.gov (United States)

    Yoon, Kwang Bae; Kim, Ji Young; Kim, Hye Ri; Cho, Jae Youl; Park, Yung Chul

    2013-02-01

    There are two subspecies of Rhinolophus ferrumequinum currently recognized in South Korea. The Korean greater horseshoe bat subspecies, Rhinolophus ferrumequinum quelpartis, is distributed only in Jeju Island. The complete mitochondrial genome of the island subspecies was determined and revealed 99.7% similarity to the mainland subspecies Rhinolophus ferrumequinum korai. If d-loop region is excluded, similarity of the two genomes was 99.9%.

  7. Mandibular and cranial modularity in the greater horseshoe bat Rhinolophus ferrumequinum (Chiroptera: Rhinolophidae)

    OpenAIRE

    Jojic, Vida; Budinski, Ivana; Blagojevic, Jelena; Vujosevic, Mladen

    2015-01-01

    We report the first evaluation of mandibular and cranial modularity in the greater horseshoe bat (Rhinolophus ferrumequinum). Although some authors found no modular pattern of these morphological structures in mammals, we discovered that traits integration in R. ferrumequinum is not uniform throughout the mandible and cranium, but structured into two distinct modules. Allometry does not affect mandibular and cranial modularity in R. ferrumequinum probably as a result of the low fraction of sh...

  8. Fiscal consequences of greater openness: from tax avoidance and tax arbitrage to revenue growth

    OpenAIRE

    Jouko Ylä-Liedenpohja

    2008-01-01

    Revenue from corporation tax and taxes on capital income, net of revenue loss from deductibility of interest, as a percentage of the GDP has tripled in Finland over the past two decades. This is argued to result from greater openness of the economy as well as from simultaneous tax reforms towards neutrality of capital income taxation by combining tax-base broadening with tax-rate reductions. They implied improved efficiency of real investments, elimination of tax avoidance in entrepreneurial ...

  9. Professional performance attributes according to accounting entrepreneurs from greater São Paulo

    OpenAIRE

    Ivam Ricardo Peleias; Rafael Augusto Lourenço; Marcos Reinaldo Severino Peters; Carlos Eduardo Farcin Lavarda

    2015-01-01

    Accounting has a broad activity universe, which requires skilled professionals who are prepared to practice the profession. One possibility is to be an accounting entrepreneur, whose profile requires specific attributes and attitudes. The results reported on in this paper derive from a research developed using the oral history technique, concerning the identification and analysis of attributes valued in the performance of the profession by accounting entrepreneurs from greater São Paulo. A fi...

  10. How Can Asian Snack FuLoi Plan Successful Entering to Greater Helsinki Area? : Market research

    OpenAIRE

    Nguyen, Loc

    2014-01-01

    This thesis introduces the significant factors of market research and its importance when considering doing international business. Furthermore, it could be useful for investors who have same favour to enter Finnish market. The case company is Asian Snack FuLoi- a German food industry company looking for new market. The goal of this study was to investigate the possibility for a company to enter Finland in general and Greater Helsinki in particular. The thesis was structured with theor...

  11. Greater absolute risk for all subtypes of breast cancer in the US than Malaysia.

    Science.gov (United States)

    Horne, Hisani N; Beena Devi, C R; Sung, Hyuna; Tang, Tieng Swee; Rosenberg, Philip S; Hewitt, Stephen M; Sherman, Mark E; Anderson, William F; Yang, Xiaohong R

    2015-01-01

    Hormone receptor (HR) negative breast cancers are relatively more common in low-risk than high-risk countries and/or populations. However, the absolute variations between these different populations are not well established given the limited number of cancer registries with incidence rate data by breast cancer subtype. We, therefore, used two unique population-based resources with molecular data to compare incidence rates for the 'intrinsic' breast cancer subtypes between a low-risk Asian population in Malaysia and high-risk non-Hispanic white population in the National Cancer Institute's surveillance, epidemiology, and end results 18 registries database (SEER 18). The intrinsic breast cancer subtypes were recapitulated with the joint expression of the HRs (estrogen receptor and progesterone receptor) and human epidermal growth factor receptor-2 (HER2). Invasive breast cancer incidence rates overall were fivefold greater in SEER 18 than in Malaysia. The majority of breast cancers were HR-positive in SEER 18 and HR-negative in Malaysia. Notwithstanding the greater relative distribution for HR-negative cancers in Malaysia, there was a greater absolute risk for all subtypes in SEER 18; incidence rates were nearly 7-fold higher for HR-positive and 2-fold higher for HR-negative cancers in SEER 18. Despite the well-established relative breast cancer differences between low-risk and high-risk countries and/or populations, there was a greater absolute risk for HR-positive and HR-negative subtypes in the US than Malaysia. Additional analytical studies are sorely needed to determine the factors responsible for the elevated risk of all subtypes of breast cancer in high-risk countries like the United States.

  12. Radioactivity concentrations and their radiological significance in sediments of the Tema Harbour (Greater Accra, Ghana)

    OpenAIRE

    Benjamin O. Botwe; Antonio Schirone; Ivana Delbono; Mattia Barsanti; Roberta Delfanti; Peter Kelderman; Elvis Nyarko; Piet N.L. Lens

    2017-01-01

    Studies on environmental radioactivity in tropical Africa are scarce. Therefore, a baseline study of natural (238U, 210Pb, 226Ra, 232Th, 228Ra, 228Th, 40K) and anthropogenic (137Cs) radionuclides was carried out on Tema Harbour (Greater Accra, Ghana) surface sediments and on their radiological significance. Grab surface sediment samples were collected from 21 stations within the Tema Harbour and their radioactivity concentrations measured by gamma spectrometry. The mean sediment radioactivity...

  13. Retinopathy of Prematurity in Neonatal Patients with Birth Weight Greater than 1500 g in Taiwan

    Directory of Open Access Journals (Sweden)

    Yi-Hsing Chen

    2013-04-01

    Full Text Available Background: To understand the characteristics, ophthalmic outcomes, and risk factors of retinopathy of prematurity (ROP in patients with birth weight (BW greater than 1500 g. The applicability of the ROP screening criteria to the Taiwanese population was also examined. Methods: The study included 104 eyes from 54 ROP patients who had BW greater than 1500 g from 1981 to 2008. Demographic information, disease courses, ophthalmic outcomes, and possible systemic risk factors were recorded. The infants were divided into groups of mild and severe ROP for a risk factor analysis. Results: The mean gestational age (GA of the infants was 31 ± 1.3 weeks, and the mean BW was 1675 ± 249 g. Mild ROP regressed in 94 eyes (90%, and 10 eyes (10% developed severe ROP. After various treatments, the regression rates for prethreshold or threshold ROP (n = 8 and stage 4 ROP (n = 2 were 100% and 50%, respectively. Forty-eight patients (85% had at least three associated systemic risk factors. A multiple logistic regression analysis revealed that patients with an intraventricular hemorrhage were found to have an increased chance of developing severe ROP, especially those with BW greater than 1500 g (p = 0.015. There was also a significant association between patients who had severe ROP and an increased risk of having cerebral palsy (CP at 1.5 years of age (p = 0.013. Conclusion: The majority of patients with BW greater than 1500 g developed mild ROP. However, advanced ROP with poor visual outcome was also encountered in some patients.

  14. 'Utilitarian' judgments in sacrificial moral dilemmas do not reflect impartial concern for the greater good.

    Science.gov (United States)

    Kahane, Guy; Everett, Jim A C; Earp, Brian D; Farias, Miguel; Savulescu, Julian

    2015-01-01

    A growing body of research has focused on so-called 'utilitarian' judgments in moral dilemmas in which participants have to choose whether to sacrifice one person in order to save the lives of a greater number. However, the relation between such 'utilitarian' judgments and genuine utilitarian impartial concern for the greater good remains unclear. Across four studies, we investigated the relationship between 'utilitarian' judgment in such sacrificial dilemmas and a range of traits, attitudes, judgments and behaviors that either reflect or reject an impartial concern for the greater good of all. In Study 1, we found that rates of 'utilitarian' judgment were associated with a broadly immoral outlook concerning clear ethical transgressions in a business context, as well as with sub-clinical psychopathy. In Study 2, we found that 'utilitarian' judgment was associated with greater endorsement of rational egoism, less donation of money to a charity, and less identification with the whole of humanity, a core feature of classical utilitarianism. In Studies 3 and 4, we found no association between 'utilitarian' judgments in sacrificial dilemmas and characteristic utilitarian judgments relating to assistance to distant people in need, self-sacrifice and impartiality, even when the utilitarian justification for these judgments was made explicit and unequivocal. This lack of association remained even when we controlled for the antisocial element in 'utilitarian' judgment. Taken together, these results suggest that there is very little relation between sacrificial judgments in the hypothetical dilemmas that dominate current research, and a genuine utilitarian approach to ethics. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  15. The conscious city II: traffic congestion and the tipping point in greater Vancouver

    OpenAIRE

    Holt, Rebecca

    2007-01-01

    The Conscious City II explores how broad, long-term change toward sustainability in cities can be fostered, nurtured and facilitated. Using a qualitative, mixed-method approach, this research adapts a model from Malcolm Gladwell’s Tipping Point framework to explore how social consciousness can be mobilized to achieve change toward sustainability through an analysis of traffic congestion in Greater Vancouver. The results demonstrate the important influence of leadership, context and message on...

  16. Innovative Payment Solutions in Agricultural Value Chain as a Means for Greater Financial Inclusion

    OpenAIRE

    Pandey, Tushar; Krishna, Nagahari; Vickers, Venetia; Menezes, Antonio; Raghavendra, M.

    2010-01-01

    The efforts for financial inclusion need to be designed with a vision beyond just the percentage of the country population with access to a bank account or a no frills account; to focus more on how this can enhance the capability and convenience for the un-banked and under-banked, specifically the small and marginal farmers in this case, to enable greater transparency, accountability, efficiency and convenient access to necessary facilities. The growth of ICT industry and mobile telecom revol...

  17. Factors that influence soft tissue thickness over the greater trochanter: application to understanding hip fractures.

    Science.gov (United States)

    Levine, Iris C; Minty, Lauren E; Laing, Andrew C

    2015-03-01

    Fall-related hip injuries are a concern for the growing population of older adults. Evidence suggests that soft tissue overlying the greater trochanter attenuates the forces transmitted to the proximal femur during an impact, reducing mechanical risk of hip fracture. However, there is limited information about the factors that influence trochanteric soft tissue thickness. The current study used ultrasonography and electromyography to determine whether trochanteric soft tissue thickness could be quantified reproducibly and whether it was influenced by: (1) gender; (2) hip postures associated with potential falling configurations in the sagittal plane (from 30° of extension to 60° of flexion, at 15° intervals), combined adduction-flexion, and combined adduction-extension; and (3) activation levels of the tensor fascia lata (TFL) and gluteus medius (GM) muscles. Our results demonstrated that soft tissue thickness can be measured reliably in nine hip postures and three muscle activation conditions (for all conditions, ICC >0.98). Mean (SD) thickness in quiet stance was 2.52 cm. Thickness was 27.0% lower for males than females during quiet stance. It was 16.4% greater at maximum flexion than quiet standing, 27.2% greater at maximum extension, and 12.5% greater during combined adduction-flexion. However, there was no significant difference between combined adduction-extension and quiet standing. Thickness was not affected by changes in muscle activity. Forces applied to the femoral neck during a lateral fall decrease as trochanteric soft tissue thickness increases; gender and postural configuration at impact could influence the loads applied to the proximal femur (and thus hip fracture risk) during falls on the hip. © 2014 Wiley Periodicals, Inc.

  18. Supply Chain Management for Sustainable Development: Perspective from the Greater Pearl River Delta (China)

    OpenAIRE

    Tsoi, Joyce

    2006-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by the University of Hong Kong. This thesis investigates the application and implications of supply chain management as a modern management model in regulating corporate outsourcing activities within the Greater Pearl River Delta. Globalisation has accelerated the application of supply chain management as a mechanism to enhance corporate performance. At the same time this rapid economic development has also accele...

  19. Torsion of the Greater Omentum Secondary to Omental Lymphangioma in a Child: A Case Report

    International Nuclear Information System (INIS)

    Mistry, Kewal Arunkumar; Iyer, Dayashankar

    2015-01-01

    Omental cyst and omental torsion both are uncommon but important causes of acute abdomen with a difficult clinical diagnosis due to nonspecific features. Here we report a case of an eight year old child with acute abdominal pain referred for USG and CT scan which revealed two cysts in greater omentum leading to secondary omental torsion. An eight year old male child presented to casualty with severe pain abdomen since 1 day. There was no history of vomiting or altered bowel habits. The patient was febrile with tachycardia on arrival. On examination rigidity and tenderness all over abdomen were present. Serum amylase was within normal range. USG and CECT abdomen were done subsequently. USG showed two well defined cystic lesions in lower abdomen with presence of some internal echogenic debris and calcified foci in their dependent part. There was also presence of omentum with a whirl of blood vessels seen along anterior abdominal wall leading to these lesions suggesting torsion. On colour Doppler the presence of blood flow within the whirl of vessels was seen. Mild amount of free fluid was also seen in the peritoneal cavity. On CECT abdomen the findings of omental cysts and torsion of greater omentum with free fluid in abdomen were confirmed. The cysts measured 60×55 and 65×55mm on CT. The patient was taken for an emergency laparotomy for indication of acute generalized peritonitis. Two large omental cysts were found in the pelvic cavity along with torsed greater omentum along with 150 ml of hemorrhagic fluid in peritoneal cavity. The cysts and twisted necrotic part of the greater omentum were excised at surgery. No postoperative complications were observed. Histopathologic examination was suggestive of lymphangioma of omentum. Lymphangioma of the omentum is an not very uncommon however acute presentation with omental torsion and infarction is an unusual entity. Optimal utilization of preoperative imaging with USG, Doppler and contrast enhanced CT scan can provide

  20. Men exhibit greater fatigue resistance than women in alternated bench press and leg press exercises.

    Science.gov (United States)

    Monteiro, Estêvão R; Steele, James; Novaes, Jefferson S; Brown, Amanda F; Cavanaugh, Mark T; Vingren, Jakob L; Behm, David G

    2017-11-17

    The purpose of this study was to evaluate the influence of sex, exercise order, and rest interval on neuromuscular fatigue resistance for an alternated strength training sequence of bench press (BP) and leg press (LP) exercises. Twelve women and 16 men, both recreationally trained, performed four sessions in a random order: 1) BP followed by LP with three-minutes rest (BP+LP with rest), 2) LP followed by BP with three-minutes rest (LP+BP with rest), 3) BP followed by LP without rest interval (BP+LP no rest), and 4) LP followed by BP without rest interval (LP+BP no rest). Participants performed four sets with 100% of 10RM load to concentric failure with the goal of completing the maximum number of repetitions in both exercises. The fatigue index was analyzed from the first and last sets of each exercise bout. A main effect for sex showed that women exhibited 25.5% (p=0.001) and 24.5% (p=0.001) greater BP and LP fatigue than men respectively when performing 10RM. Men exhibited greater BP (p<0.0001; 34.1%) and LP (p<0.0001; 30.5%) fatigue resistance when a rest period was provided. Men did not show an exercise order effect for BP fatigue and exhibited greater (p=0.0003; 14.5%) LP fatigue resistance when BP was performed first. The present study demonstrated the greater fatigue resistance of men when performing 10RM BP and LP exercises. Since men tend to experience less fatigue with the second exercise in the exercise pairing, women's training programs should be adjusted to ensure they do not parallel men's resistance training programs.

  1. Unintended de-marketing manages visitor demand in Greater Blue Mountains World Heritage Area

    OpenAIRE

    Burgin, Shelley; Hardiman, Nigel

    2014-01-01

    Kotler and Levy (1971, p.76) introduced the term ‘de-marketing’, defined as ‘that aspect of marketing that deals with discouraging customers in general or a certain class of customers in particular on either a temporary or permanent basis’. Subsequently, Groff (1998) interpreted the concept in the context of parks and recreation administration. Recently, Armstrong and Kern (2011) used the concept to underpin their investigation of visitor demand management within the Greater Blue Mountains Wo...

  2. Aspartame intake is associated with greater glucose intolerance in individuals with obesity.

    Science.gov (United States)

    Kuk, Jennifer L; Brown, Ruth E

    2016-07-01

    This study examined whether sucrose, fructose, aspartame, and saccharin influences the association between obesity and glucose tolerance in 2856 adults from the NHANES III survey. Aspartame intake significantly influenced the association between body mass index (BMI) and glucose tolerance (interaction: P = 0.004), wherein only those reporting aspartame intake had a steeper positive association between BMI and glucose tolerance than those reporting no aspartame intake. Therefore, consumption of aspartame is associated with greater obesity-related impairments in glucose tolerance.

  3. Efficacy of prophylactic splenectomy for proximal advanced gastric cancer invading greater curvature.

    Science.gov (United States)

    Ohkura, Yu; Haruta, Shusuke; Shindoh, Junichi; Tanaka, Tsuyoshi; Ueno, Masaki; Udagawa, Harushi

    2017-05-25

    For proximal gastric cancer invading the greater curvature, concomitant splenectomy is frequently performed to secure the clearance of lymph node metastases. However, prognostic impact of prophylactic splenectomy remains unclear. The aim of this study was to clarify the oncological significance of prophylactic splenectomy for advanced proximal gastric cancer invading the greater curvature. Retrospective review of 108 patients who underwent total or subtotal gastrectomy for advanced proximal gastric cancer involving the greater curvature was performed. Short-term and long-term outcomes were compared between the patients who underwent splenectomy (n = 63) and those who did not (n = 45). Patients who underwent splenectomy showed higher amount of blood loss (538 vs. 450 mL, p = 0.016) and morbidity rate (30.2 vs. 13.3, p = 0.041) compared with those who did not undergo splenectomy. In particular, pancreas-related complications were frequently observed among patients who received splenectomy (17.4 vs. 0%, p = 0.003). However, no significant improvement of long-term outcomes were confirmed in the cases with splenectomy (5-year recurrence-free rate, 60.2 vs. 67.3%; p = 0.609 and 5-year overall survival rates, 63.7 vs. 73.6%; p = 0.769). On the other hand, splenectomy was correlated with marginally better survival in patients with Borrmann type 1 or 2 gastric cancer (p = 0.072). For advanced proximal gastric cancer involving the greater curvature, prophylactic splenectomy may have no significant prognostic impact despite the increased morbidity rate after surgery. Such surgical procedure should be avoided as long as lymph node involvement is not evident.

  4. Method of combined radionuclide assessment of the greater and uteroplacental circulation in plural pregnency

    International Nuclear Information System (INIS)

    Illarionova, N.M.; Fuks, M.A.; Ehventov, A.Z.

    1987-01-01

    The paper is concerned with the results of the clinical testing of a combined radionuclide method of assessment of the greater and uteroplacentral circulation in 15 women with plural pregnancy. The method permits the detection of hemodynamic changes without increasing radiation exposure to the mother's body and fetuses, the determination of a type of plural pregnancy (monochorionic or dichorial twins), and the prediction of pregnancy outcome that is very important for the choice of appropriate and timely therapy

  5. ELISA-seroprevalence of Toxoplasma gondii in draught horses in Greater Cairo, Egypt.

    Science.gov (United States)

    Haridy, Fouad M; Shoukry, Nahla M; Hassan, Aly Awad; Morsy, Tosson A

    2009-12-01

    Toxoplasma gondii is one of the important zoonotic parasites of worldwide. In this paper the seroprevalence of T. gondii in draught horses (3-15 years) including 90 males and 10 females in the first half of the year 2009 was studied. The result showed that the overall ELISA-T. gondii antibodies were 25% of the horses in Greater Cairo, 50% (females) and 22.2% (males).

  6. Faster Movement Speed Results in Greater Tendon Strain during the Loaded Squat Exercise

    Science.gov (United States)

    Earp, Jacob E.; Newton, Robert U.; Cormie, Prue; Blazevich, Anthony J.

    2016-01-01

    Introduction: Tendon dynamics influence movement performance and provide the stimulus for long-term tendon adaptation. As tendon strain increases with load magnitude and decreases with loading rate, changes in movement speed during exercise should influence tendon strain. Methods: Ten resistance-trained men [squat one repetition maximum (1RM) to body mass ratio: 1.65 ± 0.12] performed parallel-depth back squat lifts with 60% of 1RM load at three different speeds: slow fixed-tempo (TS: 2-s eccentric, 1-s pause, 2-s concentric), volitional-speed without a pause (VS) and maximum-speed jump (JS). In each condition joint kinetics, quadriceps tendon length (LT), patellar tendon force (FT), and rate of force development (RFDT) were estimated using integrated ultrasonography, motion-capture, and force platform recordings. Results: Peak LT, FT, and RFDT were greater in JS than TS (p < 0.05), however no differences were observed between VS and TS. Thus, moving at faster speeds resulted in both greater tendon stress and strain despite an increased RFDT, as would be predicted of an elastic, but not a viscous, structure. Temporal comparisons showed that LT was greater in TS than JS during the early eccentric phase (10–14% movement duration) where peak RFDT occurred, demonstrating that the tendon's viscous properties predominated during initial eccentric loading. However, during the concentric phase (61–70 and 76–83% movement duration) differing FT and similar RFDT between conditions allowed for the tendon's elastic properties to predominate such that peak tendon strain was greater in JS than TS. Conclusions: Based on our current understanding, there may be an additional mechanical stimulus for tendon adaptation when performing large range-of-motion isoinertial exercises at faster movement speeds. PMID:27630574

  7. On the possibility of a bridge between CBA and CEA

    DEFF Research Database (Denmark)

    Hansen, Bodil Olai; Hougaard, Jens Leth; Keiding, Hans

    2004-01-01

    cost-benefit analysis, cost-effectiveness analysis, aggregation of preferences, quality-adjusted life years......cost-benefit analysis, cost-effectiveness analysis, aggregation of preferences, quality-adjusted life years...

  8. Mapping grasslands suitable for cellulosic biofuels in the Greater Platte River Basin, United States

    Science.gov (United States)

    Wylie, Bruce K.; Gu, Yingxin

    2012-01-01

    Biofuels are an important component in the development of alternative energy supplies, which is needed to achieve national energy independence and security in the United States. The most common biofuel product today in the United States is corn-based ethanol; however, its development is limited because of concerns about global food shortages, livestock and food price increases, and water demand increases for irrigation and ethanol production. Corn-based ethanol also potentially contributes to soil erosion, and pesticides and fertilizers affect water quality. Studies indicate that future potential production of cellulosic ethanol is likely to be much greater than grain- or starch-based ethanol. As a result, economics and policy incentives could, in the near future, encourage expansion of cellulosic biofuels production from grasses, forest woody biomass, and agricultural and municipal wastes. If production expands, cultivation of cellulosic feedstock crops, such as switchgrass (Panicum virgatum L.) and miscanthus (Miscanthus species), is expected to increase dramatically. The main objective of this study is to identify grasslands in the Great Plains that are potentially suitable for cellulosic feedstock (such as switchgrass) production. Producing ethanol from noncropland holdings (such as grassland) will minimize the effects of biofuel developments on global food supplies. Our pilot study area is the Greater Platte River Basin, which includes a broad range of plant productivity from semiarid grasslands in the west to the fertile corn belt in the east. The Greater Platte River Basin was the subject of related U.S. Geological Survey (USGS) integrated research projects.

  9. Defining greater-than-class-C low-level radioactive waste

    International Nuclear Information System (INIS)

    Knecht, M.A.; Oztunali, O.I.

    1986-01-01

    The Low-Level Radioactive Waste Policy Amendments Act of 1985 (LLRWPAA) was signed by President Reagan on January 15, 1986. This act requires the federal government to be responsible for the disposal of greater-than-class-C low-level radioactive waste (LLRW) that is generated commercially by state agencies and by federal entities (other than waste generated by atomic weapons research, development, or testing, or by decommissioning of vessels of the nuclear navy). To plan for disposal, the federal government will require estimates of the volume of waste involved and characterization of this waste. A clear definition of greater-than-class-C LLRW is the first step in determining what wastes will be included in the waste to be received by the federal government. This definition will influence major policy decisions to be made for management of such waste. The purpose of this paper is to examine the existing information on greater-than-class-C LLRW in view of the current definition of such waste and potential changes in this definition - for example, an upper limit on the concentrations of radionuclides in LLRW. The paper identifies further information needs to develop a clear definition of such waste for use in federal planning for acceptance of responsibility for disposal of such waste

  10. Coping Skills Help Explain How Future-Oriented Adolescents Accrue Greater Well-Being Over Time.

    Science.gov (United States)

    Chua, Li Wen; Milfont, Taciano L; Jose, Paul E

    2015-11-01

    Adolescents who endorse greater levels of future orientation report greater well-being over time, but we do not know the mechanism by which this happens. The present longitudinal study examined whether both adaptive as well as maladaptive coping strategies might explain how future orientation leads to ill-being and well-being over time in young New Zealanders. A sample of 1,774 preadolescents and early adolescents (51.9 % female) aged 10-15 years at Time 1 completed a self-report survey three times with 1 year intervals in between. Longitudinal mediation path models were constructed to determine whether and how maladaptive and adaptive coping strategies at Time 2 functioned as mediators between future orientation at Time 1 and ill-being and well-being at Time 3. Results showed that future orientation predicted lower maladaptive coping, which in turn predicted lower substance use and self-harming behavior. All three well-being outcomes (i.e., happiness with weight, vitality, and sleep) were consistently predicted by future orientation, and all three pathways were mediated by both lower maladaptive and higher adaptive coping strategies (with the exception of happiness with weight, which was mediated only by lower maladaptive coping). The results suggest that several pathways by which future orientation leads to greater well-being occurs through an increased use of adaptive coping, a decreased use of maladaptive coping, or both.

  11. Demystifying the Clinical Diagnosis of Greater Trochanteric Pain Syndrome in Women.

    Science.gov (United States)

    Ganderton, Charlotte; Semciw, Adam; Cook, Jill; Pizzari, Tania

    2017-06-01

    To evaluate the diagnostic accuracy of 10 clinical tests that can be used in the diagnosis of greater trochanteric pain syndrome (GTPS) in women, and to compare these clinical tests to magnetic resonance imaging (MRI) findings. Twenty-eight participants with GTPS (49.5 ± 22.0 years) and 18 asymptomatic participants (mean age ± standard deviation [SD], 52.5 ± 22.8 years) were included. A blinded physiotherapist performed 10 pain provocation tests potentially diagnostic for GTPS-palpation of the greater trochanter, resisted external derotation test, modified resisted external derotation test, standard and modified Ober's tests, Patrick's or FABER test, resisted hip abduction, single-leg stance test, and the resisted hip internal rotation test. A sample of 16 symptomatic and 17 asymptomatic women undertook a hip MRI scan. Gluteal tendons were evaluated and categorized as no pathology, mild tendinosis, moderate tendinosis/partial tear, or full-thickness tear. Clinical test analyses show high specificity, high positive predictive value, low to moderate sensitivity, and negative predictive value for most clinical tests. All symptomatic and 88% of asymptomatic participants had pathological gluteal tendon changes on MRI, from mild tendinosis to full-thickness tear. The study found the Patrick's or FABER test, palpation of the greater trochanter, resisted hip abduction, and the resisted external derotation test to have the highest diagnostic test accuracy for GTPS. Tendon pathology on MRI is seen in both symptomatic and asymptomatic women.

  12. Effects of the May 5-6, 1973, storm in the Greater Denver area, Colorado

    Science.gov (United States)

    Hansen, Wallace R.

    1973-01-01

    Rain began falling on the Greater Denver area the evening of Saturday, May 5, 1973, and continued through most of Sunday, May 6. Below about 7,000 feet altitude, the precipitation was mostly rain; above that altitude, it was mostly snow. Although the rate of fall was moderate, at least 4 inches of rain or as much as 4 feet of snow accumulated in some places. Sustained precipitation falling at a moderate rate thoroughly saturated the ground and by midday Sunday sent most of the smaller streams into flood stage. The South Platte River and its major tributaries began to flood by late Sunday evening and early Monday morning. Geologic and hydrologic processes activated by the May 5-6 storm caused extensive damage to lands and to manmade structures in the Greater Denver area. Damage was generally most intense in areas where man had modified the landscape--by channel constrictions, paving, stripping of vegetation and topsoil, and oversteepening of hillslopes. Roads, bridges, culverts, dams, canals, and the like were damaged or destroyed by erosion and sedimentation. Streambanks and structures along them were scoured. Thousands of acres of croplands, pasture, and developed urban lands were coated with mud and sand. Flooding was intensified by inadequate storm sewers, blocked drains, and obstructed drainage courses. Saturation of hillslopes along the Front Range caused rockfalls, landslides, and mudflows as far west as Berthoud Pass. Greater attention to geologic conditions in land-use planning, design, and construction would minimize storm damage in the future.

  13. Quantifying Arabia-Eurasia convergence accommodated in the Greater Caucasus by paleomagnetic reconstruction

    Science.gov (United States)

    van der Boon, A.; van Hinsbergen, D. J. J.; Rezaeian, M.; Gürer, D.; Honarmand, M.; Pastor-Galán, D.; Krijgsman, W.; Langereis, C. G.

    2018-01-01

    Since the late Eocene, convergence and subsequent collision between Arabia and Eurasia was accommodated both in the overriding Eurasian plate forming the Greater Caucasus orogen and the Iranian plateau, and by subduction and accretion of the Neotethys and Arabian margin forming the East Anatolian plateau and the Zagros. To quantify how much Arabia-Eurasia convergence was accommodated in the Greater Caucasus region, we here provide new paleomagnetic results from 97 volcanic sites (∼500 samples) in the Talysh Mountains of NW Iran, that show ∼15° net clockwise rotation relative to Eurasia since the Eocene. We apply a first-order kinematic restoration of the northward convex orocline that formed to the south of the Greater Caucasus, integrating our new data with previously published constraints on rotations of the Eastern Pontides and Lesser Caucasus. This suggests that north of the Talysh ∼120 km of convergence must have been accommodated. North of the Eastern Pontides and Lesser Caucasus this is significantly more: 200-280 km. Our reconstruction independently confirms previous Caucasus convergence estimates. Moreover, we show for the first time a sharp contrast of convergence between the Lesser Caucasus and the Talysh. This implies that the ancient Paleozoic-Mesozoic transform plate boundary, preserved between the Iranian and East-Anatolian plateaus, was likely reactivated as a right-lateral transform fault since late Eocene time.

  14. Moderate Versus Light Pressure Massage Therapy Leads to Greater Weight Gain in Preterm Infants

    Science.gov (United States)

    Field, Tiffany; Diego, Miguel A.; Hernandez-Reif, Maria; Deeds, Osvelia; Figuereido, Barbara

    2007-01-01

    Sixty-eight preterm infants (M GA=3Owks.) were randomly assigned to a moderate or to a light pressure massage therapy group to receive 15 massages 3 times per day for 5 days. Behavior state, stress behaviors and heart rate were recorded for 15 minutes before and during the first 15-minute therapy session. Weight gain was recorded over the 5 day therapy period. The moderate versus light pressure massage group gained significantly more weight per day. During the behavior observations the moderate versus light pressure massage group showed significantly lower increases from the pre-session to the session recording on: 1) active sleep; 2) fussing; 3) crying; 4) movement; and 5) stress behavior (hiccupping). They also showed a smaller decrease in deep sleep, a greater decrease in heart rate and a greater increase in vagal tone. Thus, the moderate pressure massage therapy group appeared to be more relaxed and less aroused than the light pressure massage group which may have contributed to the greater weight gain of the moderate pressure massage therapy group. PMID:17138310

  15. Environmental characteristics of shallow bottoms used by Greater Flamingo Phoenicopterus roseus in a northern Adriatic lagoon

    Directory of Open Access Journals (Sweden)

    Scarton Francesco

    2017-12-01

    Full Text Available Since the beginning of this century, Greater Flamingo Phoenicopterus roseus flocks have been observed regularly when feeding in the large extensions of shallow bottoms in the Lagoon of Venice (NE Italy, the largest lagoon along the Mediterranean. Nowadays thousands of flamingos are present throughout the year. Between 2013 and 2017 I collected data on the environmental features of the shallow bottoms used by feeding flocks, along with measurements of flight initiation distance (FID of Greater Flamingo in response to the approach of boats and pedestrians. Shallow bottoms were shown to be used when covered with approximately 10 to 60 cm of water. All the feeding sites were in open landscapes, with low occurrence of saltmarshes in a radius of 500 m. The bottoms were barely covered with seagrasses (<4% of the surface around the survey points and were mostly silty. Feeding flocks were on average 1.2 km far from the nearest road or dyke, while the mean distance from channels that could be used by boats was about 420 m. The mean FID caused by boats or pedestrians was 241 m ± 117 m (N = 31, ± 1 SD without significant differences between those for the two disturbance sources. The use of shallow bottoms by the Greater Flamingo appears governed primarily by the tidal cycle, but boat disturbance probably modifies this effect. According to FID values, a set-back distance of 465 m is suggested to reduce the disturbance caused by boats and pedestrians to the flamingo feeding flocks.

  16. Spatial pattern of groundwater arsenic occurrence and association with bedrock geology in greater augusta, maine

    Science.gov (United States)

    Yang, Q.; Jung, H.B.; Culbertson, C.W.; Marvinney, R.G.; Loiselle, M.C.; Locke, D.B.; Cheek, H.; Thibodeau, H.; Zheng, Yen

    2009-01-01

    In New England, groundwater arsenic occurrence has been linked to bedrock geology on regional scales. To ascertain and quantify this linkage at intermediate (100-101 km) scales, 790 groundwater samples from fractured bedrock aquifers in the greater Augusta, Maine area are analyzed, and 31% of the sampled wells have arsenic concentrations >10 ??g/L. The probability of [As] exceeding 10 ??g/L mapped by indicator kriging is highest in Silurian pelite-sandstone and pelite-limestone units (???40%). This probability differs significantly (p bedrock map. Thus, bedrock geology is associated with arsenic occurrence in fractured bedrock aquifers of the study area at intermediate scales relevant to water resources planning. The arsenic exceedance rate for each rock unit is considered robust because low, medium, and high arsenic occurrences in four cluster areas (3-20 km2) with a low sampling density of 1-6 wells per km2 are comparable to those with a greater density of 5-42 wells per km2. About 12,000 people (21% of the population) in the greater Augusta area (???1135 km2) are at risk of exposure to >10 ??g/L arsenic in groundwater. ?? 2009 American Chemical Society.

  17. Spatial Pattern of Groundwater Arsenic Occurrence and Association with Bedrock Geology in Greater Augusta, Maine, USA

    Science.gov (United States)

    Yang, Qiang; Jung, Hun Bok; Culbertson, Charles W.; Marvinney, Robert G.; Loiselle, Marc C.; Locke, Daniel B.; Cheek, Heidi; Thibodeau, Hilary; Zheng, Yan

    2009-01-01

    In New England, groundwater arsenic occurrence has been linked to bedrock geology on regional scales. To ascertain and quantify this linkage at intermediate (100-101 km) scales, 790 groundwater samples from fractured bedrock aquifers in the greater Augusta, Maine area are analyzed. 31% of the sampled wells have arsenic >10 μg/L. The probability of [As] exceeding 10 μg/L mapped by indicator kriging is highest in Silurian pelite-sandstone and pelite-limestone units (~40%). This probability differs significantly (pbedrock map. Thus, bedrock geology is associated with arsenic occurrence in fractured bedrock aquifers of the study area at intermediate scales relevant to water resources planning. The arsenic exceedance rate for each rock unit is considered robust because low, medium and high arsenic occurrences in 4 cluster areas (3-20 km2) with a low sampling density of 1-6 wells per km2 are comparable to those with a greater density of 5-42 wells per km2. About 12,000 people (21% of the population) in the greater Augusta area (~1135 km2) are at risk of exposure to >10 μg/L arsenic in groundwater. PMID:19475939

  18. Greater impairment of postprandial triacylglycerol than glucose response in metabolic syndrome subjects with fasting hyperglycaemia.

    Science.gov (United States)

    Jackson, Kim G; Walden, Charlotte M; Murray, Peter; Smith, Adrian M; Minihane, Anne M; Lovegrove, Julie A; Williams, Christine M

    2013-08-01

    Studies have started to question whether a specific component or combinations of metabolic syndrome (MetS) components may be more important in relation to cardiovascular disease risk. Our aim was to examine the impact of the presence of raised fasting glucose as a MetS component on postprandial lipaemia. Men classified with the MetS underwent a sequential test meal investigation, in which blood samples were taken at regular intervals after a test breakfast (t=0 min) and lunch (t=330 min). Lipids, glucose and insulin were measured in the fasting and postprandial samples. MetS subjects with 3 or 4 components were subdivided into those without (n=34) and with (n=23) fasting hyperglycaemia (≥5.6 mmol/l), irrespective of the combination of components. Fasting lipids and insulin were similar in the two groups, with glucose significantly higher in the men with glucose as a MetS component (Pcurve (AUC) and incremental AUC (P ≤0.016) for the postprandial triacylglycerol (TAG) response in men with fasting hyperglycaemia. Greater glucose AUC (Pglucose to be an important predictor of the postprandial TAG and glucose response. Our data analysis has revealed a greater impairment of postprandial TAG than glucose response in MetS subjects with raised fasting glucose. The worsening of postprandial lipaemic control may contribute to the greater CVD risk reported in individuals with MetS component combinations which include hyperglycaemia. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Adjusting Pulse Amplitude During Transcutaneous Electrical Nerve Stimulation Does Not Provide Greater Hypoalgesia.

    Science.gov (United States)

    Bergeron-Vézina, Kayla; Filion, Camille; Couture, Chantal; Vallée, Élisabeth; Laroche, Sarah; Léonard, Guillaume

    2018-03-01

    Transcutaneous electrical nerve stimulation (TENS) is an electrotherapeutic modality commonly used in rehabilitation to relieve pain. Adjusting pulse amplitude (intensity) during TENS treatment has been suggested to overcome nerve habituation. However, it is still unclear if this procedure leads to greater hypoalgesia. The aim of this study was to determine if the hypoalgesic effect of TENS is greater when pulse amplitude is adjusted throughout the TENS treatment session in chronic low-back pain patients. Randomized double-blind crossover study. Recruitment and assessment were conducted at the Clinique universitaire de réadaptation de l'Estrie (CURE) of the Faculty of Medicine and Health Sciences of the Université de Sherbrooke. Twenty-one volunteers with chronic low-back pain were enrolled and completed this investigation. Each patient received two high-frequency TENS treatments on two separate sessions: (1) with adjustment of pulse amplitude and (2) without pulse amplitude adjustment. Pain intensity and unpleasantness were assessed before, during, and after TENS application with a 10 cm visual analog scale. Both TENS conditions (with and without adjustment of intensity) decreased pain intensity and unpleasantness when compared with baseline. No difference was observed between the two stimulation conditions for both pain intensity and unpleasantness. The current results suggest that adjustment of pulse amplitude during TENS application does not provide greater hypoalgesia in individuals with chronic low-back pain. Future studies are needed to confirm these findings in other pain populations.

  20. ICAO safety management systems (SMS) development in environmental contexts: A field study of greater China

    Science.gov (United States)

    Leib, Steven M.

    This was a mixed-methods exploratory study to investigate association between environmental context and the implementation status of Safety Management Systems (SMS) at airports in Greater China. Using a framework of Institutional Theory, this study looked at three regions of Greater China and explored internal and external environments of SMS at airports within each region. It used ICAO standards to evaluate the implementation status of SMS at those airports based on the perceptions of 126 participants. This research also employed snowballing technique to spread a survey tool to participants in Greater China through several key gatekeepers, and then applied the Delphi method for interviews with key gatekeepers themselves. Analysis of the data suggested several associations between various sub-concepts of the external environment and different components of SMS in the three regions. In addition, the data suggested a relationship between the internal environment as a whole and the overall status of SMS implementation in each region. Lastly, the study makes several recommendations for future research regarding global standards implemented in local environments, the evaluation of SMS implementation status, and the theoretical implications of this study.

  1. The essence of life.

    Science.gov (United States)

    Ma, Wentao

    2016-09-26

    Although biology has achieved great successes in recent years, we have not got a clear idea on "what is life?" Actually, as explained here, the main reason for this situation is that there are two completely distinct aspects for "life", which are usually talked about together. Indeed, in respect to these two aspects: Darwinian evolution and self-sustaining, we must split the concept of life correspondingly, for example, by defining "life form" and "living entity", separately. For life's implementation (related to the two aspects) in nature, three mechanisms are crucial: the replication of DNA/RNA-like polymers by residue-pairing, the sequence-dependent folding of RNA/protein-like polymers engendering special functions, and the assembly of phospholipid-like amphiphiles forming vesicles. The notion "information" is significant for us to comprehend life phenomenon: the life form of a living entity can just be defined by its genetic information; Darwinian evolution is essentially an evolution of such information, transferred across generations. The in-depth analysis concerning the essence of life would improve our cognition in the whole field of biology, and may have a direct influence on its subfields like the origin of life, artificial life and astrobiology. This article was reviewed by Anthony Poole and Thomas Dandekar.

  2. Lower inhibitory control interacts with greater pain catastrophizing to predict greater pain intensity in women with migraine and overweight/obesity.

    Science.gov (United States)

    Galioto, Rachel; O'Leary, Kevin C; Thomas, J Graham; Demos, Kathryn; Lipton, Richard B; Gunstad, John; Pavlović, Jelena M; Roth, Julie; Rathier, Lucille; Bond, Dale S

    2017-12-01

    Pain catastrophizing (PC) is associated with more severe and disabling migraine attacks. However, factors that moderate this relationship are unknown. Failure of inhibitory control (IC), or the ability to suppress automatic or inappropriate responses, may be one such factor given previous research showing a relationship between higher PC and lower IC in non-migraine samples, and research showing reduced IC in migraine. Therefore, we examined whether lower IC interacts with increased PC to predict greater migraine severity as measured by pain intensity, attack frequency, and duration. Women (n = 105) aged 18-50 years old (M = 38.0 ± 1.2) with overweight/obesity and migraine who were seeking behavioral treatment for weight loss and migraine reduction completed a 28-day smartphone-based headache diary assessing migraine headache severity. Participants then completed a modified computerized Stroop task as a measure of IC and self-report measures of PC (Pain Catastrophizing Scale [PCS]), anxiety, and depression. Linear regression was used to examine independent and joint associations of PC and IC with indices of migraine severity after controlling for age, body mass index (BMI) depression, and anxiety. Participants on average had BMI of 35.1 ± 6.5 kg/m 2 and reported 5.3 ± 2.6 migraine attacks (8.3 ± 4.4 migraine days) over 28 days that produced moderate pain intensity (5.9 ± 1.4 out of 10) with duration of 20.0 ± 14.2 h. After adjusting for covariates, higher PCS total (β = .241, SE = .14, p = .03) and magnification subscale (β = .311, SE = .51, p migraine attacks. Future studies are needed to determine whether interventions to improve IC could lead to less painful migraine attacks via improvements in PC.

  3. The perceptions of inquiry held by greater Houston area science supervisors

    Science.gov (United States)

    Aoki, Jon Michael

    The purpose of this study was to describe the perceptions of inquiry held by responding greater Houston area science supervisors. Leading science organizations proposed that students might be better served if students are mentally and physically engaged in the process of finding out about natural phenomena rather than by didactic modes of teaching and learning. During the past fifty years, inquiry-based instruction has become a significant theme of new science programs. Students are more likely to make connections between classroom exercises and their personal lives through the use of inquiry-based instruction. Learning becomes relevant to students. Conversely, traditional science instruction often has little or no connection to students' everyday lives (Papert, 1980). In short, inquiry-based instruction empowers students to become independent thinkers. The utilization of inquiry-based instruction is essential to a successful reform in science education. However, a reform's success is partly determined by the extent to which science supervisors know and understand inquiry and consequently promote its integration in the district's science curricula. Science supervisors have the role of providing curriculum and instructional support to science teachers and for implementing science programs. There is a fundamental need to assess the perceptions of inquiry held by greater Houston area science supervisors. Science supervisor refers to a class of job titles that include department chairperson, science specialist, science consultant, and science coordinator. The target population was greater Houston area science supervisors in Texas. This study suggests that there are three major implications for educational practice. First, there is the implication that responding greater Houston area science supervisors need an inclusive perception of inquiry. Second, responding greater Houston area science supervisors' perception of inquiry may affect the perceptions and understandings

  4. Urbanism and life satisfaction among the aged.

    Science.gov (United States)

    Liang, J; Warfel, B L

    1983-01-01

    This study examines the impact of urbanism on the causal mechanisms by which life satisfaction is determined. Although the links between the type of community and life satisfaction have been the foci of many studies, the findings are by no means conclusive. Some have found that the rural elderly express greater satisfaction, others have not. Such a discrepancy may be due to (a) the neglect of other variables, (b) a lack of explicit causal specifications, and (c) the failure to distinguish main effects from interaction effects. In this study a causal model that incorporates urbanism as a polytomous variable and its interaction effects has been proposed. The model was evaluated by using four data sets with sample sizes ranging from 961 to 3,996. Urbanism was found to have indirect main effects as well as interaction effects on life satisfaction.

  5. Factors influencing professional life satisfaction among neurologists.

    Science.gov (United States)

    Teixeira-Poit, Stephanie M; Halpern, Michael T; Kane, Heather L; Keating, Michael; Olmsted, Murrey

    2017-06-19

    Predicted shortages in the supply of neurologists may limit patients' access to and quality of care for neurological disorders. Retaining neurologists already in practice provides one opportunity to support the overall supply of practicing neurologists. Understanding factors associated with professional life satisfaction (and dissatisfaction) and implementing policies to enhance satisfaction may encourage neurologists to remain in clinical practice. In this paper, we present results from the first study examining factors associated with professional life satisfaction among a large sample of U.S, neurologists. We collaborated with the AAN to survey a sample of U.S. neurologists about their professional life satisfaction. Analyses examined the association of physician and practice characteristics with aspects of professional life satisfaction, including satisfaction with their career in medicine, medical specialty, current position, relationship with colleagues, relationship with patients, work/life balance, and pay. The study population consisted of 625 neurologists. In multivariate regression analyses, no single group or population stratum indicated high (or low) responses to all aspects of satisfaction. Older neurologists reported higher satisfaction with career, specialty, and relationship with patients than younger neurologists. Female neurologists had significantly lower satisfaction with pay than male neurologists. Neurologists who spent more time in research and teaching had greater satisfaction with specialty, relationship with colleagues, and relationship with patients than those spending no time in research. Neurologists who practiced in small cities/rural areas reported lower satisfaction across multiple dimensions than those practicing in large urban areas. Neurologists in solo practice had greater satisfaction with the relationship with their patients, but lower satisfaction with pay. Satisfaction is a multidimensional construct that is associated with

  6. Artificial life and Piaget.

    Science.gov (United States)

    Mueller, Ulrich; Grobman, K H.

    2003-04-01

    Artificial life provides important theoretical and methodological tools for the investigation of Piaget's developmental theory. This new method uses artificial neural networks to simulate living phenomena in a computer. A recent study by Parisi and Schlesinger suggests that artificial life might reinvigorate the Piagetian framework. We contrast artificial life with traditional cognitivist approaches, discuss the role of innateness in development, and examine the relation between physiological and psychological explanations of intelligent behaviour.

  7. The government of life

    DEFF Research Database (Denmark)

    Villadsen, Kaspar; Wahlberg, Ayo

    2015-01-01

    . Subsequent research on biopolitics and governmentality has tended to separate the concepts, differentiating into distinct research traditions each with different intellectual pathways. We propose to bring these conceptual innovations together to understand contemporary problems of the government of life...... of death power, the interplay of sovereignty, discipline and security, governmentalization through medical normalization, and ‘securitization’ of life as circulations and open series. The article also introduces this special feature on the government of life in which significant scholars explores issues...

  8. Life Span Developmental Approach

    OpenAIRE

    Ali Eryilmaz

    2011-01-01

    The Life Span Developmental Approach examines development of individuals which occurs from birth to death. Life span developmental approach is a multi-disciplinary approach related with disciplines like psychology, psychiatry, sociology, anthropology and geriatrics that indicates the fact that development is not completed in adulthood, it continues during the life course. Development is a complex process that consists of dying and death. This approach carefully investigates the development of...

  9. The quantum life

    Science.gov (United States)

    Davies, Paul

    2009-07-01

    To a physicist, life seems little short of miraculous-all those stupid atoms getting together to perform such clever tricks! For centuries, living organisms were regarded as some sort of magic matter. Today, we know that no special "life force" is at work in biology; there is just ordinary matter doing extraordinary things, all the while obeying the familiar laws of physics. What, then, is the secret of life's remarkable properties?

  10. Life insurance mathematics

    CERN Document Server

    Gerber, Hans U

    1997-01-01

    This concise introduction to life contingencies, the theory behind the actuarial work around life insurance and pension funds, will appeal to the reader who likes applied mathematics. In addition to model of life contingencies, the theory of compound interest is explained and it is shown how mortality and other rates can be estimated from observations. The probabilistic model is used consistently throughout the book. Numerous exercises (with answers and solutions) have been added, and for this third edition several misprints have been corrected.

  11. Work-Life Balance

    OpenAIRE

    Kvasničková, Katarína

    2011-01-01

    The subject of this thesis is Work-Life Balance - the reconciliation of professional and personal lives. The primary objective of this work is to analyze employee satisfaction in achieving a balance between the professional and personal life and to develop recommendations for employer on that basis. The theoretical portion of this work defines the issues surrounding Work-Life Balance and tools that employees can use to harmonize the two with an analysis of applications in the Czech Republic a...

  12. Early Life Exposures and Cancer

    Science.gov (United States)

    Early-life events and exposures have important consequences for cancer development later in life, however, epidemiological studies of early-life factors and cancer development later in life have had significant methodological challenges.

  13. Greater reproductive investment, but shorter lifespan, in agrosystem than in natural-habitat toads

    Directory of Open Access Journals (Sweden)

    Francisco Javier Zamora-Camacho

    2017-09-01

    Full Text Available Global amphibian decline is due to several factors: habitat loss, anthropization, pollution, emerging diseases, and global warming. Amphibians, with complex life cycles, are particularly susceptible to habitat alterations, and their survival may be impaired in anthropized habitats. Increased mortality is a well-known consequence of anthropization. Life-history theory predicts higher reproductive investment when mortality is increased. In this work, we compared age, body size, and different indicators of reproductive investment, as well as prey availability, in natterjack toads (Epidalea calamita from agrosystems and adjacent natural pine groves in Southwestern Spain. Mean age was lower in agrosystems than in pine groves, possibly as a consequence of increased mortality due to agrosystem environmental stressors. Remarkably, agrosystem toads were larger despite being younger, suggesting accelerated growth rate. Although we detected no differences in prey availability between habitats, artificial irrigation could shorten aestivation in agrosystems, thus increasing energy trade. Moreover, agrosystem toads exhibited increased indicators of reproductive investment. In the light of life-history theory, agrosystem toads might compensate for lesser reproductive events—due to shorter lives—with a higher reproductive investment in each attempt. Our results show that agrosystems may alter demography, which may have complex consequences on both individual fitness and population stability.

  14. Life as quale

    Directory of Open Access Journals (Sweden)

    Roland Cazalis

    2013-07-01

    Full Text Available The developments of relational biology during these last thirty years tend to classify autonomous system such as biological, cognitive or social groups among the living systems which they models as such. This present article tries to understand the nature of life by the transition phase which characterizes the passage from the inanimate world to the organic one. Our proposal is that life belongsto the category of qualia. Consequently, qualia are already obvious at least with the simplest forms of the living world. Furthermore, if life, consciousness and language are emergences of complex entities,life as quale is specifically the self of the cellular organism.

  15. Male Astronauts Have Greater Bone Loss and Risk of Hip Fracture Following Long Duration Spaceflights than Females

    Science.gov (United States)

    Ellman, Rachel; Sibonga, Jean; Bouxsein, Mary

    2010-01-01

    This slide presentation reviews bone loss in males and compares it to female bone loss during long duration spaceflight. The study indicates that males suffer greater bone loss than females and have a greater risk of hip fracture. Two possible reason for the greater male bone loss are that the pre-menopausal females have the estrogen protection and the greater strength of men max out the exercise equipment that provide a limited resistance to 135 kg.

  16. Life Is Hard But Life Is Good

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

    Cancer, paralysis, the death of her loved ones...Lei Juli has experienced more unexpected suffering than most other people. She was once in despair, but she managed to overcome all of these catastrophes. She tells the world what her experience has taught her: Love the life you’re given.

  17. Is Industry Funding Associated with Greater Scholarly Impact Among Academic Neurosurgeons?

    Science.gov (United States)

    Eloy, Jean Anderson; Kilic, Suat; Yoo, Nicholas G; Mcleod, Thomas; Svider, Peter F; Baredes, Soly; Folbe, Adam J; Couldwell, William T; Liu, James K

    2017-07-01

    To determine the relationship between industry payments and scholarly impact among academic neurosurgeons. Faculty names and academic rank data were obtained from department websites, bibliometric data were obtained from the Scopus database, and industry payment data were obtained from the Center for Medicare and Medicaid Services open payments database (openpayments.cms.gov). The h-index was used to estimate scholarly impact. Payments were classified as "general," "associated research," and "research payments." Subgroup analyses were done for academic rank, fellowship training, and sex. Among 1008 academic neurosurgeons, scholarly impact was greater among individuals receiving associated research industry support compared with those not receiving it. Scholarly impact also was greater among individuals who received more than $10,000 of any type of industry support compared with individuals who received less than that or no payment. This association also was seen in fellowship-trained surgeons. Female neurosurgeons were less likely than male neurosurgeons to get industry funding and were likely to get less funding. There is a strong association between associated research funding from industry and scholarly impact among academic neurosurgeons. It's unclear whether this association is a result of funding facilitating more research projects that eventually lead to more high-impact publications, if industry is providing more funding to academic neurosurgeons with greater scholarly impact, or whether it represents intrinsic academic activity among a group of neurosurgeons who are more likely to be academically productive and procure funding from all potential sources to increase this activity. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Epidemiological link of a major cholera outbreak in Greater Accra region of Ghana, 2014.

    Science.gov (United States)

    Ohene-Adjei, Kennedy; Kenu, Ernest; Bandoh, Delia Akosua; Addo, Prince Nii Ossah; Noora, Charles Lwanga; Nortey, Priscillia; Afari, Edwin Andrew

    2017-10-11

    Cholera remains an important public health challenge globally. Several pandemics have occurred in different parts of the world and have been epidemiologically linked by different researchers to illustrate how the cases were spread and how they were related to index cases. Even though the risk factors associated with the 2014 cholera outbreak were investigated extensively, the link between index cases and the source of infection was not investigated to help break the transmission process. This study sought to show how the index cases from various districts of the Greater Accra Region may have been linked. We carried out a descriptive cross sectional study to investigate the epidemiological link of the 2014 cholera outbreak in the Greater Accra region of Ghana. An extensive review of all district records on cholera cases in the Greater Accra region was carried out. Index cases were identified with the help of line lists. Univariate analyses were expressed as frequency distributions, percentages, mean ± Standard Deviation, and rates (attack rates, case-fatality rates etc.) as appropriate. Maps were drawn using Arc GIS and Epi info software to describe the pattern of transmission. Up to 20,199 cholera cases were recorded. Sixty percent of the cases were between 20 and 40 years and about 58% (11,694) of the total cases were males. Almost 50% of the cases occurred in the Accra Metro district. Two-thirds of the index cases ate food prepared outside their home and had visited the Accra Metropolis. The 2014 cholera outbreak can be described as a propagated source outbreak linked to the Accra Metropolis. The link between index cases and the source of infection, if investigated earlier could have helped break the transmission process. Such investigations also inform decision-making about the appropriate interventions to be instituted to prevent subsequent outbreaks.

  19. Importance of regional variation in conservation planning: A rangewide example of the Greater Sage-Grouse

    Science.gov (United States)

    Doherty, Kevin E.; Evans, Jeffrey S.; Coates, Peter S.; Juliusson, Lara; Fedy, Bradley C.

    2016-01-01

    We developed rangewide population and habitat models for Greater Sage-Grouse (Centrocercus urophasianus) that account for regional variation in habitat selection and relative densities of birds for use in conservation planning and risk assessments. We developed a probabilistic model of occupied breeding habitat by statistically linking habitat characteristics within 4 miles of an occupied lek using a nonlinear machine learning technique (Random Forests). Habitat characteristics used were quantified in GIS and represent standard abiotic and biotic variables related to sage-grouse biology. Statistical model fit was high (mean correctly classified = 82.0%, range = 75.4–88.0%) as were cross-validation statistics (mean = 80.9%, range = 75.1–85.8%). We also developed a spatially explicit model to quantify the relative density of breeding birds across each Greater Sage-Grouse management zone. The models demonstrate distinct clustering of relative abundance of sage-grouse populations across all management zones. On average, approximately half of the breeding population is predicted to be within 10% of the occupied range. We also found that 80% of sage-grouse populations were contained in 25–34% of the occupied range within each management zone. Our rangewide population and habitat models account for regional variation in habitat selection and the relative densities of birds, and thus, they can serve as a consistent and common currency to assess how sage-grouse habitat and populations overlap with conservation actions or threats over the entire sage-grouse range. We also quantified differences in functional habitat responses and disturbance thresholds across the Western Association of Fish and Wildlife Agencies (WAFWA) management zones using statistical relationships identified during habitat modeling. Even for a species as specialized as Greater Sage-Grouse, our results show that ecological context matters in both the strength of habitat selection (i

  20. Greater Proptosis Is Not Associated With Improved Compressive Optic Neuropathy in Thyroid Eye Disease.

    Science.gov (United States)

    Nanda, Tavish; Dunbar, Kristen E; Campbell, Ashley A; Bathras, Ryan M; Kazim, Michael

    2018-05-18

    Despite the paucity of supporting data, it has generally been held that proptosis in thyroid eye disease (TED) may provide relative protection from compressive optic neuropathy (CON) by producing spontaneous decompression. The objective of this study was to investigate this phenomenon in patients with bilateral TED-CON. We retrospectively reviewed the charts of 67 patients (134 orbits) with bilateral TED-CON at Columbia-Presbyterian Medical Center. Significant asymmetric proptosis (Hertel) was defined as ≥ 2 mm. Significant asymmetric CON was defined first, as the presence of an relative afferent pupillary defect. Those without an relative afferent pupillary defect were evaluated according to the TED-CON formula y = -0.69 - 0.31 × (motility) - 0.2 × (mean deviation) - 0.02 × (color vision) as previously established for the diagnosis of TED-CON. A difference in the formula result ≥ 1.0 between eyes was considered significant. Patients were then divided into 4 groups. Forty-one of 67 patients demonstrated asymmetric CON (29 by relative afferent pupillary defect, 12 by formula). Twenty-one of 67 patients demonstrated asymmetric proptosis. Only 5 of 12 (41.6%) of the patients who had both asymmetric proptosis and asymmetric CON (group 1) showed greater proptosis in the eye with less CON. Twenty-nine patients (group 2) showed that asymmetric CON occurred despite symmetrical proptosis. Seventeen patients (group 3), showed the inverse, that asymmetric differences in proptosis occurred with symmetrical CON. Despite commonly held assumptions, our results suggest that greater proptosis is not associated with improved TED-CON. Combining groups 1 to 3-all of which demonstrated asymmetry of either proptosis, CON, or both-91.4% of patients did not show a relationship between greater proptosis and improved CON.

  1. Exposure to Sexual Stimuli Induces Greater Discounting Leading to Increased Involvement in Cyber Delinquency Among Men.

    Science.gov (United States)

    Cheng, Wen; Chiou, Wen-Bin

    2018-02-01

    People frequently encounter sexual stimuli during Internet use. Research has shown that stimuli inducing sexual motivation can lead to greater impulsivity in men, as manifested in greater temporal discounting (i.e., a tendency to prefer smaller, immediate gains to larger, future ones). Extant findings in crime research suggest that delinquents tend to focus on short-term gains while failing to adequately think through the longer-term consequences of delinquent behavior. We experimentally tested the possibility that exposure to sexual stimuli is associated with the tendency to engage in cyber delinquency among men, as a result of their overly discounting remote consequences. In Experiment 1, participants exposed to pictures of "sexy" women were more likely to discount the future and were more inclined to make cyber-delinquent choices (e.g., cyberbullying, cyber fraud, cyber theft, and illegal downloading), compared with male participants who rated the sex appeal of less sexy opposite-sex pictures. However, these relationships were not observed in female participants exposed to either highly or less sexy pictures of men. In Experiment 2, male participants exposed to sexual primes showed a greater willingness to purchase a wide range of counterfeit rather than authentic products online and experienced a higher likelihood of logging into the other person's Facebook webpage (i.e., invading online privacy). The discounting tendency mediated the link between exposure to sexual primes and the inclination to engage in cyber-delinquent behavior. These findings provide insight into a strategy for reducing men's involvement in cyber delinquency; that is, through less exposure to sexual stimuli and promotion of delayed gratification. The current results suggest that the high availability of sexual stimuli in cyberspace may be more closely associated with men's cyber-delinquent behavior than previously thought.

  2. Runners with Patellofemoral Pain Exhibit Greater Peak Patella Cartilage Stress Compared to Pain-Free Runners.

    Science.gov (United States)

    Liao, Tzu-Chieh; Keyak, Joyce H; Powers, Christopher M

    2018-02-27

    The purpose of this study is to determine whether recreational runners with patellofemoral pain (PFP) exhibit greater peak patella cartilage stress compared to pain-free runners. A secondary purpose was to determine the kinematic and/or kinetic predictors of peak patella cartilage stress during running. Twenty-two female recreational runners participated (12 with PFP and 10 pain-free controls). Patella cartilage stress profiles were quantified using subject-specific finite element models simulating the maximum knee flexion angle during stance phase of running. Input parameters to the finite element model included subject-specific patellofemoral joint geometry, quadriceps muscle forces, and lower extremity kinematics in the frontal and transverse planes. Tibiofemoral joint kinematics and kinetics were quantified to determine the best predictor of stress using stepwise regression analysis. Compared to the pain-free runners, those with PFP exhibited greater peak hydrostatic pressure (PFP vs. control, 21.2 ± 5.6 MPa vs. 16.5 ± 4.6 MPa) and maximum shear stress (11.3 ± 4.6 MPa vs. 8.7 ± 2.3 MPa). Knee external rotation was the best predictor of peak hydrostatic pressure and peak maximum shear stress (38% and 25% of variances, respectively) followed by the knee extensor moment (21% and 25% of variances, respectively). Runners with PFP exhibit greater peak patella cartilage stress during running compared to pain-free individuals. The combination of knee external rotation and a high knee extensor moment best predicted elevated peak stress during running.

  3. Epidemiological aspects of centipede (Scolopendromorphae: Chilopoda bites registered in Greater S. Paulo, SP, Brazil

    Directory of Open Access Journals (Sweden)

    Irene Knysak

    1998-12-01

    Full Text Available INTRODUCTION: The lack of basic knowledge on venomous arthropods and the benignity of the clinical manifestations contribute to the centipede bite victims' not being taken to a treatment reference center, leading to underestimation of the number of cases and minimizing the possibility of a broader epidemiological view. An inventory of the centipede bite occurrences in Greater S. Paulo, Brazil, and the therapeutic methods employed, by the main Brazilian medical center for the notification of poisoning by venomous animals, is presented. METHOD: All patient cards of the period 1980-1989 have been checked as to place, month and time of occurrence; sex, age, affected part of the body, signs and symptoms have been observed, as well as the therapeutic methods employed. The centipedes that caused the accidents were identified at the Arthropods Laboratory. RESULTS: It was registered 216 accidents, with a 69% predominance of the Greater S. Paulo and in only 63% of the cases (136 was the agent brought in by the victim for identification. The genera most frequently represented were Cryptops (58%, Otostigmus (33% and Scolopendra (4%. Of the 136 cases, 87% showed erythema, edema, hemorrhage, burns, cephalalgia, and intense pain. There was a predominance of accidents in the warm rainy season, in the morning and for females between 21 and 60 years of age. Hands and feet were the parts of the body most affected. The benign evolution of the clinical picture (54% made therapeutical treatment unnecessary. Only the victims of Scolopendra and Otostigmus (46% were medicated with anesthetics (51%, analgesics (25%, antihistamines and cortisone (24%. CONCLUSION: The reproductive period of the centipedes, associated with their sinanthropic habits, contributes to the greater incidence of accidents in urban areas in the warm rainy season. Only patients bitten by Scolopendra and Otostigmus require therapeutical treatment.

  4. Hypermetabolism in ALS is associated with greater functional decline and shorter survival.

    Science.gov (United States)

    Steyn, Frederik J; Ioannides, Zara A; van Eijk, Ruben P A; Heggie, Susan; Thorpe, Kathryn A; Ceslis, Amelia; Heshmat, Saman; Henders, Anjali K; Wray, Naomi R; van den Berg, Leonard H; Henderson, Robert D; McCombe, Pamela A; Ngo, Shyuan T

    2018-04-29

    To determine the prevalence of hypermetabolism, relative to body composition, in amyotrophic lateral sclerosis (ALS) and its relationship with clinical features of disease and survival. Fifty-eight patients with clinically definite or probable ALS as defined by El Escorial criteria, and 58 age and sex-matched control participants underwent assessment of energy expenditure. Our primary outcome was the prevalence of hypermetabolism in cases and controls. Longitudinal changes in clinical parameters between hypermetabolic and normometabolic patients with ALS were determined for up to 12 months following metabolic assessment. Survival was monitored over a 30-month period following metabolic assessment. Hypermetabolism was more prevalent in patients with ALS than controls (41% vs 12%, adjusted OR=5.4; pALS. Mean lower motor neuron score (SD) was greater in hypermetabolic patients when compared with normometabolic patients (4 (0.3) vs 3 (0.7); p=0.04). In the 12 months following metabolic assessment, there was a greater change in Revised ALS Functional Rating Scale score in hypermetabolic patients when compared with normometabolic patients (-0.68 points/month vs -0.39 points/month; p=0.01). Hypermetabolism was inversely associated with survival. Overall, hypermetabolism increased the risk of death during follow-up to 220% (HR 3.2, 95% CI 1.1 to 9.4, p=0.03). Hypermetabolic patients with ALS have a greater level of lower motor neuron involvement, faster rate of functional decline and shorter survival. The metabolic index could be important for informing prognosis in ALS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. 78 FR 65703 - Notice of Availability of the Idaho and Southwestern Montana Greater Sage-Grouse Draft Land Use...

    Science.gov (United States)

    2013-11-01

    ...] Notice of Availability of the Idaho and Southwestern Montana Greater Sage-Grouse Draft Land Use Plan... Environmental Impact Statement (EIS) for managing Greater Sage- Grouse (GRSG) in the Idaho and Southwestern... Southwestern Montana Greater Sage-Grouse Draft LUP Amendments/Draft EIS by any of the following methods: Email...

  6. 78 FR 50088 - Notice of Availability of the Northwest Colorado Greater Sage-Grouse Draft Resource Management...

    Science.gov (United States)

    2013-08-16

    ... Availability of the Northwest Colorado Greater Sage- Grouse Draft Resource Management Plan Amendment and Draft... Land Management (BLM) has prepared a Northwest Colorado Greater Sage-Grouse Draft Resource Management.../or mailings. ADDRESSES: You may submit comments related to the Northwest Colorado Greater Sage-Grouse...

  7. Loneliness and life satisfaction in Japan and Australia.

    Science.gov (United States)

    Schumaker, J F; Shea, J D; Monfries, M M; Groth-Marnat, G

    1993-01-01

    We examined the relationship between loneliness and life satisfaction in 121 residents of Fukoku, Japan, and 139 residents of Melbourne, Australia, using the Satisfaction With Life Scale (Diener, Emmons, Larsen, & Griffin, 1983) and the Revised UCLA Loneliness Scale (Russell, Peplau, & Cutrona, 1980). Australian subjects reported significantly less loneliness and significantly greater life satisfaction than Japanese subjects. A high inverse correlation was found between loneliness and life satisfaction in Australian subjects, with a much smaller inverse relationship observed among the Japanese, suggesting that loneliness in Japanese subjects did not emotionally translate into life dissatisfaction as it did in Australian subjects. Instead, the experience of loneliness in Japanese individuals may remain largely independent of general life satisfaction.

  8. Assessment of greater-than-Class C waste at Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Shuman, R.; Jennrich, E.A.; Merrell, G.B.

    1991-02-01

    Department of Energy (DOE) Order 5820.2A regulates the onsite disposal of low-level radioactive waste (LLW) at all DOE facilities. Among its stipulations, the Order states that ''Disposition of wastes designated as greater-than-Class C, as defined in 10 CFR 61.55 must be handled as special cases. Disposal systems for such waste must be justified by a specific performance assessment.'' Los Alamos National Laboratory (LANL) personnel have undertaken a review and performance assessment of LLW disposal at its Area-G disposal facility, which is described in this report

  9. Integration of large-scale heat pumps in the district heating systems of Greater Copenhagen

    DEFF Research Database (Denmark)

    Bach, Bjarne; Werling, Jesper; Ommen, Torben Schmidt

    2016-01-01

    This study analyses the technical and private economic aspects of integrating a large capacity of electric driven HP (heat pumps) in the Greater Copenhagen DH (district heating) system, which is an example of a state-of-the-art large district heating system with many consumers and suppliers....... The analysis was based on using the energy model Balmorel to determine the optimum dispatch of HPs in the system. The potential heat sources in Copenhagen for use in HPs were determined based on data related to temperatures, flows, and hydrography at different locations, while respecting technical constraints...

  10. Beyond the Inventory: An Interagency Collaboration to Reduce Greenhouse Gas Emissions in the Greater Yellowstone Area

    Energy Technology Data Exchange (ETDEWEB)

    Kandt, A.; Hotchkiss, E.; Fiebig, M.

    2010-10-01

    As one of the largest, intact ecosystems in the continental United States, land managers within the Greater Yellowstone Area (GYA) have recognized the importance of compiling and understanding agency greenhouse gas (GHG) emissions. The 10 Federal units within the GYA have taken an active role in compiling GHG inventories on a unit- and ecosystem-wide level, setting goals for GHG mitigation, and identifying mitigation strategies for achieving those goals. This paper details the processes, methodologies, challenges, solutions, and lessons learned by the 10 Federal units within the GYA throughout this ongoing effort.

  11. Temporal, spatial, and environmental influences on the demographics of grizzly bears in the Greater Yellowstone Ecosystem

    Science.gov (United States)

    Schwartz, Charles C.; Haroldson, Mark A.; White, Gary C.; Harris, Richard B.; Cherry, Steve; Keating, Kim A.; Moody, Dave; Servheen, Christopher

    2006-01-01

    During the past 2 decades, the grizzly bear (Ursus arctos) population in the Greater Yellowstone Ecosystem (GYE) has increased in numbers and expanded in range. Understanding temporal, environmental, and spatial variables responsible for this change is useful in evaluating what likely influenced grizzly bear demographics in the GYE and where future management efforts might benefit conservation and management. We used recent data from radio-marked bears to estimate reproduction (1983–2002) and survival (1983–2001); these we combined into models to evaluate demographic vigor (lambda [λ]). We explored the influence of an array of individual, temporal, and spatial covariates on demographic vigor.

  12. Cold Water Mediates Greater Reductions in Limb Blood Flow than Whole Body Cryotherapy.

    Science.gov (United States)

    Mawhinney, Chris; Low, David A; Jones, Helen; Green, Daniel J; Costello, Joseph T; Gregson, Warren

    2017-06-01

    Cold-water immersion (CWI) and whole body cryotherapy (WBC) are widely used recovery methods in an attempt to limit exercise-induced muscle damage, soreness, and functional deficits after strenuous exercise. The aim of this study was to compare the effects of ecologically valid CWI and WBC protocols on postexercise lower limb thermoregulatory, femoral artery, and cutaneous blood flow responses. Ten males completed a continuous cycle exercise protocol at 70% maximal oxygen uptake until a rectal temperature of 38°C was attained. Participants were then exposed to lower-body CWI (8°C) for 10 min, or WBC (-110°C) for 2 min, in a randomized crossover design. Rectal and thigh skin, deep, and superficial muscle temperatures, thigh, and calf skin blood flow (laser Doppler flowmetry), superficial femoral artery blood flow (duplex ultrasound), and arterial blood pressure were measured before, and for 40 min post, cooling interventions. Greater reductions in thigh skin (CWI, -5.9°C ± 1.8°C; WBC, 0.2°C ± 0.5°C; P < 0.001) and superficial (CWI, -4.4°C ± 1.3°C; WBC, -1.8°C ± 1.1°C; P < 0.001) and deep (CWI, -2.9°C ± 0.8°C; WBC, -1.3°C ± 0.6°C; P < 0.001) muscle temperatures occurred immediately after CWI. Decreases in femoral artery conductance were greater after CWI (CWI, -84% ± 11%; WBC, -59% ± 21%, P < 0.02) and thigh (CWI, -80% ± 5%; WBC, -59% ± 14%, P < 0.001), and calf (CWI, -73% ± 13%; WBC, -45% ± 17%, P < 0.001) cutaneous vasoconstriction was greater after CWI. Reductions in rectal temperature were similar between conditions after cooling (CWI, -0.6°C ± 0.4°C; WBC, -0.6°C ± 0.3°C; P = 0.98). Greater reductions in blood flow and tissue temperature were observed after CWI in comparison with WBC. These novel findings have practical and clinical implications for the use of cooling in the recovery from exercise and injury.

  13. On efficiency of fire simulation realization: parallelization with greater number of computational meshes

    Science.gov (United States)

    Valasek, Lukas; Glasa, Jan

    2017-12-01

    Current fire simulation systems are capable to utilize advantages of high-performance computer (HPC) platforms available and to model fires efficiently in parallel. In this paper, efficiency of a corridor fire simulation on a HPC computer cluster is discussed. The parallel MPI version of Fire Dynamics Simulator is used for testing efficiency of selected strategies of allocation of computational resources of the cluster using a greater number of computational cores. Simulation results indicate that if the number of cores used is not equal to a multiple of the total number of cluster node cores there are allocation strategies which provide more efficient calculations.

  14. Greater palatine nerve neuropraxia after laryngeal mask insertion: A rare occurrence

    Directory of Open Access Journals (Sweden)

    Jyoti Garg

    2017-01-01

    Full Text Available With the more frequent use of the laryngeal mask airway (LMA over endotracheal tubes for general anaesthesia, various cranial nerve injuries have been reported recently. We report a rare occurrence of greater palatine nerve (GPN palsy subsequent to the use of LMA Supreme™ in a young female scheduled for hand surgery. Although the exact mechanism of a nerve injury is still a matter of further research, we postulate pressure neuropraxia of GPN as a causative factor in the development of numbness over the hard palate after the removal of LMA in the post operative period.

  15. COMPLETION OF THE TRANSURANIC GREATER CONFINEMENT DISPOSAL BOREHOLE PERFORMANCE ASSESSMENT FOR THE NEVADA TEST SITE

    International Nuclear Information System (INIS)

    Colarusso, Angela; Crowe, Bruce; Cochran, John R.

    2003-01-01

    Classified transuranic material that cannot be shipped to the Waste Isolation Pilot Plant in New Mexico is stored in Greater Confinement Disposal boreholes in the Area 5 Radioactive Waste Management Site on the Nevada Test Site. A performance assessment was completed for the transuranic inventory in the boreholes and submitted to the Transuranic Waste Disposal Federal Review Group. The performance assessment was prepared by Sandia National Laboratories on behalf of the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office using an iterative methodology that assessed radiological releases from the intermediate depth disposal configuration against the regulatory requirements of the 1985 version of 40 CFR 191 of the U.S. Environmental Protection Agency. The transuranic materials are stored at 21 to 37 m depth (70 to 120 ft) in large diameter boreholes constructed in the unsaturated alluvial deposits of Frenchman Flat. Hydrologic processes that affect long- term isolation of the radionuclides are dominated by extremely slow upward rates of liquid/vapor advection and diffusion; there is no downward pathway under current climatic conditions and there is no recharge to groundwater under future ''glacial'' climatic conditions. A Federal Review Team appointed by the Transuranic Waste Disposal Federal Review Group reviewed the Greater Confinement Disposal performance assessment and found that the site met the majority of the regulatory criteria of the 1985 and portions of the 1993 versions of 40 CFR 191. A number of technical and procedural issues required development of supplemental information that was incorporated into a final revision of the performance assessment. These issues include inclusion of radiological releases into the complementary cumulative distribution function for the containment requirements associated with drill cuttings from inadvertent human intrusion, verification of mathematical models used in the performance

  16. Investigation of the sidereal anisotropy of muons with energies greater than 2 GeV

    International Nuclear Information System (INIS)

    Uhr, R.C.; Faehnders, E.; Koseck, K.; Klemke, G.; Jokisch, H.; Dau, W.D.

    1975-01-01

    The sidereal variation of the intensity of cosmic-ray-muons is investigated by means of a stack of four wire-spark-chambers with magneto-strictive readout. The apparatus is sensitive for particles with a momentum greater than 2 GeV/c, the triggerrate is 0.74 sec -1 and the arrival directions can be determined with an accuracy of some tenths of degree. The apparatus is scanning all arrival directions the declination of which lay between -25 and +60 degrees. Till now 1.26 x 10 6 muons were scanned and no anisotropies found. (orig.) [de

  17. The Arab Awakening and US counterterrorism in the Greater Middle East: A missed opportunity

    Directory of Open Access Journals (Sweden)

    Eugenio Lilli

    2015-05-01

    Full Text Available 'In 2011, the Arab Awakening offered an opportunity to the Obama administration to advance the US interest to counter terrorism in the Greater Middle East without compromising its commitment to the promotion of democracy. As of early 2015, however, with the exception of still-hopeful Tunisia, democracy has not made any significant progress in Middle Eastern countries. Additionally, old and new regional extremist groups have become increasingly active. How did the Obama administration miss the opportunity offered by the Arab Awakening? What actions could the United States take to reverse current unfavorable trends and advance US policies of counterterrorism and democratization in the region?'''

  18. The shaking signal of the honey bee informs workers to prepare for greater activity

    OpenAIRE

    Seeley, Thomas D.; Weidenmüller, Anja; Kühnholz, Susanne

    2010-01-01

    One of the most conspicuous activities o f worker bees inside a hive is the shaking of other wc~rliersT. his shaking has long been suspected to be a communication behavior, but its information content and function have until recently remained mysterious. Prior studies of the colony-level patterns of the production of ihc shaking signal supgest strongly that this signal semes to arouse workers to greater activity, such as at times of good foraging. Data from our obsenrauons of mdividual bees h...

  19. Price freezes, durables and residential electricity demand - Evidence from the Greater Buenos Aires

    Energy Technology Data Exchange (ETDEWEB)

    Casarin, Ariel; Delfino, Maria Eugenia

    2010-09-15

    This paper examines the determinants of residential electricity demand in the Greater Buenos Aires between 1997 and 2006. During the second half of this period, residential tariffs remained nominally fixed, while an income boom boosted up the sales of durables. This study differs from previous works in that it explicitly considers the impact of the stock of air-conditioners on residential demand. The paper reports short- and long-run elasticities and examines the contribution of prices and durables to recent demand growth. Simulations illustrate the impact of prices and durables on future demand.

  20. One-stage reconstruction of chest wall defects with greater omentum transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Harashina, T [Keio Univ., Tokyo (Japan). School of Medicine; Oshiro, T; Sato, K

    1976-11-01

    Reconstructive operation by greater omentum transplantation in two cases of chest wall ulcer due to radiation therapy following an operation of breast cancer was introduced. The exposed dose of one case was not clarified, but that of another case was 5000 rad. This operation method is an excellent one, because operation is completed at one-stage and reconstruction of tissue is great owing to good blood circulation. It was thought that this method must be used more positively in the treatment of chest wall ulcer due to irradiation which is difficult to be treated.

  1. On differential radiodiagnosis of ulcerations of the greater curvature of the stomach

    International Nuclear Information System (INIS)

    Portnoj, L.M.; Nefedova, V.O.; Turovskij, B.M.; Marchenko, V.A.; Osadchij, P.A.; Konina, E.A.

    1980-01-01

    The problems connected with the differential diagnosis of ulcerations of the greater curvature of the stomach are considered on the base of analysis of 176 observations of ulcerated forms of cancer and 14 benign injuries localized in this area. Emphasizing the great importance of the X-ray method for such diagnosis, the authors give recommendations concerning the methods of the common X-ray examination of the stomach and the interpretation of the details of the X-ray appearance: they also point to the advisability of using pneumogastrography in some cases

  2. Rural Livelihoods, Climate Change and Micro-Level Adaptive Capacity in the Greater Mekong Subregion

    DEFF Research Database (Denmark)

    Jiao, Xi

    The Greater Mekong Subregion (GMS) is one of the fastest developing regions in the world, experiencing significant economic, environmental and social transformations. There is an increasing demand for policy relevant and decision support information at micro level. This PhD research contributes...... and Laos, two of the poorest countries in the GMS. Structured household surveys and participatory focus group discussions were the primary data collection methods. The findings provide new, additional and much needed quantitative information in the region, and several policy implications for rural...

  3. The Stereotype-Matching Effect: Greater Influence on Functioning When Age Stereotypes Correspond to Outcomes

    Science.gov (United States)

    Levy, Becca R.; Leifheit-Limson, Erica

    2009-01-01

    Older individuals assimilate, and are targeted by, contradictory positive and negative age stereotypes. It was unknown whether the influence of stereotype valence is stronger when the stereotype content corresponds to the outcome domain. We randomly assigned older individuals to either positive-cognitive, negative-cognitive, positive-physical, or negative-physical subliminal-age-stereotype groups and assessed cognitive and physical outcomes. As predicted, when the age stereotypes corresponded to the outcome domains, their valence had a significantly greater impact on cognitive and physical performance. This suggests that if a match occurs, it is more likely to generate expectations that become self-fulfilling prophecies. PMID:19290757

  4. Lower core body temperature and greater body fat are components of a human thrifty phenotype.

    Science.gov (United States)

    Reinhardt, M; Schlögl, M; Bonfiglio, S; Votruba, S B; Krakoff, J; Thearle, M S

    2016-05-01

    In small studies, a thrifty human phenotype, defined by a greater 24-hour energy expenditure (EE) decrease with fasting, is associated with less weight loss during caloric restriction. In rodents, models of diet-induced obesity often have a phenotype including a reduced EE and decreased core body temperature. We assessed whether a thrifty human phenotype associates with differences in core body temperature or body composition. Data for this cross-sectional analysis were obtained from 77 individuals participating in one of two normal physiology studies while housed on our clinical research unit. Twenty-four-hour EE using a whole-room indirect calorimeter and 24-h core body temperature were measured during 24 h each of fasting and 200% overfeeding with a diet consisting of 50% carbohydrates, 20% protein and 30% fat. Body composition was measured by dual X-ray absorptiometry. To account for the effects of body size on EE, changes in EE were expressed as a percentage change from 24-hour EE (%EE) during energy balance. A greater %EE decrease with fasting correlated with a smaller %EE increase with overfeeding (r=0.27, P=0.02). The %EE decrease with fasting was associated with both fat mass and abdominal fat mass, even after accounting for covariates (β=-0.16 (95% CI: -0.26, -0.06) %EE per kg fat mass, P=0.003; β=-0.0004 (-0.0007, -0.00004) %EE kg(-1) abdominal fat mass, P=0.03). In men, a greater %EE decrease in response to fasting was associated with a lower 24- h core body temperature, even after adjusting for covariates (β=1.43 (0.72, 2.15) %EE per 0.1 °C, P=0.0003). Thrifty individuals, as defined by a larger EE decrease with fasting, were more likely to have greater overall and abdominal adiposity as well as lower core body temperature consistent with a more efficient metabolism.

  5. Alternatives for packaging and transport of greater-than-class C low-level waste

    International Nuclear Information System (INIS)

    Smith, R.I.

    1990-06-01

    Viable methods for packaging greater-than-class C (GTCC) low-level wastes and for transporting those wastes from the waste generator sites or from an eastern interim storage site to the Yucca Mountain repository site have been identified and evaluated. Estimated costs for packaging and transporting the population of GTCC wastes expected to be accumulated through the year 2040 have been developed for three waste volume scenarios, for two preferred packaging methods for activated metals from reactor operations and from reactor decommissioning, and for two packaging density assumptions for the activated metals from reactor decommissioning. 7 refs. 7 tabs

  6. Does work/life balance depend on where and how you work?

    OpenAIRE

    Kinman, G; McDowall, A

    2009-01-01

    This article reports on a symposium presented in EAWOP, 2009 that examined work-life balance issues in different occupational contexts. During a global recession where developing work-life balance policies may not be considered organizational priorities; we argue that the need for systematic research into work-life balance has never been greater. The findings of the four papers included in the symposium suggest that work-life balance initiatives that are firmly grounded in workplace context a...

  7. Identifying Greater Sage-Grouse source and sink habitats for conservation planning in an energy development landscape.

    Science.gov (United States)

    Kirol, Christopher P; Beck, Jeffrey L; Huzurbazar, Snehalata V; Holloran, Matthew J; Miller, Scott N

    2015-06-01

    Conserving a declining species that is facing many threats, including overlap of its habitats with energy extraction activities, depends upon identifying and prioritizing the value of the habitats that remain. In addition, habitat quality is often compromised when source habitats are lost or fragmented due to anthropogenic development. Our objective was to build an ecological model to classify and map habitat quality in terms of source or sink dynamics for Greater Sage-Grouse (Centrocercus urophasianus) in the Atlantic Rim Project Area (ARPA), a developing coalbed natural gas field in south-central Wyoming, USA. We used occurrence and survival modeling to evaluate relationships between environmental and anthropogenic variables at multiple spatial scales and for all female summer life stages, including nesting, brood-rearing, and non-brooding females. For each life stage, we created resource selection functions (RSFs). We weighted the RSFs and combined them to form a female summer occurrence map. We modeled survival also as a function of spatial variables for nest, brood, and adult female summer survival. Our survival-models were mapped as survival probability functions individually and then combined with fixed vital rates in a fitness metric model that, when mapped, predicted habitat productivity (productivity map). Our results demonstrate a suite of environmental and anthropogenic variables at multiple scales that were predictive of occurrence and survival. We created a source-sink map by overlaying our female summer occurrence map and productivity map to predict habitats contributing to population surpluses (source habitats) or deficits (sink habitat) and low-occurrence habitats on the landscape. The source-sink map predicted that of the Sage-Grouse habitat within the ARPA, 30% was primary source, 29% was secondary source, 4% was primary sink, 6% was secondary sink, and 31% was low occurrence. Our results provide evidence that energy development and avoidance of

  8. Charting the internal landscape: Affect associated with thoughts about major life domains explains life satisfaction

    Directory of Open Access Journals (Sweden)

    Talya Miron-Shatz

    2013-09-01

    Full Text Available Studies of happiness have examined the impact of demographics, personality and emotions accompanying daily activities on life satisfaction. We suggest that how people feel while contemplating aspects of their lives, including their weight, children and future prospects, is a promising yet uncharted territory within the internal landscape of life satisfaction. In a sample of 811 American women, we assessed women's feelings when thinking about major life domains and frequency of thoughts about each domain. Regression and dominance analyses showed that emotional valence of thoughts about major life domains was an important predictor of current and prior life satisfaction, surpassing, in descending order, demographics, participants' feelings during recent activities, and their neuroticism and extraversion scores. Domains thought about more frequently were often associated with greater emotional valence. These results suggest that life satisfaction may be improved by modifying emotional valence and frequency of thoughts about life domains. Moreover, these thoughts appear to be an important and relatively stable component of well-being worthy of further study.

  9. Managing work-life balance of working mothers

    OpenAIRE

    2014-01-01

    M.Comm. (Business Management) Changes in the corporate landscape and an increase in female participation rates in corporate workforces necessitate a better understanding of female career paths and how organisations can accommodate them better. The purpose of this study is to identify the most appropriate work-life balance benefits organisations can offer to female employees to assist them in achieving greater work-life balance. The study further aims to identify learning and development op...

  10. Curcuma alismatifolia vase life

    DEFF Research Database (Denmark)

    Trevenzoli Favero, Bruno; Pace Pereira Lima, Giuseppina; Dole, John

    2017-01-01

    Cut curcuma stem has a reported vase life of 7 to 21 days and this difference in vase life is probably due to a combination of different factors such as growing conditions and postharvest treatments. However, the cut flower industry needs key postharvest information for new species and cultivars ...

  11. Partying as Everyday Life

    DEFF Research Database (Denmark)

    Demant, Jakob; Østergaard, Jeanette

    2007-01-01

    situates the event in everyday life. By drawing on Maffesoli's (1996) concept of ‘sociality' and Lincoln's (2005) concept of zoning the spatial and social logic of the house, partying is analysed using both qualitative and quantitative material. The analysis suggests that the consumption of alcohol (i...... to reaffirm friendship and is therefore an integrated part of adolescents' everyday life.  ...

  12. Go4Life

    Medline Plus

    Full Text Available ... now Alzheimer's Disease-Related Dementias: Research Challenges and Opportunities - Duration: 5 minutes, 32 seconds. National Institute On ... This item has been hidden Go4Life Exercises — Building Strength Play all Try some of these Go4Life exercises ...

  13. Life cycle management (LCM)

    DEFF Research Database (Denmark)

    Remmen, Arne; Thrane, Mikkel

    2004-01-01

    The chapter gives an introduction to Life Cycle Management (LCM) and shows how LCM can be practiced in different contexts and at different ambition levels.......The chapter gives an introduction to Life Cycle Management (LCM) and shows how LCM can be practiced in different contexts and at different ambition levels....

  14. A Life in Words

    DEFF Research Database (Denmark)

    Siegumfeldt, Inge Birgitte; Auster, Paul

    "Paul Auster's A Life in Words--a wide-ranging dialogue between Auster and the Danish professor I.B. Siegumfeldt--is a remarkably candid and often surprising celebration of one writer's art, craft, and life. It includes many revelations that have never been shared before, such as that he doesn...

  15. Go4Life

    Medline Plus

    Full Text Available ... all Try some of these Go4Life exercises to improve your flexibility! 2:48 Play next Play now ... all Try some of these Go4Life exercises to improve your strength! Stronger muscles can make it easier ...

  16. ICTs and Political Life.

    Science.gov (United States)

    Robbin, Alice; Courtright, Christina; Davis, Leah

    2004-01-01

    Presents a literature review that covers the following topics related to information and communications technologies (ICTs): (1) theories of ICTs and how they frame political life; (2) normative democratic theory and concepts; (3) e-political life; and (4) research on e-government, e-governance, and e-democracy; (Contains 276 references.) (MES)

  17. Thermostable Shelf Life Study

    Science.gov (United States)

    Perchonok, M. H.; Antonini, D. K.

    2008-01-01

    The objective of this project is to determine the shelf life end-point of various food items by means of actual measurement or mathematical projection. The primary goal of the Advanced Food Technology Project in these long duration exploratory missions is to provide the crew with a palatable, nutritious and safe food system while minimizing volume, mass, and waste. The Mars missions could be as long as 2.5 years with the potential of the food being positioned prior to the crew arrival. Therefore, it is anticipated that foods that are used during the Mars missions will require a 5 year shelf life. Shelf life criteria are safety, nutrition, and acceptability. Any of these criteria can be the limiting factor in determining the food's shelf life. Due to the heat sterilization process used for the thermostabilized food items, safety will be preserved as long as the integrity of the package is maintained. Nutrition and acceptability will change over time. Since the food can be the sole source of nutrition to the crew, a significant loss in nutrition may determine when the shelf life endpoint has occurred. Shelf life can be defined when the food item is no longer acceptable. Acceptability can be defined in terms of appearance, flavor, texture, or aroma. Results from shelf life studies of the thermostabilized food items suggest that the shelf life of the foods range from 0 months to 8 years, depending on formulation.

  18. Thermostabilized Shelf Life Study

    Science.gov (United States)

    Perchonok, Michele H.; Catauro, Patricia M.

    2009-01-01

    The objective of this project is to determine the shelf life end-point of various food items by means of actual measurement or mathematical projection. The primary goal of the Advanced Food Technology Project in these long duration exploratory missions is to provide the crew with a palatable, nutritious and safe food system while minimizing volume, mass, and waste. The Mars missions could be as long as 2.5 years with the potential of the food being positioned prior to the crew arrival. Therefore, it is anticipated that foods that are used during the Mars missions will require a 5 year shelf life. Shelf life criteria are safety, nutrition, and acceptability. Any of these criteria can be the limiting factor in determining the food's shelf life. Due to the heat sterilization process used for the thermostabilized food items, safety will be preserved as long as the integrity of the package is maintained. Nutrition and acceptability will change over time. Since the food can be the sole source of nutrition to the crew, a significant loss in nutrition may determine when the shelf life endpoint has occurred. Shelf life can be defined when the food item is no longer acceptable. Acceptability can be defined in terms of appearance, flavor, texture, or aroma. Results from shelf life studies of the thermostabilized food items suggest that the shelf life of the foods range from 0 months to 8 years, depending on formulation.

  19. Life Cycle Impact Assessment

    DEFF Research Database (Denmark)

    Rosenbaum, Ralph K.; Hauschild, Michael Zwicky; Boulay, Anne-Marie

    2018-01-01

    This chapter is dedicated to the third phase of an LCA study, the Life Cycle Impact Assessment (LCIA) where the life cycle inventory’s information on elementary flows is translated into environmental impact scores. In contrast to the three other LCA phases, LCIA is in practice largely automated...

  20. Life sciences report 1987

    Science.gov (United States)

    1987-01-01

    Highlighted here are the major research efforts of the NASA Life Sciences Division during the past year. Topics covered include remote health care delivery in space, space biomedical research, gravitational biology, biospherics (studying planet Earth), the NASA Closed Ecological Life Support System (CELSS), exobiology, flight programs, international cooperation, and education programs.