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  1. Report of VA Medical Training Programs

    Data.gov (United States)

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

  2. Why support a women's medical college? Philadelphia's early male medical pro-feminists.

    Science.gov (United States)

    Peitzman, Steven J

    2003-01-01

    The male founders and early faculty of Philadelphia's Woman's Medical College were mostly abolitionist physicians, zealous moralists for whom medical feminism formed only one of the cherished causes they could "manfully" and righteously defend. Male faculty of the late nineteenth century comprised "self-made" men, mostly new specialists, for whom strict sexism probably seemed inconsistent with progressive medicine. For some of these physicians-obviously a small minority-defending medical women and breaking the barriers of fraternity could be consistent with "manly" responsibility. The outcome of the collaboration of women and the dissident men physicians in nineteenth-century Philadelphia amounted to another seeming paradox: the majority of the male medical profession, both locally and nationally, tyrannically hindered women's entry into the profession, yet medicine opened its doors in advance of law and the clergy; and where this first occurred, such as in the community centered on Woman's Medical College, a novel gender rearrangement arose based on collaboration and friendship.

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

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2018-02-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

  5. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Science.gov (United States)

    2010-07-01

    ... AFFAIRS MEDICAL Outpatient Treatment § 17.96 Medication prescribed by non-VA physicians. Any prescription... and medicines ordered by a private or non-Department of Veterans Affairs doctor of medicine or doctor of osteopathy duly licensed to practice in the jurisdiction where the prescription is written, shall...

  6. OneVA Pharmacy

    Data.gov (United States)

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

  7. Changing Patterns of Glucose-Lowering Medication Use in VA Nursing Home Residents With Diabetes, 2005 to 2011.

    Science.gov (United States)

    Lee, Sei J; Stijacic-Cenzer, Irena; Barnhart, Caroline; McClymont, Keelan; Steinman, Michael A

    2015-10-01

    Although nursing home (NH) residents make up a large and growing proportion of Americans with diabetes mellitus, little is known about how glucose-lowering medications are used in this population. We sought to examine glucose-lowering medication use in Veterans Affairs (VA) NH residents with diabetes between 2005 and 2011. Retrospective cohort study, using linked laboratory, pharmacy, administrative, and NH Minimum Dataset (MDS) 2.0 databases in 123 VA NHs. A total of 9431 long-stay (>90 days) VA NH residents older than 65 followed for 52,313 person-quarters. We identified receipt of glucose-lowering medications, including insulin, metformin, sulfonylureas, thiazolidinediones, and others (alpha-glucosidase inhibitors, meglitinides, glucagonlike peptide-1 analogs, dipeptidyl peptidase-4 inhibitors and amylin analogs) per quarter. The rates of sulfonylurea use in long-stay NH residents dropped dramatically from 24% in 2005 to 12% in 2011 (P use (10% to 2%, P use in 2007 (4% to Metformin use was stable, ranging between 7% and 9% (P = .24). Insulin use increased slightly from 30% to 32% (P Use of other classes of glucose-lowering medications was stable (P = .22) and low, remaining below 1.3%. Between 2005 and 2011, there were dramatic declines in use of sulfonylureas and thiazolidinediones in VA NH residents, suggesting that prescribing practices can be quickly changed in this setting. Published by Elsevier Inc.

  8. Comparison of rates of potentially inappropriate medication use according to the Zhan criteria for VA versus private sector medicare HMOs.

    Science.gov (United States)

    Barnett, Mitchell J; Perry, Paul J; Langstaff, Jodi D; Kaboli, Peter J

    2006-06-01

    Inappropriate prescribing in the elderly is common, but rates across different health care systems and the impact of formulary restrictions are not well described. To determine if rates of inappropriate medication use in the elderly differ between the Veterans Affairs (VA) health care system and the private sector Medicare health maintenance organization (HMO) patients. A cross-sectional study design compared administrative pharmacy claims from 10 distinct geographic regions in the United States in the VA health care system and 10 analogous regions for patients enrolled in Medicare HMOs. The cohorts included 123,633 VA and 157,517 Medicare HMO patients aged 65 years and older. Inappropriate medication use was identified using the Zhan modification of the Beers criteria, which categorizes 33 potentially inappropriate drugs into 3 major classifications: "always avoid," "rarely appropriate," and "some indications." Comparisons between the VA health care system and the private sector Medicare HMO were performed for overall differences and stratified by gender and age. The drug formulary status of the Zhan-criteria drugs was known for the VA health system but not for the Medicare HMO patients. Compared with private sector patients, VA patients were less likely to receive any inappropriate medication (21% vs. 29%, P private sector for males (21% vs. 24%, P private sector Medicare HMOs, elderly VA patients were less likely to receive medications defined by the Zhan criteria as potentially inappropriate. A restrictive formulary that excludes 12 of the 33 Zhan criteria drugs may be a factor in the reduction of undesired prescribing patterns in elderly populations.

  9. US veterans use vitamins and supplements as substitutes for prescription medication.

    Science.gov (United States)

    Goldstein, Jennifer N; Long, Judith A; Arevalo, Doris; Ibrahim, Said A; Mao, Jun J

    2014-12-01

    Vitamins and supplements are the most commonly used form of complementary and alternative medicine in the United States. Growing research suggests that patients substitute vitamins and supplements for their prescription medications. The reasons might include cost of prescription medications and discordant patient and doctor health belief systems. To investigate the prevalence of substitution of vitamins and supplements for prescription medications among veterans who receive care in the VA health care system and whether substitution is associated with prescription rationing due to cost, treatment beliefs, or distrust of the health system. Cross-sectional observational survey. Primary care patients (n=275) at the Philadelphia VA Medical Center. Medication substitution, prescription medication rationing, treatment beliefs, and health system distrust were measured with structured instruments. Multivariate logistic regression was performed with substitution as the dependent variable. A significant number of primary care patients in the VA system use vitamins and supplements 206 (75%). The prevalence of medication substitution is high 48 (18%). Medication substitution is strongly associated with prescription rationing due to cost (adjusted odds ratio 6.3, 95% confidence interval: 2.0-19.5, P=0.001). Similarly, greater belief in complementary and alternative approaches to care positively predicts medication substitution (adjusted odds ratio 1.08, 95% confidence interval: 1.01-1.15, P=0.011). There is no significant association between health system distrust and likelihood of medication substitution. Medication substitution is prevalent in this sample of inner city primary care patients who receive care in the VA system. Cost of prescriptions and belief in the value of complementary and alternative approaches to care appear to be associated with this patient-driven treatment decision.

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

    Science.gov (United States)

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

    2014-07-01

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

  11. Has the VA Become a White Elephant?

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2016-11-01

    Full Text Available No abstract available. Article truncated at 150 words. As I write this Dennis Wagner is publishing a series of articles in the Arizona Republic describing his quest to find out if care at VA hospitals have improved over the last 2 years (1. To begin the article Wagner describes the fable of the King of Siam who presented albino pachyderms to his enemies knowing they would be bankrupted because the cost of food and care outweighed all usefulness. A modern expression derives from this parable: the white elephant. The Department of Veterans Affairs (VA has prided itself on being a leader in healthcare. It is the largest healthcare system in the US, implemented the first electronic medical record, and more than 70 percent of all US doctors have received training in the VA healthcare system (2. This year the VA is celebrating the 70th anniversary of its partnership with US medical schools. Beginning in 1946, the VA partnered ...

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

    Science.gov (United States)

    Cosio, David; Lin, Erica H

    2015-06-01

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

  13. Accessing VA Healthcare During Large-Scale Natural Disasters.

    Science.gov (United States)

    Der-Martirosian, Claudia; Pinnock, Laura; Dobalian, Aram

    2017-01-01

    Natural disasters can lead to the closure of medical facilities including the Veterans Affairs (VA), thus impacting access to healthcare for U.S. military veteran VA users. We examined the characteristics of VA patients who reported having difficulty accessing care if their usual source of VA care was closed because of natural disasters. A total of 2,264 veteran VA users living in the U.S. northeast region participated in a 2015 cross-sectional representative survey. The study used VA administrative data in a complex stratified survey design with a multimode approach. A total of 36% of veteran VA users reported having difficulty accessing care elsewhere, negatively impacting the functionally impaired and lower income VA patients.

  14. Molecular Analysis Research at Community College of Philadelphia

    Science.gov (United States)

    2015-09-21

    YOUR FORM TO THE ABOVE ADDRESS. Community College of Philadelphia Community College of Philadelphia 1700 Spring Garden Street Philadelphia, PA 19130...Approved for Public Release; Distribution Unlimited Final Report: Molecular Analysis Research at Community College of Philadelphia The views, opinions...Molecular Analysis Research at Community College of Philadelphia Report Title AXIMA Assurance mass spectrometer, Leica DMI-8 fluorescent microscope

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

    Directory of Open Access Journals (Sweden)

    Erin K Nichols

    2018-01-01

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

  16. The Philadelphia Glaucoma Detection and Treatment Project

    Science.gov (United States)

    Waisbourd, Michael; Pruzan, Noelle L.; Johnson, Deiana; Ugorets, Angela; Crews, John E.; Saaddine, Jinan B.; Henderer, Jeffery D.; Hark, Lisa A.; Katz, L. Jay

    2016-01-01

    Purpose To evaluate the detection rates of glaucoma-related diagnoses and the initial treatments received in the Philadelphia Glaucoma Detection and Treatment Project, a community-based initiative aimed at improving the detection, treatment, and follow-up care of individuals at risk for glaucoma. Design Retrospective analysis. Participants A total of 1649 individuals at risk for glaucoma who were examined and treated in 43 community centers located in underserved communities of Philadelphia. Methods Individuals were enrolled if they were African American aged ≥50 years, were any other adult aged ≥60 years, or had a family history of glaucoma. After attending an informational glaucoma workshop, participants underwent a targeted glaucoma examination including an ocular, medical, and family history; visual acuity testing, intraocular pressure (IOP) measurement, and corneal pachymetry; slit-lamp and optic nerve examination; automated visual field testing; and fundus color photography. If indicated, treatments included selective laser trabeculoplasty (SLT), laser peripheral iridotomy (LPI), or IOP-lowering medications. Follow-up examinations were scheduled at the community sites after 4 to 6 weeks or 4 to 6 months, depending on the clinical scenario. Main Outcome Measures Detection rates of glaucoma-related diagnoses and types of treatments administered. Results Of the 1649 individuals enrolled, 645 (39.1%) received a glaucoma-related diagnosis; 20.0% (n = 330) were identified as open-angle glaucoma (OAG) suspects, 9.2% (n = 151) were identified as having narrow angles (or as a primary angle closure/suspect), and 10.0% (n = 164) were diagnosed with glaucoma, including 9.0% (n = 148) with OAG and 1.0% (n = 16) with angle-closure glaucoma. Overall, 39.0% (n = 64 of 164) of those diagnosed with glaucoma were unaware of their diagnosis. A total of 196 patients (11.9%) received glaucoma-related treatment, including 84 (5.1%) who underwent LPI, 13 (0.8%) who underwent SLT

  17. Undergraduate Program: Philadelphia

    Science.gov (United States)

    Betsock, Lori

    2008-08-01

    Undergraduate chemical science students—join us in Philadelphia on August 17 and 18, 2008, for an educational and career-oriented program designed specifically for you. Attend symposia about global climate change and clean energy; hear Nobel Laureate F. Sherwood Rowland speak about his fascinating career, "A Life in Tracer Chemistry". Weigh options for your future by attending the Graduate School Reality Check and graduate school recruiting events. All events will take place in the Sheraton Philadelphia City Center at 17th and Race Streets, except the Undergraduate Poster Sessions and Sci-Mix, which will be held in the Pennsylvania Convention Center.

  18. Patient deaths blamed on long waits at the Phoenix VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-04-01

    Full Text Available No abstract available. Article truncated at 150 words. This morning the lead article in the Arizona Republic was a report blaming as many as 40 deaths at the Phoenix VA on long waits (1. Yesterday, Rep. Jeff Miller, the chairman of the House Committee on Veterans Affairs, held a hearing titled “A Continued Assessment of Delays in VA Medical Care and Preventable Veteran Deaths.” “It appears as though there could be as many as 40 veterans whose deaths could be related to delays in care,” Miller announced to a stunned audience. The committee has spent months investigating patient-care scandals and allegations at VA facilities in Pittsburgh, Atlanta, Miami and other cities. said that dozens of VA hospital patients in Phoenix may have died while awaiting medical care. He went on to say that staff investigators have evidence that the Phoenix VA Health Care System keeps two sets of records to conceal prolonged waits that patients must endure for ...

  19. African Diaspora Movement Arts in Philadelphia: A Beginning Resource List. Philadelphia Folklore Project Working Papers #10.

    Science.gov (United States)

    Brown-Danquah, Benita Binta

    This guide provides history, format, contact names, addresses, and phone numbers of some African dance and African American marching units in Philadelphia (Pennsylvania). The working papers are divided into two categories. "Part One: Movements of African Dance in Philadelphia" begins with a sensitive, detailed explanation of the…

  20. VA Vascular Injury Study (VAVIS): VA-DoD extremity injury outcomes collaboration.

    Science.gov (United States)

    Shireman, Paula K; Rasmussen, Todd E; Jaramillo, Carlos A; Pugh, Mary Jo

    2015-02-03

    Limb injuries comprise 50-60% of U.S. Service member's casualties of wars in Afghanistan and Iraq. Combat-related vascular injuries are present in 12% of this cohort, a rate 5 times higher than in prior wars. Improvements in medical and surgical trauma care, including initial in-theatre limb salvage approaches (IILS) have resulted in improved survival and fewer amputations, however, the long-term outcomes such as morbidity, functional decline, and risk for late amputation of salvaged limbs using current process of care have not been studied. The long-term care of these injured warfighters poses a significant challenge to the Department of Defense (DoD) and Department of Veterans Affairs (VA). The VA Vascular Injury Study (VAVIS): VA-DoD Extremity Injury Outcomes Collaborative, funded by the VA, Health Services Research and Development Service, is a longitudinal cohort study of Veterans with vascular extremity injuries. Enrollment will begin April, 2015 and continue for 3 years. Individuals with a validated extremity vascular injury in the Department of Defense Trauma Registry will be contacted and will complete a set of validated demographic, social, behavioral, and functional status measures during interview and online/ mailed survey. Primary outcome measures will: 1) Compare injury, demographic and geospatial characteristics of patients with IILS and identify late vascular surgery related limb complications and health care utilization in Veterans receiving VA vs. non-VA care, 2) Characterize the preventive services received by individuals with vascular repair and related outcomes, and 3) Describe patient-reported functional outcomes in Veterans with traumatic vascular limb injuries. This study will provide key information about the current process of care for Active Duty Service members and Veterans with polytrauma/vascular injuries at risk for persistent morbidity and late amputation. The results of this study will be the first step for clinicians in VA and

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

    Science.gov (United States)

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

    2017-11-01

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

  2. Building capacity in VA to provide emergency gynecology services for women.

    Science.gov (United States)

    Cordasco, Kristina M; Huynh, Alexis K; Zephyrin, Laurie; Hamilton, Alison B; Lau-Herzberg, Amy E; Kessler, Chad S; Yano, Elizabeth M

    2015-04-01

    Visits to Veterans Administration (VA) emergency departments (EDs) are increasingly being made by women. A 2011 national inventory of VA emergency services for women revealed that many EDs have gaps in their resources and processes for gynecologic emergency care. To guide VA in addressing these gaps, we sought to understand factors acting as facilitators and/or barriers to improving VA ED capacity for, and quality of, emergency gynecology care. Semistructured interviews with VA emergency and women's health key informants. ED directors/providers (n=14), ED nurse managers (n=13), and Women Veteran Program Managers (n=13) in 13 VA facilities. Leadership, staff, space, demand, funding, policies, and community were noted as important factors influencing VA EDs building capacity and improving emergency gynecologic care for women Veterans. These factors are intertwined and cross multiple organizational levels so that each ED's capacity is a reflection not only of its own factors, but also those of its local medical center and non-VA community context as well as VA regional and national trends and policies. Policies and quality improvement initiatives aimed at building VA's emergency gynecologic services for women need to be multifactorial and aimed at multiple organizational levels. Policies need to be flexible to account for wide variations across EDs and their medical center and community contexts. Approaches that build and encourage local leadership engagement, such as evidence-based quality improvement methodology, are likely to be most effective.

  3. Comprehensive District Reform: Philadelphia's Grand Experiment.

    Science.gov (United States)

    Useem, Elizabeth; Balfanz, Robert

    2002-01-01

    This report describes "Philadelphia's Grand Experiment" in comprehensive school district reform, from its conception through its initial months of implementation. In 2001, as part of the remedy for low student performance, the governor ordered the state to take over governance of the Philadelphia School District, with a substantial…

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

    Directory of Open Access Journals (Sweden)

    P. A. Ivanov

    2017-01-01

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

  5. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for Department of Veterans Affairs. James J. Peters VA Medical Center, Bronx, NY

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    Schey, Stephen [Intertek Testing Services, North America, Phoenix, AZ (United States); Francfort, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-10-01

    This report focuses on the Department of Veterans Affairs, James J. Peters VA Medical Center (VA - Bronx) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of PEVs into the agencies’ fleets. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (collectively referred to as PEVs) can fulfill the mission requirements.

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

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2013-03-01

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

  7. VA Health Care: VA Spends Millions on Post-Traumatic Stress Disorder Research and Incorporates Research Outcomes into Guidelines and Policy for Post-Traumatic Stress Disorder Services

    Science.gov (United States)

    2011-01-01

    post - traumatic stress disorder ( PTSD ) and...Veterans Affairs (VA) Intramural Post - Traumatic Stress Disorder ( PTSD ) Research Funding and VA’s Medical and Prosthetic Research Appropriation...Table 6: Department of Veterans Affairs (VA) Research Centers and Programs That Conduct or Support Post - Traumatic Stress Disorder ( PTSD ) Research

  8. Promoting good health in the age of reform: the medical publications of Henry H. Porter of Philadelphia, 1829-32.

    Science.gov (United States)

    Horrocks, T A

    1995-01-01

    In the early 1830s, the Philadelphia publisher Henry H. Porter rapidly published five journals, six books, and an almanac, works having a particular emphasis on health and personal hygiene. Porter's health publications linked the traditional message about the importance of personal hygiene to health to the messages conveyed by the flourishing American reform movements at the time, and his Journal of Health was among the first American medically oriented periodicals published for the layperson. Yet Porter did not survive in the intensely competitive and financially unstable book trade. This study examines Porter's health publications, attempting to explain why he chose to publish what he did, the message(s) his works contained, the audience(s) he tried to reach, and the failure of his business.

  9. Systems innovation model: an integrated interdisciplinary team approach pre- and post-bariatric surgery at a veterans affairs (VA) medical center.

    Science.gov (United States)

    Eisenberg, Dan; Lohnberg, Jessica A; Kubat, Eric P; Bates, Cheryl C; Greenberg, Lauren M; Frayne, Susan M

    2017-04-01

    Provision of bariatric surgery in the Veterans Health Administration must account for obese veterans' co-morbidity burden and the geographically dispersed location of patients relative to Veterans Affairs (VA) bariatric centers. To evaluate a collaborative, integrated, interdisciplinary bariatric team of surgeons, bariatricians, psychologists, dieticians, and physical therapists working in a hub-and-spokes care model, for pre- and post-bariatric surgery assessment and management. This is a description of an interdisciplinary clinic and bariatric program at a VA healthcare system and a report on program evaluation findings. Retrospective data of a prospective database was abstracted. For program evaluation, we abstracted charts to characterize patient data and conducted a patient survey. Since 2009, 181 veterans have undergone bariatric surgery. Referrals came from 7 western U.S. states. Mean preoperative body mass index was 46 kg/m 2 (maximum 71). Mean age was 53 years, with 33% aged>60 years; 79% were male. Medical co-morbidity included diabetes (70%), hypertension (85%), and lower back or extremity joint pain (84%). A psychiatric diagnosis was present in 58%. At 12 months, follow-up was 81% and percent excess body mass index loss was 50.5%. Among 54 sequential clinic patients completing anonymous surveys, overall satisfaction with the interdisciplinary team approach and improved quality of life were high (98% and 94%, respectively). The integrated, interdisciplinary team approach using a hub-and-spokes model is well suited to the VA bariatric surgery population, with its heavy burden of medical and mental health co-morbidity and its system of geographically dispersed patients receiving treatment at specialty centers. As the VA seeks to expand the use of bariatric surgery as an option for obese veterans, interdisciplinary models crafted to address case complexity, care coordination, and long-term outcomes should be part of policy planning efforts. Published by

  10. Gout Self-Management in African American Veterans: A Qualitative Exploration of Challenges and Solutions From Patients' Perspectives.

    Science.gov (United States)

    Singh, Jasvinder A; Herbey, Ivan; Bharat, Aseem; Dinnella, Janet E; Pullman-Mooar, Sally; Eisen, Seth; Ivankova, Nataliya

    2017-11-01

    To explore gout self-management and associated challenges and solutions in African Americans. We conducted semistructured interviews with 35 African American veterans with gout, who received health care at Birmingham or Philadelphia Veterans Affairs (VA) medical centers, had filled urate-lowering therapy (ULT; most commonly allopurinol) for at least 6 months, and had a ULT medication possession ratio ≥80%. The interview protocol was constructed to explore key concepts related to gout self-management, including initial diagnosis of gout, beginning medical care for gout, the course of the gout, ULT medication adherence, dietary strategies, comorbidity and side effects, and social support. Thirty-five African American male veterans with gout who had ≥80% ULT adherence (most commonly, allopurinol) were interviewed at Birmingham (n = 18) or Philadelphia (n = 17) VA medical centers. Mean age was 65 years, mean body mass index was 31.9 kg/m 2 , 97% had hypertension, 23% had coronary artery disease, and 31% had renal failure. The main themes motivating African American veterans to better gout self-management were fear of pain, adherence to medications, self-discipline, lifestyle changes, information gathering, and developing a positive outlook. Birmingham participants more frequently revealed skipping gout medications. More Philadelphia participants discussed lifestyle/diet changes to prevent gout flares, indicated limiting social activities that involved drinking, and sought more information about gout self-management from health care providers and internet sources. Identified themes, including cultural differences by site, led to the development of a patient-centered intervention to improve gout self-management in African American men with gout. © 2017, American College of Rheumatology.

  11. The impact of the Department of Veterans Affairs Health Care Personnel Enhancement Act of 2004 on VA physicians' salaries and retention.

    Science.gov (United States)

    Weeks, William B; Wallace, Tanner A; Wallace, Amy E

    2009-01-01

    To determine whether the Department of Veterans Affairs Health Care Personnel Enhancement Act (the Act), which was designed to achieve VA physician salary parity with American Academy of Medical Colleges (AAMC) Associate Professors and enacted in 2006, had achieved its goal. Using VA human resources datasets and data from the AAMC, we calculated mean VA physician salaries, with 95 percent confidence intervals, for 15 different medical specialties. For each specialty, we compared VA salaries to the median, 25th, and 75th percentile of AAMC Associate Professors' incomes. The Act's passage resulted in a $20,000 annual increase in VA physicians' salaries. VA primary care physicians, medical subspecialists, and psychiatrists had salaries that were comparable to their AAMC counterparts prior to and after enactment of the Act. However, VA surgical specialists', anesthesiologists', and radiologists' salaries lagged their AAMC counterparts both before and after the Act's enactment. Income increases were negatively correlated with full-time workforce changes. VA does not appear to provide comparable salaries for physicians necessary for surgical care. In certain cases, VA should consider outsourcing surgical services.

  12. Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers.

    Science.gov (United States)

    Wang, Virginia; Maciejewski, Matthew L; Patel, Uptal D; Stechuchak, Karen M; Hynes, Denise M; Weinberger, Morris

    2013-01-18

    Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA), requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1) VA, (2) VA-outsourced settings, or (3) both ("dual") settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans' baseline dialysis date. Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48%) were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. VA expenditures for "buying" outsourced dialysis are high and increasing relative to "making" dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans' access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services.

  13. Enhancing Cross-Cultural Collaboration between DoD and VA

    Science.gov (United States)

    2012-04-27

    Philadelphia. In 1853 and 1855, the Soldiers Home and St. Elizabeth’s Hospital followed in Washington, DC. In 1866, Congress established the National Homes...veterans. The quality of medical care at these homes improved until it was comparable to hospital care of that day. In 1862, the National Cemetery...Evaluation System WG Pain Management WG DoD Recovery Coordination Program ( RCP )* Federal Recovery Coordination Program (FRCP)* * Programs with JEC

  14. Maximizing Green Infrastructure in a Philadelphia Neighborhood

    OpenAIRE

    Kate Zidar; Timothy A. Bartrand; Charles H. Loomis; Chariss A. McAfee; Juliet M. Geldi; Gavin J. Rigall; Franco Montalto

    2017-01-01

    While the Philadelphia Water Department (PWD) is counting on Green Stormwater Infrastructure (GI) as a key component of its long-term plan for reducing combined sewer overflows, many community stakeholders are also hoping that investment in greening can help meet other ancillary goals, collectively referred to as sustainable redevelopment. This study investigates the challenges associated with implementation of GI in Point Breeze, a residential neighborhood of South Philadelphia. The project ...

  15. Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers

    Directory of Open Access Journals (Sweden)

    Wang Virginia

    2013-01-01

    Full Text Available Abstract Background Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA, requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. Methods We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1 VA, (2 VA-outsourced settings, or (3 both (“dual” settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans’ baseline dialysis date. Results Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48% were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. Conclusions VA expenditures for “buying” outsourced dialysis are high and increasing relative to “making” dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans’ access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services.

  16. (Dis)empowerment: The Implementation of Corrective Mathematics in Philadelphia Empowerment Schools

    Science.gov (United States)

    Connor, Hannah

    2011-01-01

    The need to improve math education around the country has been well documented, especially in urban school systems like Philadelphia. In Spring 2010, only 56.6% of students in Philadelphia Public schools scored proficient or advanced on the Pennsylvania State Standardized Assessment (PSSA). In Philadelphia Empowerment Schools, the 107 lowest…

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

    International Nuclear Information System (INIS)

    Ramon, Javier; Pena, Jorge

    2002-01-01

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

  18. Making Health Easier: Active Living in Philadelphia, PA PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    Making communities bike-friendly can help reduce traffic congestion and increase the physical activity of residents. Learn how one Philadelphia resident worked with his community to make Philadelphia a more bike-friendly city.

  19. Improving Access to Eye Care among Persons at High-Risk of Glaucoma in Philadelphia--Design and Methodology: The Philadelphia Glaucoma Detection and Treatment Project.

    Science.gov (United States)

    Hark, Lisa; Waisbourd, Michael; Myers, Jonathan S; Henderer, Jeffrey; Crews, John E; Saaddine, Jinan B; Molineaux, Jeanne; Johnson, Deiana; Sembhi, Harjeet; Stratford, Shayla; Suleiman, Ayman; Pizzi, Laura; Spaeth, George L; Katz, L Jay

    2016-01-01

    The Wills Eye Glaucoma Research Center initiated a 2-year demonstration project to develop and implement a community-based intervention to improve detection and management of glaucoma in Philadelphia. The glaucoma detection examination consisted of: ocular, medical, and family history; visual acuity testing; corneal pachymetry; biomicroscopy of the anterior segment; intraocular pressure (IOP) measurement; gonioscopy; funduscopy; automated visual field testing; and fundus-color photography. Treatment included laser surgery and/or IOP-lowering medication. A cost analysis was conducted to understand resource requirements. Outcome measures included; prevalence of glaucoma-related pathology and other eye diseases among high-risk populations; the impact of educational workshops on level of knowledge about glaucoma (assessed by pre- and post-test evaluation); and patient satisfaction of the glaucoma detection examinations in the community (assessed by satisfaction survey). Treatment outcome measures were change in IOP at 4-6 weeks and 4-6 months following selective laser trabeculoplasty treatment, deepening of the anterior chamber angle following laser-peripheral iridotomy treatment, and rate of adherence to recommended follow-up examinations. Cost outcomes included total program costs, cost per case of glaucoma detected, and cost per case of ocular disease detected. This project enrolled 1649 participants (African Americans aged 50+ years, adults 60+ years and individuals with a family history of glaucoma). A total of 1074 individuals attended a glaucoma educational workshop and 1508 scheduled glaucoma detection examination appointments in the community setting. The Philadelphia Glaucoma Detection and Treatment Project aimed to improve access and use of eye care and to provide a model for a targeted community-based glaucoma program.

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

    Science.gov (United States)

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

    2003-06-01

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

  1. Philadelphia and the Tomato.

    Science.gov (United States)

    Smith, Andrew F.; Kling, Tatiana

    This booklet describes for elementary students the many contributions of people, traveling many places, over many years to bring the tomato to Philadelphia. The booklet includes the following: (1) "Introduction to the Tomato"; (2) "Where Does the Tomato Come From?"; (3) "The Spanish Tomato"; (4) "The Philadelphia…

  2. Elements of team-based care in a patient-centered medical home are associated with lower burnout among VA primary care employees.

    Science.gov (United States)

    Helfrich, Christian D; Dolan, Emily D; Simonetti, Joseph; Reid, Robert J; Joos, Sandra; Wakefield, Bonnie J; Schectman, Gordon; Stark, Richard; Fihn, Stephan D; Harvey, Henry B; Nelson, Karin

    2014-07-01

    A high proportion of the US primary care workforce reports burnout, which is associated with negative consequences for clinicians and patients. Many protective factors from burnout are characteristics of patient-centered medical home (PCMH) models, though even positive organizational transformation is often stressful. The existing literature on the effects of PCMH on burnout is limited, with most findings based on small-scale demonstration projects with data collected only among physicians, and the results are mixed. To determine if components of PCMH related to team-based care were associated with lower burnout among primary care team members participating in a national medical home transformation, the VA Patient Aligned Care Team (PACT). Web-based, cross-sectional survey and administrative data from May 2012. A total of 4,539 VA primary care personnel from 588 VA primary care clinics. The dependent variable was burnout, and the independent variables were measures of team-based care: team functioning, time spent in huddles, team staffing, delegation of clinical responsibilities, working to top of competency, and collective self-efficacy. We also included administrative measures of workload and patient comorbidity. Overall, 39 % of respondents reported burnout. Participatory decision making (OR 0.65, 95 % CI 0.57, 0.74) and having a fully staffed PACT (OR 0.79, 95 % CI 0.68, 0.93) were associated with lower burnout, while being assigned to a PACT (OR 1.46, 95 % CI 1.11, 1.93), spending time on work someone with less training could do (OR 1.29, 95 % CI 1.07, 1.57) and a stressful, fast-moving work environment (OR 4.33, 95 % CI 3.78, 4.96) were associated with higher burnout. Longer tenure and occupation were also correlated with burnout. Lower burnout may be achieved by medical home models that are appropriately staffed, emphasize participatory decision making, and increase the proportion of time team members spend working to the top of their competency level.

  3. VA Library Service--Today's look at Tomorrow's Library.

    Science.gov (United States)

    Veterans Administration, Washington, DC.

    The Conference Poceedings are divided into three broad topics: systems planning, audiovisuals in biomedical communication, and automation and networking. Speakers from within the Veterans Administration (VA), from the National Medical Audiovisual Center, and the Lister Hill National Center for Biomedical Communications, National Library of…

  4. 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…

  5. Comparing VA and private sector healthcare costs for end-stage renal disease.

    Science.gov (United States)

    Hynes, Denise M; Stroupe, Kevin T; Fischer, Michael J; Reda, Domenic J; Manning, Willard; Browning, Margaret M; Huo, Zhiping; Saban, Karen; Kaufman, James S

    2012-02-01

    Healthcare for end-stage renal disease (ESRD) is intensive, expensive, and provided in both the public and private sector. Using a societal perspective, we examined healthcare costs and health outcomes for Department of Veterans Affairs (VA) ESRD patients comparing those who received hemodialysis care at VA versus private sector facilities. Dialysis patients were recruited from 8 VA medical centers from 2001 through 2003 and followed for 12 months in a prospective cohort study. Patient demographics, clinical characteristics, quality of life, healthcare use, and cost data were collected. Healthcare data included utilization (VA), claims (Medicare), and patient self-report. Costs included VA calculated costs, Medicare dialysis facility reports and reimbursement rates, and patient self-report. Multivariable regression was used to compare costs between patients receiving dialysis at VA versus private sector facilities. The cohort comprised 334 patients: 170 patients in the VA dialysis group and 164 patients in the private sector group. The VA dialysis group had more comorbidities at baseline, outpatient and emergency visits, prescriptions, and longer hospital stays; they also had more conservative anemia management and lower baseline urea reduction ratio (67% vs. 72%; Pprivate sector dialysis group (Pprivate sector settings is critical in informing health policy options for patients with complex chronic illnesses such as ESRD.

  6. The long road back for a reborn Philadelphia Electric

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    On 31 March 1987, the US NRC ordered Philadelphia Electric to shut down its Peach Bottom BWR station because of operator inattentiveness. Since then Philadelphia Electric has undergone the most complete transformation of corporate and nuclear management of any US utility. Everyone in direct line supervision was replaced, from the chairman of the board down to shift supervisors. Nuclear operations were completely reorganized and a dedicated nuclear group formed. Procedures were rewritten and operator training and career development upgraded. Plant maintenance and housekeeping have been raised to new levels of excellence. It has been a long road back for Philadelphia Electric. But all major goals are now being met and a corporate culture is being developed focused on excellence in nuclear operations. (author)

  7. School Closings in Philadelphia

    Science.gov (United States)

    Jack, James; Sludden, John

    2013-01-01

    In 2012, the School District of Philadelphia closed six schools. In 2013, it closed 24. The closure of 30 schools has occurred amid a financial crisis, headlined by the district's $1.35 billion deficit. School closures are one piece of the district's plan to cut expenditures and close its budget gap. The closures are also intended to make…

  8. Comparing Catheter-associated Urinary Tract Infection Prevention Programs Between VA and Non-VA Nursing Homes

    Science.gov (United States)

    Mody, Lona; Greene, M. Todd; Saint, Sanjay; Meddings, Jennifer; Trautner, Barbara W.; Wald, Heidi L.; Crnich, Christopher; Banaszak-Holl, Jane; McNamara, Sara E.; King, Beth J.; Hogikyan, Robert; Edson, Barbara; Krein, Sarah L.

    2018-01-01

    OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that U.S. Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the “AHRQ Safety Program for Long-term Care” collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention. RESULTS A total of 353 (71%; 47 VA, 306 non-VA) of 494 nursing homes from 41 states responded. VA nursing homes reported more hours/week devoted to infection prevention-related activities (31 vs. 12 hours, P<.001), and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs. 66%, P<.001), sharing CAUTI data with leadership (94% vs. 70%, P=.014) and nursing personnel (85% vs. 56%, P=.003). However, fewer VA nursing homes reported having policies for appropriate catheter use (64% vs. 81%, P=.004) and catheter insertion (83% vs. 94%, P=.004). CONCLUSIONS Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems. PMID:27917728

  9. Improving Access to Eye Care among Persons at High-Risk of Glaucoma in Philadelphia — Design and Methodology: The Philadelphia Glaucoma Detection and Treatment Project

    Science.gov (United States)

    Myers, Jonathan S.; Henderer, Jeffrey; Crews, John E.; Saaddine, Jinan B.; Molineaux, Jeanne; Johnson, Deiana; Sembhi, Harjeet; Stratford, Shayla; Suleiman, Ayman; Pizzi, Laura; Spaeth, George L.; Katz, L. Jay

    2016-01-01

    Purpose The Wills Eye Glaucoma Research Center initiated a 2-year demonstration project to develop and implement a community-based intervention to improve detection and management of glaucoma in Philadelphia. Methods The glaucoma detection examination consisted of: ocular, medical, and family history; visual acuity testing; corneal pachymetry; biomicroscopy of the anterior segment; intraocular pressure (IOP) measurement; gonioscopy; funduscopy; automated visual field testing; and fundus-color photography. Treatment included laser surgery and/or IOP-lowering medication. A cost analysis was conducted to understand resource requirements. Outcome measures included; prevalence of glaucoma-related pathology and other eye diseases among high-risk populations; the impact of educational workshops on level of knowledge about glaucoma (assessed by pre- and post-test evaluation); and patient satisfaction of the glaucoma detection examinations in the community (assessed by satisfaction survey). Treatment outcome measures were change in IOP at 4–6 weeks and 4–6 months following selective laser trabeculoplasty treatment, deepening of the anterior chamber angle following laser-peripheral iridotomy treatment, and rate of adherence to recommended follow-up examinations. Cost outcomes included total program costs, cost per case of glaucoma detected, and cost per case of ocular disease detected. Results This project enrolled 1649 participants (African Americans aged 50+ years, adults 60+ years and individuals with a family history of glaucoma). A total of 1074 individuals attended a glaucoma educational workshop and 1508 scheduled glaucoma detection examination appointments in the community setting. Conclusions The Philadelphia Glaucoma Detection and Treatment Project aimed to improve access and use of eye care and to provide a model for a targeted community-based glaucoma program. PMID:26950056

  10. Time's Up: Applying Teacher Management Skills to Solving Philadelphia's Problems

    Science.gov (United States)

    Lax, Zach

    2013-01-01

    Teachers are natural problem solvers, and they should be using this quality to their advantage when it comes to solving the systemic issues that plague Philadelphia's education system. Many of the articles in this issue have already gone into great detail about what is happening in Philadelphia. Torch Lytle has provided a summary of the recent…

  11. Making Health Easier: Active Living in Philadelphia, PA PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-06-07

    Making communities bike-friendly can help reduce traffic congestion and increase the physical activity of residents. Learn how one Philadelphia resident worked with his community to make Philadelphia a more bike-friendly city.  Created: 6/7/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/7/2013.

  12. 75 FR 78806 - Agency Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Science.gov (United States)

    2010-12-16

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt.... 2900-0474.'' SUPPLEMENTARY INFORMATION: Title: Create Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt, VA Form 26-8986. OMB Control Number: 2900...

  13. 38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

    Science.gov (United States)

    2010-07-01

    ... for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17.1000 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment Or Reimbursement for Emergency Services for Nonservice-Connected Conditions in Non-Va Facilities § 17.1000 Payment...

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

    Science.gov (United States)

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

    2017-08-25

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

  15. The Geometric-VaR Backtesting Method

    DEFF Research Database (Denmark)

    Wei, Wei; Pelletier, Denis

    2014-01-01

    This paper develops a new test to evaluate Value af Risk (VaR) forecasts. VaR is a standard risk measure widely utilized by financial institutions and regulators, yet estimating VaR is a challenging problem, and popular VaR forecast relies on unrealistic assumptions. Hence, assessing...

  16. Training medical students in the social determinants of health: the Health Scholars Program at Puentes de Salud

    Directory of Open Access Journals (Sweden)

    O’Brien MJ

    2014-09-01

    Full Text Available Matthew J O’Brien,1–4 Joseph M Garland,4,5 Katie M Murphy,4,6,7 Sarah J Shuman,3,4 Robert C Whitaker,1,3,8 Steven C Larson4,9 1Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA; 2Department of Medicine, Section of General Internal Medicine, Temple University of Medicine, Philadelphia, PA, USA; 3Department of Public Health, Temple University, Philadelphia, PA, USA; 4Puentes de Salud Health Center, Philadelphia, PA, USA; 5Department of Medicine, Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 6Master of Public Health Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 7Graduate School of Education, University of Pennsylvania, Philadelphia, PA, USA; 8Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA, USA; 9Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Purpose: Given the large influence of social conditions on health, physicians may be more effective if they are trained to identify and address social factors that impact health. Despite increasing interest in teaching the social determinants of health in undergraduate medical education, few models exist. Participants and methods: We present a 9-month pilot course on the social determinants of health for medical and other health professional students, which is based at Puentes de Salud, Philadelphia, PA, USA, a community health center serving a Latino immigrant population. This service-learning course, called the Health Scholars Program (HSP, was developed and implemented by volunteer medical and public health faculty in partnership with the community-based clinic. The HSP curriculum combines didactic instruction with service experiences at Puentes de Salud and opportunities for critical reflection. The HSP curriculum also includes a longitudinal project where

  17. 78 FR 59771 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Science.gov (United States)

    2013-09-27

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); a Computer Generated Funding Fee Receipt.... Title: Create Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated... through the Federal Docket Management System (FDMS) at www.Regulations.gov or to Nancy J. Kessinger...

  18. 75 FR 61252 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Science.gov (United States)

    2010-10-04

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... information through the Federal Docket Management System (FDMS) at http://www.Regulations.gov or to Nancy J...

  19. 75 FR 61859 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Science.gov (United States)

    2010-10-06

    ... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... Payment Request for the VA Funding Fee Payment System (VA FFPS); A Computer Generated Funding Fee Receipt... information through the Federal Docket Management System (FDMS) at http://www.Regulations.gov or to Nancy J...

  20. Treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia.

    Science.gov (United States)

    Milone, Jorge H; Enrico, Alicia

    2009-12-01

    The presence of the Philadelphia chromosome is a poor prognosis factor in acute lymphoblastic leukemia (ALL), in both children and adults. Using molecular techniques of the gen bcr/abl, it is possible to detect the abnormality, in up to the 40% of adult patients. The unsatisfactory results with conventional chemotherapy schemes have determined the intensification of the treatments and the consideration of allogenic bone marrow transplants as the best therapeutic instance. The development of tyrosine kinase inhibitors have become a therapeutic improvement in the treatment of Philadelphia chromosome-positive ALL, being combined with chemotherapy schemes, only in a selected group of patients, even in therapeutic programs that include transplant.

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

    Science.gov (United States)

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

    2016-03-15

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

  2. Philadelphia's community based drug abuse program: broader medical and social concepts.

    Science.gov (United States)

    Schut, J

    1975-06-01

    The rehabilitation of drug dependent people has undergone drastic changes since first attempts were made to curb the abuse of illegal drugs. The isolated law-enforcement model proved to be of no use in this area. So, too, the medical model, the psychological model and the public health model proved disappointingly low in their results. During the last ten years, a so-called "metabolic replacement model" has had its upsurge, creating a controversy still under discussion. The Drug Abuse Rehabilitation Programs of the West Philadelphia Community Mental Health Consortium, Inc. have been in the forefront with its treatment models. Established in 1968 as a purely methadone maintenance program, it has evolved into becoming a model, applying community mental health principles. This paper will explore this model further, describing the mechanics of its changes. From a municipal hospital-based methadone dispensing station, the program has developed into a multi-modality project. Three decentralized drug-free outpatient services are located in the midst of the community where the drug abuse problem is more accute. Outreach is emphasized and case-funding is applied. A possibly unique river-front motel was just acquired for the development of a community-based treatment modality. The 94 rooms were converted into a first-floor alcoholism program which also has a "highway safety program" and an intermediate care facility for alcoholics. The second floor of this facility contains outpatient services for the treatment of drug addicts, including a methadone maintenance program, counselling, family therapy and group therapy. The place where most of the emphasis has been placed is the Work Rehabilitation Center (a novel approach whereby patients will spend up to six hours in "partial hospitalization"). Clients will be tested for vocational aptitude and four workshops will be developed on the premises - carpentry, automotive, electricity and clerical. A huge cafeteria with a semi

  3. The urban forests of Philadelphia

    Science.gov (United States)

    David J. Nowak; Allison R. Bodine; Robert Hoehn; Alexis Ellis; Sarah C. Low; Lara A. Roman; Jason G. Henning; Emily Stephan; Tom Taggert; Ted. Endreny

    2016-01-01

    An analysis of the urban forest in Philadelphia, Pennsylvania, reveals that this city has an estimated 2.9 million trees (encompassing all woody plants greater than 1 inch diameter at breast height [d.b.h]) with tree canopy that covers 20 percent of the city. The most common tree species are spicebush, black cherry, ash, tree-of-heaven, and boxelder, but the most...

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

    Science.gov (United States)

    2010-10-01

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

  5. Low incidence of painless thyroiditis in the Philadelphia area

    International Nuclear Information System (INIS)

    Schorr, A.B.; Miller, J.L.; Shtasel, P.; Rose, L.I.

    1986-01-01

    Publications from the midwestern region of the United States have demonstrated an incidence of 14-23% of painless thyroiditis in hyperthyroid individuals. This possibly could represent a local phenomenon, and perhaps is not typical for other areas of the country. The 24 hour radioactive iodine uptakes in 152 consecutive hyperthyroid individuals in the Philadelphia area were evaluated. No patient in the series, with clinical and biochemical evidence of hyperthyroidism, had painless thyroiditis. It is concluded that the incidence of painless thyroiditis is markedly lower in the Philadelphia area than in the Midwest regions of the United States

  6. Do Older Rural and Urban Veterans Experience Different Rates of Unplanned Readmission to VA and Non-VA Hospitals?

    Science.gov (United States)

    Weeks, William B.; Lee, Richard E.; Wallace, Amy E.; West, Alan N.; Bagian, James P.

    2009-01-01

    Context: Unplanned readmission within 30 days of discharge is an indicator of hospital quality. Purpose: We wanted to determine whether older rural veterans who were enrolled in the VA had different rates of unplanned readmission to VA or non-VA hospitals than their urban counterparts. Methods: We used the combined VA/Medicare dataset to examine…

  7. 75 FR 62348 - Reimbursement Offsets for Medical Care or Services

    Science.gov (United States)

    2010-10-08

    ... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN55 Reimbursement Offsets for Medical Care... Veterans Affairs (VA) proposes to amend its regulations concerning the reimbursement of medical care and... situations where third-party payers are required to reimburse VA for costs related to care provided by VA to...

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

    Science.gov (United States)

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

    2014-12-01

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

  9. Non-VA Hospital System (NVH)

    Data.gov (United States)

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

  10. Philadelphia's Renaissance Schools Initiative after Four Years

    Science.gov (United States)

    Stratos, Kati; Wolford, Tonya; Reitano, Adrienne

    2015-01-01

    In 2010-2011, the School District of Philadelphia (the District) launched its Renaissance Schools Initiative, a program designed to dramatically improve student achievement in the District's lowest performing schools. Some schools became Promise Academies, based on the federal turnaround model, and remained District-operated neighborhood schools.…

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

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-08-01

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

  12. Assessing Vulnerability to Heat: A Geospatial Analysis for the City of Philadelphia

    Directory of Open Access Journals (Sweden)

    Laura Barron

    2018-04-01

    Full Text Available Urban heat island (UHI effect is an increasingly prominent health and environmental hazard that is linked to urbanization and climate change. Greening reduces the negative impacts of UHI; trees specifically are the most effective in ambient temperature reduction. This paper investigates vulnerability to heat in the Philadelphia, Pennsylvania and identifies where street trees can be planted as a public intervention. We used geospatial information systems (GIS software to map a validated Heat Vulnerability Index to identify vulnerability at the block level. Using a high-low geospatial cluster analysis, we assessed where the City of Philadelphia can most effectively plant street trees to address UHI. This information was then aggregated to the neighborhood level for more effective citizen communication and policymaking. We identified that 26 of 48 (54% neighborhoods that were vulnerable to heat also lacked street trees. Of 158 Philadelphia neighborhoods, 63 (40% contained block groups of high vulnerability to either heat or street tree infrastructure. Neighborhoods that were ranked highest in both classifications were identified in two adjacent West Philadelphia neighborhoods. Planting street trees is a public service a city can potentially reduce the negative health impacts of UHI. GIS can be used to identify and recommend street tree plantings to reduce urban heat.

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

    Science.gov (United States)

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

    2013-04-01

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

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

    Science.gov (United States)

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

    2015-03-01

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

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

    Science.gov (United States)

    Schneider, K C; Dove, H G

    1983-01-01

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

  16. KENO V.a Primer: A Primer for Criticality Calculations with SCALE/KENO V.a Using CSPAN for Input

    International Nuclear Information System (INIS)

    Busch, R.D.

    2003-01-01

    The SCALE (Standardized Computer Analyses for Licensing Evaluation) computer software system developed at Oak Ridge National Laboratory (ORNL) is widely used and accepted around the world for criticality safety analyses. The well-known KENO V.a three-dimensional Monte Carlo criticality computer code is the primary criticality safety analysis tool in SCALE. The KENO V.a primer is designed to help a new user understand and use the SCALE/KENO V.a Monte Carlo code for nuclear criticality safety analyses. It assumes that the user has a college education in a technical field. There is no assumption of familiarity with Monte Carlo codes in general or with SCALE/KENO V.a in particular. The primer is designed to teach by example, with each example illustrating two or three features of SCALE/KENO V.a that are useful in criticality analyses. The primer is based on SCALE 4.4a, which includes the Criticality Safety Processor for Analysis (CSPAN) input processor for Windows personal computers (PCs). A second edition of the primer, which uses the new KENO Visual Editor, is currently under development at ORNL and is planned for publication in late 2003. Each example in this first edition of the primer uses CSPAN to provide the framework for data input. Starting with a Quickstart section, the primer gives an overview of the basic requirements for SCALE/KENO V.a input and allows the user to quickly run a simple criticality problem with SCALE/KENO V.a. The sections that follow Quickstart include a list of basic objectives at the beginning that identifies the goal of the section and the individual SCALE/KENO V.a features which are covered in detail in the example problems in that section. Upon completion of the primer, a new user should be comfortable using CSPAN to set up criticality problems in SCALE/KENO V.a

  17. Electroencephalogram (EEG spectral features discriminate between Alzheimer’s (AD and Vascular dementia (VaD

    Directory of Open Access Journals (Sweden)

    Emanuel eNeto

    2015-02-01

    Full Text Available Alzheimer’s disease (AD and vascular dementia (VaD present with similar clinical symptoms of cognitive decline, but the underlying pathophysiological mechanisms differ. To determine whether clinical electroencephalography (EEG can provide information relevant to discriminate between these diagnoses, we used quantitative EEG analysis to compare the spectra between non-medicated patients with AD (n=77 and VaD (n=77 and healthy elderly normal controls (NC (n=77. We use curve-fitting with a combination of a power loss and Gaussian function to model the averaged resting-state spectra of each EEG channel extracting six parameters. We assessed the performance of our model and tested the extracted parameters for group differentiation. We performed regression analysis in a MANCOVA with group, age, gender, and number of epochs as predictors and further explored the topographical group differences with pair-wise contrasts. Significant topographical differences between the groups were found in several of the extracted features. Both AD and VaD groups showed increased delta power when compared to NC, whereas the AD patients showed a decrease in alpha power for occipital and temporal regions when compared with NC. The VaD patients had higher alpha power than NC and AD. The AD and VaD groups showed slowing of the alpha rhythm. Variability of the alpha frequency was wider for both AD and VaD groups. There was a general decrease in beta power for both AD and VaD. The proposed model is a useful to parameterize spectra which allowed extracting relevant clinical EEG key features that move towards simple and interpretable diagnostic criteria.

  18. 76 FR 48204 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program

    Science.gov (United States)

    2011-08-08

    ... programs addressing emotional, social, spiritual, and generative needs. Terminally Ill (1) Help... optimize reintegration such as life-skills education, recreational activities, and follow up case..., and medication education. Through this NOFA, VA seeks to renew the FY 2009 previous grant and per diem...

  19. Erectile Dysfunction Medication Use in Veterans Eligible for Medicare Part D.

    Science.gov (United States)

    Spencer, Samantha H; Suda, Katie J; Smith, Bridget M; Huo, Zhiping; Bailey, Lauren; Stroupe, Kevin T

    2016-07-01

    Erectile dysfunction (ED) medications are therapeutically effective and associated with satisfaction. Medicare Part D included ED medications on the formulary during 2006 and inadvertently in 2007-2008. To characterize phosphodiesterase-5 inhibitor (PDE-5) medication use among veterans who were dually eligible for Veterans Affairs (VA) and Medicare Part D benefits. Veterans aged > 66 years who received PDE-5 inhibitors between 2005 and 2009 were included. Veterans were categorized by PDE-5 inhibitor claims: VA-only, Part D-only, or dual users of VA and Part D-reimbursed pharmacies. T-tests and chi-square tests were applied as appropriate. From 2005 to 2009, the majority (85.2%) of veterans used VA benefits exclusively for their PDE-5 inhibitors; 11.4% used Medicare Part D exclusively; and 3.4% were dual users. The Part D-only group was older, more frequently not black, had a VA copay, and had a higher income (P filling prescriptions for PDE-5 inhibitors (-68%) and total number of PDE-5 inhibitor 30-day equivalents dispensed (-86.7%) from the VA decreased. Part D prescriptions increased through 2006 (full coverage period) and 2007 (accidental partial coverage) and decreased in 2008. While Part D accounted for only 10% of PDE-5 inhibitor 30-day equivalents, it equaled 29.2% of dispensed tablets. In October 2007, VA PDE-5 inhibitor use returned to 2005 levels. Implementation of Medicare Part D reduced VA PDE-5 inhibitor acquisition. However, after removal of PDE-5 inhibitors from the Part D formulary, use of VA pharmacies for PDE-5 inhibitors resumed. Medication policies outside the VA can affect medication use. Veterans with access to non-VA health care may obtain medications from the private sector because of VA restrictions. This may be especially true for nonformulary and lifestyle medications. The authors received funding support for this research project from the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and

  20. 78 FR 75902 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Philadelphia County...

    Science.gov (United States)

    2013-12-13

    ... to EPA. See NRDC v. EPA, 571 F.3d 1245 (D.C. Cir. 2009). Since the Philadelphia County 2006 SIP... Call constitutes RACT for EGU sources in Philadelphia County. Thus, AMS needs to perform a NO X RACT... 52.2020(d)(1)) continue to represent adequately RACT for the 1997 8-hour ozone NAAQS; or (2) perform...

  1. Molecular diagnostic of the philadelphia chromosome

    International Nuclear Information System (INIS)

    Campos Rudin, M.; Cuenca Berger, P.; Gutierrez Espeleta, G.; Jimenez Cruz, G.; Montero Umana, C.; Vazquez Castillo, L.; Ramon Ortiz, M.

    1998-01-01

    The importance that has to confirm the presence or absence of the chromosome Philadelphia in the diagnostic and follow up of the patient affected with chronic myeloid leukemia and other leukemia. It is considered necessary to implement the molecular diagnostic in Costa Rica. They studied 32 patient affected by Chronic Myeloid Leukemia, 7 by other Myeloproliferative Chronic Disorders and 2 by Myelodysplastic Syndrome. It utilized the sound Trans probe-1 (Oncogene Science, Inc), which was marked with radioactivity ( 32 P) or chemiluminescence (digoxigenin). Of the 32 cases affected by L mc, in 28 it was possible to carry out the molecular analysis detecting the characteristic translocation of the chromosome Philadelphia among the Mbcr/c-ABL genes in 21 (75%) of the patients, in 7 (25%) the rearrangement was not found. In seven of the nine affected by other sufferings it was possible to obtain results, 3 that turned out to be positive for the rearrangement among Mbcr/c-ABL and 4 normal. In all the cases, they obtained results marking the sound with radioactivity. However, they tested the marks with digoxigenin in seven of the patients, as an methodological alternative for the laboratories that lacks the requirements to work with radiation. The results obtained were identical. (S. Grainger) [es

  2. Strategies from a nationwide health information technology implementation: the VA CART story.

    Science.gov (United States)

    Box, Tamára L; McDonell, Mary; Helfrich, Christian D; Jesse, Robert L; Fihn, Stephan D; Rumsfeld, John S

    2010-01-01

    The VA Cardiovascular Assessment, Reporting, and Tracking (CART) system is a customized electronic medical record system which provides standardized report generation for cardiac catheterization procedures, serves as a national data repository, and is the centerpiece of a national quality improvement program. Like many health information technology projects, CART implementation did not proceed without some barriers and resistance. We describe the nationwide implementation of CART at the 77 VA hospitals which perform cardiac catheterizations in three phases: (1) strategic collaborations; (2) installation; and (3) adoption. Throughout implementation, success required a careful balance of technical, clinical, and organizational factors. We offer strategies developed through CART implementation which are broadly applicable to technology projects aimed at improving the quality, reliability, and efficiency of health care.

  3. [Disappearance of a Philadelphia chromosome-positive clone and appearance of a -negative clone following treatment with imatinib mesylate in acute myelomonocytic leukemia].

    Science.gov (United States)

    Takahashi, Wataru; Arai, Yukihiro; Tadokoro, Jiro; Takeuchi, Kengo; Yamagata, Tetsuya; Mitani, Kinuko

    2006-02-01

    A 63-year-old female was diagnosed as having Philadelphia chromosome-positive acute myelomonocytic leukemia in June 2002. The patient received monotherapy with imatinib mesylate or combination therapy with DCM and idarubicin/cytarabine, both of which failed in attaining disease remission. However, the second imatinib administration plus CAG therapy resulted in disappearance of the Philadelphia chromosome-positive clone and increase of Philadelphia chromosome-negative cells. During a therapy-withholding period due to fungal infection, the Philadelphia chromosome-positive clone expanded and the patient died of cerebral hemorrhage in February 2003. The transient suppression of the Philadelphia chromosome-positive clone may have brought about amplification of the Philadelphia chromosome-negative cells after the secondary imatinib treatment.

  4. VaR Methodology Application for Banking Currency Portfolios

    Directory of Open Access Journals (Sweden)

    Daniel Armeanu

    2007-02-01

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

  5. 77 FR 70893 - Authorization for Non-VA Medical Services

    Science.gov (United States)

    2012-11-28

    ... care, nursing home care, domiciliary care, or medical services and who requires medical services to... care, nursing home care, domiciliary care, or medical services, and requires medical services to... may contract for certain hospital care (inpatient care) and medical services (outpatient care) for...

  6. Quest for professionalism: a biography of the North American Medical and Surgical Journal (1826-31).

    Science.gov (United States)

    Shultz, S M

    2011-08-01

    This is the biography of a deceased medical journal, the North American Medical and Surgical Journal, born in 1826 in Philadelphia. It was a publication of the Philadelphia Chapter of the Kappa Lambda Society. In the prospectus of the North American Medical and Surgical Journal the promoters observed that a well-conducted journal would achieve the object of elevating the medical profession to its legitimate rank which up to that time had been the recipient of low public opinion. The Journal hoped to inculcate 'a higher standard of excellence not merely in the professional or ministrative but also in the ethical relations and duties of physicians'. After several successful and productive years it passed into history in October 1831, the victim of financial difficulty.

  7. Use of the Decision Support System for VA cost-effectiveness research.

    Science.gov (United States)

    Barnett, P G; Rodgers, J H

    1999-04-01

    The Department of Veterans Affairs is adopting the Decision Support System (DSS), computer software and databases which include a cost-accounting system which determines the cost of health care products and patient encounters. A system for providing cost data for cost-effectiveness analysis should be provide valid, detailed, and comprehensive data that can be aggregated. The design of DSS is described and compared with those criteria. Utilization data from DSS was compared with other VA utilization data. Aggregate DSS cost data from 35 medical centers was compared with relative resource weights developed for the Medicare program. Data on hospital stays at 3 facilities found that 3.7% of the stays in DSS were not in the VA discharge database, whereas 7.6% of the stays in the discharge data were not in DSS. DSS reported between 68.8% and 97.1% of the outpatient encounters reported by six facilities in the ambulatory care data base. Relative weights for each Diagnosis Related Group based on DSS data from 35 VA facilities correlated with Medicare weights (correlation coefficient of .853). DSS will be useful for research if certain problems are overcome. It is difficult to distinguish long-term from acute hospital care. VA does not have a complete database of all inpatient procedures, so DSS has not assigned them a specific cost. The authority to access encounter-level DSS data needs to be centralized. Researchers can provide the feedback needed to improve DSS cost estimates. A comprehensive encounter-level extract would facilitate use of DSS for research.

  8. VaST: A variability search toolkit

    Science.gov (United States)

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

    2018-01-01

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

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

    Data.gov (United States)

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

  10. Visionary leadership and the future of VA health system.

    Science.gov (United States)

    Bezold, C; Mayer, E; Dighe, A

    1997-01-01

    As the U.S. Department of Veterans Affairs (VA) makes the change over to Veterans Integrated Service Network (VISNs) the need for new and better leadership is warranted if VA wants to not only survive, but thrive in the emerging twenty-first century healthcare system. VA can prepare for the future and meet the challenges facing them by adopting a system of visionary leadership. The use of scenarios and vision techniques are explained as they relate to VA's efforts to move toward their new system of VISNs. The four scenarios provide snapshots of possible futures for the U.S. healthcare system as well as the possible future role and mission of VA--from VA disappearing to its becoming a premier virtual organization.

  11. Hospitality and Inclusion Logistics of a Spotlight Event: An Insiders Look at the 2016 DNC in Philadelphia

    Directory of Open Access Journals (Sweden)

    Leora Halpern Lanz

    2016-10-01

    Full Text Available The 2016 Democratic National Convention held in Philadelphia, Pennsylvania prioritized hospitality efforts and incorporated inclusion and diversity as its theme. These strategies helped to create a successful spotlight event, benefiting the city of Philadelphia and its hospitality industry.

  12. ESTIMASI NILAI VaR PORTOFOLIO MENGGUNAKAN FUNGSI ARCHIMEDEAN COPULA

    Directory of Open Access Journals (Sweden)

    AULIA ATIKA PRAWIBTA SUHARTO

    2017-01-01

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

  13. Philadelphia obtains useful information from its customers about taste and odour quality.

    Science.gov (United States)

    Burlingame, G A; Mackey, E D

    2007-01-01

    Customers are sensitive to the flavour of water. Customers evaluate drinking water based on their expectations, on experiences with their usual drinking water and on experiences with alternative waters. The Philadelphia Water Department provides one example of success in developing a better understanding of customer perceptions and attitudes about tap water taste and odour. Philadelphia found that customers do communicate in ways that water utilities can understand. Water utilities can enhance that communication and collect useful data. In addition, water utilities can characterise their tap water flavour, track it for changes and correlate changes to customer complaints.

  14. Adherence to Follow-up Recommendations Among Individuals in the Philadelphia Glaucoma Detection and Treatment Project.

    Science.gov (United States)

    Hark, Lisa A; Leiby, Benjamin E; Waisbourd, Michael; Myers, Jonathan S; Fudemberg, Scott J; Mantravadi, Anand V; Dai, Yang; Gilligan, John P; Resende, Arthur F; Katz, L Jay

    2017-08-01

    To evaluate rates of adherence to free follow-up eye exam appointments among participants in the Philadelphia Glaucoma Detection and Treatment Project. Ophthalmologists and testing equipment were brought directly to participants at risk for glaucoma at 43 community sites in Philadelphia. Those diagnosed with glaucoma-related pathology were recommended to return for follow-up to be reexamined on site. Rates of adherence and clinical and demographic risk factors for adherence were evaluated. Five hundred thirty-one participants were diagnosed with glaucoma-related conditions and recommended to attend community-based follow-up exams. Follow-up adherence rate was 61.2% (n=325/531). Significant factors associated with greater eye exam appointment adherence, based on our univariable analysis, included final diagnosis of glaucoma (risk ratio [RR]=1.33; 95% confidence interval [CI], 1.13-1.57), male sex (RR=1.19; 95% CI, 1.04-1.36), white race (RR=1.26; 95% CI, 1.08-1.48), age (RR=1.17; 95% CI, 1.00-1.37) recommendation for glaucoma medication (RR=1.52; 95% CI, 1.35-1.71), recommendation for laser peripheral iridotomy (RR=1.18; 95% CI, 1.02-1.35), diagnosis of age-related macular degeneration (RR=1.42; 95% CI, 1.13-1.77) and an increased intraocular pressure (>22 mm Hg in the worse eye) (RR=1.23; 95% CI, 1.06-1.42). On the basis of our multivariable model, diagnosis, sex, and recommended glaucoma medications were significantly associated with follow-up adherence. This study demonstrates that individuals living in underserved urban communities would take advantage of free eye exams in community sites and return for follow-up eye exams in these same settings. Future studies could investigate interventions to improve eye exam appointment adherence in community-based settings to detect glaucoma-eye conditions.

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

    National Research Council Canada - National Science Library

    Stockwell, David

    1999-01-01

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

  16. 75 FR 26160 - Drug and Drug-Related Supply Promotion by Pharmaceutical Company Sales Representatives at VA...

    Science.gov (United States)

    2010-05-11

    ... ward areas where patients may be encountered; (ii) Clinic examination rooms; (iii) Nurses stations; (iv... access to VA medical facilities by sales representatives (including account managers and clinical... would require the Chief of Pharmacy or other official responsible for such decisions to approve...

  17. The Post-Revolutionary Woman Idealized: Philadelphia Media's "Republican Mother."

    Science.gov (United States)

    List, Karen K.

    1989-01-01

    Examines eighteenth-century periodical literature published in Philadelphia to explore the major shift of women's roles in the United States during the period following the American Revolution. Notes that independence remained a male prerogative in periodicals, while women's issues and movements toward self-realization were ignored. (MM)

  18. Maximizing Green Infrastructure in a Philadelphia Neighborhood

    Directory of Open Access Journals (Sweden)

    Kate Zidar

    2017-10-01

    Full Text Available While the Philadelphia Water Department (PWD is counting on Green Stormwater Infrastructure (GI as a key component of its long-term plan for reducing combined sewer overflows, many community stakeholders are also hoping that investment in greening can help meet other ancillary goals, collectively referred to as sustainable redevelopment. This study investigates the challenges associated with implementation of GI in Point Breeze, a residential neighborhood of South Philadelphia. The project team performed a detailed study of physical, social, legal, and economic conditions in the pilot neighborhood over the course of several years, culminating in the development of an agent-based model simulation of GI implementation. The model evaluates a whether PWD’s GI goals can be met in a timely manner, b what kinds of assumptions regarding participation would be needed under different theoretical GI policies, and c the extent to which GI could promote sustainable redevelopment. The model outcomes underscore the importance of private land in helping PWD achieve its GI goals in Point Breeze. Achieving a meaningful density of GI in the neighborhoods most in need of sustainable redevelopment may require new and creative strategies for GI implementation tailored for the types of land present in those particular communities.

  19. 38 CFR 1.203 - Information to be reported to VA Police.

    Science.gov (United States)

    2010-07-01

    ... reported to VA Police. 1.203 Section 1.203 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... be reported to VA Police. Information about actual or possible violations of criminal laws related to... occurs on VA premises, will be reported by VA management officials to the VA police component with...

  20. Brand-Name Prescription Drug Use Among Diabetes Patients in the VA and Medicare Part D: A National Comparison

    Science.gov (United States)

    Gellad, Walid F.; Donohue, Julie M.; Zhao, Xinhua; Mor, Maria K.; Thorpe, Carolyn T.; Smith, Jeremy; Good, Chester B.; Fine, Michael J.; Morden, Nancy E.

    2013-01-01

    Background Medicare Part D and the Department of Veterans Affairs (VA) use different approaches to manage prescription drug benefits, with implications for spending. Medicare relies on private plans with distinct formularies, whereas VA administers its own benefit using a national formulary. Objective To compare overall and regional rates of brand-name drug use among older adults with diabetes in Medicare and VA. Design Retrospective cohort Setting Medicare and VA Patients National sample in 2008 of 1,061,095 Part D beneficiaries and 510,485 Veterans age 65+ with diabetes. Measurements Percent of patients on oral hypoglycemics, statins, and angiotensin-converting-enzyme inhibitors/angiotensin-receptor-blockers who filled brand-name drugs and percent of patients on long-acting insulin who filled analogues. We compared sociodemographic and health-status adjusted hospital referral region (HRR) brand-name use to examine local practice patterns, and calculated changes in spending if each system’s brand-name use mirrored the other. Results Brand-name use in Medicare was 2–3 times that of VA: 35.3% vs. 12.7% for oral hypoglycemics, 50.7% vs. 18.2% for statins, 42.5% vs. 20.8% for angiotensin-converting-enzyme inhibitors/angiotensin-receptor-blockers, and 75.1% vs. 27.0% for insulin analogues. Adjusted HRR brand-name statin use ranged (5th to 95th percentile) from 41.0%–58.3% in Medicare and 6.2%–38.2% in VA. For each drug group, the HRR at the 95th percentile in VA had lower brand-name use than the 5th percentile HRR in Medicare. Medicare spending in this population would have been $1.4 billion less if brand-name use matched the VA for these medications. Limitation This analysis cannot fully describe the factors underlying differences in brand-name use. Conclusions Medicare beneficiaries with diabetes use 2–3 times more brand-name drugs than a comparable group within VA, at substantial excess cost. Primary Funding Sources VA; NIH; RWJF PMID:23752663

  1. SlaVaComp: Konvertierungstool (= SlaVaComp Fonts Converter

    Directory of Open Access Journals (Sweden)

    Simon Skilevic

    2013-12-01

    Full Text Available Der vorliegende Beitrag informiert über ein Tool, das im Rahmen eines Freiburger Projekts zur historischen Korpuslinguistik entwickelt wurde und dazu dient, kirchenslavische Texte, die ohne Einsatz von Unicode digitalisiert wurden, ohne Verlust von Information bzw. Formatierung ins Unicode-Format zu überführen. Das Tool heißt SlaVaComp-Konvertierer. Es eignet sich für die Konvertierung aller idiosynkratischen Fonts und kann somit nicht nur in der Paläoslavistik, sondern in allen historisch arbeitenden Philologien eingesetzt werden. ____________________ This paper presents a fonts converter that was developed as a part of the Freiburg project on historical corpus linguistics. The tool named SlaVaComp-Konvertierer converts Church Slavonic texts digitized with non-Unicode fonts into the Unicode format without any loss of information contained in the original file and without damage to the original formatting. It is suitable for the conversion of all idiosyncratic fonts—not only Church Slavonic—and therefore can be used not only in Palaeoslavistic, but also in all historical and philological studies.

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

    Science.gov (United States)

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

    2016-03-01

    Effective poststroke rehabilitation care can speed patient recovery and minimize patient functional disabilities. Veterans affairs (VA) community living centers (CLCs) and VA-contracted community nursing homes (CNHs) are the 2 major sources of institutional long-term care for Veterans with stroke receiving care under VA auspices. This study compares rehabilitation therapy and restorative nursing care among Veterans residing in VA CLCs versus those Veterans in VA-contracted CNHs. Retrospective observational. All Veterans diagnosed with stroke, newly admitted to the CLCs or CNHs during the study period who completed at least 2 Minimum Data Set assessments postadmission. The outcomes were numbers of days for rehabilitation therapy and restorative nursing care received by the Veterans during their stays in CLCs or CNHs as documented in the Minimum Data Set databases. For rehabilitation therapy, the CLC Veterans had lower user rates (75.2% vs. 76.4%, P=0.078) and fewer observed therapy days (4.9 vs. 6.4, Pcare, CLC Veterans had higher user rates (33.5% vs. 30.6%, Pcare days (9.4 vs. 5.9, Pcare (coefficient=5.48±0.37, Pcare both before and after risk adjustment.

  3. Item Response Theory Modeling of the Philadelphia Naming Test

    Science.gov (United States)

    Fergadiotis, Gerasimos; Kellough, Stacey; Hula, William D.

    2015-01-01

    Purpose: In this study, we investigated the fit of the Philadelphia Naming Test (PNT; Roach, Schwartz, Martin, Grewal, & Brecher, 1996) to an item-response-theory measurement model, estimated the precision of the resulting scores and item parameters, and provided a theoretical rationale for the interpretation of PNT overall scores by relating…

  4. Systemwide Implementation of Project-Based Learning: The Philadelphia Approach

    Science.gov (United States)

    Schwalm, Jason; Tylek, Karen Smuck

    2012-01-01

    Citywide implementation of project-based learning highlights the benefits--and the challenges--of promoting exemplary practices across an entire out-of-school time (OST) network. In summer 2009, the City of Philadelphia and its intermediary, the Public Health Management Corporation (PHMC), introduced project-based learning to a network of more…

  5. Whistle-blower accuses VA inspector general of a "whitewash"

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-09-01

    Full Text Available No abstract available. Article truncated after 150 words. Yesterday, Dr. Sam Foote, the initial whistle-blower at the Phoenix VA, criticized the Department of Veterans Affairs inspector general's (VAOIG report on delays in healthcare at the Phoenix VA at a hearing before the House Committee of Veterans Affairs (1,2. Foote accused the VAOIG of minimizing bad patient outcomes and deliberately confusing readers, downplaying the impact of delayed health care at Phoenix VA facilities. "At its best, this report is a whitewash. At its worst, it is a feeble attempt at a cover-up," said Foote. Foote earlier this year revealed that as many as 40 Phoenix patients died while awaiting care and that the Phoenix VA maintained secret waiting lists while under-reporting patient wait times for appointments. His disclosures triggered the national VA scandal. Richard Griffin, the acting VAOIG, said that nearly 300 patients died while on backlogged wait lists in the Phoenix VA Health Care System, a much higher ...

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

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2013-04-01

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

  7. Heterogeneity of genomic fusion of BCR and ABL in Philadelphia chromosome-positive acute lymphoblastic leukemia

    International Nuclear Information System (INIS)

    Rubin, C.M.; Carrino, J.J.; Dickler, M.N.; Leibowitz, D.; Smith, S.D.; Westbrook, C.A.

    1988-01-01

    Philadelphia chromosome-positive acute lymphoblastic leukemia occurs in two molecular forms, those with and those without rearrangement of the breakpoint cluster region on chromosome 22. The molecular abnormality in the former group is similar to that found in chronic myelogenous leukemia. To characterize the abnormality in the breakpoint cluster region-unrearranged form, the authors have mapped a 9; 22 translocation from the Philadelphia chromosome-positive acute lymphoblastic leukemia cell line SUP-B13 by using pulsed-field gel electrophoresis and have cloned the DNA at the translocation junctions. They demonstrate a BCR-ABL fusion gene on the Philadelphia chromosome. The exons from ABL are the same. Analysis of leukemic cells from four other patients with breakpoint cluster region-unrearranged Philadelphia chromosome-positive acute lymphoblastic leukemia revealed a rearrangement on chromosome 22 close to the breakpoint in SUP-B13 in only one patient. These data indicate that breakpoints do not cluster tightly in this region but are scattered, possibly in a large intron. Given the large size of BCR and the heterogeneity in breakpoint location, detection of BCR rearrangement by standard Southern blot analysis is difficult. Pulsed-field gel electrophoresis should allow detection at the DNA level in every patient and thus will permit clinical correlation of the breakpoint location with prognosis

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

    Science.gov (United States)

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

    2009-02-01

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

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

    Data.gov (United States)

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

  10. Settlement to Improve Water Quality in Delaware River, Philadelphia-Area Creeks

    Science.gov (United States)

    EPA and the U.S. Department of Justice have reached agreement with a major water utility in the greater Philadelphia area to significantly reduce sewage discharges to the Delaware River and local creeks.

  11. Comparison of geographic methods to assess travel patterns of persons diagnosed with HIV in Philadelphia: how close is close enough?

    Science.gov (United States)

    Eberhart, Michael G; Share, Amanda M; Shpaner, Mark; Brady, Kathleen A

    2015-02-01

    Travel distance to medical care has been assessed using a variety of geographic methods. Network analyses are less common, but may generate more accurate estimates of travel costs. We compared straight-line distances and driving distance, as well as average drive time and travel time on a public transit network for 1789 persons diagnosed with HIV between 2010 and 2012 to identify differences overall, and by distinct geographic areas of Philadelphia. Paired t-tests were used to assess differences across methods, and analysis of variance was used to assess between-group differences. Driving distances were significantly longer than straight-line distances (ptravel costs, and may improve models to predict medical care outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. [Control discourses and power relations of yellow fever: Philadelphia in 1793].

    Science.gov (United States)

    Kim, Seohyung

    2014-12-01

    1793 Yellow fever in Philadelphia was the most severe epidemics in the late 18th century in the United States. More than 10% of the population in the city died and many people fled to other cities. The cause of yellow fever in the United States had close relationship with slaves and sugar in Philadelphia. Sugarcane plantation had needed many labors to produce sugar and lots of Africans had to move to America as slaves. In this process, Aëdes aegypti, the vector of yellow fever had migrated to America and the circumstances of ships or cities provided appropriate conditions for its breeding. In this period, the cause of yellow fever could not be established exactly, so suggestions of doctors became entangled in political and intellectual discourses in American society. There was a critical conflict between Jeffersonian Republicanism and Federalism about the origin and treatment of yellow fever. Benjamin Rush, a Jeffersonian Republican, suggested urban sanitation reform and bloodletting. He believed the infectious disease happened because of unsanitary city condition, so he thought the United States could be a healthy nation by improvement of the public health and sanitation. He would like to cope with national crisis and develop American society on the basis of republicanism. While Rush suggested the improvement of public health and sanitation, the city government of Philadelphia suggested isolation of yellow fever patients and quarantine. City government isolated the patients from healthy people and it reconstructed space of hospital. Also, it built orphanages to take care of children who lost their parents during the epidemic and implemented power to control people put in the state of exception. Of course, city government tried to protect the city and nation by quarantine of every ship to Philadelphia. Control policies of yellow fever in 1793 showed different conflicts and interactions. Through the yellow fever, Jeffersonian Republicanism and Federalism had

  13. Seasonal dependence of aerosol processing in urban Philadelphia

    Science.gov (United States)

    Avery, A. M.; Waring, M. S.; DeCarlo, P. F.

    2017-12-01

    Urban aerosols pose an important threat to human health due to the conflation of emissions and concentrated population exposed. Winter and summer aerosol and trace gas measurements were taken in downtown Philadelphia in 2016. Measurements included aerosol composition and size with an Aerodyne Aerosol Mass Spectrometer (AMS), particle size distributions with an SMPS, and an aethalometer. Trace gas measurements of O3, NO, CH4, CO, and CO2 were taken concurrently. Sampling in seasonal extremes provided contrast in aerosol and trace gas composition, aerosol processing, and emission factors. Inorganic aerosol components contributed approximately 60% of the submicron aerosol mass, while summertime aerosol composition was roughly 70% organic matter. Positive Matrix Factorization (PMF) on the organic aerosol (OA) matrix revealed three factors in common in each season, including an oxygenated organic aerosol (OOA) factor with different temporal behavior in each season. In summertime, OOA varied diurnally with ozone and daytime temperature, but in the wintertime, it was anti-correlated with ozone and temperature, and instead trended with calculated liquid water, indicating a seasonally-dependent processing of organic aerosol in Philadelphia's urban environment. Due to the inorganic dominant winter aerosol, liquid water much higher (2.65 μg/m3) in winter than in summer (1.54 μg/m3). Diurnally varying concentrations of background gas phase species (CH4, CO2) were higher in winter and varied less as a result of boundary layer conditions; ozone was also higher in background in winter than summer. Winter stagnation events with low windspeed showed large buildup of trace gases CH4, CO, CO2, and NO. Traffic related aerosol was also elevated with black carbon and hydrocarbon-like OA (HOA) plumes of each at 3-5 times higher than the winter the average value for each. Winter ratios of HOA to black carbon were significantly higher in the winter than the summer due to lower

  14. Medication-use evaluation with a Web application.

    Science.gov (United States)

    Burk, Muriel; Moore, Von; Glassman, Peter; Good, Chester B; Emmendorfer, Thomas; Leadholm, Thomas C; Cunningham, Francesca

    2013-12-15

    A Web-based application for coordinating medication-use evaluation (MUE) initiatives within the Veterans Affairs (VA) health care system is described. The MUE Tracker (MUET) software program was created to improve VA's ability to conduct national medication-related interventions throughout its network of 147 medical centers. MUET initiatives are centrally coordinated by the VA Center for Medication Safety (VAMedSAFE), which monitors the agency's integrated databases for indications of suboptimal prescribing or drug therapy monitoring and adverse treatment outcomes. When a pharmacovigilance signal is detected, VAMedSAFE identifies "trigger groups" of at-risk veterans and uploads patient lists to the secure MUET application, where locally designated personnel (typically pharmacists) can access and use the data to target risk-reduction efforts. Local data on patient-specific interventions are stored in a centralized database and regularly updated to enable tracking and reporting for surveillance and quality-improvement purposes; aggregated data can be further analyzed for provider education and benchmarking. In a three-year pilot project, the MUET program was found effective in promoting improved prescribing of erythropoiesis-stimulating agents (ESAs) and enhanced laboratory monitoring of ESA-treated patients in all specified trigger groups. The MUET initiative has since been expanded to target other high-risk drugs, and efforts are underway to refine the tool for broader utility. The MUET application has enabled the increased standardization of medication safety initiatives across the VA system and may serve as a useful model for the development of pharmacovigilance tools by other large integrated health care systems.

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

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  16. Localization of preferential sites of rearrangement within the BCR gene in Philadelphia chromosome-positive acute lymphoblastic leukemia

    International Nuclear Information System (INIS)

    Denny, C.T.; Shah, N.P.; Ogden, S.; Willman, C.; McConnell, T.; Crist, W.; Carroll, A.; Witte, O.N.

    1989-01-01

    The Philadelphia chromosome associated with acute lymphoblastic leukemia (ALL) has been linked to a hybrid BCR/ABL protein product that differs from that found in chronic myelogenous leukemia. This implies that the molecular structures of the two chromosomal translocations also differ. Localization of translocation breakpoints in Philadelphia chromosome-positive ALL has been impeded due to the only partial characterization of the BCR locus. The authors have isolated the entire 130-kilobase BCR genomic locus from a human cosmid library. They have demonstrated that these breakpoints are all located at the 3' end of the intron around an unusual restriction fragment length polymorphism caused by deletion of a 1-kilobase fragment containing Alu family reiterated sequences. This clustering is unexpected in light of previous theories of rearrangement in Philadelphia chromosome-positive chronic myelogenous leukemia that would have predicted a random dispersion of breakpoints in the first intron in Philadelphia chromosome-positive ALL. The proximity of the translocation breakpoints to this constitutive deletion may indicate shared mechanisms of rearrangement or that such polymorphisms mark areas of the genome prone to recombination

  17. 76 FR 44086 - Agency Information Collection (Report of Medical Examination for Disability Evaluation) Activity...

    Science.gov (United States)

    2011-07-22

    ... Medical Examination for Disability Evaluation, VA Form 21-2545. OMB Control Number: 2900-0052. Type of... of Medical Examination for Disability Evaluation) Activity Under OMB Review AGENCY: Veterans Benefits... prior to undergoing a VA examination for disability benefits. The examining physician also completes the...

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

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  19. Analysis of VaR on Stock Investing%股票投资的风险价值VaR分析

    Institute of Scientific and Technical Information of China (English)

    张江红; 唐泉

    2011-01-01

    VaR is a tool to measure financial risk,which is supported and recognized by the international financial community in recent years.For equity portfolios consisting of different market factors or different financial instruments,VaR can reliably evaluate the market risks.In the paper the basic principle and calculation of VaR is introduced,the company stock value at risk has been analyzed using normal method,which company has issued convertible bond and stock.Meanwhile the affect that the issuance of convertible bond to the underlying stock fluctuation has been taken into account in order to provide reference for the different types of investors.%VaR是近年来受到国际金融界广泛支持和认可的一种度量金融风险的工具.对于不同市场因子和不同金融工具的投资组合,VaR可以相对可靠地衡量其市场风险.本文介绍了VaR的基本原理和计算方法,并用正态分布对发行有可转债的上市公司股票的风险价值进行分析,考虑了可转债的发行对标的股票波动的影响,以期为资本市场不同类型的投资者在进行资本投资前估计风险提供参考.

  20. 77 FR 45717 - Proposed Information Collection (Former Prisoner of War Medical History); Comment Request

    Science.gov (United States)

    2012-08-01

    ... use of other forms of information technology. Title: Former Prisoner of War (FPOW) Medical History, VA... Prisoner of War veteran. VA will use the data collected as a guide and reference for treatment planning for... Prisoner of War Medical History); Comment Request AGENCY: Veterans Health Administration, Department of...

  1. Pediatric radiology in the Philadelphia region: a history of pedigrees and legacies.

    Science.gov (United States)

    Markowitz, Richard I

    2009-09-01

    The specialty of pediatric radiology in the Philadelphia region has grown and evolved over the past eight decades originating from early "visiting" radiologists to Drs. Hope and Kirkpatrick, the "giants" of the 1950s and 1960s, to over 40 actively practicing pediatric radiologists. Clinical excellence, commitment to teaching, and advancement of knowledge through research remain the goals and ideals, much as they were many years ago. Philadelphia has been a fertile home and environment for this development, mostly because of outstanding leaders and role models who have trained and influenced generations of pediatric radiologists. The purpose of this article is to tell the story of this growth and development and to explore the intellectual origins, professional "genealogy," and legacies left by those who created this tradition.

  2. Faith Partnerships and Public Schools in Philadelphia: Rewards and Perils.

    Science.gov (United States)

    Mundell, Leah

    In 1999, Philadelphia (Pennsylvania) school superintendent David Hornbeck introduced educators and religious leaders to his requirement that each public school in the city develop a relationship with a faith partner, a religious institution that could share facilities and resources with the school. Hornbeck saw religious institutions and schools…

  3. The VA mission act: Funding to fail?

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2018-06-01

    Full Text Available No abstract available. Article truncated after 150 words. Yesterday on D-Day, the 74th anniversary of the invasion of Normandy, President Trump signed the VA Mission Act. The law directs the VA to combine a number of existing private-care programs, including the so-called Choice program, which was created in 2014 after veterans died waiting for appointments at the Phoenix VA (1. During the signing Trump touted the new law saying “there has never been anything like this in the history of the VA” and saying that veterans “can go right outside [the VA] to a private doctor”-but can they? Although the bill authorizes private care, it appropriates no money to pay for it. Although a bipartisan plan to fund the expansion is proposed in the House, the White House has been lobbying Republicans to vote the plan down (2. Instead Trump has been asking Congress to pay for veteran’s programs by cutting spending elsewhere (2. We in Arizona are …

  4. 77 FR 17086 - Section 8 Housing Choice Vouchers: Revised Implementation of the HUD-VA Supportive Housing Program

    Science.gov (United States)

    2012-03-23

    ... Housing g. Mobility and Portability of HUD-VASH Vouchers h. Case Management Requirements i. Turnover of... veterans with case management and clinical services provided by the VA through its community medical... services sites and Community-Based Outpatient Clinics (CBOCs) across the nation. The HUD- VASH program is a...

  5. Demonstration Assessment of LED Roadway Lighting: Philadelphia, PA

    Energy Technology Data Exchange (ETDEWEB)

    Royer, Michael P.; Tuenge, Jason R.; Poplawski, Michael E.

    2012-09-01

    For this demonstration assessment, 10 different groups of LED luminaires were installed at three sites in Philadelphia, PA. Each of the three sites represented a different set of conditions, most importantly with regard to the incumbent HPS luminaires, which were nominally 100 W, 150 W, and 250 W. The performance of each product was evaluated based on manufacturer data, illuminance calculations, field measurements of illuminance, and the subjective impressions of both regular and expert observers.

  6. The Implementation of CRM at FISC Norfolk Detachment Philadelphia

    Science.gov (United States)

    2003-06-01

    Customer Relationship Management system. [28] If FISC decides to implement a CRM system, the decision will impact the duties of the...distribution is unlimited 12b. DISTRIBUTION CODE 13. ABSTRACT (maximum 200 words) Customer Relations Management ( CRM ) can be defined in many ways. In...Norfolk Philadelphia Mission Statement. 15. NUMBER OF PAGES 91 14. SUBJECT TERMS Customer Relations Management System, CRM ,

  7. 78 FR 56271 - FY 2014-2020 Draft VA Strategic Plan

    Science.gov (United States)

    2013-09-12

    ... DEPARTMENT OF VETERANS AFFAIRS FY 2014-2020 Draft VA Strategic Plan AGENCY: Department of Veterans... Affairs (VA) is announcing the availability of the FY 2014-2020 Draft VA Strategic Plan (Strategic Plan... Act of 2010 (GPRAMA) (Pub. L. 111-352). The Strategic Plan provides the Department's long-term...

  8. GATEWAY Report Brief: SSL Evaluation: Philadelphia International Airport Apron Lighting

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2015-10-30

    Summary of report that documents a trial installation of LED apron lighting that replaced the existing high-pressure sodium luminaires at Philadelphia International Airport. Such high-mast applications remain challenging for LED technology, and the lessons learned from this project may help facility managers and LED product manufacturers better meet those challenges.

  9. The process of implementing a rural VA wound care program for diabetic foot ulcer patients.

    Science.gov (United States)

    Reiber, Gayle E; Raugi, Gregory J; Rowberg, Donald

    2007-10-01

    Delivering and documenting evidence-based treatment to all Department of Veterans Affairs (VA) foot ulcer patients has wide appeal. However, primary and secondary care medical centers where 52% of these patients receive care are at a disadvantage given the frequent absence of trained specialists to manage diabetic foot ulcers. A retrospective review of diabetic foot ulcer patient records and a provider survey were conducted to document the foot ulcer problem and to assess practitioner needs. Results showed of the 125 persons with foot ulcers identified through administrative data, only, 21% of diabetic foot patients were correctly coded. Chronic Care and Microsystem models were used to prepare a tailored intervention in a VA primary care medical center. The site Principal Investigators, a multidisciplinary site wound care team, and study investigators jointly implemented a diabetic foot ulcer program. Intervention components include wound care team education and training, standardized good wound care practices based on strong scientific evidence, and a wound care template embedded in the electronic medical record to facilitate data collection, clinical decision making, patient ordering, and coding. A strategy for delivering offloading pressure devices, regular case management support, and 24/7 emergency assistance also was developed. It took 9 months to implement the model. Patients were enrolled and followed for 1 year. Process and outcome evaluations are on-going.

  10. Pediatric radiology in the Philadelphia region: a history of pedigrees and legacies

    International Nuclear Information System (INIS)

    Markowitz, Richard I.

    2009-01-01

    The specialty of pediatric radiology in the Philadelphia region has grown and evolved over the past eight decades originating from early ''visiting'' radiologists to Drs. Hope and Kirkpatrick, the ''giants'' of the 1950s and 1960s, to over 40 actively practicing pediatric radiologists. Clinical excellence, commitment to teaching, and advancement of knowledge through research remain the goals and ideals, much as they were many years ago. Philadelphia has been a fertile home and environment for this development, mostly because of outstanding leaders and role models who have trained and influenced generations of pediatric radiologists. The purpose of this article is to tell the story of this growth and development and to explore the intellectual origins, professional ''genealogy,'' and legacies left by those who created this tradition. (orig.)

  11. Troubles continue for the Phoenix VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-10-01

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

  12. 38 CFR 26.7 - VA environmental decision making and documents.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA environmental decision making and documents. 26.7 Section 26.7 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) ENVIRONMENTAL EFFECTS OF THE DEPARTMENT OF VETERANS AFFAIRS (VA) ACTIONS § 26.7 VA environmental decision making and document...

  13. Medical-Legal Partnerships At Veterans Affairs Medical Centers Improved Housing And Psychosocial Outcomes For Vets.

    Science.gov (United States)

    Tsai, Jack; Middleton, Margaret; Villegas, Jennifer; Johnson, Cindy; Retkin, Randye; Seidman, Alison; Sherman, Scott; Rosenheck, Robert A

    2017-12-01

    Medical-legal partnerships-collaborations between legal professionals and health care providers that help patients address civil legal problems that can affect health and well-being-have been implemented at several Veterans Affairs (VA) medical centers to serve homeless and low-income veterans with mental illness. We describe the outcomes of veterans who accessed legal services at four partnership sites in Connecticut and New York in the period 2014-16. The partnerships served 950 veterans, who collectively had 1,384 legal issues; on average, the issues took 5.4 hours' worth of legal services to resolve. The most common problems were related to VA benefits, housing, family issues, and consumer issues. Among a subsample of 148 veterans who were followed for one year, we observed significant improvements in housing, income, and mental health. Veterans who received more partnership services showed greater improvements in housing and mental health than those who received fewer services, and those who achieved their predefined legal goals showed greater improvements in housing status and community integration than those who did not. Medical-legal partnerships represent an opportunity to expand cross-sector, community-based partnerships in the VA health care system to address social determinants of mental health.

  14. Philadelphia (1993: las claves de un icono cultural

    Directory of Open Access Journals (Sweden)

    José Aijón Oliva

    2008-10-01

    Full Text Available Philadelphia responde a la razón fundamental del cine comercial de los últimos tiempos: darle al público aquello que quiere ver. A medida que van surgiendo los problemas en la sociedad, el cine se interesa por ellos y realiza películas centradas en ese tema. A principios de los años 90 la alarma social ante el virus del SIDA era tan importante que surgieron muchas películas que trataban este tema. Philadelphia es la más popular de todas ellas y la más accesible (y probablemente la de mayor calidad cinematográfica, aunque su planteamiento es bastante engañoso: no es tanto una película sobre el SIDA como del rechazo al colectivo homosexual. No obstante, desmitifica algunos aspectos del SIDA y da algunas respuestas que se pueden considerar pedagógicas.             Un gran director, un reparto muy acertado, un guión (de estructura clásica de categoría, una música muy bien seleccionada y unos juegos de luces y cámara muy cuidados son los ingredientes que convierten a esta película en uno de los iconos de la cultura popular de los 90.

  15. 38 CFR 74.27 - How will VA store information?

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.27 How will VA store information? VA... examination visits will be scanned onto portable media and fully secured in the Center for Veterans Enterprise...

  16. Structural and Functional Characterization of a New Double Variant Haemoglobin (HbG-Philadelphia/Duarte α(2)β(2)).

    Science.gov (United States)

    Fais, Antonella; Casu, Mariano; Ruggerone, Paolo; Ceccarelli, Matteo; Porcu, Simona; Era, Benedetta; Anedda, Roberto; Sollaino, Maria Carla; Galanello, Renzo; Corda, Marcella

    2011-01-01

    WE REPORT THE FIRST CASE OF COSEGREGATION OF TWO HAEMOGLOBINS (HBS): HbG-Philadelphia [α68(E17)Asn → Lys] and HbDuarte [β62(E6)Ala → Pro]. The proband is a young patient heterozygous also for β°-thalassaemia. We detected exclusively two haemoglobin variants: HbDuarte and HbG-Philadelphia/Duarte. Functional study of the new double variant HbG-Philadelphia/Duarte exhibited an increase in oxygen affinity, with a slight decrease of cooperativity and Bohr effect. This functional behaviour is attributed to β62Ala → Pro instead of α68Asn → Lys substitution. Indeed, HbG-Philadelphia isolated in our laboratory from blood cells donor carrier for this variant is not affected by any functional modification, whereas purified Hb Duarte showed functional properties very similar to the double variant. NMR and MD simulation studies confirmed that the presence of Pro instead of Ala at the β62 position produces displacement of the E helix and modifications of the tertiary structure. The substitution α68(E17)Asn → Lys does not cause significant structural and dynamical modifications of the protein. A possible structure-based rational of substitution effects is suggested.

  17. Searching for Silver Linings: Is Perceived Medical Discrimination Weaker in Segregated Areas?

    Science.gov (United States)

    Gibbons, Joseph; Yang, Tse-Chuan

    2018-03-01

    An ongoing obstacle in dealing with minority health disparities is discriminatory behavior from healthcare practitioners, also known as medical discrimination. It is not clear, however, if the effects of medical discriminations onto health are constant across space. For example, there is evidence to suspect minorities in racially segregated neighborhoods suffer less from discrimination compared to those living elsewhere. To determine the presence of spatial heterogeneity underlying medical discrimination, we implement logistic geographically weighted regression (GWR) using individual data in the city of Philadelphia from the 2006 and 2008 Public Health Management Corporation's Southeastern Pennsylvania Household Health Surveys. Evaluating the potential role residential segregation has in offsetting medical discrimination, we compare the GWR results to tract data from the 2005-2009 American Community Survey. Through this comparison, we find that the effects of medical discrimination on self-rated health are weaker in magnitude in areas that are mostly minority. However, evidence of direct health benefits for minorities in segregated communities is inconclusive. Thus, while we cannot say living in segregated neighborhoods leads to better minority health, the sting of medical discrimination can be weaker in these places. These results emphasize the importance of local variation, even within a city like Philadelphia, challenging the aspatial one-model-fits-all approach normally found in population studies.

  18. Pediatric radiology in the Philadelphia region: a history of pedigrees and legacies

    Energy Technology Data Exchange (ETDEWEB)

    Markowitz, Richard I. [University of Pennsylvania School of Medicine, Department of Radiology, Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2009-09-15

    The specialty of pediatric radiology in the Philadelphia region has grown and evolved over the past eight decades originating from early ''visiting'' radiologists to Drs. Hope and Kirkpatrick, the ''giants'' of the 1950s and 1960s, to over 40 actively practicing pediatric radiologists. Clinical excellence, commitment to teaching, and advancement of knowledge through research remain the goals and ideals, much as they were many years ago. Philadelphia has been a fertile home and environment for this development, mostly because of outstanding leaders and role models who have trained and influenced generations of pediatric radiologists. The purpose of this article is to tell the story of this growth and development and to explore the intellectual origins, professional ''genealogy,'' and legacies left by those who created this tradition. (orig.)

  19. A systematic exploration of differences in contextual factors related to implementing the MOVE! weight management program in VA: A mixed methods study

    Directory of Open Access Journals (Sweden)

    Fletcher Carol E

    2011-09-01

    Full Text Available Abstract Background In January 2006, Veterans Affairs (VA disseminated the MOVE!® Weight Management Program to VA medical centers to address the high prevalence of overweight/obesity. In its second year, MOVE! implementation varied widely across facilities. The objective of this study was to understand contextual factors that facilitated or impeded implementation of MOVE! in VA medical centers in the second year after its dissemination. Methods We used an embedded mixed methods cross-sectional study design. Qualitative and quantitative data were collected simultaneously with the primary purpose to explore contextual factors most likely to influence MOVE! implementation effectiveness at five purposively selected facilities. Facilities were selected to maximize variation with respect to participation in MOVE! by candidate Veterans. Semi-structured phone interviews were conducted with 24 staff across the five facilities. Quantitative responses were elicited followed by open-ended questions. The quantitative measures were adapted from a published implementation model. Qualitative analysis was conducted using rigorous content analysis methods. Results Qualitative and quantitative data converged to strengthen findings that point to several recommendations. Management support can help increase visibility of the program, commit needed resources, and communicate the importance of implementation efforts. Establishing a receptive implementation climate can be accomplished by emphasizing the important role that weight management may have in reducing incidence and severity of obesity-related chronic conditions. Coalescing highly functioning multi-disciplinary teams was an essential step for more effective implementation of MOVE!. In some situations, local champions can overcome challenging barriers in facilities that lack sufficient management support. Conclusions Key organizational factors at local VA medical centers were strongly associated with MOVE

  20. The effect of pre-existing mental health comorbidities on the stage at diagnosis and timeliness of care of solid tumor malignances in a Veterans Affairs (VA) medical center

    International Nuclear Information System (INIS)

    Wadia, Roxanne J; Yao, Xiaopan; Deng, Yanhong; Li, Jia; Maron, Steven; Connery, Donna; Gunduz-Bruce, Handan; Rose, Michal G

    2015-01-01

    There are limited data on the impact of mental health comorbidities (MHC) on stage at diagnosis and timeliness of cancer care. Axis I MHC affect approximately 30% of Veterans receiving care within the Veterans Affairs (VA) system. The purpose of this study was to compare stage at diagnosis and timeliness of care of solid tumor malignancies among Veterans with and without MHC. We performed a retrospective analysis of 408 charts of Veterans with colorectal, urothelial, and head/neck cancer diagnosed and treated at VA Connecticut Health Care System (VACHS) between 2008 and 2011. We collected demographic data, stage at diagnosis, medical and mental health co-morbidities, treatments received, key time intervals, and number of appointments missed. The study was powered to assess for stage migration of 15–20% from Stage I/II to Stage III/IV. There was no significant change in stage distribution for patients with and without MHC in the entire study group (p = 0.9442) and in each individual tumor type. There were no significant differences in the time intervals from onset of symptoms to initiation of treatment between patients with and without MHC (p = 0.1135, 0.2042 and 0.2352, respectively). We conclude that at VACHS, stage at diagnosis for patients with colorectal, urothelial and head and neck cancers did not differ significantly between patients with and without MHC. Patients with MHC did not experience significant delays in care. Our study indicates that in a medical system in which mental health is integrated into routine care, patients with Axis I MHC do not experience delays in cancer care

  1. 48 CFR 852.219-71 - VA mentor-protégé program.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA mentor-protégÃ....219-71 VA mentor-protégé program. As prescribed in 819.7115(a), insert the following clause: VA Mentor-Protégé Program (DEC 2009) (a) Large businesses are encouraged to participate in the VA Mentor-Protégé...

  2. The effect of Philadelphia and Pennsylvania Clean Indoor Air Act on food services and drinking places sales and numbers, 1998-2011.

    Science.gov (United States)

    Ma, Zhen-Qiang; Fisher, Monica A

    2013-11-27

    Philadelphia enacted its Clean Indoor Air Act (CIAA) nearly 2 years before the statewide CIAA. In this study, we assessed the economic impact of CIAAs on 4 types of food services and drinking places and addressed the predominant limitation of previous pre-post ban studies, namely the lack of control for confounders and changes in secular trends over time. We analyzed data from Pennsylvania Department of Revenue Quarterly 1998-2011 taxable county-level revenue sales and number of food services and drinking places. Region-specific and type-specific adjusted sales and number of food services and drinking places accounted for consumer spending as a general economic indicator. Segmented regression analysis of interrupted time-series methodology assessed changes in trend and level. Pennsylvania CIAA had no significant effect on adjusted sales or numbers except for an increase in sales in Philadelphia for limited-service eating places and in the surrounding 4 counties for special food services. Philadelphia CIAA was associated with an increase in adjusted numbers of full-service restaurants in Philadelphia and the rest of the state, special food services in Philadelphia, and drinking places in the rest of the state, and a decrease in the number of special food services in the surrounding counties. Philadelphia CIAA had no significant effect on adjusted sales except for an increase in special food services in the rest of the state. Overall, CIAAs had no negative business-related impact and, for the most part, suggest a positive impact on restaurant sales and numbers. Our results provide further support for comprehensive CIAA ordinance for restaurants.

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

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2018-03-01

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

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

    Science.gov (United States)

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

    2014-03-01

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

  5. Optimal management of steroid-dependent ulcerative colitis

    Directory of Open Access Journals (Sweden)

    Khan HMW

    2015-11-01

    Full Text Available Hafiz M Waqas Khan,1 Faisal Mehmood,1 Nabeel Khan2 1Department of Medicine, King Edward Medical University, Lahore, Pakistan; 2Section of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia VA Medical Center, Philadelphia, PA, USA Abstract: Ulcerative colitis (UC is a chronic inflammatory condition that is variable in both extent and severity of disease as well as response to therapy. Corticosteroids (CSs were the first drugs used in the management of UC and are still used for induction of remission. However, because of their extensive side-effect profile, they are not utilized for maintenance of remission. In view of this, CS-free remission has become an important end point while evaluating therapeutic agents used in the management of UC. This review highlights the results of various studies conducted to evaluate the efficacy of different medications to attain CS-free remission in the setting of active UC. The drugs reviewed include established agents such as thiopurines, methotrexate, infliximab, adalimumab, vedolizumab, golimumab, and newer experimental agents, and if all else fails, colectomy will be performed. The efficacy of these drugs is evaluated individually. Our aim is to provide a synopsis of the work done in this field to date. Keywords: ulcerative colitis, steroid dependent, thiopurines, MTX, adalimumab, infliximab

  6. 77 FR 67063 - VA Directive 0005 on Scientific Integrity

    Science.gov (United States)

    2012-11-08

    ... in multiple areas, including data integrity, ethics, privacy, and human research protections, as well... replace the Association for the Accreditation of Human Research Protection Programs (AAHRPP) with Alion... human research protection programs. VA Response: VA is currently reviewing its accreditation...

  7. 78 FR 14359 - Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA...

    Science.gov (United States)

    2013-03-05

    ... Business Networks Services, Inc., Specialist-Tech Customer Service, Philadelphia, PA; Verizon Business Networks Services, Inc., Specialist-Tech Customer Service, Tampa, Florida; Amended Certification Regarding... should [[Page 14360

  8. 75 FR 9277 - Proposed Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Science.gov (United States)

    2010-03-01

    ... Sports Clinic Application, VA Form 0924--233 hours. b. National Veterans Wheelchair Games Application, VA.... National Veterans TEE Tournament Application, VA Form 0927--133 hours. e. National Veterans Summer Sports... Form 0929--67 hours. OMB Control Number: 2900-New (VA Form 0924). Type of Review: Existing collection...

  9. VA National Bed Control System

    Data.gov (United States)

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

  10. Philadelphia chromosome-positive acute lymphoblastic leukemia in childhood

    Directory of Open Access Journals (Sweden)

    Hong Hoe Koo

    2011-03-01

    Full Text Available In pediatric patients with acute lymphoblastic leukemia (ALL, the Philadelphia chromosome translocation is uncommon, with a frequency of less than 5%. However, it is classified as a high or very high risk, and only 20&#8210;30% of Philadelphia chromosome-positive (Ph+ children with ALL are cured with chemotherapy alone. Allogeneic hematopoietic stem cell transplantation from a closely matched donor cures 60% of patients in first complete remission. Recent data suggest that chemotherapy plus tyrosine kinase inhibitors (TKIs may be the initial treatment of choice for Ph+ ALL in children. However, longer observation is required to determine whether long-term outcome with intensive imatinib and chemotherapy is indeed equivalent to that with allogeneic related or alternative donor hematopoietic stem cell transplantation (HSCT. Reports on the use of second-generation TKIs in children with Ph+ ALL are limited. A few case reports have indicated the feasibility and clinical benefit of using dasatinib as salvage therapy enabling HSCT. However, more extensive data from clinical trials are needed to determine whether the administration of secondgeneration TKIs in children is comparable to that in adults. Because Ph+ ALL is rare in children, the question of whether HSCT could be a dispensable part of their therapy may not be answered for some time. An international multicenter study is needed to answer the question of whether imatinib plus chemotherapy could replace sibling allogeneic HSCT in children with Ph+ ALL.

  11. Elements of Success: WorkReady Philadelphia Program Year 2011-2012 Report

    Science.gov (United States)

    Philadelphia Youth Network, 2012

    2012-01-01

    What does it take to deliver WorkReady Philadelphia's high-quality career-connected programming? In short, it's all about the "elements"--those essential components of the system that combine to produce success for young people. This 2011-12 WorkReady report reinforces this theme by using visual aspects of the "Periodic Table of…

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

    Science.gov (United States)

    2017-01-01

    Defense (DOD) responsibility for contracting support Quality assurance Accreditation and oversight from external entities and credentialing and...MTF designation would introduce additional operational requirements and challenges to the FHCC, including financial management and quality assurance...departments—including DOD’s operational readiness mission—by integrating services previously provided by the former North Chicago VA Medical Center

  13. VA Telemedicine: An Analysis of Cost and Time Savings.

    Science.gov (United States)

    Russo, Jack E; McCool, Ryan R; Davies, Louise

    2016-03-01

    The Veterans Affairs (VA) healthcare system provides beneficiary travel reimbursement ("travel pay") to qualifying patients for traveling to appointments. Travel pay is a large expense for the VA and hence the U.S. Government, projected to cost nearly $1 billion in 2015. Telemedicine in the VA system has the potential to save money by reducing patient travel and thus the amount of travel pay disbursed. In this study, we quantify this savings and also report trends in VA telemedicine volumes over time. All telemedicine visits based at the VA Hospital in White River Junction, VT between 2005 and 2013 were reviewed (5,695 visits). Travel distance and time saved as a result of telemedicine were calculated. Clinical volume in the mental health department, which has had the longest participation in telemedicine, was analyzed. Telemedicine resulted in an average travel savings of 145 miles and 142 min per visit. This led to an average travel payment savings of $18,555 per year. Telemedicine volume grew significantly over the study period such that by the final year the travel pay savings had increased to $63,804, or about 3.5% of the total travel pay disbursement for that year. The number of mental health telemedicine visits rose over the study period but remained small relative to the number of face-to-face visits. A higher proportion of telemedicine visits involved new patients. Telemedicine at the VA saves travel distance and time, although the reduction in travel payments remains modest at current telemedicine volumes.

  14. VA Dental Insurance Program--federalism. Direct final rule.

    Science.gov (United States)

    2013-10-22

    The Department of Veterans Affairs (VA) is taking direct final action to amend its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. Specifically, this rule will add language to clarify the limited preemptive effect of certain criteria in the VADIP regulations.

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

    National Research Council Canada - National Science Library

    2000-01-01

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

  16. Persistence of chromosomal abnormalities additional to the Philadelphia chromosome after Philadelphia chromosome disappearance during imatinib therapy for chronic myeloid leukemia.

    Science.gov (United States)

    Zaccaria, Alfonso; Valenti, Anna Maria; Donti, Emilio; Gozzetti, Alessandro; Ronconi, Sonia; Spedicato, Francesco

    2007-04-01

    Five Philadelphia chromosome positive (Ph+) chronic myeloid leukemia (CML) patients with additional chromosome abnormalities at diagnosis have been followed during Imatinib therapy. In all, the Ph chromosome disappeared, while the 5 cases, additional abnormalities [dup(1); del(5), +8 (2 patients) and +14] persisted in the subsequent studies, performed over a period of 11 to 49 months, either alone or together with a karyotypically normal cell population. This finding is consistent with a secondary origin of the Ph chromosome in these patients. It is still to early to evaluate the possible prognostic value of these additional abnormalities.

  17. Increased gene expression of histone deacetylases in patients with Philadelphia-negative chronic myeloproliferative neoplasms

    DEFF Research Database (Denmark)

    Skov, Vibe; Larsen, Thomas Stauffer; Thomassen, Mads

    2012-01-01

    Abstract Myeloproliferation, myeloaccumulation (decreased apoptosis), inflammation, bone marrow fibrosis and angiogenesis are cardinal features of the Philadelphia-negative chronic myeloproliferative neoplasms: essential thrombocythemia (ET), polycythemia vera (PV) and primary myelofibrosis (PMF...

  18. Job satisfaction and burnout among VA and community mental health workers.

    Science.gov (United States)

    Salyers, Michelle P; Rollins, Angela L; Kelly, Yu-Fan; Lysaker, Paul H; Williams, Jane R

    2013-03-01

    Building on two independent studies, we compared burnout and job satisfaction of 66 VA staff and 86 community mental health center staff in the same city. VA staff reported significantly greater job satisfaction and accomplishment, less emotional exhaustion and lower likelihood of leaving their job. Sources of work satisfaction were similar (primarily working with clients, helping/witnessing change). VA staff reported fewer challenges with job-related aspects (e.g. flexibility, pay) but more challenges with administration. Community mental health administrators and policymakers may need to address job-related concerns (e.g. pay) whereas VA administrators may focus on reducing, and helping workers navigate, administrative policies.

  19. 48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA Small business... Provisions and Clauses 852.219-9 VA Small business subcontracting plan minimum requirements. As prescribed in subpart 819.709, insert the following clause: VA Small Business Subcontracting Plan Minimum Requirements...

  20. Using Multispectral Analysis in GIS to Model the Potential for Urban Agriculture in Philadelphia

    Science.gov (United States)

    Dmochowski, J. E.; Cooper, W. P.

    2010-12-01

    In the context of growing concerns about the international food system’s dependence on fossil fuels, soil degradation, climate change, and other diverse issues, a number of initiatives have arisen to develop and implement sustainable agricultural practices. Many seeking to reform the food system look to urban agriculture as a means to create localized, sustainable agricultural production, while simultaneously providing a locus for community building, encouraging better nutrition, and promoting the rebirth of depressed urban areas. The actual impact of such system, however, is not well understood, and many critics of urban agriculture regard its implementation as impractical and unrealistic. This project uses multispectral imagery from United States Department of Agriculture’s National Agricultural Imagery Program with a one-meter resolution to quantify the potential for increasing urban agriculture in an effort to create a sustainable food system in Philadelphia. Color infrared images are classified with a minimum distance algorithm in ArcGIS to generate baseline data on vegetative cover in Philadelphia. These data, in addition to mapping on the ground, form the basis of a model of land suitable for conversion to agriculture in Philadelphia, which will help address questions related to potential yields, workforce, and energy requirements. This research will help city planners, entrepreneurs, community leaders, and citizens understand how urban agriculture can contribute to creating a sustainable food system in a major North American city.

  1. 78 FR 76779 - Proposed Modification of the Philadelphia, PA, Class B Airspace Area

    Science.gov (United States)

    2013-12-19

    ... regulatory and informational requirements to the scale of the businesses, organizations, and governmental... businesses, not-for-profit organizations, and small governmental jurisdictions. Agencies must perform a... southeast than intended from the Philadelphia International Airport. This was caused by the miscalculation...

  2. SEASONAL ABUNDANCE OF ORGANIC MOLECULAR MARKERS IN URBAN PARTICULATE MATTER FROM PHILADELPHIA, PA

    Science.gov (United States)

    Organic molecular markers were measured in airborne particulate matter (PM10) from the City of Philadelphia North Broad Street air quality monitoring site to identify the seasonal abundances of key tracer compounds together with their dominant sources. Daily PM10...

  3. How Philadelphia is Integrating Climate Science and Policy: Changing Capital Planning Processes and Developing Flood-Depth Tools

    Science.gov (United States)

    Bhat, C.; Dix, B.; Choate, A.; Wong, A.; Asam, S.; Schultz, P. A.

    2016-12-01

    Policy makers can implement more effective climate change adaptation programs if they are provided with two tools: accessible information on the impacts that they need to prepare for, and clear guidance on how to integrate climate change considerations into their work. This presentation will highlight recent and ongoing efforts at the City of Philadelphia to integrate climate science into their decision-making. These efforts include developing a climate change information visualization tool, climate change risk assessments across the city, and processes to integrate climate change into routine planning and budgeting practices. The goal of these efforts is to make climate change science highly targeted to decision maker needs, non-political, easily accessible, and actionable. While sea level rise inundation maps have been available to communities for years, the maps do not effectively communicate how the design of a building or a piece of infrastructure would need to be modified to protect it. The Philadelphia Flood Risk Viewer is an interactive planning tool that allows Philadelphia to identify projected depths of flooding for any location within the City, for a variety of sea level rise and storm surge scenarios. Users can also determine whether a location is located in a FEMA floodplain. By having access to information on the projected depth of flooding at a given location, the City can determine what flood protection measures may be effective, or even inform the long-term viability of developing a particular area. With an understanding of climate vulnerabilities, cities have the opportunity to make smart, climate-resilient investments with their capital budgets that will yield multiple benefits for years to come. Few, however, have established protocols for doing so. Philadelphia, with support from ICF, developed a guidance document that identifies recommendations for integrating climate change considerations throughout the Capital Program and capital budgeting

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

    Directory of Open Access Journals (Sweden)

    Rachel Peterson

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2018-03-15

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

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

    Science.gov (United States)

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

    2016-12-01

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

  8. OneVA EA Vision and Strategy

    Data.gov (United States)

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

  9. Flexural Stiffness of Myosin Va Subdomains as Measured from Tethered Particle Motion

    Science.gov (United States)

    Michalek, Arthur J.; Kennedy, Guy G.; Warshaw, David M.; Ali, M. Yusuf

    2015-01-01

    Myosin Va (MyoVa) is a processive molecular motor involved in intracellular cargo transport on the actin cytoskeleton. The motor's processivity and ability to navigate actin intersections are believed to be governed by the stiffness of various parts of the motor's structure. Specifically, changes in calcium may regulate motor processivity by altering the motor's lever arm stiffness and thus its interhead communication. In order to measure the flexural stiffness of MyoVa subdomains, we use tethered particle microscopy, which relates the Brownian motion of fluorescent quantum dots, which are attached to various single- and double-headed MyoVa constructs bound to actin in rigor, to the motor's flexural stiffness. Based on these measurements, the MyoVa lever arm and coiled-coil rod domain have comparable flexural stiffness (0.034 pN/nm). Upon addition of calcium, the lever arm stiffness is reduced 40% as a result of calmodulins potentially dissociating from the lever arm. In addition, the flexural stiffness of the full-length MyoVa construct is an order of magnitude less stiff than both a single lever arm and the coiled-coil rod. This suggests that the MyoVa lever arm-rod junction provides a flexible hinge that would allow the motor to maneuver cargo through the complex intracellular actin network. PMID:26770194

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

    Directory of Open Access Journals (Sweden)

    Véronique Geoffroy

    2015-03-01

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

  11. Home Health Care and Patterns of Subsequent VA and Medicare Health Care Utilization for Veterans

    Science.gov (United States)

    Van Houtven, Courtney Harold; Jeffreys, Amy S.; Coffman, Cynthia J.

    2008-01-01

    Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HOC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched…

  12. Phylogenetic reconstruction of the Legionella pneumophila Philadelphia-1 laboratory strains through comparative genomics.

    Directory of Open Access Journals (Sweden)

    Chitong Rao

    Full Text Available Over 20 years ago, two groups independently domesticated Legionella pneumophila from a clinical isolate of bacteria collected during the first recognized outbreak of Legionnaires' disease (at the 1976 American Legion's convention in Philadelphia. These two laboratory strains, JR32 and Lp01, along with their derivatives, have been disseminated to a number of laboratories around the world and form the cornerstone of much of the research conducted on this important pathogen to date. Nevertheless, no exhaustive examination of the genetic distance between these strains and their clinical progenitor has been performed thus far. Such information is of paramount importance for making sense of several phenotypic differences observed between these strains. As environmental replication of L. pneumophila is thought to exclusively occur within natural protozoan hosts, retrospective analysis of the domestication and axenic culture of the Philadelphia-1 progenitor strain by two independent groups also provides an excellent opportunity to uncover evidence of adaptation to the laboratory environment. To reconstruct the phylogenetic relationships between the common laboratory strains of L. pneumophila Philadelphia-1 and their clinical ancestor, we performed whole-genome Illumina resequencing of the two founders of each laboratory lineage: JR32 and Lp01. As expected from earlier, targeted studies, Lp01 and JR32 contain large deletions in the lvh and tra regions, respectively. By sequencing additional strains derived from Lp01 (Lp02 and Lp03, we retraced the phylogeny of these strains relative to their reported ancestor, thereby reconstructing the evolutionary dynamics of each laboratory lineage from genomic data.

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

    International Nuclear Information System (INIS)

    Costello, Alexandra; Asem, Ebenezer; Gardner, Eldon

    2008-01-01

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

  14. Unfulfilled Promise: The Dimensions and Characteristics of Philadelphia's Dropout Crisis, 2000-2005

    Science.gov (United States)

    Neild, Ruth Curran; Balfanz, Robert

    2006-01-01

    This report uses a unique set of data obtained from the Kids Integrated Data System (KIDS), which is housed at the University of Pennsylvania's Cartographic Modeling Laboratory. The KIDS system merges individual-level data on young people from the School District of Philadelphia and the city's social service agencies, including the Department of…

  15. Urban ecosystem services and decision making for a green Philadelphia

    Science.gov (United States)

    Hogan, Dianna M.; Shapiro, Carl D.; Karp, David N.; Wachter, Susan M.

    2014-01-01

    Traditional approaches to urban development often do not account for, or recognize, the role of ecosystem services and the benefits these services provide to the health and well-being of city residents. Without such accounting, urban ecosystem services are likely to be degraded over time, with negative consequences for the sustainability of cities and the well-being of their residents (Millennium Ecosystem Assessment, 2005; Hirsch, 2008). On May 23, 2013, the Spatial Integration Laboratory for Urban Systems (SILUS), a collaboration between the U.S. Geological Survey (USGS) Science and Decisions Center and the Wharton GIS Lab, convened a one-day symposium—Urban Ecosystem Services and Decision Making: A Green Philadelphia—at the University of Pennsylvania in Philadelphia, Pennsylvania, to examine the role of green infrastructure in the environmental, economic, and social well-being of cities. Cosponsored by the USGS and the Penn Institute for Urban Research (Penn IUR), the symposium brought together policymakers, practitioners, and researchers from a range of disciplines to advance a research agenda on the use of science in public decision making to inform investment in green infrastructure and ecosystem services in urban areas. The city of Philadelphia has recently implemented a program designed to sustain urban ecosystem services and advance the use of green infrastructure. In 2009, the Philadelphia Mayor’s Office of Sustainability launched its Greenworks plan, establishing a citywide sustainability strategy. Major contributions towards its goals are being implemented in coordination with the Philadelphia Water Department (PWD). The Green City, Clean Waters initiative, the city’s nationally recognized stormwater management plan, was signed into action with the U.S. Environmental Protection Agency (EPA) in April 2012. The plan outlines a 25-year strategy to use green infrastructure to protect and improve the city’s watershed. Widespread support for the

  16. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Science.gov (United States)

    2010-10-01

    ... poster. 803.7000 Section 803.7000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS... Improper Business Practices 803.7000 Display of the VA Hotline poster. (a) Under the circumstances described in paragraph (b) of this section, a contractor must display prominently a VA Hotline poster...

  17. Young People Take Their Rightful Places as Full and Contributing Members of a World Class Workforce: Philadelphia Youth Network Annual Report 2006

    Science.gov (United States)

    Philadelphia Youth Network, 2006

    2006-01-01

    The title of this year's annual report has particular meaning for all of the staff at the Philadelphia Youth Network. The phrase derives from Philadelphia Youth Network's (PYN's) new vision statement, developed as part of its recent strategic planning process, which reads: All of our city's young people take their rightful places as full and…

  18. The Short-Term Impacts of the Philadelphia Beverage Tax on Beverage Consumption.

    Science.gov (United States)

    Zhong, Yichen; Auchincloss, Amy H; Lee, Brian K; Kanter, Genevieve P

    2018-04-11

    On January 1, 2017, Philadelphia implemented a beverage tax of $0.015/ounce on sugar ("regular") and sugar-substitute ("diet") beverages. The purpose of this study was to evaluate the immediate impact of the tax on residents' consumption of soda, fruit drinks, energy drinks, and bottled water. A repeat cross-sectional study design used data from a random-digit-dialing phone survey during a no-tax period (December 6-31, 2016) and a tax period (January 15-February 31, 2017) among 899 respondents in Philadelphia, Pennsylvania, and 878 respondents in three nearby comparison cities. Survey questions included frequency and volume of bottled water and beverages. Outcomes were daily consumption, and 30-day consumption frequency and volume. Propensity score-weighted difference-in-differences regression was used to control for secular time trend and confounding. Covariates were sociodemographics, BMI, health status, smoking, and alcohol use. Analyses were conducted in 2017. Within the first 2 months of tax implementation, relative to the comparison cities, in Philadelphia the odds of daily consumption of regular soda was 40% lower (OR=0.6, 95% CI=0.37, 0.97); energy drink was 64% lower (OR=0.36, 95% CI=0.17, 0.76); bottled water was 58% higher (OR=1.58, 95% CI=1.13, 2.20); and the 30-day regular soda consumption frequency was 38% lower (ratio of consumption frequency=0.62, 95% CI=0.40, 0.98). Early results suggest that the tax influenced daily consumption of regular soda, energy drinks, and bottled water. Future studies are needed to evaluate longer-term impact of the tax on sugared beverage consumption and substitutions. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Contracting Out Schools: The First Year of the Philadelphia Diverse Provider Model

    Science.gov (United States)

    Bulkley, Katrina; Mundell, Leah; Riffer, Morgan

    2004-01-01

    Educators nationwide focused on Philadelphia in the summer of 2001 as politicians and policy makers explored the possibility of a state takeover of the city's school system, a seismic power shift that would produce the largest privatization of a public school district in American history. The findings reported in this document are based on…

  20. ESTIMATING RISK ON THE CAPITAL MARKET WITH VaR METHOD

    Directory of Open Access Journals (Sweden)

    Sinisa Bogdan

    2015-06-01

    Full Text Available The two basic questions that every investor tries to answer before investment are questions about predicting return and risk. Risk and return are generally considered two positively correlated sizes, during the growth of risk it is expected increase of return to compensate the higher risk. The quantification of risk in the capital market represents the current topic since occurrence of securities. Together with estimated future returns it represents starting point of any investment. In this study it is described the history of the emergence of VaR methods, usefulness in assessing the risks of financial assets. Three main Value at Risk (VaR methodologies are decribed and explained in detail: historical method, parametric method and Monte Carlo method. After the theoretical review of VaR methods it is estimated risk of liquid stocks and portfolio from the Croatian capital market with historical and parametric VaR method, after which the results were compared and explained.

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

    Energy Technology Data Exchange (ETDEWEB)

    Costello, Alexandra [Seminole Canada Energy, Calgary, AB (Canada); Asem, Ebenezer; Gardner, Eldon [Faculty of Management, University of Lethbridge, Lethbridge, AB (Canada)

    2008-09-15

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

  2. VA Veterans Health Administration Access Data

    Data.gov (United States)

    Department of Veterans Affairs — At the Department of Veterans Affairs (VA), our most important mission is to provide the high quality health care and benefits Veterans have earned and deserve —...

  3. Idiopathic hypersomnia

    Science.gov (United States)

    ... T, Dement WC, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 91. ... Blaivas, DO, Division of Pulmonary, Critical Care, and Sleep Medicine, VA New Jersey Health Care System, Clinical Assistant ...

  4. Isolated sleep paralysis

    Science.gov (United States)

    ... T, Dement WC, eds. Principles and Practice of Sleep Medicine. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 103. ... Blaivas, DO, Division of Pulmonary, Critical Care, and Sleep Medicine, VA New Jersey Health Care System, Clinical Assistant ...

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

    Science.gov (United States)

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

    2014-05-01

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

  6. Research on Interval Forecast For Metal Futures Market′s VaR Based on Bootstrap%基于Bootstrap的金属期货市场风险VaR区间预测

    Institute of Scientific and Technical Information of China (English)

    沈盟; 王璐

    2016-01-01

    金属期货市场风险VaR的准确测度对防范期货交易风险及保持市场健康平稳运行有重要作用.传统的VaR测度方法主要以点预测为主,无法反映预测近似值的精确程度及范围. 因此,提出了一种基于Bootstrap的金属期货市场风险VaR区间预测方法,同时引入LR检验区间预测的有效性,最后利用我国铜和铝期货市场数据进行了VaR风险的区间预测. 结果表明,新的VaR区间预测方法能克服点预测的不足,准确有效地描述VaR的估计风险,同时置信区间上下限可用于风险的预警及控制.%The accurate measurement on metal futures market′s VaR is important to prevent the futures′transaction risk and maintain the market healthy and stable operation.The traditional methods measuring VaR focus on point forecast which can't re-flect the accuracy of the predictive value.A new method to measure the interval forecast for metal futures market's VaR based on bootstrap is put forward.LR test is used to test the effectiveness of interval forecast.Finally,we empirical study the interval fore-cast of copper and aluminum futures market's VaR in China.The results show that the new method can overcome the lack of point forecast,while the upper and lower confidence interval can be used for early warning and control financial risks.

  7. 76 FR 52230 - Establishment of Class E Airspace; Forest, VA

    Science.gov (United States)

    2011-08-22

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

  8. VA Personal Health Record Sample Data

    Data.gov (United States)

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

  9. Computing Conditional VaR using Time-varying CopulasComputing Conditional VaR using Time-varying Copulas

    Directory of Open Access Journals (Sweden)

    Beatriz Vaz de Melo Mendes

    2005-12-01

    Full Text Available It is now widespread the use of Value-at-Risk (VaR as a canonical measure at risk. Most accurate VaR measures make use of some volatility model such as GARCH-type models. However, the pattern of volatility dynamic of a portfolio follows from the (univariate behavior of the risk assets, as well as from the type and strength of the associations among them. Moreover, the dependence structure among the components may change conditionally t past observations. Some papers have attempted to model this characteristic by assuming a multivariate GARCH model, or by considering the conditional correlation coefficient, or by incorporating some possibility for switches in regimes. In this paper we address this problem using time-varying copulas. Our modeling strategy allows for the margins to follow some FIGARCH type model while the copula dependence structure changes over time.

  10. Validation of verbal autopsy methods using hospital medical records: a case study in Vietnam.

    Science.gov (United States)

    Tran, Hong Thi; Nguyen, Hoa Phuong; Walker, Sue M; Hill, Peter S; Rao, Chalapati

    2018-05-18

    Information on causes of death (COD) is crucial for measuring the health outcomes of populations and progress towards the Sustainable Development Goals. In many countries such as Vietnam where the civil registration and vital statistics (CRVS) system is dysfunctional, information on vital events will continue to rely on verbal autopsy (VA) methods. This study assesses the validity of VA methods used in Vietnam, and provides recommendations on methods for implementing VA validation studies in Vietnam. This validation study was conducted on a sample of 670 deaths from a recent VA study in Quang Ninh province. The study covered 116 cases from this sample, which met three inclusion criteria: a) the death occurred within 30 days of discharge after last hospitalisation, and b) medical records (MRs) for the deceased were available from respective hospitals, and c) the medical record mentioned that the patient was terminally ill at discharge. For each death, the underlying cause of death (UCOD) identified from MRs was compared to the UCOD from VA. The validity of VA diagnoses for major causes of death was measured using sensitivity, specificity and positive predictive value (PPV). The sensitivity of VA was at least 75% in identifying some leading CODs such as stroke, road traffic accidents and several site-specific cancers. However, sensitivity was less than 50% for other important causes including ischemic heart disease, chronic obstructive pulmonary diseases, and diabetes. Overall, there was 57% agreement between UCOD from VA and MR, which increased to 76% when multiple causes from VA were compared to UCOD from MR. Our findings suggest that VA is a valid method to ascertain UCOD in contexts such as Vietnam. Furthermore, within cultural contexts in which patients prefer to die at home instead of a healthcare facility, using the available MRs as the gold standard may be meaningful to the extent that recall bias from the interval between last hospital discharge and death

  11. Relationship Between Total and Biaccessible Lead on Children's Blood Lead Levles in Urban Residential Philadelphia Soils.

    Data.gov (United States)

    U.S. Environmental Protection Agency — Relationship Between Total and Biaccessible Lead on Children's Blood Lead Levles in Urban Residential Philadelphia Soils. This dataset is not publicly accessible...

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

    Directory of Open Access Journals (Sweden)

    Carla Fernández Espinel

    2017-04-01

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

  13. Interferon-alpha in the treatment of Philadelphia-negative chronic myeloproliferative neoplasms. Status and perspectives

    DEFF Research Database (Denmark)

    Hasselbalch, Hans Carl; Larsen, Thomas Stauffer; Riley, Caroline Hasselbalch

    2011-01-01

    The Philadelphia-negative chronic myeloproliferative neoplasms encompass essential thrombocythemia (ET), polycythemia vera (PV) and primary myelofibrosis (PMF). A major break-through in the understanding of the pathogenesis of these neoplasms occurred in 2005 by the discovery of the JAK2 V617F...

  14. The Application of VaR Method to Risk Evaluation of Bank Loans%VaR方法在银行贷款风险评估中的应用

    Institute of Scientific and Technical Information of China (English)

    邹新月

    2005-01-01

    Value-at-Risk model developed recently is a mathemetical medol to measure and monitor market risk. The article focuses on discussing calculate procedure and calculate method about applying VaR means for the bank loan risk in evaluation, we make clear differentiate both the Bank for International Settlements draw credit risk reserve and VaR means calculate bank loan risk value, find VaR means in application practicality value and extensity perspective in our bank loan risk for evaluation

  15. Trend Analyses of Users of a Syringe Exchange Program in Philadelphia, Pennsylvania: 1999-2014.

    Science.gov (United States)

    Maurer, Laurie A; Bass, Sarah Bauerle; Ye, Du; Benitez, José; Mazzella, Silvana; Krafty, Robert

    2016-12-01

    This study examines trends of injection drug users' (IDUs) use of a Philadelphia, Pennsylvania, syringe exchange program (SEP) from 1999 to 2014, including changes in demographics, drug use, substance abuse treatment, geographic indicators, and SEP use. Prevention Point Philadelphia's SEP registration data were analyzed using linear regression, Pearson's Chi square, and t-tests. Over time new SEP registrants have become younger, more racially diverse, and geographically more concentrated in specific areas of the city, corresponding to urban demographic shifts. The number of new registrants per year has decreased, however syringes exchanged have increased. Gentrification, cultural norms, and changes in risk perception are believed to have contributed to the changes in SEP registration. Demographic changes indicate outreach strategies for IDUs may need adjusting to address unique barriers for younger, more racially diverse users. Implications for SEPs are discussed, including policy and continued ability to address current public health threats.

  16. 78 FR 76412 - Agency Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Science.gov (United States)

    2013-12-17

    ... INFORMATION: Titles: a. National Disabled Veterans Winter Sports Clinic Application, VA Form 0924a, c, d and..., c, e. j. Voluntary Service Application, VA Form 0927f. k. National Veterans Summer sports Clinic... Festival Event Application, VA0929a, b, c, d, e, f, g, h. Type of Review: Revision of an already approved...

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

    Directory of Open Access Journals (Sweden)

    WAYAN ARTHINI

    2012-09-01

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

  18. A comparison of physicians and medical assistants in interpreting verbal autopsy interviews for allocating cause of neonatal death in Matlab, Bangladesh: can medical assistants be considered an alternative to physicians?

    Science.gov (United States)

    2010-01-01

    Objective This study assessed the agreement between medical physicians in their interpretation of verbal autopsy (VA) interview data for identifying causes of neonatal deaths in rural Bangladesh. Methods The study was carried out in Matlab, a rural sub-district in eastern Bangladesh. Trained persons conducted the VA interview with the mother or another family member at the home of the deceased. Three physicians and a medical assistant independently reviewed the VA interviews to assign causes of death using the International Classification of Diseases - Tenth Revision (ICD-10) codes. A physician assigned cause was decided when at least two physicians agreed on a cause of death. Cause-specific mortality fraction (CSMF), kappa (k) statistic, sensitivity, specificity, and positive predictive values were applied to compare agreement between the reviewers. Results Of the 365 neonatal deaths reviewed, agreement on a direct cause of death was reached by at least two physicians in 339 (93%) of cases. Physician and medical assistant reviews of causes of death demonstrated the following levels of diagnostic agreement for the main causes of deaths: for birth asphyxia the sensitivity was 84%, specificity 93%, and kappa 0.77. For prematurity/low birth weight, the sensitivity, specificity, and kappa statistics were, respectively, 53%, 96%, and 0.55, for sepsis/meningitis they were 48%, 98%, and 0.53, and for pneumonia they were 75%, 94%, and 0.51. Conclusion This study revealed a moderate to strong agreement between physician- assigned and medical assistant- assigned major causes of neonatal death. A well-trained medical assistant could be considered an alternative for assigning major causes of neonatal deaths in rural Bangladesh and in similar settings where physicians are scarce and their time costs more. A validation study with medically confirmed diagnosis will improve the performance of VA for assigning cause of neonatal death. PMID:20712906

  19. Poincare group, SU(3) and V-A in leptonic decay

    International Nuclear Information System (INIS)

    Boehm, A.

    1975-07-01

    From as few assumptions as possible about the relations between the Poincare group, the particle classifying SU(3) and V-A we derive properties of the K/sub l 3 / and K/sub L 2 / decays. From the assumed relation between SU(3) and the Poincare group and the first class condition it follows that the formfactor ratio Xi of K/sub l 3 / decay is Xi = --0.57, and that a value of Xi = 0 is in disagreement with very general and well accepted theoretical assumptions. Assuming universality of V-A, the Cabibbo suppression is derived from the relations between SU(3) and V-A as a consequence of the brokenness of SU(3). (U.S.)

  20. Secondhand Smoke Exposure and Smoke-free Policy in Philadelphia Public Housing.

    Science.gov (United States)

    Klassen, Ann C; Lee, Nora L; Pankiewicz, Aaron; Ward, Rikki; Shuster, Michelle; Ogbenna, Bethany Townsend; Wade, Anita; Boamah, Maxwell; Osayameh, Olufunlayo; Rule, Ana M; Szymkowiak, Dorota; Coffman, Ryan; Bragg, Virginius; Mallya, Giridhar

    2017-04-01

    Multi-unit housing environments remain significant sources of secondhand smoke (SHS) exposure, especially for vulnerable populations in subsidized housing. In Philadelphia, the largest US housing authority to implement smoke-free policies, we measured baseline resident smoking-related behaviors and attitudes, and longitudinal exposures to airborne nicotine, during policy development and implementation. In 4 communities, we collected data in 2013, 2014, and 2016, before and after introduction of comprehensive smoke-free policies, interviewing persons in 172 households, and monitoring air-borne nicotine in non-smoking homes and public areas. Average nicotine level differences across years were estimated with multi-level models. Fifty-six percent of respondents smoked. Only 37% of households were smoke-free, with another 41% restricting smoking by area or time of day. The number of locations with detectable nicotine did not differ before and after policy implementation, with approximately 20% of non-smoking homes and 70%-80% of public areas having detectable nicotine. However, public area nicotine levels were lower in 2016, after policy implementation, than in 2013 and 2014 (-0.19 μg/m 3 , p = .03). Findings suggest that initial policy implementation was associated with reduced SHS exposure in Philadelphia. As HUD strengthens smoke-free policies, SHS monitoring can be useful to educate stakeholders and build support for policy enforcement.

  1. OZONE PRODUCTION IN THE PHILADELPHIA URBAN AREA DURING NE-OPS 99

    International Nuclear Information System (INIS)

    KLEINMAN, L.I.; DAUM, P.H.; BRECHTEL, F.; LEE, Y.N.; NUNNERMACKER, L.J.; SPRINGSTON, S.R.; WEINSTEIN-LLOYD, J.

    2001-01-01

    As part of the 1999 NARSTO Northeast Oxidant and Particulate Study (NE-OPS) field campaign, the DOE G-1 aircraft sampled trace gases and aerosols in and around the Philadelphia metropolitan area. Twenty research flights were conducted between July 25 and August 11. The overall goals of these flights were to obtain a mechanistic understanding of O(sub 3) production; to characterize the spatial and temporal behavior of photo-oxidants and aerosols; and to study the evolution of aerosol size distributions, including the process of new particle formation. Within the NE-OPS program, other groups provided additional trace gas, aerosol, and meteorological observations using aircraft, balloon, remote sensing, and surface based instruments (Phillbrick et al., 2000). In this article we provide an overview of the G-1 observations related to O(sub 3) production, focusing on the vertical distribution of pollutants. Ozone production rates are calculated using a box model that is constrained by observed trace gas concentrations. Highest O(sub 3) concentrations were observed on July 31, which we present as a case study. On that day, O(sub 3) concentrations above the 1-hour 120 ppb standard were observed downwind of Philadelphia and also in the plume of a single industrial facility located on the Delaware River south of the city

  2. 78 FR 18425 - Proposed Information Collection VA Police Officer Pre-Employment Screening Checklist); Comment...

    Science.gov (United States)

    2013-03-26

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

  3. 76 FR 24570 - Proposed Information Collection (Application for VA Education Benefits) Activity; Comment Request

    Science.gov (United States)

    2011-05-02

    ... (Application for VA Education Benefits) Activity; Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA... Under the Montgomery GI Bill, VA Form 22-1990E. c. Application for VA Education Benefits Under the...

  4. 78 FR 23543 - Procurement List Deletions

    Science.gov (United States)

    2013-04-19

    ... Logistics Agency Troop Support, Philadelphia, PA NSN: 1680-00-677-2060--Bottom Assembly, Crew Berth NPA: None assigned. Contracting Activity: Defense Logistics Agency Aviation, Richmond, VA Service Service..., Property Management Service Center, Chicago, IL Patricia Briscoe, Deputy Director, Business Operations...

  5. Validation of KENO V.a for the Portsmouth Gaseous Diffusion Plant

    International Nuclear Information System (INIS)

    Felsher, H.D.; Fentiman, A.W.; Tayloe, R.W.; D'Aquila, D.

    1992-01-01

    At the Portsmouth Gaseous Diffusion Plant, KENO V.a is used to make criticality calculations for complex configurations and a wide range of 235 U enrichments. It is essential that the calculated critical conditions either accurately reflect the true critical state or that the bias from the true critical conditions are well known. Accordingly, a study has been initiated to validate KENO V.a over the ranges of parameters expected to be used when modeling equipment and processes at Portsmouth. Preliminary results of that study are reported in this paper. The ultimate goal of this study is to identify a set of data from existing critical experiments that will exercise all KENO V.a parameters commonly used by Portsmouth's criticality safety personnel. A second goal is to identify a relatively small subset of those experiments that may be run frequently to ensure that KENO V.a provides consistent results

  6. VA Health Care: Improvements Needed in Monitoring Antidepressant Use for Major Depressive Disorder and in Increasing Accuracy of Suicide Data

    Science.gov (United States)

    2014-11-01

    2009-2013 13 Contents Page ii GAO-15-55 VA Psychiatric Medications and Suicide Data Table 2: Number of Veterans in GAO’s Sample...anxiety, depressed mood, ruminations , suicidal ideation, sleep problems, intrusive memories, drug seeking behaviors, flashbacks, guilt/remorse...recommendation, with estimated completion dates in calendar year 2015. As agreed with your office, unless you publicly announce the contents of this

  7. Uncovering Clinical Features of De Novo Philadelphia Positive Myelodysplasia.

    Science.gov (United States)

    Armas, Aristides; Chen, Chen; Mims, Martha; Rivero, Gustavo

    2017-01-01

    Myelodysplastic syndrome (MDS) is cytogenetically heterogeneous and retains variable risk for acute myeloid leukemia transformation. Though not yet fully understood, there is an association between genetic abnormalities and defects in gene expression. The functional role for infrequent cytogenetic alteration remains unclear. An uncommon chromosomic abnormality is the presence of the Philadelphia (Ph) chromosome. Here, we report a patient with Ph+ MDS treated with low dose Dasatinib who achieved hematologic response for 7 months. In addition, we also examined the English literature on all de novo Ph + MDS cases between 1996 and 2015 to gain insight into clinical features and outcome.

  8. Herbarium specimens, photographs, and field observations show Philadelphia area plants are responding to climate change.

    Science.gov (United States)

    Panchen, Zoe A; Primack, Richard B; Anisko, Tomasz; Lyons, Robert E

    2012-04-01

    The global climate is changing rapidly and is expected to continue changing in coming decades. Studying changes in plant flowering times during a historical period of warming temperatures gives us a way to examine the impacts of climate change and allows us to predict further changes in coming decades. The Greater Philadelphia region has a long and rich history of botanical study and documentation, with abundant herbarium specimens, field observations, and botanical photographs from the mid-1800s onward. These extensive records also provide an opportunity to validate methodologies employed by other climate change researchers at a different biogeographical area and with a different group of species. Data for 2539 flowering records from 1840 to 2010 were assessed to examine changes in flowering response over time and in relation to monthly minimum temperatures of 28 Piedmont species native to the Greater Philadelphia region. Regression analysis of the date of flowering with year or with temperature showed that, on average, the Greater Philadelphia species studied are flowering 16 d earlier over the 170-yr period and 2.7 d earlier per 1°C rise in monthly minimum temperature. Of the species studied, woody plants with short flowering duration are the best indicators of a warming climate. For monthly minimum temperatures, temperatures 1 or 2 mo prior to flowering are most significantly correlated with flowering time. Studies combining herbarium specimens, photographs, and field observations are an effective method for detecting the effects of climate change on flowering times.

  9. Low frequency of c-MPL gene mutations in Iranian patients with Philadelphia-negative myeloproliferative disorders.

    Science.gov (United States)

    Ghotaslou, A; Nadali, F; Chahardouli, B; Alizad Ghandforosh, N; Rostami, S H; Alimoghaddam, K; Ghavamzadeh, A

    2015-01-01

    Myeloproliferative disorders are a group of diseases characterized by increased proliferation of myeloid lineage. In addition to JAK2V617F mutation, several mutations in the c-MPL gene have been reported in patients with philadelphia-negative chronic myeloproliferative disorders that could be important in the pathogenesis of diseases. The aim of the present study was to investigate the frequency of c-MPL and JAK2V617F mutations in Iranian patients with Philadelphia-negativemyeloproliferative disorders. Peripheral blood samples were collected from 60 patients with Philadelphia-negative MPD) Subgroups ET and PMF) and 25 healthy subjects as control group. The mutation status of c-MPL and Jak2V617F were investigated by using Amplification-refractory mutation system (ARMS) and Allele-Specific PCR (AS-PCR), respectively. The results were confirmed by sequencing. Among 60 patients, 34 (56.6%) and 1(1.7%) had Jak2V617F and c-MPL mutation, respectively. Patients with Jak2V617F mutation had higher WBC counts and hemoglobin concentration than those without the mutation (p= 0.005, p=0.003). In addition, for all healthy subjects in control group, mutations were negative. The present study revealed that the c-MPL mutations unlike the Jak2V617F mutations are rare in Iranian patients with Ph-negative MPNs and the low mutation rate should be considered in the design of screening strategies of MPD patients.

  10. Geographic Distribution of VA Expenditures FY 2016

    Data.gov (United States)

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

  11. Geographic Distribution of VA Expenditures FY2010

    Data.gov (United States)

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

  12. Geographic Distribution of VA Expenditures FY2012

    Data.gov (United States)

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

  13. Geographic Distribution of VA Expenditures FY2004

    Data.gov (United States)

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

  14. Geographic Distribution of VA Expenditures FY1998

    Data.gov (United States)

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

  15. Geographic Distribution of VA Expenditures FY2009

    Data.gov (United States)

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

  16. Geographic Distribution of VA Expenditures FY2013

    Data.gov (United States)

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

  17. Geographic Distribution of VA Expenditures FY2002

    Data.gov (United States)

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

  18. 78 FR 76061 - Authorization for Non-VA Medical Services

    Science.gov (United States)

    2013-12-16

    ... rule that may: (1) Have an annual effect on the economy of $100 million or more or adversely affect in a material way the economy, a sector of the economy, productivity, competition, jobs, the... Domiciliary Care; 64.015, Veterans State Nursing Home Care; 64.018, Sharing Specialized Medical Resources; 64...

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  20. Gentrification and Residential Mobility in Philadelphia.

    Science.gov (United States)

    Ding, Lei; Hwang, Jackelyn; Divringi, Eileen

    2016-11-01

    Gentrification has provoked considerable controversy surrounding its effects on residential displacement. Using a unique individual-level, longitudinal data set, this study examines mobility rates and residential destinations of residents in gentrifying neighborhoods during the recent housing boom and bust in Philadelphia for various strata of residents and different types of gentrification. We find that vulnerable residents, those with low credit scores and without mortgages, are generally no more likely to move from gentrifying neighborhoods compared with their counterparts in nongentrifying neighborhoods. When they do move, however, they are more likely to move to lower-income neighborhoods. Residents in gentrifying neighborhoods at the aggregate level have slightly higher mobility rates, but these rates are largely driven by more advantaged residents. These findings shed new light on the heterogeneity in mobility patterns across residents in gentrifying neighborhoods and suggest that researchers should focus more attention on the quality of residential moves and nonmoves for less advantaged residents, rather than mobility rates alone.

  1. 78 FR 39601 - Safety Zone, Sugar House Casino Fireworks Display, Delaware River; Philadelphia, PA

    Science.gov (United States)

    2013-07-02

    ...-AA00 Safety Zone, Sugar House Casino Fireworks Display, Delaware River; Philadelphia, PA AGENCY: Coast... the Delaware River. Sugar House Casino has contracted with Pyrotecnico Fireworks to arrange for this display. The Captain of the Port, Sector Delaware Bay, has determined that the Sugar House Casino...

  2. 77 FR 70967 - Authorization for Non-VA Medical Services

    Science.gov (United States)

    2012-11-28

    ... regulatory action that is likely to result in a rule that may: (1) Have an annual effect on the economy of $100 million or more or adversely affect in a material way the economy, a sector of the economy..., Sharing Specialized Medical Resources; 64.019, Veterans Rehabilitation Alcohol and Drug Dependence; 64.022...

  3. CoVaCS: a consensus variant calling system.

    Science.gov (United States)

    Chiara, Matteo; Gioiosa, Silvia; Chillemi, Giovanni; D'Antonio, Mattia; Flati, Tiziano; Picardi, Ernesto; Zambelli, Federico; Horner, David Stephen; Pesole, Graziano; Castrignanò, Tiziana

    2018-02-05

    The advent and ongoing development of next generation sequencing technologies (NGS) has led to a rapid increase in the rate of human genome re-sequencing data, paving the way for personalized genomics and precision medicine. The body of genome resequencing data is progressively increasing underlining the need for accurate and time-effective bioinformatics systems for genotyping - a crucial prerequisite for identification of candidate causal mutations in diagnostic screens. Here we present CoVaCS, a fully automated, highly accurate system with a web based graphical interface for genotyping and variant annotation. Extensive tests on a gold standard benchmark data-set -the NA12878 Illumina platinum genome- confirm that call-sets based on our consensus strategy are completely in line with those attained by similar command line based approaches, and far more accurate than call-sets from any individual tool. Importantly our system exhibits better sensitivity and higher specificity than equivalent commercial software. CoVaCS offers optimized pipelines integrating state of the art tools for variant calling and annotation for whole genome sequencing (WGS), whole-exome sequencing (WES) and target-gene sequencing (TGS) data. The system is currently hosted at Cineca, and offers the speed of a HPC computing facility, a crucial consideration when large numbers of samples must be analysed. Importantly, all the analyses are performed automatically allowing high reproducibility of the results. As such, we believe that CoVaCS can be a valuable tool for the analysis of human genome resequencing studies. CoVaCS is available at: https://bioinformatics.cineca.it/covacs .

  4. 76 FR 44288 - Establishment of Class E Airspace; New Market, VA

    Science.gov (United States)

    2011-07-25

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

  5. 76 FR 40453 - Agency Information Collection (Application for VA Education Benefits) Activity Under OMB Review

    Science.gov (United States)

    2011-07-08

    ... (Application for VA Education Benefits) Activity Under OMB Review AGENCY: Veterans Benefits Administration... Education Benefits, VA Form 22-1990. b. Application for Family Member to Use Transferred Benefits, VA Form 22-1990E. [[Page 40454

  6. Association between women veterans' experiences with VA outpatient health care and designation as a women's health provider in primary care clinics.

    Science.gov (United States)

    Bastian, Lori A; Trentalange, Mark; Murphy, Terrence E; Brandt, Cynthia; Bean-Mayberry, Bevanne; Maisel, Natalya C; Wright, Steven M; Gaetano, Vera S; Allore, Heather; Skanderson, Melissa; Reyes-Harvey, Evelyn; Yano, Elizabeth M; Rose, Danielle; Haskell, Sally

    2014-01-01

    Women veterans comprise a small percentage of Department of Veterans Affairs (VA) health care users. Prior research on women veterans' experiences with primary care has focused on VA site differences and not individual provider characteristics. In 2010, the VA established policy requiring the provision of comprehensive women's health care by designated women's health providers (DWHPs). Little is known about the quality of health care delivered by DWHPs and women veterans' experience with care from these providers. Secondary data were obtained from the VA Survey of Healthcare Experience of Patients (SHEP) using the Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient-centered medical home (PCMH) survey from March 2012 through February 2013, a survey designed to measure patient experience with care and the DWHPs Assessment of Workforce Capacity that discerns between DWHPs versus non-DWHPs. Of the 28,994 surveys mailed to women veterans, 24,789 were seen by primary care providers and 8,151 women responded to the survey (response rate, 32%). A total of 3,147 providers were evaluated by the SHEP-CAHPS-PCMH survey (40%; n = 1,267 were DWHPs). In a multivariable model, patients seen by DWHPs (relative risk, 1.02; 95% CI, 1.01-1.04) reported higher overall experiences with care compared with patients seen by non-DWHPs. The main finding is that women veterans' overall experiences with outpatient health care are slightly better for those receiving care from DWHPs compared with those receiving care from non-DWHPs. Our findings have important policy implications for how to continue to improve women veterans' experiences. Our work provides support to increase access to DWHPs at VA primary care clinics. Published by Elsevier Inc.

  7. Medical Total Force Management

    Science.gov (United States)

    2014-05-01

    Facilities (MTFs). For specialties that are common in civilian labor markets , civilian providers generally cost less than military providers. While the...produced in Military Treatment Facilities (MTFs). For specialties that are common in civilian labor markets , civilian providers generally cost less...Attracting Fully Trained Medical Personnel,” CRM D0013237.A2 (Alexandria, VA: CNA Corporation, 2006). 66

  8. A Survey of Automotive Mechanics Programs in the Philadelphia Public Schools. Report No. 8701.

    Science.gov (United States)

    Chern, Hermine J.; And Others

    During March and April of 1986, the three members of the Career Education Evaluation Unit of the Philadelphia (Pennsylvania) School District interviewed 29 automotive mechanics teachers working at nine comprehensive high schools, two vocational technical schools, and two skills centers. The interviews focused on the implementation of standardized…

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

    Science.gov (United States)

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

    1992-01-01

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

  10. MODEL NON LINIER GARCH (NGARCH UNTUK MENGESTIMASI NILAI VALUE at RISK (VaR PADA IHSG

    Directory of Open Access Journals (Sweden)

    I KOMANG TRY BAYU MAHENDRA

    2015-06-01

    Full Text Available In investment, risk measurement is important. One of risk measure is Value at Risk (VaR. There are many methods that can be used to estimate risk based on VaR framework. One of them Non Linier GARCH (NGARCH model. In this research, determination of VaR used NGARCH model. NGARCH model allowed for asymetric behaviour in the volatility such that “good news” or positive return and “bad news” or negative return. Based on calculations of VaR, the higher of the confidence level and the longer the investment period, the risk was greater. Determination of VaR using NGARCH model was less than GARCH model.

  11. Vectorization of the KENO V.a criticality safety code

    International Nuclear Information System (INIS)

    Hollenbach, D.F.; Dodds, H.L.; Petrie, L.M.

    1991-01-01

    The development of the vector processor, which is used in the current generation of supercomputers and is beginning to be used in workstations, provides the potential for dramatic speed-up for codes that are able to process data as vectors. Unfortunately, the stochastic nature of Monte Carlo codes prevents the old scalar version of these codes from taking advantage of the vector processors. New Monte Carlo algorithms that process all the histories undergoing the same event as a batch are required. Recently, new vectorized Monte Carlo codes have been developed that show significant speed-ups when compared to the scalar version of themselves or equivalent codes. This paper discusses the vectorization of an already existing and widely used criticality safety code, KENO V.a All the changes made to KENO V.a are transparent to the user making it possible to upgrade from the standard scalar version of KENO V.a to the vectorized version without learning a new code

  12. Buying Program of the Standard Automated Materiel Management System. Automated Small Purchase System: Defense Supply Center Philadelphia

    National Research Council Canada - National Science Library

    2001-01-01

    The Standard Automated Materiel Management System Automated Small Purchase System is a fully automated micro-purchases system used by the General and Industrial Directorate at the Defense Supply Center Philadelphia...

  13. GATEWAY Demonstrations: Philadelphia International Airport Apron Lighting: LED System Performance in a Trial Installation

    Energy Technology Data Exchange (ETDEWEB)

    Davis, Robert G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wilkerson, Andrea M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-10-30

    This report documents a trial installation of LED apron lighting that replaced the existing high-pressure sodium luminaires at Philadelphia International Airport. Such high-mast applications remain challenging for LED technology, and the lessons learned from this project may help facility managers and LED product manufacturers better meet those challenges.

  14. 76 FR 79067 - Payment or Reimbursement for Emergency Treatment Furnished by Non-VA Providers in Non-VA...

    Science.gov (United States)

    2011-12-21

    ... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN49 Payment or Reimbursement for Emergency..., authorize the Secretary of Veterans Affairs to reimburse eligible veterans for costs related to non-VA.... Specifically, section 1725 authorizes reimbursement for emergency treatment for eligible veterans with...

  15. The Quality of Medication Treatment for Mental Disorders in the Department of Veterans Affairs and in Private-Sector Plans.

    Science.gov (United States)

    Watkins, Katherine E; Smith, Brad; Akincigil, Ayse; Sorbero, Melony E; Paddock, Susan; Woodroffe, Abigail; Huang, Cecilia; Crystal, Stephen; Pincus, Harold Alan

    2016-04-01

    The quality of mental health care provided by the U.S. Department of Veterans Affairs (VA) was compared with care provided to a comparable population treated in the private sector. Two cohorts of individuals with mental disorders (schizophrenia, bipolar disorder, posttraumatic stress disorder, major depression, and substance use disorders) were created with VA administrative data (N=836,519) and MarketScan data (N=545,484). The authors computed VA and MarketScan national means for seven process-based quality measures related to medication evaluation and management and estimated national-level performance by age and gender. In every case, VA performance was superior to that of the private sector by more than 30%. Compared with individuals in private plans, veterans with schizophrenia or major depression were more than twice as likely to receive appropriate initial medication treatment, and veterans with depression were more than twice as likely to receive appropriate long-term treatment. Findings demonstrate the significant advantages that accrue from an organized, nationwide system of care. The much higher performance of the VA has important clinical and policy implications.

  16. A Case Study of the Philadelphia Sugar-Sweetened Beverage Tax Policymaking Process: Implications for Policy Development and Advocacy.

    Science.gov (United States)

    Purtle, Jonathan; Langellier, Brent; Lê-Scherban, Félice

    Policymakers are increasingly proposing sugar-sweetened beverage (SSB) taxes as an evidence-based strategy to reduce chronic disease risk; and local health departments (LHDs) are well-positioned to play a role in SSB policy development and advocacy. However, most SSB tax proposals fail to become law and limited empiric guidance exists to inform advocacy efforts. In June 2016, Philadelphia, Pennsylvania, passed an SSB tax. To identify features of the Philadelphia SSB tax policymaking process that contributed to the proposal's passage. Qualitative case study. Semistructured interviews were conducted with key informants closely involved with the policymaking process. Interviews were audio-recorded and transcribed. Local news media about the SSB tax proposal were analyzed to triangulate interview findings. Analysis was conducted in NVivo 10 using inductive qualitative content analysis. Philadelphia, Pennsylvania, during the SSB tax policymaking in process. Nine key informants (2 city councilpersons, 4 city agency officials, 1 community-based advocate, 1 news reporter, and 1 researcher). The Philadelphia SSB tax proposal was introduced with the explicit goal of financing universal prekindergarten and deliberately not framed as a health intervention. This framing shifted contentious debates about government involvement in individual behavior toward discussions about how to finance universal prekindergarten, a goal for which broad support existed. The LHD played an important role in communicating research evidence about potential health benefits of the SSB tax proposal at the end of the policymaking process. During local SSB tax policy development processes, LHD officials and other advocates should encourage policymakers to design SSB tax policies so that revenue is directed toward community investments for which broad public support exists. When communicating with policymakers and the public, LHDs should consider emphasizing how SSB tax revenue will be used in addition

  17. Malaria epidemiology in the Pakaanóva (Wari') Indians, Brazilian Amazon.

    Science.gov (United States)

    Sá, D Ribeiro; Souza-Santos, R; Escobar, A L; Coimbra, C E A

    2005-04-01

    This paper reports the results of a longitudinal study of malaria incidence (1998-2002) among the Pakaanóva (Wari') Indians, Brazilian southwest Amazon region, based on data routinely gathered by Brazilian National Health Foundation outposts network in conjunction with the Indian health service. Malaria is present yearlong in the Pakaanóva. Statistically significant differences between seasons or months were not noticed. A total of 1933 cases of malaria were diagnosed in the Pakaanóva during this period. The P. vivax / P. falciparum ratio was 3.4. P. vivax accounted for 76.5% of the cases. Infections with P. malariae were not recorded. Incidence rates did not differ by sex. Most malaria cases were reported in children < 10 years old (45%). About one fourth of all cases were diagnosed on women 10-40 years old. An entomological survey carried out at two Pakaanóva villages yielded a total of 3.232 specimens of anophelines. Anopheles darlingi predominated (94.4%). Most specimens were captured outdoors and peak activity hours were noted at early evening and just before sunrise. It was observed that Pakaanóva cultural practices may facilitate outdoor exposure of individuals of both sexes and all age groups during peak hours of mosquito activities (e.g., coming to the river early in the morning for bathing or to draw water, fishing, engaging in hunting camps, etc). In a context in which anophelines are ubiquitous and predominantly exophilic, and humans of both sexes and all ages are prone to outdoor activities during peak mosquito activity hours, malaria is likely to remain endemic in the Pakaanóva, thus requiring the development of alternative control strategies that are culturally and ecologically sensitive.

  18. 75 FR 25010 - Self-Regulatory Organizations; Stock Clearing Corporation of Philadelphia; Notice of Filing and...

    Science.gov (United States)

    2010-05-06

    ...-025, The NASDAQ Stock Market LLC (``NASDAQ Exchange'') sought and received Commission approval to... requirements apply to elections of directors and were not amended. Each share of common stock has one vote,\\8...-Regulatory Organizations; Stock Clearing Corporation of Philadelphia; Notice of Filing and Immediate...

  19. [Acute transformation of chronic myeloid leukemia: disappearance of the Philadelphia chromosome after autograft].

    Science.gov (United States)

    Reiffers, J; David, B; Bernard, P; Vezon, G; Marit, G; Moulinier, J; Broustet, A

    1984-04-12

    Two patients with chronic granulocytic leukemia (C.G.L.) undergoing transformation were treated by high dose chemotherapy and total body irradiation followed by autografting of hematopoietic stem cells collected and cryo-preserved at the time of diagnosis. Recovery of hematopoiesis was characterized by disappearance of the Philadelphia chromosome in most metaphases. A new approach of the management of C.G.L. is discussed.

  20. 40 CFR Appendix A to Subpart E of... - References

    Science.gov (United States)

    2010-07-01

    ... Standard Quality Systems—Model for Quality Assurance in Design, Development, Production, Installation, and... Desk, 700 Robbins Avenue, Building 4D, Philadelphia, PA 1911-5094. (5) Quality Assurance Handbook for...-600/R-94-038d. Available from National Technical Information Service, Springfield, VA 22161, (800-553...

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

    Directory of Open Access Journals (Sweden)

    Mustafa Ç. Korkmaz

    2017-12-01

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

  2. 75 FR 33216 - Payment or Reimbursement for Emergency Treatment Furnished by Non-VA Providers in Non-VA...

    Science.gov (United States)

    2010-06-11

    ... health care services for veterans).'' Proposed Sec. 17.121(a) would establish the clinical decision maker... practice to utilize the services of health care professionals, such as nurses, for purposes of clinical review. For this reason, establishing the clinical decision maker as a ``designated VA clinician'' would...

  3. Acute, fatal Sarcocystis calchasi-associated hepatitis in Roller pigeons (Columbia livia f. dom.) at Philadelphia Zoo

    Science.gov (United States)

    Four Roller pigeons (Columba livia f. dom.) at the Philadelphia Zoo died suddenly. Necropsy examination revealed macroscopic hepatitis. Microscopically, the predominant lesions were in liver, characterized with necrosis and mixed cell inflammatory response. Sarcocystis calchasi-like schizonts and fr...

  4. Testing popular VaR models in EU new member and candidate states

    Directory of Open Access Journals (Sweden)

    Saša Žiković

    2007-12-01

    Full Text Available The impact of allowing banks to calculate their capital requirement based on their internal VaR models, and the impact of regulation changes on banks in transitional countries has not been well studied. This paper examines whether VaR models that are created and suited for developed markets apply to the volatile stock markets of EU new member and candidate states (Bulgaria, Romania, Croatia and Turkey. Nine popular VaR models are tested on five stock indexes from EU new member and candidate states. Backtesting results show that VaR models commonly used in developed stock markets are not well suited for measuring market risk in these markets. Presented findings bear very important implications that have to be addressed by regulators and risk practitioners operating in EU new member andcandidate states. Risk managers have to start thinking outside the frames set by their parent companies or else investors present in these markets may find themselves in serious trouble, dealing with losses that they have not been expecting. National regulators have to take into consideration that simplistic VaR models that are widely used in some developed countries are not well suited for these illiquid and developing stock markets.

  5. 76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers

    Science.gov (United States)

    2011-11-21

    ... concerning the billing methodology for non-VA providers of home health services and hospice care. The proposed rulemaking would include home health services and hospice care under the VA regulation governing... to ``RIN 2900-AN98--Payment for home health and services and hospice care by non-VA providers...

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

    Science.gov (United States)

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

    1992-01-01

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

  7. Health and housing collaboration at LAST: the Philadelphia Lead Abatement Strike Team.

    OpenAIRE

    Campbell, Carla; Himmelsbach, Robert; Palermo, Peter; Tobin, Richard

    2005-01-01

    The Lead Abatement Strike Team (LAST) was developed in 2002 by the Philadelphia Department of Public Health (PDPH) in response to community concern about management of children with elevated blood lead levels (EBLLs). Fourteen hundred backlog properties (housing at least one child with EBLLs) were identified through inspection as having housing-based lead hazards for which no satisfactory environmental remediation (control of lead hazards) had been achieved. In the first two years of LAST, 83...

  8. 78 FR 66265 - Drawbridge Operation Regulation; Elizabeth River, Eastern Branch, Norfolk, VA

    Science.gov (United States)

    2013-11-05

    ... Operation Regulation; Elizabeth River, Eastern Branch, Norfolk, VA AGENCY: Coast Guard, DHS. ACTION: Notice... Elizabeth River Eastern Branch, mile 1.1, at Norfolk, VA. This deviation is necessary to facilitate... maintenance. The Norfolk Southern 5 railroad Bridge, at mile 1.1, across the Elizabeth River (Eastern Branch...

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

    Science.gov (United States)

    2010-10-01

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

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

    OpenAIRE

    Ou, Shian Kao

    2006-01-01

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

  11. 77 FR 60969 - Procurement List; Proposed Additions and Deletions

    Science.gov (United States)

    2012-10-05

    ...., Wichita, KS. Contracting Activity: Defense Logistics Agency Troop Support, Philadelphia, PA. Coverage: C-List for 100% of the requirement of the Department of Defense, as aggregated by the Defense Logistics...., Portsmouth, VA. Contracting Activity: Dept. of the Army, W071 Endist Kansas City, Kansas City, MO. Deletions...

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

    Science.gov (United States)

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

    2012-01-01

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

  13. 46 CFR 7.45 - Cape Henlopen, DE to Cape Charles, VA.

    Science.gov (United States)

    2010-10-01

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

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

    Data.gov (United States)

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

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

    Data.gov (United States)

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

  16. 38 CFR 74.26 - What types of business information will VA collect?

    Science.gov (United States)

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.26 What types of business information will VA collect? VA will examine a variety of business records. See § 74.12, “What is... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false What types of business...

  17. Second malignancies in hydroxyurea and interferon-treated Philadelphia-negative myeloproliferative neoplasms

    DEFF Research Database (Denmark)

    Hansen, Iben Onsberg; Sørensen, Anders Lindholm; Hasselbalch, Hans Carl

    2017-01-01

    OBJECTIVE: In an era of controversy in regard to 'hydroxyurea-leukaemogenicity' and when interferon-alfa2 (IFN) is being revived in the treatment of Philadelphia-negative myeloproliferative neoplasms (MPNs), we aim in this single-centre observational study to describe the frequencies of second...... malignancies in a cohort of MPN patients treated with hydroxyurea (HU) or IFN monotherapy or the combination of these agents. PATIENTS AND METHODS: Records of a MPN cohort of 196 patients were reviewed, and a retrospective analysis was performed on 90 patients treated with HU, 38 patients treated with IFN...

  18. Payment or reimbursement for certain medical expenses for Camp Lejeune family members. Interim final rule.

    Science.gov (United States)

    2014-09-24

    The Department of Veterans Affairs (VA) is promulgating regulations to implement statutory authority to provide payment or reimbursement for hospital care and medical services provided to certain veterans' family members who resided at Camp Lejeune, North Carolina, for at least 30 days during the period beginning on January 1, 1957, and ending on December 31, 1987. Under this rule, VA will reimburse family members, or pay providers, for medical expenses incurred as a result of certain illnesses and conditions that may be attributed to exposure to contaminated drinking water at Camp Lejeune during this time period. Payment or reimbursement will be made within the limitations set forth in statute and Camp Lejeune family members will receive hospital care and medical services that are consistent with the manner in which we provide hospital care and medical services to Camp Lejeune veterans.

  19. Relationship Between Total and Bioaccessible Lead on Children’s Blood Lead Levels in Urban Residential Philadelphia Soils

    Science.gov (United States)

    Relationships between total soil or bioaccessible lead (Pb), measured using an in vitro bioaccessibility assay, and children’s blood lead levels (BLL) were investigated in an urban neighborhood in Philadelphia, Pennsylvania, USA, with a history of soil Pb contamination....

  20. Educating English Language Learners: Instructional Approaches and Teacher Collaboration in Philadelphia Public Schools. PERC Research Brief

    Science.gov (United States)

    Reumann-Moore, Rebecca; Rowland, Jeannette; Hughes, Rosemary; Lin, Joshua

    2016-01-01

    Districts, charter management organizations, and individual schools can learn a great deal from each other about strategies for creating robust and supportive learning environments for English Language Learners (ELLS). This brief highlights key findings about how Philadelphia public schools were crafting instructional approaches to serve their…

  1. Volunteer Environmental Stewardship and Affective Labour in Philadelphia

    Directory of Open Access Journals (Sweden)

    Alec Foster

    2018-01-01

    Full Text Available Recent research has critically evaluated the rapid growth of volunteer urban environmental stewardship. Framings of this phenomenon have largely focused upon environmentality and/or neoliberal environments, unfortunately often presenting a totalising picture of the state and/or market utilising power from above to create environmental subjects with limited agency available to local citizens. Based upon qualitative research with volunteer urban environmental stewards in Philadelphia, affective labour is proposed as an alternative explanation for participation. Stewards volunteered their time and labour due to the intense emotional attachments they formed with their neighbourhoods, neighbours, and nonhuman others in relationships of affective labour. Volunteer urban environmental stewardship as affective labour provides room for agency on the part of individuals and groups involved in volunteer urban environmental reproduction and opens up new ways of relating to and being with human and nonhuman others.

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

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  3. Learning From Philadelphia: Topographies of HIV/AIDS Media Assemblages.

    Science.gov (United States)

    Cartwright, Lisa

    2016-01-01

    For this contribution to the special issue on "Mapping Queer Bioethics," the author employs an array of public health and popular media texts (especially Jonathan Demme's film Philadelphia) to challenge the construction and reconstruction of HIV-positive bodies as sites of bioethical concern. In outlining notions of "digital restoration," the author argues that there has been of late a remapping of the first decade of the HIV/AIDS pandemic through media projects assembled from archived materials. Accordingly, the author suggests that in the first decades of the 2000s, we have witnessed a media-archaeological turn, whereby old materials have been reassembled for commemorative purposes that oftentimes perform a reshaping of the topography of the first decade of the AIDS pandemic.

  4. Patients, privacy and trust: patients' willingness to allow researchers to access their medical records.

    Science.gov (United States)

    Damschroder, Laura J; Pritts, Joy L; Neblo, Michael A; Kalarickal, Rosemarie J; Creswell, John W; Hayward, Rodney A

    2007-01-01

    The federal Privacy Rule, implemented in the United States in 2003, as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), created new restrictions on the release of medical information for research. Many believe that its restrictions have fallen disproportionately on researchers prompting some to call for changes to the Rule. Here we ask what patients think about researchers' access to medical records, and what influences these opinions. A sample of 217 patients from 4 Veteran Affairs (VA) facilities deliberated in small groups at each location with the opportunity to question experts and inform themselves about privacy issues related to medical records research. After extensive deliberation, these patients were united in their inclination to share their medical records for research. Yet they were also united in their recommendations to institute procedures that would give them more control over whether and how their medical records are used for research. We integrated qualitative and quantitative results to derive a better understanding of this apparent paradox. Our findings can best be presented as answers to questions related to five dimensions of trust: Patients' trust in VA researchers was the most powerful determinant of the kind of control they want over their medical records. More specifically, those who had lower trust in VA researchers were more likely to recommend a more stringent process for obtaining individual consent. Insights on the critical role of trust suggest actions that researchers and others can take to more fully engage patients in research.

  5. 75 FR 25321 - Agency Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Science.gov (United States)

    2010-05-07

    ... Winter Sports Clinic Application, VA Form 0924a series. b. National Veterans Wheelchair Games Application.... National Veterans TEE Tournament Application, VA Form 0927a series. e. National Veterans Summer Sports... Form 0929a series. Type of Review: Existing collection in use without an OMB control number. Abstract...

  6. Characteristics of Black Men Who Have Sex With Men in Baltimore, Philadelphia, and Washington, D.C.: Geographic Diversity in Socio-Demographics and HIV Transmission Risk.

    Science.gov (United States)

    German, Danielle; Brady, Kathleen; Kuo, Irene; Opoku, Jenevieve; Flynn, Colin; Patrick, Rudy; Park, Ju Nyeong; Adams, Joella; Carroll, Makeda; Simmons, Ron; Smith, Carlton R; Davis, Wendy W

    2017-07-01

    Baltimore, Philadelphia, and Washington, DC are geographically proximate cities with high HIV prevalence, including among black men who have sex with men (BMSM). Using data collected among BMSM in CDC's National HIV Behavioral Surveillance project, we compared socio-demographic characteristics, HIV risk behaviors, and service utilization to explore similarities and differences that could inform local and regional HIV intervention approaches. BMSM were recruited through venue time location sampling, June-December, 2011. Participants completed identical socio-behavioral surveys and voluntary HIV testing. Analyses were conducted among the full sample and those aged 18-24. Participants included 159 (DC), 364 (Baltimore), and 331 (Philadelphia) eligible BMSM. HIV prevalence was 23.1% (DC), 48.0% (Baltimore), 14.6% (Philadelphia) with 30.6%, 69.0%, 33.3% unrecognized HIV infection, respectively. Among BMSM 18-24, HIV prevalence was 11.1% (DC), 38.9% (Baltimore), 9.6% (Philadelphia) with unrecognized HIV infection 0.0%, 73.8%, 60.0% respectively. Compared with the other 2 cities, Baltimore participants were less likely to identify as gay/homosexual; more likely to report unemployment, incarceration, homelessness, sex exchange; and least likely to use the internet for partners. DC participants were more likely to have a college degree and employment. Philadelphia participants were more likely to report gay/homosexual identity, receptive condomless anal sex, having only main partners, and bars/clubs as partner meeting places. Sexually transmitted disease testing was universally low. Analyses showed especially high HIV prevalence among BMSM in Baltimore including among young BMSM. Socio-demographic characteristics and HIV infection correlates differed across cities but unrecognized HIV infection and unknown partner status were universally high.

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

    Directory of Open Access Journals (Sweden)

    Kuzminykh Sergey V.

    2014-12-01

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

  8. Thromboembolism prophylaxis in patients with Philadelphia-negative myeloproliferative neoplasms-Clinical practice among Nordic specialists.

    Science.gov (United States)

    Bjerrum, Ole Weis; Samuelsson, Jan; Ghanima, Waleed; Kauppila, Marjut; Andersen, Christen Lykkegaard

    2018-05-01

    Patients with Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs) have higher risks of developing thromboembolisms compared to the general population. International guidelines on the management of MPNs therefore include recommendations concerning thromboembolism prophylaxis. In clinical practice, strict adherence to guidelines may be challenging and dependent on factors such as physician experience, outpatient clinic setting, and access to therapy; however, no data exist on physician adherence or patient compliance to thromboembolism prophylaxis in MPNs. The Nordic Myeloproliferative Neoplasm Study Group (NMPN) performed a survey among Nordic hematology specialists with the aim of documenting the implementation of international recommendations in a region of Northern Europe with similar healthcare systems. The study showed that Nordic specialists managed their patients in accordance with international guidelines concerning medical intervention, but to a lesser degree regarding the management of additional cardiovascular risk factors. The survey also drew attention to the common clinical dilemma of combining antiaggregatory agents with vitamin K antagonists (VKA), or novel oral anticoagulants (NOAC), as well as phlebotomy limits in female polycythemia vera patients. The results of this study highlight the importance of considering all risk factors for thrombosis and an optimal collaboration with the primary healthcare sector. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Vađenje podrtina i potonulih stvari u svjetlu novele Pomorskog zakonika iz 2013. godine

    Directory of Open Access Journals (Sweden)

    Vesna Skorupan Wolff

    2017-11-01

    Full Text Available Materiju vađenja podrtina i potonulih stvari uređuju odredbe upravnopravne prirode koje reguliraju odnose između vlasnika podrtine ili potonule stvari, odnosno ovlaštene osobe i upravnih tijela, a kojima se uređuju razni pravni aspekti postupka vađenja. Pravo vaditi podrtinu ili potonulu stvar primarno ima njezin vlasnik odnosno ovlaštena osoba. Zakon vlasnicima podrtina i potonulih stvari, odnosno ovlaštenim osobama, ostavlja primjeren rok u kojem mogu pokrenuti upravni postupak za dobivanje dozvole za vađenje podrtine ili potonule stvari. Na taj način jamči se nepovredivost vlasništva i utvrđuje načelo prema kojem činjenica da je stvar potonula ili se nasukala ne utječe izravno na vlasnička prava njezina dotadašnjeg vlasnika. Međutim, ako vlasnik, odnosno ovlaštena osoba ne zatraži odobrenje za vađenje podrtine ili potonule stvari, ili kad bez opravdanog razloga prekine ili napusti započeto vađenje kao i u slučaju ako je ovlaštena osoba nepoznata, PZ nudi pravni okvir i omogućuje da vađenje podrtine ili potonule stvari poduzme pošteni nalaznik ili lučka kapetanija. U okviru instituta vađenja podrtina i potonulih stvari uvodi se posebno pravno uređenje za nalaz stvari u moru te se precizno normiraju svi segmenti postupka vađenja kada ga poduzima pošteni nalaznik ili lučka kapetanija. Uređuju se i sva relevantna pitanja u svezi postupanja s izvađenim stvarima kao što su njihovo čuvanje te u propisanim slučajevima mogućnost prodaje na javnoj dražbi. PZ-om se precizno uređuju obvezni odnosi koji nastaju između vlasnika, odnosno ovlaštene osobe i poštenog nalaznika te vlasnika, odnosno ovlaštene osobe i lučke kapetanije, ovisno o tome tko je poduzeo vađenje, a koji se odnose na plaćanje naknade za vađenje, čuvanje, nalazninu i druge tražbine koje zakon priznaje poštenim nalaznicima i lučkim kapetanijama. U okviru toga, uređuje se i posebno stvarnopravno uređenje za stjecanje prava vlasni

  10. VA Dental Insurance Program--federalism. Direct final rule; confirmation of effective date.

    Science.gov (United States)

    2014-03-20

    The Department of Veterans Affairs (VA) published a direct final rule in the Federal Register on October 22, 2013, amending its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents of veterans. Specifically, this rule adds language to clarify the limited preemptive effect of certain criteria in the VADIP regulations. VA received no comments concerning this rule or its companion substantially identical proposed rule published in the Federal Register on October 23, 2013. This document confirms that the direct final rule became effective on December 23, 2013. In a companion document in this issue of the Federal Register, we are withdrawing as unnecessary the proposed rule.

  11. Planning by Search through Simulations.

    Science.gov (United States)

    1985-10-01

    Info. Scl. Philadelphia, PA 19104 Mr. Fred M. Griffee 1 copy Technical Advisor C3 Division Marine Corps Development and Education Command Quantico, VA...ing, intervals during the execution of the plan (e.g., a thesis advisor is used discon- tinuously by a graduate student during his thesis research...The Garden I le\\ Ro4m tob Pita *44a Fr4Teot4i 4444444.4 (S-R4EST44CTIO pro444444 444 ( 4IT4 I B4 tually ~ ~ Rom com int effct For exmpe if the robo

  12. 38 CFR 1.9 - Description, use, and display of VA seal and flag.

    Science.gov (United States)

    2010-07-01

    ... stars represent the five branches of military service. The crossed flags represent our nation's history... employees. (D) Official VA signs. (E) Official publications or graphics issued by and attributed to VA, or...) Souvenir or novelty items. (iii) Toys or commercial gifts or premiums. (iv) Letterhead design, except on...

  13. Developing a Community-Wide Initiative to Address Childhood Adversity and Toxic Stress: A Case Study of The Philadelphia ACE Task Force.

    Science.gov (United States)

    Pachter, Lee M; Lieberman, Leslie; Bloom, Sandra L; Fein, Joel A

    The Philadelphia ACE Task Force is a community based collaborative of health care providers, researchers, community-based organizations, funders, and public sector representatives. The mission of the task force is to provide a venue to address childhood adversity and its consequences in the Philadelphia metropolitan region. In this article we describe the origins and metamorphosis of the Philadelphia ACE Task Force, which initially was narrowly focused on screening for adverse childhood experiences (ACEs) in health care settings but expanded its focus to better represent a true community-based approach to sharing experiences with addressing childhood adversity in multiple sectors of the city and region. The task force has been successful in developing a research agenda and conducting research on ACEs in the urban context, and has identified foci of local activity in the areas of professional training and workforce development, community education, and local practical interventions around adversity, trauma, and resiliency. In this article we also address the lessons learned over the first 5 years of the task force's existence and offers recommendations for future efforts to build a local community-based ACEs collaborative. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Ana-Maria Fuertes

    2016-09-01

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

  15. Topiramate Protects Pericytes from Glucotoxicity: Role for Mitochondrial CA VA in Cerebromicrovascular Disease in Diabetes.

    Science.gov (United States)

    Patrick, Ping; Price, Tulin O; Diogo, Ana L; Sheibani, Nader; Banks, William A; Shah, Gul N

    Hyperglycemia in diabetes mellitus causes oxidative stress and pericyte depletion from the microvasculature of the brain thus leading to the Blood-Brain Barrier (BBB) disruption. The compromised BBB exposes the brain to circulating substances, resulting in neurotoxicity and neuronal cell death. The decline in pericyte numbers in diabetic mouse brain and pericyte apoptosis in high glucose cultures are caused by excess superoxide produced during enhanced respiration (mitochondrial oxidative metabolism of glucose). Superoxide is precursor to all Reactive Oxygen Species (ROS) which, in turn, cause oxidative stress. The rate of respiration and thus the ROS production is regulated by mitochondrial carbonic anhydrases (mCA) VA and VB, the two isoforms expressed in the mitochondria. Inhibition of both mCA: decreases the oxidative stress and restores the pericyte numbers in diabetic brain; and reduces high glucose-induced respiration, ROS, oxidative stress, and apoptosis in cultured brain pericytes. However, the individual role of the two isoforms has not been established. To investigate the contribution of mCA VA in ROS production and apoptosis, a mCA VA overexpressing brain pericyte cell line was engineered. These cells were exposed to high glucose and analyzed for the changes in ROS and apoptosis. Overexpression of mCA VA significantly increased pericyte ROS and apoptosis. Inhibition of mCA VA with topiramate prevented increases both in glucose-induced ROS and pericyte death. These results demonstrate, for the first time, that mCA VA regulates the rate of pericyte respiration. These findings identify mCA VA as a novel and specific therapeutic target to protect the cerebromicrovascular bed in diabetes.

  16. 77 FR 21158 - VA Directive 0005 on Scientific Integrity: Availability for Review and Comment

    Science.gov (United States)

    2012-04-09

    ... Draft VA Directive 0005 on Scientific Integrity: [square] Fosters a culture of transparency, integrity, and ethical behavior in the development and application of scientific and technological findings in VA... information from inappropriate political or commercial influence; [square] Ensures that selection and...

  17. 48 CFR 853.236-70 - VA Form 10-6298, Architect-Engineer Fee Proposal.

    Science.gov (United States)

    2010-10-01

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

  18. Funding quality pre-kindergarten slots with Philadelphia's new 'sugary drink tax': simulating effects of using an excise tax to address a social determinant of health.

    Science.gov (United States)

    Langellier, Brent A; Lê-Scherban, Félice; Purtle, Jonathan

    2017-09-01

    Philadelphia passed a 1·5-cent-per-ounce sweetened beverage tax (SBT). Revenue will fund 10 000 quality pre-kindergarten slots for poor children. It is imperative to understand how revenue from SBT can be used to fund programmes to address education and other social determinants of health. The objective of the present study was to simulate quality pre-kindergarten attendance, educational achievement and sugar-sweetened beverage (SSB) consumption among Philadelphia children and adolescents under six intervention scenarios: (i) no intervention; (ii) 10 000 additional quality pre-kindergarten slots; (iii) a 1·5-cent-per-ounce SBT; (iv) expanded pre-kindergarten and 1·5-cent-per-ounce SBT; (v) a 3-cent-per-ounce SBT; and (vi) expanded pre-kindergarten and 3-cent-per-ounce SBT. We used an agent-based model to estimate pre-kindergarten enrolment, educational achievement and SSB consumption under the six policy scenarios. We identified key parameters in the model from the published literature and secondary analyses of the Panel Study of Income Dynamics - Child Development Supplement. Philadelphia, Pennsylvania, USA. Philadelphia children and adolescents aged 4-18 years. A 1·5-cents-per-ounce tax would reduce SSB consumption by 1·3 drinks/week among Philadelphia children and adolescents relative to no intervention, with larger effects among children below the poverty level. Quality pre-kindergarten expansion magnifies the effect of the SBT by 8 %, but has the largest effect on moderate-income children just above the poverty level. The SBT and quality pre-kindergarten programme each reduce SSB consumption, but primarily benefit different children and adolescents. Pairing an excise tax with a complementary programme to improve a social determinant of health represents a progressive strategy to combat obesity, a disease regressive in its social patterning.

  19. Nutrition environments in corner stores in Philadelphia.

    Science.gov (United States)

    Cavanaugh, Erica; Mallya, Giridhar; Brensinger, Colleen; Tierney, Ann; Glanz, Karen

    2013-02-01

    To examine the availability, quality, and price of key types of healthy and less-healthy foods found in corner stores in low-income urban neighborhoods and the associations between store characteristics and store food environments. A sample of 246 corner stores was selected from all corner stores participating in the Philadelphia Healthy Corner Store Initiative (HCSI). The Nutrition Environment Measures Survey for Corner Stores (NEMS-CS) was used to assess the availability, quality, and price of foods and beverages in 11 common categories between February and May, 2011. NEMS-CS measures were completed in 233 stores, 94.7% of the 246 stores approached. The healthier options were significantly less available in all food categories and often more expensive. Baked goods, bread, chips and cereals were sold at nearly all stores, with significantly fewer offering low-fat baked goods (5.7%, pbread (56.2%, pfood environment and dietary choices among low-income urban populations. Availability of certain healthier foods could be improved. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Kritika važećeg i prijedlog novog pravnog uređenja vađenja i uklanjanja podrtina i potonulih stvari

    Directory of Open Access Journals (Sweden)

    Vesna Skorupan Wolff

    2012-12-01

    Full Text Available Glavni cilj rada je ponuditi i prikazati rješenja koja predstavljaju prijedlog novog pravnog uređenja instituta vađenja i uklanjanja podrtina i potonulih stvari. Prije toga, autorice u radu prikazuju genezu pravnih izvora u povijesti i ranijem domaćem zakonodavstvu te proučavaju sva relevantna pitanja i sve odredbe važećeg Pomorskog zakonika (u nastavku PZ o ovoj materiji. Analizira se značenje i uporaba pojedinih izraza, sistematizacija zakonske građe unutar strukture zakona te sadržaj i domašaj pojedinih odredbi. Autorice preispituju razinu usklađenosti pozitivnog PZ-a sa suvremenom međunarodnom regulativom u ovom području. Ukazuje se na važne probleme koji mogu nastati zbog manjkavosti odredbi pozitivnog PZ-a i nepostojanja sustavne regulacije svih relevantnih pitanja koja se mogu pojaviti u praksi. U okviru istraživanja provodi se i poredbena analiza ovih instituta u drugim nacionalnim zakonodavstvima. Predložena zakonska rješenja odlikuju se cjelovitošću i sustavnošću u normiranju svih relevantnih pitanja. Uređivanje ovih instituta specijalnim odredbama pružit će viši stupanj pravne sigurnosti te viši stupanj sigurnosti plovidbe Jadranom, zaštite okoliša, njegovih prirodnih bogatstava i drugih povezanih interesa.

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

    Science.gov (United States)

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

    2014-12-01

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

  2. 38 CFR 3.2130 - Will VA accept a signature by mark or thumbprint?

    Science.gov (United States)

    2010-07-01

    ... signature by mark or thumbprint? 3.2130 Section 3.2130 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF... of This Title General § 3.2130 Will VA accept a signature by mark or thumbprint? VA will accept signatures by mark or thumbprint if: (a) They are witnessed by two people who sign their names and give their...

  3. Medical team training: applying crew resource management in the Veterans Health Administration.

    Science.gov (United States)

    Dunn, Edward J; Mills, Peter D; Neily, Julia; Crittenden, Michael D; Carmack, Amy L; Bagian, James P

    2007-06-01

    Communication failure, a leading source of adverse events in health care, was involved in approximately 75% of more than 7,000 root cause analysis reports to the Department of Veterans Affairs (VA) National Center for Patient Safety (NCPS). The VA NCPS Medical Team Training (MTT) program, which is based on aviation principles of crew resource management (CRM), is intended to improve outcomes of patient care by enhancing communication between health care professionals. Unique features of MTT include a full-day interactive learning session (facilitated entirely by clinical peers in a health care context), administration of pre-and postintervention safety attitudes questionnaires, and follow-up semistructured interviews with reports of program activities and lessons learned. Examples of projects in these facilities include intensive care unit (ICU) teams' patient-centered multidisciplinary rounds, surgical teams' preoperative briefings and debriefings, an entire operating room (OR) unit's adoption of "Rules of Conduct" for expected staff behavior, and an ICU team's use of the model for daily administrative briefings. An MTT program based on applied CRM principles was successfully developed and implemented in 43 VA medical centers from September 2003 to May 2007.

  4. School Autonomy and District Support: How Principals Respond to a Tiered Autonomy Initiative in Philadelphia Public Schools

    Science.gov (United States)

    Steinberg, Matthew P.; Cox, Amanda Barrett

    2017-01-01

    A tiered autonomy policy was recently implemented in Philadelphia, where select principals were granted autonomy to manage school operations while others were promised greater district support to improve school functioning. This article provides evidence on how principals used their autonomy and the extent of district support for non-autonomous…

  5. 78 FR 62441 - VA Dental Insurance Program-Federalism

    Science.gov (United States)

    2013-10-22

    ...--Federalism AGENCY: Department of Veterans Affairs. ACTION: Direct final rule. SUMMARY: The Department of... that they are submitted in response to ``RIN 2900-AO85-VA Dental Insurance Program-- Federalism... add preemption language in accordance with the discussion above. Executive Order 13132, Federalism...

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  7. VaR: Exchange Rate Risk and Jump Risk

    Directory of Open Access Journals (Sweden)

    Fen-Ying Chen

    2010-01-01

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

  8. SlaVaComp Fonts Converter

    Directory of Open Access Journals (Sweden)

    Simon Skilevic

    2013-12-01

    Full Text Available This paper presents a fonts converter that was developed as a part of the Freiburg project on historical corpus linguistics. The tool named SlaVaComp-Konvertierer converts Church Slavonic texts digitized with non-Unicode fonts into the Unicode format without any loss of information contained in the original file and without damage to the original formatting. It is suitable for the conversion of all idiosyncratic fonts—not only Church Slavonic—and therefore can be used not only in Palaeoslavistic, but also in all historical and philological studies.

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

    International Nuclear Information System (INIS)

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

    1986-12-01

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

  10. Assessing the Health-Care Risk: The Clinical-VaR, a Key Indicator for Sound Management

    Directory of Open Access Journals (Sweden)

    Enrique Jiménez-Rodríguez

    2018-03-01

    Full Text Available Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE. The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs. Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR concept in combination to the Loss Distribution Approach (LDA is proved to be a proactive tool, within the frame of balanced scorecard (BSC, in health organizations. For this purpose, the historical events recorded in the Algo-OpData® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls.

  11. Assessing the Health-Care Risk: The Clinical-VaR, a Key Indicator for Sound Management.

    Science.gov (United States)

    Jiménez-Rodríguez, Enrique; Feria-Domínguez, José Manuel; Sebastián-Lacave, Alonso

    2018-03-30

    Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI) that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR) concept in combination to the Loss Distribution Approach (LDA) is proved to be a proactive tool, within the frame of balanced scorecard (BSC), in health organizations. For this purpose, the historical events recorded in the Algo-OpData ® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA) have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls.

  12. Assessing the Health-Care Risk: The Clinical-VaR, a Key Indicator for Sound Management

    Science.gov (United States)

    Jiménez-Rodríguez, Enrique; Sebastián-Lacave, Alonso

    2018-01-01

    Clinical risk includes any undesirable situation or operational factor that may have negative consequences for patient safety or capable of causing an adverse event (AE). The AE, intentional or unintentionally, may be related to the human factor, that is, medical errors (MEs). Therefore, the importance of the health-care risk management is a current and relevant issue on the agenda of many public and private institutions. The objective of the management has been evolving from the identification of AE to the assessment of cost-effective and efficient measures that improve the quality control through monitoring. Consequently, the goal of this paper is to propose a Key Risk Indicator (KRI) that enhances the advancement of the health-care management system. Thus, the application of the Value at Risk (VaR) concept in combination to the Loss Distribution Approach (LDA) is proved to be a proactive tool, within the frame of balanced scorecard (BSC), in health organizations. For this purpose, the historical events recorded in the Algo-OpData® database (Algorithmics Inc., Toronto, ON, Canada, IBM, Armonk, NY, USA) have been used. The analysis highlights the importance of risk in the financials outcomes of the sector. The results of paper show the usefulness of the Clinical-VaR to identify and monitor the risk and sustainability of the implemented controls. PMID:29601529

  13. 78 FR 63143 - VA Dental Insurance Program-Federalism

    Science.gov (United States)

    2013-10-23

    ...--Federalism AGENCY: Department of Veterans Affairs. ACTION: Proposed rule. SUMMARY: The Department of Veterans... that they are submitted in response to ``RIN 2900-AO86-VA Dental Insurance Program-- Federalism... Order 13132, Federalism Section 6(c) of Executive Order 13132 (entitled ``Federalism'') requires an...

  14. Maximum power per VA control of vector controlled interior ...

    Indian Academy of Sciences (India)

    Thakur Sumeet Singh

    2018-04-11

    Apr 11, 2018 ... Department of Electrical Engineering, Indian Institute of Technology Delhi, New ... The MPVA operation allows maximum-utilization of the drive-system. ... Permanent magnet motor; unity power factor; maximum VA utilization; ...

  15. 77 FR 60746 - Proposed Information Collection (VA/DOD Joint Disability Evaluation Board Claim) Activity...

    Science.gov (United States)

    2012-10-04

    ... burden of the collection of information on respondents, including through the use of automated collection techniques or the use of other forms of information technology. Title: VA/DOD Joint Disability Evaluation... War on Terror Heroes, VA and the Department of Defense (DOD) have agreed to develop a joint process in...

  16. 78 FR 77204 - Proposed Information Collection (VA National Veterans Sports Programs and Special Event Surveys...

    Science.gov (United States)

    2013-12-20

    ... AGENCY: Office of Public & Intergovernmental Affairs, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Office of Public Affairs (OPA), Department of Veterans Affairs (VA), is announcing an... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-NEW] Proposed Information Collection (VA...

  17. Access to mental health care among women Veterans: is VA meeting women's needs?

    Science.gov (United States)

    Kimerling, Rachel; Pavao, Joanne; Greene, Liberty; Karpenko, Julie; Rodriguez, Allison; Saweikis, Meghan; Washington, Donna L

    2015-04-01

    Patient-centered access to mental health describes the fit between patient needs and resources of the system. To date, little data are available to guide implementation of services to women veterans, an underrepresented minority within Department of Veteran Affairs (VA) health care. The current study examines access to mental health care among women veterans, and identifies gender-related indicators of perceived access to mental health care. A population-based sample of 6287 women veterans using VA primary care services participated in a survey of past year perceived need for mental health care, mental health utilization, and gender-related mental health care experiences. Subjective rating of how well mental health care met their needs was used as an indicator of perceived access. Half of all women reported perceived mental health need; 84.3% of those women received care. Nearly all mental health users (90.9%) used VA services, although only about half (48.8%) reported that their mental health care met their needs completely or very well. Gender related experiences (availability of female providers, women-only treatment settings, women-only treatment groups, and gender-related comfort) were each associated with 2-fold increased odds of perceived access, and associations remained after adjusting for ease of getting care. Women VA users demonstrate very good objective access to mental health services. Desire for, and access to specialized mental health services for women varies across the population and are important aspects of shared decision making in referral and treatment planning for women using VA primary care.

  18. 76 FR 38302 - Safety Zone; Cape Charles Fireworks, Cape Charles Harbor, Cape Charles, VA

    Science.gov (United States)

    2011-06-30

    ... the Town of Cape Charles will sponsor a fireworks display on the shoreline of the navigable waters of...-AA00 Safety Zone; Cape Charles Fireworks, Cape Charles Harbor, Cape Charles, VA AGENCY: Coast Guard... navigable waters of Cape Charles City Harbor in Cape Charles, VA in support of the Fourth of July Fireworks...

  19. 76 FR 27970 - Safety Zone; Cape Charles Fireworks, Cape Charles Harbor, Cape Charles, VA.

    Science.gov (United States)

    2011-05-13

    ... Charles will sponsor a fireworks display on the shoreline of the navigable waters of Cape Charles City...[deg]01'30'' W (NAD 1983). This safety zone will be established in the vicinity of Cape Charles, VA...-AA00 Safety Zone; Cape Charles Fireworks, Cape Charles Harbor, Cape Charles, VA. AGENCY: Coast Guard...

  20. Correlates to Human Papillomavirus Vaccination Status and Willingness to Vaccinate in Low-Income Philadelphia High School Students

    Science.gov (United States)

    Bass, Sarah B.; Leader, Amy; Shwarz, Michelle; Greener, Judith; Patterson, Freda

    2015-01-01

    Background: Little is known about the correlates of human papillomavirus (HPV) vaccination or willingness to be vaccinated in urban, minority adolescents. Methods: Using responses to the 2013 Youth Risk Behavior Survey in Philadelphia, a random sample of high schools provided weighted data representing 20,941 9th to 12th graders. Stratified by…

  1. Muusikamaailm : Philadelphia Orkester Euroopas. Lloyd Webber La Scalasse? Algas Glyndebourne'i ooperifestival. Kolm kompositsioonipreemiat / Priit Kuusk

    Index Scriptorium Estoniae

    Kuusk, Priit, 1938-

    2000-01-01

    Philadelphia Orchestra 100. aastapäevale pühendatud Euroopa turneest. Milano La Scala plaanitavast uuslavastuste sarjast "Mõistes XX sajandit ئ sisse elades XXI sajandisse", kus oleks kesksel kohal nelja elava helilooja lavateosed XX sajandist. Glyndebourne'i ooperifestivalist Inglismaal, A. Davise tegevusest. Kolme kompositsioonipreemia kätteandmisest : Salzburgi Osterfestspiele kompositsioonipreemia, Teatro Lirico Sperimentale kammerooperi konkursi preemia ja fondi Stiftung Christoph Delz kompositsioonikonkursi preemia

  2. 3-D Scanning of Headstones at the U.S. Naval Plot, Mount Moriah Cemetery, Philadelphia, PA

    Science.gov (United States)

    2017-11-17

    unrecognizable because these monuments of history provide a record of the heroes who served this country with honor and distinction. The naval plot at Mount...Eventually, 1 History of Philadelphia, 1609-1884, by John Thomas Scharf and Thompson...digital imaging requires natural or artificial light to work effec- tively. The point cloud is the most important aspect of this technology for

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2016-05-01

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

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

    Science.gov (United States)

    Nocentini, Annalaura; Menesini, Ersilia

    2016-11-01

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

  6. Payment or Reimbursement for Certain Medical Expenses for Camp Lejeune Family Members. Final rule.

    Science.gov (United States)

    2017-05-05

    The Department of Veterans Affairs (VA) adopts as final an interim final rule addressing payment or reimbursement of certain medical expenses for family members of Camp Lejeune veterans. Under this rule, VA reimburses family members, or pays providers, for medical expenses incurred as a result of certain illnesses and conditions that may be associated with contaminants present in the base water supply at U.S. Marine Corps Base Camp Lejeune (Camp Lejeune), North Carolina, from August 1, 1953, to December 31, 1987. Payment or reimbursement is made within the limitations set forth in statute and Camp Lejeune family members receive hospital care and medical services that are consistent with the manner in which we provide hospital care and medical services to Camp Lejeune veterans. The statutory authority has since been amended to also include certain veterans' family members who resided at Camp Lejeune, North Carolina, for no less than 30 days (consecutive or nonconsecutive) between August 1, 1953, and December 31, 1987. This final rule will reflect that statutory change and will address public comments received in response to the interim final rule.

  7. 77 FR 74279 - Agency Information Collection (VA/DOD Joint Disability Evaluation Board Claim): Activity under...

    Science.gov (United States)

    2012-12-13

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

  8. Dasatinib crosses the blood-brain barrier and is an efficient therapy for central nervous system philadelphia chromosome positive leukemia

    NARCIS (Netherlands)

    K. Porkka (Kimmo); P. Koskenvesa (Perttu); T. Lundan (Tuija); J. Rimpiläinen (Johanna); S. Mustjoki (Satu); R. Smykla (Richard); R. Wild (Robert); R. Luo (Roger); M. Arnan (Montserrat); B. Brethon (Benoit); L. Eccersley (Lydia); H. Hjorth-Hansen (Henrik); M. Höglund (Martin); H. Klamova (Hana); H. Knutsen (Håvar); S. Parikh (Suhag); E. Raffoux (Emmanuel); F. Gruber (Franz); F. Brito-Babapulle (Finella); H. Dombret (Hervé); R.F. Duarte (Rafael); E. Elonen (Erkki); R. Paquette (Ron); C.M. Zwaan (Christian Michel); F.Y.F. Lee (Francis)

    2008-01-01

    textabstractAlthough imatinib, a BCR-ABL tyrosine kinase inhibitor, is used to treat acute Philadelphia chromosome-positive (Ph+) leukemia, it does not prevent central nervous system (CNS) relapses resulting from poor drug penetration through the blood-brain barrier. Imatinib and dasatinib (a

  9. Conformational determination of [Leu]enkephalin based on theoretical and experimental VA and VCD spectral analyses

    DEFF Research Database (Denmark)

    Abdali, Salim; Jalkanen, Karl J.; Cao, X.

    2004-01-01

    Conformational determination of [Leu]enkephalin in DMSO-d6 is carried out using VA and VCD spectral analyses. Conformational energies, vibrational frequencies and VA and VCD intensities are calculated using DFT at B3LYP/6-31G* level of theory. Comparison between the measured spectra...

  10. 78 FR 55777 - Proposed Information Collection (VA, National Veterans Sports Programs and Special Events, Event...

    Science.gov (United States)

    2013-09-11

    ... techniques or the use of other forms of information technology. Titles: a. National Disabled Veterans Winter... Form 0928h. m. Surfing Personnel Application, VA Form 0928i. n. Venue Personnel Application, VA Form... Creative Arts Festival, National Veterans TEE Tournament, National Disabled Veterans Winter Sports Clinic...

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

    Science.gov (United States)

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

    2016-02-01

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

  12. NCI Helps Children’s Hospital of Philadelphia to Identify and Treat New Target in Pediatric Cancer | Poster

    Science.gov (United States)

    There may be a new, more effective method for treating high-risk neuroblastoma, according to scientists at the Children’s Hospital of Philadelphia and collaborators in the Cancer and Inflammation Program at NCI at Frederick. Together, the groups published a study describing a previously unrecognized protein on neuroblastoma cells, called GPC2, as well as the creation of a

  13. 48 CFR 852.219-72 - Evaluation factor for participation in the VA mentor-protégé program.

    Science.gov (United States)

    2010-10-01

    ... participation in the VA mentor-protégé program. 852.219-72 Section 852.219-72 Federal Acquisition Regulations... Texts of Provisions and Clauses 852.219-72 Evaluation factor for participation in the VA mentor-protégé... the VA Mentor-Protégé Program (DEC2009) This solicitation contains an evaluation factor or sub-factor...

  14. Correspondence of the Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) clinical interview and the VA TBI screen.

    Science.gov (United States)

    Fortier, Catherine Brawn; Amick, Melissa M; Kenna, Alexandra; Milberg, William P; McGlinchey, Regina E

    2015-01-01

    Mild traumatic brain injury is the signature injury of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND), yet its identification and diagnosis is controversial and fraught with challenges. In 2007, the Department of Veterans Affairs (VA) implemented a policy requiring traumatic brain injury (TBI) screening on all individuals returning from deployment in the OEF/OIF/OND theaters of operation that lead to the rapid and widespread use of the VA TBI screen. The Boston Assessment of TBI-Lifetime (BAT-L) is the first validated, postcombat semistructured clinical interview to characterize head injuries and diagnose TBIs throughout the life span, including prior to, during, and post-military service. Community-dwelling convenience sample of 179 OEF/OIF/OND veterans. BAT-L, VA TBI screen. Based on BAT-L diagnosis of military TBI, the VA TBI screen demonstrated similar sensitivity (0.85) and specificity (0.82) when administered by research staff. When BAT-L diagnosis was compared with historical clinician-administered VA TBI screen in a subset of participants, sensitivity was reduced. The specificity of the research-administered VA TBI screen was more than adequate. The sensitivity of the VA TBI screen, although relatively high, suggests that it does not oversample or "catch all" possible military TBIs. Traumatic brain injuries identified by the BAT-L, but not identified by the VA TBI screen, were predominantly noncombat military injuries. There is potential concern regarding the validity and reliability of the clinician administered VA TBI screen, as we found poor correspondence between it and the BAT-L, as well as low interrater reliability between the clinician-administered and research-administered screen.

  15. The Buried Past: An Archaeological History of Philadelphia, by John L. Cotter, Daniel G. Roberts, and Michael Parrington. University of Pennsylvania Press, Philadelphia. 1992

    Directory of Open Access Journals (Sweden)

    James A. Delle

    1995-05-01

    Full Text Available Having been involved in both contract and academic archaeology in recent years, I have heard (and sympathized with a pervasive lament. It seems increasingly common that even the best contract archaeology is rarely published, but compiled into reports that disappear into state repositories and contract firm offices, never again to be thought of except (maybe when it comes time to write the next report. There is an increasing body of both gray literature and gray excavation: work that is done in compliance with state and federal laws but which never reaches an audience of more than a dozen or so readers. Given this discouraging trend, the compendious The Buried Past is a welcomed synthesis of several generations of aca­demic and CRM investigations into the historical archaeology of the Greater Philadelphia region.

  16. 78 FR 31840 - Safety Zone; USO Patriotic Festival Air Show, Atlantic Ocean; Virginia Beach, VA

    Science.gov (United States)

    2013-05-28

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

  17. Cloning, Characterization, and Functional Investigation of VaHAESA from Vitis amurensis Inoculated with Plasmopara viticola

    Directory of Open Access Journals (Sweden)

    Shaoli Liu

    2018-04-01

    Full Text Available Plant pattern recognition receptors (PRRs are essential for immune responses and establishing symbiosis. Plants detect invaders via the recognition of pathogen-associated molecular patterns (PAMPs by PRRs. This phenomenon is termed PAMP-triggered immunity (PTI. We investigated disease resistance in Vitis amurensis to identify PRRs that are important for resistance against downy mildew, analyzed the PRRs that were upregulated by incompatible Plasmopara viticola infection, and cloned the full-length cDNA of the VaHAESA gene. We then analyzed the structure, subcellular localization, and relative disease resistance of VaHAESA. VaHAESA and PRR-receptor-like kinase 5 (RLK5 are highly similar, belonging to the leucine-rich repeat (LRR-RLK family and localizing to the plasma membrane. The expression of PRR genes changed after the inoculation of V. amurensis with compatible and incompatible P. viticola; during early disease development, transiently transformed V. vinifera plants expressing VaHAESA were more resistant to pathogens than those transformed with the empty vector and untransformed controls, potentially due to increased H2O2, NO, and callose levels in the transformants. Furthermore, transgenic Arabidopsis thaliana showed upregulated expression of genes related to the PTI pathway and improved disease resistance. These results show that VaHAESA is a positive regulator of resistance against downy mildew in grapevines.

  18. Power Factor Improvement Using Automatic Power Factor Compensation (APFC) Device for Medical Industries in Malaysia

    OpenAIRE

    Zaidi Maryam Nabihah; Ali Adlan

    2018-01-01

    This paper present the project designed to correcting power factor for medical industries in Malaysia automatically. Which with hope to make the cost and energy usage efficient, because the energy source are depleting due to increase in population. Power factor is the ratio of real power and apparent power. This definition is mathematically represented as kW/kVA where kW is active power and kVA is apparent power (active + reactive). Reactive power is the non-working power generated by the mag...

  19. VA Construction: Improved Processes Needed to Monitor Contract Modifications, Develop Schedules, and Estimate Costs

    Science.gov (United States)

    2017-03-01

    the Handbook.36 VA headquarters officials told us that regional CFM offices monitor change- order - processing time frames for projects in their...visited collected different types of data on change orders. Because VA lacks the data on the change order processing timeframes required by the Handbook...goals of processing change orders in a timelier manner, especially given our previous findings that change- order - processing time frames caused

  20. Small RNA sequence analysis of adenovirus VA RNA-derived miRNAs reveals an unexpected serotype-specific difference in structure and abundance.

    Directory of Open Access Journals (Sweden)

    Wael Kamel

    Full Text Available Human adenoviruses (HAds encode for one or two highly abundant virus-associated RNAs, designated VA RNAI and VA RNAII, which fold into stable hairpin structures resembling miRNA precursors. Here we show that the terminal stem of the VA RNAs originating from Ad4, Ad5, Ad11 and Ad37, all undergo Dicer dependent processing into virus-specific miRNAs (so-called mivaRNAs. We further show that the mivaRNA duplex is subjected to a highly asymmetric RISC loading with the 3'-strand from all VA RNAs being the favored strand, except for the Ad37 VA RNAII, where the 5'-mivaRNAII strand was preferentially assembled into RISC. Although the mivaRNA seed sequences are not fully conserved between the HAds a bioinformatics prediction approach suggests that a large fraction of the VA RNAII-, but not the VA RNAI-derived mivaRNAs still are able to target the same cellular genes. Using small RNA deep sequencing we demonstrate that the Dicer processing event in the terminal stem of the VA RNAs is not unique and generates 3'-mivaRNAs with a slight variation of the position of the 5' terminal nucleotide in the RISC loaded guide strand. Also, we show that all analyzed VA RNAs, except Ad37 VA RNAI and Ad5 VA RNAII, utilize an alternative upstream A start site in addition to the classical +1 G start site. Further, the 5'-mivaRNAs with an A start appears to be preferentially incorporated into RISC. Although the majority of mivaRNA research has been done using Ad5 as the model system our analysis demonstrates that the mivaRNAs expressed in Ad11- and Ad37-infected cells are the most abundant mivaRNAs associated with Ago2-containing RISC. Collectively, our results show an unexpected variability in Dicer processing of the VA RNAs and a serotype-specific loading of mivaRNAs into Ago2-based RISC.

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

    Directory of Open Access Journals (Sweden)

    Ming Zhang

    2014-01-01

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

  2. GeVaDSs – decision support system for novel Genetic Vaccine development process

    Directory of Open Access Journals (Sweden)

    Blazewicz Jacek

    2012-05-01

    Full Text Available Abstract Background The lack of a uniform way for qualitative and quantitative evaluation of vaccine candidates under development led us to set up a standardized scheme for vaccine efficacy and safety evaluation. We developed and implemented molecular and immunology methods, and designed support tools for immunization data storage and analyses. Such collection can create a unique opportunity for immunologists to analyse data delivered from their laboratories. Results We designed and implemented GeVaDSs (Genetic Vaccine Decision Support system an interactive system for efficient storage, integration, retrieval and representation of data. Moreover, GeVaDSs allows for relevant association and interpretation of data, and thus for knowledge-based generation of testable hypotheses of vaccine responses. Conclusions GeVaDSs has been tested by several laboratories in Europe, and proved its usefulness in vaccine analysis. Case study of its application is presented in the additional files. The system is available at: http://gevads.cs.put.poznan.pl/preview/(login: viewer, password: password.

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

    Directory of Open Access Journals (Sweden)

    Humberto Banda Ortiz

    2014-07-01

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

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

    Directory of Open Access Journals (Sweden)

    SEZER BOZKUŞ

    2013-06-01

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

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

    Directory of Open Access Journals (Sweden)

    M. F. Carneiro

    2013-01-01

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

  6. 75 FR 34934 - Safety Zone; Fireworks for the Virginia Lake Festival, Buggs Island Lake, Clarksville, VA

    Science.gov (United States)

    2010-06-21

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

  7. 30 CFR 57.22208 - Auxiliary fans (I-A, II-A, III, and V-A mines).

    Science.gov (United States)

    2010-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Hiroyuki Mizuguchi

    2011-07-01

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

  9. Assessment of Child Lead Exposure in a Philadelphia Community, 2014.

    Science.gov (United States)

    Dignam, Timothy; Pomales, Ana; Werner, Lora; Newbern, E Claire; Hodge, James; Nielsen, Jay; Grober, Aaron; Scruton, Karen; Young, Rand; Kelly, Jack; Brown, Mary Jean

    2018-01-10

    Several urban neighborhoods in Philadelphia, Pennsylvania, have a history of soil, household lead paint, and potential lead-emitting industry contamination. To (1) describe blood lead levels (BLLs) in target neighborhoods, (2) identify risk factors and sources of lead exposure, (3) describe household environmental lead levels, and (4) compare results with existing data. A simple, random, cross-sectional sampling strategy was used to enroll children 8 years or younger living in selected Philadelphia neighborhoods with a history of lead-emitting industry during July 2014. Geometric mean of child BLLs and prevalence of BLLs of 5 μg/dL or more were calculated. Linear and logistic regression analyses were used to ascertain risk factors for elevated BLLs. Among 104 children tested for blood lead, 13 (12.4%; 95% confidence interval [CI], 7.5-20.2) had BLLs of 5 μg/dL or more. The geometric mean BLL was 2.0 μg/dL (95% CI, 1.7-2.3 μg/dL). Higher geometric mean BLLs were significantly associated with front door entryway dust lead content, residence built prior to 1900, and a child currently or ever receiving Medicaid. Seventy-one percent of households exceeded the screening level for soil, 25% had an elevated front door floor dust lead level, 28% had an elevated child play area floor dust lead level, and 14% had an elevated interior window dust lead level. Children in households with 2 to 3 elevated environmental lead samples were more likely to have BLLs of 5 μg/dL or more. A spatial relationship between household proximity to historic lead-emitting facilities and child BLL was not identified. Entryway floor dust lead levels were strongly associated with blood lead levels in participants. Results underscore the importance to make housing lead safe by addressing all lead hazards in and around the home. Reduction of child lead exposure is crucial, and continued blood lead surveillance, testing, and inspection of homes of children with BLLs of 5 μg/dL or more to identify

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

    Science.gov (United States)

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

    2017-08-01

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

  11. 76 FR 27381 - Proposed Information Collection (Notice of Waiver of VA Compensation or Pension To Receive...

    Science.gov (United States)

    2011-05-11

    ... waive VA benefits for the number of days equal to the number of days in which they received training pay... of Waiver of VA Compensation or Pension To Receive Military Pay and Allowances) Activity; Comment... currently approved collection, and allow 60 days for public comment in response to the notice. This notice...

  12. Tagline: Information Extraction for Semi-Structured Text Elements in Medical Progress Notes

    Science.gov (United States)

    Finch, Dezon Kile

    2012-01-01

    Text analysis has become an important research activity in the Department of Veterans Affairs (VA). Statistical text mining and natural language processing have been shown to be very effective for extracting useful information from medical documents. However, neither of these techniques is effective at extracting the information stored in…

  13. [The movement to establish a Christian medical school proposed by medical missionary "John C. Berry"].

    Science.gov (United States)

    Fuseda, Tetsuya

    2014-12-01

    John C. Berry (1847-1936) came to Japan in 1872, worked as a medical missionary for the American Board of Commissioners for Foreign Missions (ABCFM . He attempted to influence Japanese medical education toward a more Christian-influenced approach. In early Meiji, the Japanese government adopted the German language and principles for its national medical program. This promoted a tendency towards the adoption of German concepts in Japanese medical education. The director of of Doshisha, Niijima, was concerned about such a tendency, which he considered rather science-oriented or skeptical and atheistic, according to his writings. The tradition of corruption among Japanese doctors also deeply disappointed him. Niijima sought the type of medical institution in which the students would learn Western medicine based on a moral base of Christianity, presumably in Kyoto, to take advantage of the foundation of Doshisha, which had already been built. Missionaries in Japan, especially Berry, supported Niijima's intentions. During his visit to the U.S. he promoted a mission statement in support of Niijima's idea in order to raise funds among Christian communities. This project produced a resolution among the Christian community in Philadelphia to establish an interdenominational foundation for establishing such a medical institution and it encouraged other cities to follow. However, the American Board of Missionaries in Japan disagreed with the idea of its being interdenominational, and then, along with other struggles such as the lack of funding in light of the economic slowdown, and the widespread social rejection of Christianity in Japan, the project fell apart and was suspended.

  14. QCD sum-rules for V-A spectral functions

    International Nuclear Information System (INIS)

    Chakrabarti, J.; Mathur, V.S.

    1980-01-01

    The Borel transformation technique of Shifman et al is used to obtain QCD sum-rules for V-A spectral functions. In contrast to the situation in the original Weinberg sum-rules and those of Bernard et al, the problem of saturating the sum-rules by low lying resonances is brought under control. Furthermore, the present sum-rules, on saturation, directly determine useful phenomenological parameters

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

    Science.gov (United States)

    Guglielmi, Anatol; Potapov, Alexander

    2017-09-01

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

  16. Communications and Collaboration Keep San Francisco VA Medical Center Project on Track

    International Nuclear Information System (INIS)

    Federal Energy Management Program

    2001-01-01

    This case study about energy saving performance contacts (ESPCs) presents an overview of how the Veterans Affairs Medical Center in San Francisco established an ESPC contract and the benefits derived from it. The Federal Energy Management Program instituted these special contracts to help federal agencies finance energy-saving projects at their facilities

  17. Scholar and teacher: V.A. Kitaev at the history department of Volgograd State University

    Directory of Open Access Journals (Sweden)

    Kuznetsov Oleg Viktorovich

    2013-11-01

    Full Text Available Vladimir A. Kitaev was born 1941. He was the first dean of the Faculty of History and the first head of the Department of History of the USSR (now the Department of History of Russia of Volgograd State University, reputable scientist, recognized expert in the history of the Russian social thought. The article shows the role of V.A. Kitaev in the formation and development of the faculty and the department. A characteristic of V.A. Kitaev’ sresearch and teaching activities is given. Kitaev’s featuresas a scholar and teacher such as great erudition, science scrupulosity, exactingness to himself andto his disciples, are marked. V.A. Kitaev worked at Volgograd State University for 16 years. All the while, he headed the Department andwas the dean for the first four years. The main thing is what he wanted in those positions – along with their colleagues was to lay and develop the traditions of the classical university, university atmosphere of the faculty and the university. The major scientific issues that are developed by V.A. Kitaev were: the history of liberalism and the fate of liberal reforms (modernization in Russia, the history of the Russian conservative thought, the problem of revolutionary violence as an inevitable result of the practical realization of socialist ideas. As an advocate of “establishing full-fledged liberal order”, V.A. Kitaev had, in essence, to ascertain: in Russia XIX – early XX century did not yet develop the historical conditions for the triumph of liberal ideas. The weakness and indecision of Russian liberals and their fear of the revolutionary movement, the constant fluctuation between the reform and reaction did not allow them to become independent of the political force that would determine the fate of the country in the end.

  18. Validation of the Monte Carlo Criticality Program KENO V.a for highly-enriched uranium systems

    International Nuclear Information System (INIS)

    Knight, J.R.

    1984-11-01

    A series of calculations based on critical experiments have been performed using the KENO V.a Monte Carlo Criticality Program for the purpose of validating KENO V.a for use in evaluating Y-12 Plant criticality problems. The experiments were reflected and unreflected systems of single units and arrays containing highly enriched uranium metal or uranium compounds. Various geometrical shapes were used in the experiments. The SCALE control module CSAS25 with the 27-group ENDF/B-4 cross-section library was used to perform the calculations. Some of the experiments were also calculated using the 16-group Hansen-Roach Library. Results are presented in a series of tables and discussed. Results show that the criteria established for the safe application of the KENO IV program may also be used for KENO V.a results

  19. 'Sharing things with people that I don't even know': help-seeking for psychological symptoms in injured Black men in Philadelphia.

    Science.gov (United States)

    Jacoby, Sara F; Rich, John A; Webster, Jessica L; Richmond, Therese S

    2018-04-01

    Psychological distress is common in survivors of traumatic injury, yet across United States' trauma systems, it is rare that standard injury care integrates psychological evaluation and professional mental healthcare. The purpose of this study was to explore help-seeking for psychological symptoms in injured Black men living in Philadelphia. A subset of a cohort of 551 injured Black men admitted to a Trauma Center in Philadelphia participated in qualitative interviews that explored their perceptions of psychological symptoms after injury and the factors that guided their decision to seek professional mental health help. Data from 32 participants were analyzed for narrative and thematic content. Three overarching themes emerged: (1) facilitators of help-seeking, (2) barriers to help-seeking, and (3) factors underlying the decision not to consider professional help. Five participants felt that their injury-related psychological distress was severe enough to merit professional help despite any perceived barriers. Seventeen participants identified systemic and interpersonal obstacles to professional help that prevented them from seeking this kind of care. These included: financial constraints, limited access to mental healthcare services, and fear of the judgments of mental healthcare professionals. Ten participants would not consider professional help; these men perceived a lack of need and sufficiency in their existing social support networks. Research is needed to inform or identify interventions that diminish the impact of barriers to care, and identify from whom, where, and how professional mental health help might be more effectively offered to injured Black men in recovery environments like Philadelphia.

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

    CERN Multimedia

    2002-01-01

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

  1. Military and Veteran Support: DOD and VA Programs That Address the Effects of Combat and Transition to Civilian Life

    Science.gov (United States)

    2014-11-01

    servicemembers to civilian life. For its part, VA’s agency priority goals are to (1) ensure access to VA benefits and services, (2) eliminate the disability...transfer their benefits to dependents. VA – Veterans Benefit Administration ( VBA ) Spinal Cord Injury and Disorders Centers Disability; Physical...who are temporarily residing in a home owned by a family member to help adapt the home to meet his or her special needs. VA - VBA Yellow Ribbon

  2. 77 FR 29929 - Safety Zone; Town of Cape Charles Fireworks, Cape Charles Harbor, Cape Charles, VA

    Science.gov (United States)

    2012-05-21

    ... section of this notice. Basis and Purpose On July 4, 2012 the Town of Cape Charles will sponsor a...-AA00 Safety Zone; Town of Cape Charles Fireworks, Cape Charles Harbor, Cape Charles, VA AGENCY: Coast... temporary safety zone on the waters of Cape Charles City Harbor in Cape Charles, VA in support of the Fourth...

  3. 75 FR 44720 - Safety Zone; Live-Fire Gun Exercise, M/V Del Monte, James River, VA

    Science.gov (United States)

    2010-07-29

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

  4. Mental illness and intensification of diabetes medications: an observational cohort study.

    Science.gov (United States)

    Frayne, Susan M; Holmes, Tyson H; Berg, Eric; Goldstein, Mary K; Berlowitz, Dan R; Miller, Donald R; Pogach, Leonard M; Laungani, Kaajal J; Lee, Tina T; Moos, Rudolf

    2014-10-22

    Mental health condition (MHC) comorbidity is associated with lower intensity care in multiple clinical scenarios. However, little is known about the effect of MHC upon clinicians' decisions about intensifying antiglycemic medications in diabetic patients with poor glycemic control. We examined whether delay in intensification of antiglycemic medications in response to an elevated Hemoglobin A1c (HbA1c) value is longer for patients with MHC than for those without MHC, and whether any such effect varies by specific MHC type. In this observational study of diabetic Veterans Health Administration (VA) patients on oral antiglycemics with poor glycemic control (HbA1c ≥8) (N =52,526) identified from national VA databases, we applied Cox regression analysis to examine time to intensification of antiglycemics after an elevated HbA1c value in 2003-2004, by MHC status. Those with MHC were no less likely to receive intensification: adjusted Hazard Ratio [95% CI] 0.99 [0.96-1.03], 1.13 [1.04-1.23], and 1.12 [1.07-1.18] at 0-14, 15-30 and 31-180 days, respectively. However, patients with substance use disorders were less likely than those without substance use disorders to receive intensification in the first two weeks following a high HbA1c, adjusted Hazard Ratio 0.89 [0.81-0.97], controlling for sex, age, medical comorbidity, other specific MHCs, and index HbA1c value. For most MHCs, diabetic patients with MHC in the VA health care system do not appear to receive less aggressive antiglycemic management. However, the subgroup with substance use disorders does appear to have excess likelihood of non-intensification; interventions targeting this high risk subgroup merit attention.

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

    Science.gov (United States)

    2017-03-01

    must manually review and correct most incoming cases due to issues with labeling, mismatched dates, and missing files. Via an internal study, VA...individuals acclimate to their jobs —and factored this into the modeling assumptions used to project the number of Board staff needed. More...Needed to Promote Increased User Satisfaction . GAO-15-582 (Washington, D.C.: September 1, 2015). Page 29 GAO-17-234 VA Disability

  6. Assessment of diabetic teleretinal imaging program at the Portland Department of Veterans Affairs Medical Center.

    Science.gov (United States)

    Tsan, Grace L; Hoban, Keely L; Jun, Weon; Riedel, Kevin J; Pedersen, Amy L; Hayes, John

    2015-01-01

    We conducted a retrospective chart review of 200 diabetic patients who had teleretinal imaging performed between January 1, 2010, and January 1, 2011, at Portland Department of Veterans Affairs (VA) Medical Center outpatient clinics to assess the effectiveness of the diabetic teleretinal imaging program. Twenty patients (10%) had diabetic retinopathy. Ninety percent of the available teleretinal imaging studies were of adequate quality for interpretation. In accordance with local VA policy at that time, all teleretinal imaging patients should have been referred for a dilated retinal examination the following year. Image readers referred 97.5% of the patients to eye clinics for subsequent eye examinations, but the imagers scheduled appointments for only 80% of these patients. The redundancy rate, i.e., patients who had an eye examination within the past 6 mo, was 11%; the duplicate recall rate, i.e., patients who had a second teleretinal imaging performed within 1 yr of the eye examination, was 37%. Rates of timely diabetic eye examinations at clinics with teleretinal imaging programs, particularly when teleretinal imaging and eye clinics were colocated at the same community-based outpatient clinic, were higher than those without a teleretinal imaging program. We concluded that the Portland VA Medical Center's teleretinal imaging program was successful in increasing the screening rate for diabetic retinopathy.

  7. Defensible Spaces in Philadelphia: Exploring Neighborhood Boundaries Through Spatial Analysis

    Directory of Open Access Journals (Sweden)

    Rory Kramer

    2017-02-01

    Full Text Available Few spatial scales are as important to individual outcomes as the neighborhood. However, it is nearly impossible to define neighborhoods in a generalizable way. This article proposes that by shifting the focus to measuring neighborhood boundaries rather than neighborhoods, scholars can avoid the problem of the indefinable neighborhood and better approach questions of what predicts racial segregation across areas. By quantifying an externality space theory of neighborhood boundaries, this article introduces a novel form of spatial analysis to test where potential physical markers of neighborhood boundaries (major roads, rivers, railroads, and the like are associated with persistent racial boundaries between 1990 and 2010. Using Philadelphia as a case study, the paper identifies neighborhoods with persistent racial boundaries. It theorizes that local histories of white reactions to black in-migration explain which boundaries persistently resisted racial turnover, unlike the majority of Philadelphia’s neighborhoods, and that those racial boundaries shape the location, progress, and reaction to new residential development in those neighborhoods.

  8. Determinants of Contraceptive Availability at Medical Facilities in the Department of Veterans Affairs

    Science.gov (United States)

    Cope, Jacqueline R; Yano, Elizabeth M; Lee, Martin L; Washington, Donna L

    2006-01-01

    OBJECTIVE To describe the variation in provision of hormonal and intrauterine contraception among Veterans Affairs (VA) facilities. DESIGN Key informant, cross-sectional survey of 166 VA medical facilities. Data from public use data sets and VA administrative databases were linked to facility data to further characterize their contextual environments. PARTICIPANTS All VA hospital-based and affiliated community-based outpatient clinics delivering services to at least 400 unique women during fiscal year 2000. MEASUREMENTS Onsite availability of hormonal contraceptive prescription and intrauterine device (IUD) placement. RESULTS Ninety-seven percent of facilities offered onsite prescription and management of hormonal contraception whereas 63% offered placement of IUDs. After adjusting for facility caseload of reproductive-aged women, 3 organizational factors were independently associated with onsite IUD placement: (1) onsite gynecologist (adjusted odds ratio [OR], 20.35; 95% confidence interval [CI], 7.02 to 58.74; Pwomen's health training to other clinicians (adjusted OR, 3.40; 95% CI 1.19 to 9.76; P=.02). CONCLUSIONS VA's provision of hormonal and intrauterine contraception is in accordance with community standards, although onsite availability is not universal. Although contraception is a crucial component of a woman's health maintenance, her ability to obtain certain contraceptives from the facility where she obtains her primary care is largely influenced by the availability of a gynecologist. Further research is needed to determine how fragmentation of women's care into reproductive and nonreproductive services impacts access to contraception and the incidence of unintended pregnancy. PMID:16637943

  9. 76 FR 78569 - Medical Benefits for Newborn Children of Certain Woman Veterans

    Science.gov (United States)

    2011-12-19

    ... conform to amendments made by the enactment of the Caregivers and Veteran Omnibus Health Services Act of... the Caregivers and Veterans Omnibus Health Services Act of 2010, Public Law 111-163. Section 206 of... in what is known as the VA ``medical benefits package.'' This rulemaking amends Sec. 17.38(a) to...

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

    KAUST Repository

    Gojobori, Takashi; Ikeo, Kazuho; Katayama, Yukie; Kawabata, Takeshi; Kinjo, Akira R.; Kinoshita, Kengo; Kwon, Yeondae; Migita, Ohsuke; Mizutani, Hisashi; Muraoka, Masafumi; Nagata, Koji; Omori, Satoshi; Sugawara, Hideaki; Yamada, Daichi; Yura, Kei

    2016-01-01

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

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

    KAUST Repository

    Gojobori, Takashi

    2016-12-24

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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  14. 76 FR 44086 - Agency Information Collection (Notice of Waiver of VA Compensation or Pension To Receive Military...

    Science.gov (United States)

    2011-07-22

    ... number of days equal to the number of days in which they received training pay. An agency may not conduct... of Waiver of VA Compensation or Pension To Receive Military Pay and Allowances) Activity Under OMB....'' SUPPLEMENTARY INFORMATION: Title: Notice of Waiver of VA Compensation or Pension to Receive Military Pay and...

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

    Directory of Open Access Journals (Sweden)

    Christina Salmivalli

    2012-12-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  17. Filadelfia y la botánica en Norteamérica Philadelphia and the Botany in North America

    Directory of Open Access Journals (Sweden)

    Alina Freire-Fierro

    2008-07-01

    Full Text Available El establecimiento y el desarrollo de la investigación botánica en Norteamérica se inician con la fundación de tres instituciones de Filadelfia, la American Philosophical Society en 1743, el Departamento de Botánica de la Universidad de Pennsylvania en 1768 y la Academia de Ciencias Naturales (PH en 1812. Algunos de los botánicos más influyentes durante los últimos cuatro siglos y en particular durante los siglos XVIII y XIX, vivieron en Filadelfia, entre ellos William Bartram (1699-1777, fundador del primer jardín botánico de Norteamérica, Benjamin Smith Barton (1766-1815, escritor del primer libro de texto de botánica en Estados Unidos y posiblemente en toda América, Federico Pursh (1774-1820, autor de una de las floras norteamericanas más completas del siglo XIX, Thomas Nuttall (1786-1859, autor de la primera flora norteamericana a nivel continental y Lewis David von Schweinitz (1780-1834, ampliamente reconocido como el padre de la micología norteamericana. Aunque la botánica alcanzó su cenit en Filadelfia durante el siglo XIX, continúa hoy contribuyendo al desarrollo de la botánica, gracias al aporte de muchas instituciones. El Herbario PH con sus más de 1,4 millones de especímenes y con la proporción más alta de tipos/totalidad de especímenes de todos los herbarios en los Estados Unidos, continúa siendo una fuente importante para estudios sistemáticos, no solo de taxones norteamericanos, sino también de otras regiones del mundo.The establishment and development of botanical research in North America began with the foundation of three Philadelphian institutions: The American Philosophical Society in 1743, the Botany Department at University of Pennsylvania in 1768 and the Academy of Natural Sciences of Philadelphia in 1812. Some of the most influential botanists of the last four centuries, and in particular, the 18th and 19th centuries lived in Philadelphia, including William Bartram (1699-1777, founder of the

  18. Barriers to and Facilitators of Alcohol Use Disorder Pharmacotherapy in Primary Care: A Qualitative Study in Five VA Clinics.

    Science.gov (United States)

    Williams, Emily C; Achtmeyer, Carol E; Young, Jessica P; Berger, Douglas; Curran, Geoffrey; Bradley, Katharine A; Richards, Julie; Siegel, Michael B; Ludman, Evette J; Lapham, Gwen T; Forehand, Mark; Harris, Alex H S

    2018-03-01

    Three medications are FDA-approved and recommended for treating alcohol use disorders (AUD) but they are not offered to most patients with AUD. Primary care (PC) may be an optimal setting in which to offer and prescribe AUD medications, but multiple barriers are likely. This qualitative study used social marketing theory, a behavior change approach that employs business marketing techniques including "segmenting the market," to describe (1) barriers and facilitators to prescribing AUD medications in PC, and (2) beliefs of PC providers after they were segmented into groups more and less willing to prescribe AUD medications. Qualitative, interview-based study. Twenty-four providers from five VA PC clinics. Providers completed in-person semi-structured interviews, which were recorded, transcribed, and analyzed using social marketing theory and thematic analysis. Providers were divided into two groups based on consensus review. Barriers included lack of knowledge and experience, beliefs that medications cannot replace specialty addiction treatment, and alcohol-related stigma. Facilitators included training, support for prescribing, and behavioral staff to support follow-up. Providers more willing to prescribe viewed prescribing for AUD as part of their role as a PC provider, framed medications as a potentially effective "tool" or "foot in the door" for treating AUD, and believed that providing AUD medications in PC might catalyze change while reducing stigma and addressing other barriers to specialty treatment. Those less willing believed that medications could not effectively treat AUD, and that treating AUD was the role of specialty addiction treatment providers, not PC providers, and would require time and expertise they do not have. We identified barriers to and facilitators of prescribing AUD medications in PC, which, if addressed and/or capitalized on, may increase provision of AUD medications. Providers more willing to prescribe may be the optimal target of a

  19. Muusikamaailm : Rostropovitsh Berliini müüri juures. Philadelphia Curtis Institute ئ 75. Lahti Linnaorkester Jaapanis ja USAs. Domingo taas Washingtonis / Priit Kuusk

    Index Scriptorium Estoniae

    Kuusk, Priit, 1938-

    1999-01-01

    Berliini müüri langemise 10. aastapäevale pühendatud kontserdist 9. nov. Berliinis. Ameerika muusikakõrgkoolist Philadelphia Curtis Institute. Lahti Linnaorkestri kontserdireisist Jaapanisse ja USAsse. P. Domingo on sügishooajal esinenud erinevates Ameerika ooperiteatrites

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

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A

    2015-06-01

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

  1. Dual-Routine HCV/HIV Testing: Seroprevalence and Linkage to Care in Four Community Health Centers in Philadelphia, Pennsylvania.

    Science.gov (United States)

    Coyle, Catelyn; Kwakwa, Helena

    2016-01-01

    Despite common risk factors, screening for hepatitis C virus (HCV) and HIV at the same time as part of routine medical care (dual-routine HCV/HIV testing) is not commonly implemented in the United States. This study examined improvements in feasibility of implementation, screening increase, and linkage to care when a dual-routine HCV/HIV testing model was integrated into routine primary care. National Nursing Centers Consortium implemented a dual-routine HCV/HIV testing model at four community health centers in Philadelphia, Pennsylvania, on September 1, 2013. Routine HCV and opt-out HIV testing replaced the routine HCV and opt-in HIV testing model through medical assistant-led, laboratory-based testing and electronic medical record modification to prompt, track, report, and facilitate reimbursement for tests performed on uninsured individuals. This study examined testing, seropositivity, and linkage-to-care comparison data for the nine months before (December 1, 2012-August 31, 2013) and after (September 1, 2013-May 31, 2014) implementation of the dual-routine HCV/HIV testing model. A total of 1,526 HCV and 1,731 HIV tests were performed before, and 1,888 HCV and 3,890 HIV tests were performed after dual-routine testing implementation, resulting in a 23.7% increase in HCV tests and a 124.7% increase in HIV tests. A total of 70 currently HCV-infected and four new HIV-seropositive patients vs. 101 HCV-infected and 13 new HIV-seropositive patients were identified during these two periods, representing increases of 44.3% for HCV antibody-positive and RNA-positive tests and 225.0% for HIV-positive tests. Linkage to care increased from 27 currently infected HCV--positive and one HIV-positive patient pre-dual-routine testing to 39 HCV--positive and nine HIV-positive patients post-dual-routine testing. The dual-routine HCV/HIV testing model shows that integrating dual-routine testing in a primary care setting is possible and leads to increased HCV and HIV screening

  2. Development of Universal Controller Architecture for SiC Based Power Electronic Building Blocks

    Science.gov (United States)

    2017-10-30

    SiC Based Power Electronic Building Blocks Award Number Title of Research 30 October 2017 SUBMITTED BY D R. HERBERT L. G INN, Pl DEPT. OF...Naval Research , Philadelphia PA, Aug. 2017. • Ginn, H.L. Bakos J., "Development of Universal Controller Architecture for SiC Based Power Electronic...Controller Implementation for MMC Converters", Workshop on Control Architectures for Modular Power Conversion Systems, Office of Naval Research , Arlington VA

  3. An Evaluation of a New Format for Presenting Ejection Information in a NATOPS Manual.

    Science.gov (United States)

    1979-11-01

    Assessment-the subject’s awareness of ejection system limits and knowledge of the specific principles and relationships involved in the ejection decision...percti & le pilot ejecting cannern tintiong onfigursesan at~ 71 knete arrtaeei.l From" th front cockpit. c. Normal aircraft pitc For conditions shown it...40) Arlington, VA 22209 700 Robbins Avenue * 1 CDR P.R. Chatelier Philadelphia, PA 19111 Office of the Undersecretary of Defense for Research

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

    International Nuclear Information System (INIS)

    Feng Gu; Yang Maoqiu; Bai Dengsha; Huang Quansheng

    1997-01-01

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

  5. Quality-improvement initiatives focused on enhancing customer service in the outpatient pharmacy.

    Science.gov (United States)

    Poulin, Tenley J; Bain, Kevin T; Balderose, Bonnie K

    2015-09-01

    The development and implementation of quality-improvement initiatives to enhance customer service in an outpatient pharmacy of a Veterans Affairs (VA) medical center are described. Historically low customer service satisfaction rates with the outpatient pharmacy at the Philadelphia Veterans Affairs Medical Center prompted this quality-improvement project. A three-question survey was designed to be easily and quickly administered to veterans in the outpatient pharmacy waiting area. Using 5-point Likert scale, veterans were asked to rate (1) their overall experience with the outpatient pharmacy service and (2) their satisfaction with the customer service provided by the pharmacy department. They were also asked how they thought the pharmacy department could improve its customer service. After receiving feedback from the survey, several quality-improvement initiatives were developed. The initiatives were categorized as environmental, personnel, communicative, and technological. For each initiative, one or more tasks were developed and the initiatives were subsequently implemented over eight months. After each task was completed, veterans were surveyed to measure the impact of the change. A total of 79 veterans were surveyed before the implementation of the quality-improvement initiatives, and 49% and 68% rated their experience with the outpatient pharmacy and customer service favorably, respectively. Twenty-five veterans were surveyed after the implementation of numerous quality-improvement interventions, with 44% and 72% rating their experience with the outpatient pharmacy and customer service favorably. Customer service satisfaction with an outpatient pharmacy service at a VA medical center was enhanced through the implementation of various quality-improvement initiatives. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  6. Muusikamaailm : Uus muusikasaal Philadelphias. Elgari teostekogu jätkatakse. Mortier tuleb ka Pariisi. Salonen loovutas Suomi-palkinto. Uusooper Dallases / Priit Kuusk

    Index Scriptorium Estoniae

    Kuusk, Priit, 1938-

    2001-01-01

    Philadelphia sai uue kontserdisaali. Londoni kirjastus Novello jätkab Edward Elgari kogutud teoste väljaandmist. Belgia teatrimees ja ooperiadministraator Gerard Mortierist saab Ruhri kunstidetriennaali juht. Esa-Pekka Salonen loovutas oma 100 000margalise preemia kolmele noorele soome heliloojale. Dallase Ooperis tuli maailmaesiettekandele USA helilooja Tobias Pickeri ooper "Therese Raquin"

  7. A Study of the Utility of a Participative Approach to Employee Attitude Surveys as a Management Tool at the Audie L. Murphy Memorial VA Hospital in San Antonio, Texas

    Science.gov (United States)

    1979-05-01

    Classification) A Study of the Utility of a Participative Approach to Employee Attitude Surveys as a Management Tool at the Audie L. Murphy Memoria VA...Engineering-49, Medical-38, Laboratory-32, Social Work-23, and RMS-19.) The responses of employees in all other services would be collectively identified...Laboratory 47 Social Work 78 All Others 50 TABLE 3 Positive Responses to Question Thirteen By Service Comparing responses by salary level the average positive

  8. Variants forms of Philadelphia translocation in two patients with chronic myeloid leukemia

    International Nuclear Information System (INIS)

    Valent, A.; Zamecnikova, A.; Krizan, P.; Karlic, H.; Nowotny, H.

    1996-01-01

    During a 4-year period (December 1990-December 1994), among other diagnoses hundred cases of chronic myeloid leukemia (CML) were analyzed in our departments. We focused our attention on two cases with a variant form of Philadelphia translocation. Cytogenetic and molecular genetic studies were performed to resolve the status of BCR and ABL in the bone marrow or peripheral blood cells of the two CML patients with complex translocations involving chromosomes, 3, 9, 22 and 9, 12, 22 respectively. In the first case the presence of Ph chromosome was detected cytogenetically, BCR-ABL translocation was detected by Southern hybridization. In the second phase, only the PCR method showed BCR-ABL rearrangement. The second case, with a random variant form of Ph translocation, could be detected using different methods of clinical molecular genetics. (author)

  9. Aerosol Vacuum-Assisted Plasma Ionization (Aero-VaPI) Coupled to Ion Mobility-Mass Spectrometry

    Science.gov (United States)

    Blair, Sandra L.; Ng, Nga L.; Zambrzycki, Stephen C.; Li, Anyin; Fernández, Facundo M.

    2018-02-01

    In this communication, we report on the real-time analysis of organic aerosol particles by Vacuum-assisted Plasma Ionization-Mass Spectrometry (Aero-VaPI-MS) using a home-built VaPI ion source coupled to a Synapt G2-S HDMS ion mobility-mass spectrometry (IM-MS) system. Standards of organic molecules of interest in prebiotic chemistry were used to generate aerosols. Monocaprin and decanoic acid aerosol particles were successfully detected in both the positive and negative ion modes, respectively. A complex aerosol mixture of different sizes of polymers of L-malic acid was also examined through ion mobility (IM) separations, resulting in the detection of polymers of up to eight monomeric units. This noncommercial plasma ion source is proposed as a low cost alternative to other plasma ionization platforms used for aerosol analysis, and a higher-performance alternative to more traditional aerosol mass spectrometers. VaPI provides robust online ionization of organics in aerosols without extensive ion activation, with the coupling to IM-MS providing higher peak capacity and excellent mass accuracy. [Figure not available: see fulltext.

  10. Task Delegation and Burnout Trade-offs Among Primary Care Providers and Nurses in Veterans Affairs Patient Aligned Care Teams (VA PACTs).

    Science.gov (United States)

    Edwards, Samuel T; Helfrich, Christian D; Grembowski, David; Hulen, Elizabeth; Clinton, Walter L; Wood, Gordon B; Kim, Linda; Rose, Danielle E; Stewart, Greg

    2018-01-01

    Appropriate delegation of clinical tasks from primary care providers (PCPs) to other team members may reduce employee burnout in primary care. However, (1) the extent to which delegation occurs within multidisciplinary teams, (2) factors associated with greater delegation, and (3) whether delegation is associated with burnout are all unknown. We performed a national cross-sectional survey of Veterans Affairs (VA) PCP-nurse dyads in Department of VA primary care clinics, 4 years into the VA's patient-centered medical home initiative. PCPs reported the extent to which they relied on other team members to complete 15 common primary care tasks; paired nurses reported how much they were relied on to complete the same tasks. A composite score of task delegation/reliance was developed by taking the average of the responses to the 15 questions. We performed multivariable regression to explore predictors of task delegation and burnout. Among 777 PCP-nurse dyads, PCPs reported delegating tasks less than nurses reported being relied on (PCP mean ± standard deviation composite delegation score, 2.97± 0.64 [range, 1-4]; nurse composite reliance score, 3.26 ± 0.50 [range, 1-4]). Approximately 48% of PCPs and 35% of nurses reported burnout. PCPs who reported more task delegation reported less burnout (odds ratio [OR], 0.62 per unit of delegation; 95% confidence interval [CI], 0.49-0.78), whereas nurses who reported being relied on more reported more burnout (OR, 1.83 per unit of reliance; 95% CI, 1.33-2.5). Task delegation was associated with less burnout for PCPs, whereas task reliance was associated with greater burnout for nurses. Strategies to improve work life in primary care by increasing PCP task delegation must consider the impact on nurses. © Copyright 2018 by the American Board of Family Medicine.

  11. EFFECTS OF VARIOUS SOIL ENVIRONMENTAL STRESSES ON THE OCCURRENCE, DISTRIBUTION AND EFFECTIVENESS OF VA MYCORRHIZAE

    Directory of Open Access Journals (Sweden)

    A.G. KHAN

    1995-01-01

    Full Text Available The vesicular - arbuscular (VA mycorrhizal fungi are geographically ubiquitous soil inhabitants and form universal symbiotic relationship with plants from every phylum. These fungi link host plants with host soils and their biota in the mycorrhizosphere and play an important role in plant health, productivity and soil structure. Although VA mycorrhizal fungi do not show any host specificity, there is increasing evidence that various climatic and edaphic environmental factors such as land use and management practices, physical, chemical and biological properties of host soils and host plant characteristics influence their occurrence, taxonomic distribution and effectiveness. The interaction of these factors with vesicular-arbuscular mycorrhizae (VAM is poorly understood except in a few cases. It is now very clear that VA mycorrhizal associations are ecologically significant factors that require more attention than previously accorded. This paper discusses the occurrence, distribution and significance of VAM in environmentally stressed soil conditions that limit plant growth such as drought, waterlogging and salinity.

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

    Directory of Open Access Journals (Sweden)

    Guglielmi A.V.

    2017-09-01

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

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

    Science.gov (United States)

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

    2017-03-01

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

  14. 30 CFR 57.22205 - Doors on main fans (I-A, II-A, III, and V-A mines).

    Science.gov (United States)

    2010-07-01

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

  15. Evidence-based guidelines for the use of tyrosine kinase inhibitors in adults with Philadelphia chromosome–positive or BCR-ABL–positive acute lymphoblastic leukemia: a Canadian consensus

    Science.gov (United States)

    Couban, S.; Savoie, L.; Mourad, Y. Abou; Leber, B.; Minden, M.; Turner, R.; Palada, V.; Shehata, N.; Christofides, A.; Lachance, S.

    2014-01-01

    Adult Philadelphia chromosome–positive (Ph+) or BCR-ABL–positive (BCR-ABL+) acute lymphoblastic leukemia (all) is an acute leukemia previously associated with a high relapse rate, short disease-free survival, and poor overall survival. In adults, allogeneic hematopoietic cell transplant in first remission remains the only proven curative strategy for transplant-eligible patients. The introduction of tyrosine kinase inhibitors (tkis) in the treatment of patients with Ph+ or BCR-ABL+ all has significantly improved the depth and duration of complete remission, allowing more patients to proceed to transplantation. Although tkis are now considered a standard of care in this setting, few randomized trials have examined the optimal use of tkis in patients with Ph+ all. Questions of major importance remain, including the best way to administer these medications, the choice of tki to administer, and the schedule and the duration to use. We present the results of a systematic review of the literature with consensus recommendations based on the available evidence. PMID:24764712

  16. 78 FR 27882 - VA Veteran-Owned Small Business (VOSB) Verification Guidelines

    Science.gov (United States)

    2013-05-13

    ... Verification Self-Assessment Tool that walks the veteran through the regulation and how it applies to the...) Verification Guidelines AGENCY: Department of Veterans Affairs. ACTION: Advanced notice of proposed rulemaking... regulations governing the Department of Veterans Affairs (VA) Veteran-Owned Small Business (VOSB) Verification...

  17. Comparison of Comet Enflow and VA One Acoustic-to-Structure Power Flow Predictions

    Science.gov (United States)

    Grosveld, Ferdinand W.; Schiller, Noah H.; Cabell, Randolph H.

    2010-01-01

    Comet Enflow is a commercially available, high frequency vibroacoustic analysis software based on the Energy Finite Element Analysis (EFEA). In this method the same finite element mesh used for structural and acoustic analysis can be employed for the high frequency solutions. Comet Enflow is being validated for a floor-equipped composite cylinder by comparing the EFEA vibroacoustic response predictions with Statistical Energy Analysis (SEA) results from the commercial software program VA One from ESI Group. Early in this program a number of discrepancies became apparent in the Enflow predicted response for the power flow from an acoustic space to a structural subsystem. The power flow anomalies were studied for a simple cubic, a rectangular and a cylindrical structural model connected to an acoustic cavity. The current investigation focuses on three specific discrepancies between the Comet Enflow and the VA One predictions: the Enflow power transmission coefficient relative to the VA One coupling loss factor; the importance of the accuracy of the acoustic modal density formulation used within Enflow; and the recommended use of fast solvers in Comet Enflow. The frequency region of interest for this study covers the one-third octave bands with center frequencies from 16 Hz to 4000 Hz.

  18. PTSD and Use of Outpatient General Medical Services Among Veterans of the Vietnam War.

    Science.gov (United States)

    Schlenger, William E; Mulvaney-Day, Norah; Williams, Christianna S; Kulka, Richard A; Corry, Nida H; Mauch, Danna; Nagler, Caryn F; Ho, Chia-Lin; Marmar, Charles R

    2016-05-01

    The primary goal of this analysis was to assess whether recent use of outpatient services for general medical concerns by Vietnam veterans varies according to level of posttraumatic stress disorder (PTSD) symptomatology over time. Another goal was to determine whether PTSD symptomatology was associated with veterans' reports of discussing behavioral health issues as part of a general medical visit. Self-reported service use data and measures of PTSD were from a nationally representative sample of 848 male and female Vietnam theater veterans (individuals who were deployed to the Vietnam theater of operations) who participated in the National Vietnam Veterans Longitudinal Study, a 25-year follow-up of a cohort of veterans originally interviewed from 1984-1988 as part of the National Vietnam Veterans Readjustment Study. Four categories of PTSD symptomatology course over 25 years were defined, and logistic regression models were used to assess their relationship with recent use of outpatient general medical services. Male and female theater veterans with high or increasing PTSD symptomatology over the period were more likely than those with low symptomatology to report recent VA outpatient visits. Males in the increasing and high categories were also more likely to discuss behavioral health issues at general medical visits. Vietnam veterans with high and increasing PTSD symptomatology over time were likely to use VA outpatient general health services. Attention to stressors of the aging process and to persistence of PTSD symptoms is important for Vietnam veterans, as is addressing PTSD with other psychiatric and medical comorbidities within the context of outpatient general medical care.

  19. Estimating Value at Risk with the Generalized Kalman Filter%基于Generalized Kalman Filter的VaR估计

    Institute of Scientific and Technical Information of China (English)

    赵利锋; 张崇岐

    2009-01-01

    在应用Kalman Filter方法估计时变风险β系数的基础上,引入Generalized Kalman Filter方法来估计时变卢系数,再通过Sharp对角线模型计算投资组合的VaR,并运用Backtesting检验判断两方法估计VaR的精确度.

  20. Risk of Fall-Related Injury due to Adverse Weather Events, Philadelphia, Pennsylvania, 2006-2011.

    Science.gov (United States)

    Gevitz, Kathryn; Madera, Robbie; Newbern, Claire; Lojo, José; Johnson, Caroline C

    Following a surge in fall-related visits to local hospital emergency departments (EDs) after a severe ice storm, the Philadelphia Department of Public Health examined the association between inclement winter weather events and fall-related ED visits during a 5-year period. Using a standardized set of keywords, we identified fall-related injuries in ED chief complaint logs submitted as part of Philadelphia Department of Public Health's syndromic surveillance from December 2006 through March 2011. We compared days when falls exceeded the winter fall threshold (ie, "high-fall days") with control days within the same winter season. We then conducted matched case-control analysis to identify weather and patient characteristics related to increased fall-related ED visits. Fifteen high-fall days occurred during winter months in the 5-year period. In multivariable analysis, 18- to 64-year-olds were twice as likely to receive ED care for fall-related injuries on high-fall days than on control days. The crude odds of ED visits occurring from 7:00 am to 10:59 am were 70% higher on high-fall days vs control days. Snow was a predictor of a high-fall day: the adjusted odds of snow before a high-fall day as compared with snow before a control day was 13.4. The association between the number of fall-related ED visits and weather-related fall injuries, age, and timing suggests that many events occurred en route to work in the morning. Promoting work closures or delaying openings after severe winter weather would allow time for better snow or ice removal, and including "fall risk" in winter weather advisories might effectively warn morning commuters. Both strategies could help reduce the number of weather-related fall injuries.

  1. Validation of KENO V.a for criticality safety calculations involving WR-1 fast-neutron fuel arrangements

    Energy Technology Data Exchange (ETDEWEB)

    Gauld, I. C.

    1991-07-15

    The KENO V.a criticality safety code, used with the SCALE 27-energy-group ENDF/B-IV-based cross-section library, has been validated for low-enriched uranium carbide (UC) WR-1 fast-neutron (FN) fuel arrangements. Because of a lack of relevant experimental data for UC fuel in the published literature, the validation is based primarily on calculational comparisons with critical experiments for fuel types with a range of enrichments and densities that cover those of the FN UC fuel. The ability of KENO V.a to handle the unique annular pin arrangement of the WR-1 FN fuel bundle was established using a comparison with the MCNP3B code used with a continuous-energy ENDF/B-V-based cross-section library. This report is part of the AECL--10146 report series documenting the validation of the KENO V.a criticality safety code.

  2. Prognostic significance of ASXL1, JAK2V617F mutations and JAK2V617F allele burden in Philadelphia-negative myeloproliferative neoplasms

    Directory of Open Access Journals (Sweden)

    Yonal-Hindilerden I

    2015-06-01

    Full Text Available Ipek Yonal-Hindilerden, Aynur Daglar-Aday, Basak Akadam-Teker, Ceylan Yilmaz, Meliha Nalcaci, Akif Selim Yavuz, Deniz SarginDivision of Hematology, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Fatih-Istanbul, Turkey Background: Despite insights into the genetic basis of Philadelphia-negative myeloproliferative neoplasms (Ph-negative MPNs, a significant proportion of essential thrombocythemia (ET and primary myelofibrosis (PMF patients present with no known MPN disease alleles. There were no previous studies investigating the impact of ASXL1 mutations in Ph-negative MPNs in Turkey. In the current study, we investigated the prognostic significance of ASXL1 mutations in Turkish MPN patients. We also aimed to determine the prognostic significance of JAK2V617F allele burden and the relationship of JAK2V617F mutation with ASXL1 mutations in Ph-negative MPNs. Methods: About 184 patients from a single center diagnosed with Ph-negative MPNs were screened for ASXL1, JAK2V617F mutations, and JAK2V617F allele burden: 107 ET and 77 PMF. Results: A total of 29 ASXL1 mutations were detected in 24.7% of PMF and 8.4% of ET patients. ASXL1-mutated ET patients showed a trend toward an increase in the incidence of cerebrovascular events and higher total leukocyte counts. ASXL1-mutation in PMF was associated with older age and a higher prevalence of bleeding complications. In univariate analysis, overall survival (OS was significantly reduced in ASXL1-mutated PMF patients. In multivariate analysis, Dynamic International Prognostic Scoring System-plus high-risk category and ASXL1 mutation status were independently associated with shorter survival in PMF. In PMF, mutational status and allele burden of JAK2V617F showed no difference in terms of OS and leukemia-free survival. Conclusion: We conclude that ASXL1 mutations are molecular predictors of short OS in PMF. Keywords: Philadelphia-negative myeloproliferative neoplasms (Ph

  3. 38 CFR 58.17 - VA Form 10-0144A-Statement of Assurance of Compliance with Equal Opportunity Laws.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-0144A-Statement of Assurance of Compliance with Equal Opportunity Laws. 58.17 Section 58.17 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.17 VA Form 10-0144A—Statement of Assurance of Compliance with Equal...

  4. 30 CFR 57.22204 - Main fan operation and inspection (I-A, II-A, III, and V-A mines).

    Science.gov (United States)

    2010-07-01

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

  5. Characterization and Prognosis Significance of JAK2 (V617F), MPL, and CALR Mutations in Philadelphia-Negative Myeloproliferative Neoplasms

    OpenAIRE

    Singdong, Roongrudee; Siriboonpiputtana, Teerapong; Chareonsirisuthigul, Takol; Kongruang, Adcharee; Limsuwanachot, Nittaya; Sirirat, Tanasan; Chuncharunee, Suporn; Rerkamnuaychoke, Budsaba

    2016-01-01

    Background: The discovery of somatic acquired mutations of JAK2 (V617F) in Philadelphia-negative myeloproliferative neoplasms (Ph-negative MPNs) including polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF) has not only improved rational disease classification and prognostication but also brings new understanding insight into the pathogenesis of diseases. Dosage effects of the JAK2 (V617F) allelic burden in Ph-negative MPNs may partially influence clinical ...

  6. Characterization of the interaction between the heavy and light chains of bovine factor Va.

    Science.gov (United States)

    Walker, F J

    1992-10-05

    Bovine factor Va has been previously been shown to consist of heavy (M(r) = 94,000) and light chains (M(r) = 81,000), that interact in a manner dependent upon the presence of either calcium or manganese ions. In an attempt to understand the mechanism of subunit interaction we have studied the effects of temperature and ions on factor Va stability. The rates of formation of factor Va from isolated chains and dissociation were temperature-dependent with an energy of activation of 6.2 and 1.3 kcal mol-1, respectively. The yield of factor Va from isolated chains was inversely related to the amount of time the chains were incubated at 4 degrees C. Incubation of individual chains revealed that the heavy chain is cold-labile, an effect that is reversible. Manganese ion was observed to prevent the conversion to the inactive form. High salt tends to stabilize the two-chain structure of factor Va, but is inhibitory to its formation from isolated chains. High concentrations of either manganese or calcium ions also inhibited reconstitution of activity. The light chain, in particular, was sensitive to the presence of manganese or calcium ion. Heavy chain that had been cleaved by activated protein C had a weakened interaction with the light chain, and the resulting complex had no procoagulant activity. Cooling of the heavy chain to 4 degrees C enhanced its intrinsic fluorescence. Manganese ion prevented some of this enhancement. The heavy chain fluorescence returned to the room temperature value with a half-life of approximately 10 min. In the presence of manganese ion relaxation was accelerated. The intrinsic fluorescence of activated protein C-cleaved heavy chain was not increased when the temperature was decreased. These data suggest that the heavy chain can exist in two forms. Elevated temperature converts it to a form that can bind ions and have a productive interaction with the light chain. However, conditions that prevent the heavy chain from combining with the light

  7. Philadelphia chromosome-negative myeloproliferative disorders: biology and treatment.

    Science.gov (United States)

    Hoffman, Ronald; Prchal, Josef T; Samuelson, Scott; Ciurea, Stefan O; Rondelli, Damiano

    2007-01-01

    The Philadelphia chromosome (Ph)-negative myeloproliferative disorders (MPDs) include essential thrombocythemia (ET), idiopathic myelofibrosis (IMF), and polycythemia vera (PV). All of these disorders are clonal hematologic malignancies originating at the level of the pluripotent hematopoietic stem cell. Recently, activating mutations of the intracellular cytokine-signaling molecule JAK2 have been identified in > 90% of patients with PV and in 50% of those with IMF and ET. In addition, a mutation of the thrombopoietin receptor, MPLW515L, has been documented in some patients with IMF. Both mutations activate JAK-STAT signaling pathways and likely play a role in disease progression. Both ET and PV are associated with prolonged clinical courses associated with frequent thrombotic and hemorrhagic events, and progression to myelofibrosis and acute leukemia. IMF has a much poorer prognosis and is associated with cytopenias, splenomegaly, extramedullary hematopoiesis, and bone marrow fibrosis. Stratification of risk for the development of complications from Ph-negative MPDs has guided the identification of appropriate therapies for this population. Intermediate/high-risk IMF or myelofibrosis after ET or PV is associated with a sufficiently poor prognosis to justify the use of allogeneic stem cell transplantation, which is capable of curing such patients. Reduced-intensity conditioning in preparation for allogeneic stem cell transplantation has permitted older patients with IMF to undergo transplantation with increasing success.

  8. Storing Empty Calories and Chronic Disease Risk: Snack-Food Products, Nutritive Content, and Manufacturers in Philadelphia Corner Stores

    OpenAIRE

    Lucan, Sean C.; Karpyn, Allison; Sherman, Sandy

    2010-01-01

    Corner stores are part of the urban food environment that may contribute to obesity and diet-related diseases, particularly for low-income and minority children. The snack foods available in corner stores may be a particularly important aspect of an urban child’s food environment. Unfortunately, there is little data on exactly what snack foods corner stores stock, or where these foods come from. We evaluated snack foods in 17 Philadelphia corner stores, located in three ethnically distinct, l...

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

    Science.gov (United States)

    Wlodarski, K; Tajber, L; Sawicki, W

    2016-12-01

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

  10. VA Student Financial Aid. Opportunity To Reduce Overlap in Approving Education and Training Programs. Report to the Committee on Veterans' Affairs, U.S. Senate.

    Science.gov (United States)

    General Accounting Office, Washington, DC. Health, Education, and Human Services Div.

    The Department of Veterans Affairs (VA) contracts with state approving agencies (SAAs) to assess whether schools and training programs offer education of sufficient quality for veterans to receive VA education assistance benefits when attending them. The General Accounting Office examined the gatekeeping activities of the VA and the Department of…

  11. What puts heart failure patients at risk for poor medication adherence?

    Directory of Open Access Journals (Sweden)

    Knafl GJ

    2014-07-01

    Full Text Available George J Knafl,1 Barbara Riegel2,31School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 2School of Nursing, University of Pennsylvania, Philadelphia, PA, USA; 3Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA, USABackground: Medication nonadherence is a major cause of hospitalization in patients with heart failure (HF, which contributes enormously to health care costs. We previously found, using the World Health Organization adherence dimensions, that condition and patient level factors predicted nonadherence in HF. In this study, we assessed a wider variety of condition and patient factors and interactions to improve our ability to identify those at risk for hospitalization. Materials and methods: Medication adherence was measured electronically over the course of 6 months, using the Medication Event Monitoring System (MEMS. A total of 242 HF patients completed the study, and usable MEMS data were available for 218 (90.1%. Participants were primarily white (68.3%, male (64.2%, and retired (44.5%. Education ranged from 8–29 years (mean, 14.0 years; standard deviation, 2.9 years. Ages ranged from 30–89 years (mean, 62.8 years; standard deviation, 11.6 years. Analyses used adaptive methods based on heuristic searches controlled by cross-validation scores. First, individual patient adherence patterns over time were used to categorize patients in poor versus better adherence types. Then, risk factors for poor adherence were identified. Finally, an effective model for predicting poor adherence was identified based on identified risk factors and possible pairwise interactions between them. Results: A total of 63 (28.9% patients had poor adherence. Three interaction risk factors for poor adherence were identified: a higher number of comorbid conditions with a higher total number of daily medicines, older age with poorer global sleep quality, and fewer months since diagnosis of HF with poorer

  12. A comparison of the prevalence of lead-contaminated imported Chinese ceramic dinnerware purchased inside versus outside Philadelphia's Chinatown.

    Science.gov (United States)

    Gilmore, Thomas; O'Malley, Gerald F; Lau, Wayne Bond; Vann, David R; Bromberg, Adam; Martin, Aaron; Gibbons, Andrea; Rimmer, Evan

    2013-03-01

    Lead-contaminated ceramics can be a clinically significant source of lead poisoning, with the potential to cause illness in children and adults; one death in a child has been described. We hypothesized that the prevalence of lead-contaminated ceramics would be higher within Chinatown versus outside of Chinatown. The study was a prospective observational cross-sectional study. Two areas were defined geographically as being within and outside of Philadelphia's Chinatown, and a predefined number of items were purchased in each area. Each item was screened for lead utilizing a colorimetric testing swab. Positive items were leached for lead using the ASTM C738-94 protocol for lead level quantification. The primary outcome was the prevalence of ceramics not compliant with the FDA standard for leachable lead within and outside of Philadelphia's Chinatown. A total of 132 items were purchased, 46 outside of and 86 within Chinatown. More lead-positive items originated within Chinatown than outside of Chinatown [five positive items, 5.8 % prevalence within Chinatown (95 % confidence interval, CI, 2.5-12.9 %), and zero positive, 0 % prevalence outside of Chinatown (95 % CI 0-7.5 %)]. However, this difference was not found to be statistically significant (P = 0.1624). The leachable lead-positive items were up to 40-fold the acceptable FDA levels. Testing a larger number of items may demonstrate a significant source of lead exposure.

  13. Urban sustainable energy development: A case study of the city of Philadelphia

    Science.gov (United States)

    Argyriou, Iraklis

    This study explores the role of cities in sustainable energy development through a governance-informed analysis. Despite the leading position of municipalities in energy sustainability, cities have been mostly conceptualized as sites where energy development is shaped by external policy scales, i.e. the national level. A growing body of research, however, critiques this analytical perspective, and seeks to better understand the type of factors and dynamics that influence energy sustainability within a multi-level policy context for urban energy. Given that particular circumstances are applicable across cities, a context-specific analysis can provide insight regarding how sustainable energy development takes place in urban areas. In applying such an analytical perspective on urban energy sustainability, this study undertakes a qualitative case study analysis for the city of Philadelphia, Pennsylvania, by looking at four key local policy initiatives relevant to building energy efficiency and solar electricity development at the municipal government and city-wide level. The evaluation of the initiatives suggests that renewable electricity use has increased substantially in the city over the last years but the installed capacity of local renewable electricity systems, including solar photovoltaics, is low. On the other hand, although the city has made little progress in meeting its building energy efficiency targets, more comprehensive action is taken in this area. The study finds that the above outcomes have been shaped mainly by four factors. The first is the city government's incremental policy approach aiming to develop a facilitative context for local action. The second is the role that a diverse set of stakeholders have in local sustainable energy development. The third is the constraints that systemic policy barriers create for solar power development. The fourth is the ways through which the relevant multi-level policy environment structures the city

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

    Directory of Open Access Journals (Sweden)

    Ines Kersan-Škabić

    2017-01-01

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

  15. Molecular diagnostic of the philadelphia chromosome; Diagnostico molecular del cromosoma filadelfia

    Energy Technology Data Exchange (ETDEWEB)

    Campos Rudin, M [Instituto de Investigaciones en Salud (INISA), Costa Rica (Costa Rica) and Escuela de Biologia; Cuenca Berger, P [Instituto de Investigaciones en Salud (INISA), Costa Rica (Costa Rica) and Escuela de Biologia; Gutierrez Espeleta, G [Instituto de Investigaciones en Salud (INISA), Costa Rica (Costa Rica) and Escuela de Biologia; Jimenez Cruz, G [Hospital Mexico, Costa Rica (Costa Rica). Seccion Hematologia; Montero Umana, C [Hospital Mexico, Costa Rica (Costa Rica). Seccion Hematologia; Vazquez Castillo, L [Hospital San Juan de Dios, Costa Rica (Costa Rica). Seccion de Hematologia; Ramon Ortiz, M [Hospital San Juan de Dios, Costa Rica (Costa Rica). Seccion de Hematologia

    1998-07-01

    The importance that has to confirm the presence or absence of the chromosome Philadelphia in the diagnostic and follow up of the patient affected with chronic myeloid leukemia and other leukemia. It is considered necessary to implement the molecular diagnostic in Costa Rica. They studied 32 patient affected by Chronic Myeloid Leukemia, 7 by other Myeloproliferative Chronic Disorders and 2 by Myelodysplastic Syndrome. It utilized the sound Trans probe-1 (Oncogene Science, Inc), which was marked with radioactivity ({sup 32}P) or chemiluminescence (digoxigenin). Of the 32 cases affected by L mc, in 28 it was possible to carry out the molecular analysis detecting the characteristic translocation of the chromosome Philadelphia among the Mbcr/c-ABL genes in 21 (75%) of the patients, in 7 (25%) the rearrangement was not found. In seven of the nine affected by other sufferings it was possible to obtain results, 3 that turned out to be positive for the rearrangement among Mbcr/c-ABL and 4 normal. In all the cases, they obtained results marking the sound with radioactivity. However, they tested the marks with digoxigenin in seven of the patients, as an methodological alternative for the laboratories that lacks the requirements to work with radiation. The results obtained were identical. (S. Grainger) [Spanish] La relevancia que tiene confirmar la presencia o ausencia del cromosoma Filadelfia en el diagnostico y seguimiento de los pacientes afectados con leucemia mieloide cronica y otras leucemias, se considero necesario implementar el diagnostico molecular en Costa Rica. Se estudiaron 32 pacientes afectados por Leucemia Mieloide Cronica, 7 por otros Desordenes Mieloproleferativos Cronicos y 2 por Sindromes Mielodisplasicos. Se utilizo la sonda Transprobe-1 (Oncogene Science, Inc), la cual fue marcada con radioactividad ({sup 32}P) o quimioluminiscencia (digoxigenina). De los 32 casos afectados por LMC, en 28 se logro realizar el analisis molecular detectandose la

  16. Acute, fatal Sarcocystis calchasi-associated hepatitis in Roller pigeons (Columba livia f. dom.) at Philadelphia Zoo.

    Science.gov (United States)

    Trupkiewicz, J G; Calero-Bernal, R; Verma, S K; Mowery, J; Davison, S; Habecker, P; Georoff, T A; Ialeggio, D M; Dubey, J P

    2016-01-30

    Four Roller pigeons (Columba livia f. dom.) at the Philadelphia Zoo died suddenly. Necropsy examination revealed macroscopic hepatitis. Microscopically, the predominant lesions were in liver, characterized with necrosis and mixed cell inflammatory response. Sarcocystis calchasi-like schizonts and free merozoites were identified in liver. Transmission electron microscopy confirmed that schizonts were in hepatocytes. A few schizonts were in spleen. PCR using S. calchasi-specific primers confirmed the diagnosis. Neither lesions nor protozoa were found in brain and muscles. This is the first report of acute visceral S. calchasi-associated sarcocystosis in naturally infected avian hosts. Published by Elsevier B.V.

  17. Otto Rank, the Rankian circle in Philadelphia, and the origins of Carl Rogers' person-centered psychotherapy.

    Science.gov (United States)

    deCarvalho, R J

    1999-05-01

    Otto Rank's will therapy helped shape the ideas and techniques of relationship therapy developed by the Philadelphia social workers Jessie Taft, Virginia Robinson, and Frederick Allen in the 1930s. Rank's work and these ideas and techniques in turn strongly influenced the formulation of Carl Rogers' person-centered psychotherapy. This article compares and contrasts will, relationship, and person-centered approaches to psychotherapy and discusses the social factors--primarily the professional conflicts between a male-dominated psychiatry and female social workers over the independent practice of psychotherapy--that were crucial in the dissemination of Rank's psychological thought and the early popularity of Rogers.

  18. Perspectives of patients on factors relating to adherence to post-acute coronary syndrome medical regimens

    Directory of Open Access Journals (Sweden)

    Lambert-Kerzner A

    2015-07-01

    Full Text Available Anne Lambert-Kerzner,1,2 Edward P Havranek,2,3 Mary E Plomondon,1,2 Katherine M Fagan,1 Marina S McCreight,1 Kelty B Fehling,1 David J Williams,2 Alison B Hamilton,4 Karen Albright,2 Patrick J Blatchford,2 Renee Mihalko-Corbitt,5 Chris L Bryson,6 Hayden B Bosworth,7 Miriam A Kirshner,7 Eric J Del Giacco,5 P Michael Ho1,2 1Department of Cardiology, Veterans Health Administration (VA Eastern Colorado Health Care System, Denver, CO, 2School of Public Health or School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, 3Cardiology, Denver Health Medical Center, Denver, CO, 4Health Services Research, Veterans Health Administration (VA Greater Los Angeles Healthcare System, Los Angeles, CA, 5Internal Medicine, John L. McClellan Memorial Veterans Hospital, Little Rock, AR, 6Health Services Research, Veterans Health Administration (VA Puget Sound Health Care System, Seattle, WA, 7Health Services Research, Durham Veterans Affairs Medical Center, Durham, NC, USA Purpose: Poor adherence to cardioprotective medications after acute coronary syndrome (ACS hospitalization is associated with increased risk of rehospitalization and mortality. Clinical trials of multifaceted interventions have improved medication adherence with varying results. Patients’ perspectives on interventions could help researchers interpret inconsistent outcomes. Identifying factors that patients believe would improve adherence might inform the design of future interventions and make them more parsimonious and sustainable. The objective of this study was to obtain patients’ perspectives on adherence to medical regimens after experiencing an ACS event and their participation in a medication adherence randomized control trial following their hospitalization. Patients and methods: Sixty-four in-depth interviews were conducted with ACS patients who participated in an efficacious, multifaceted, medication adherence randomized control trial. Interview transcripts were

  19. KENO3D, Visualisation Tool for KENO V.A and KENO-VI Geometry Models

    International Nuclear Information System (INIS)

    2008-01-01

    1 - Description of program or function: The KENO3D Visualization Tool for KENO Geometry Models is a powerful state-of-the-art visualization tool that enables KENO V.a users and KENO-VI to interactively display their three-dimensional geometry models. The KENO3D interactive options include: - Shaded or wire-frame images ; - Standard views such as top view, side view, front view, and isometric(3-D) view; - Rotating the model ; - Zooming in on selected locations ; - Selecting parts of the model to display ; - Editing colors and displaying legends ; - Displaying properties of any unit in the model ; - Creating cut-away views ; - Removing units from the model; - Printing image or saving image to a common graphics formats. KENO3D was developed for use by criticality safety specialists that use the KENO three-dimensional Monte Carlo criticality computer code. KENO V.a and KENO-VI are part of the SCALE (Standardized Computer Analyses for Licensing Evaluations) computer software system developed at Ridge National Laboratory (ORNL) that is widely used and accepted around the world for criticality safety analyses. 2 - Methods: KENO3D reads CSAS, KENO V.a, or KENO-VI input files. It attempts to verify that the KENO geometry input is 'legal', i.e., it conforms to the code input guidelines. KENO3D prints a warning message for illegal geometry input, and if possible, it displays the illegal KENO geometry to facilitate debugging of the input. Problems with more than 300,000 KENO V.a bodies have been successfully tested and displayed. KENO3D has the look and feel of a typical PC Windows application. Toolbar buttons are included for all major menu options. There is a setup dialog that allows the user to specify toolbars that should be displayed

  20. 77 FR 33089 - OPSAIL 2012 Virginia, Port of Hampton Roads, VA

    Science.gov (United States)

    2012-06-05

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

  1. 77 FR 19957 - OPSAIL 2012 Virginia, Port of Hampton Roads, VA

    Science.gov (United States)

    2012-04-03

    ...-0174] RIN 1625-AA00, AA01, AA08, AA11, AA87 OPSAIL 2012 Virginia, Port of Hampton Roads, VA AGENCY... temporary regulations in the Port of Hampton Roads, Virginia for Operation Sail (OPSAIL) 2012 Virginia... portions of Chesapeake Bay, Hampton Roads, the James River and Elizabeth River. DATES: Comments and related...

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

    Directory of Open Access Journals (Sweden)

    Fenglan Li

    2017-01-01

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

  3. The Untreated Addiction: Going Tobacco-Free in a VA Substance Abuse Residential Rehabilitation Treatment Program (SARRTP).

    Science.gov (United States)

    Conrad, Megan; Bolte, Teri; Gaines, Leigh; Avery, Zackery; Bodie, Linda

    2018-05-02

    Despite negative effects of tobacco on the human body and the high prevalence of smoking among those who enter treatment for substance use, few residential programs endorse a tobacco-free policy. Conventional wisdom suggests that it is overwhelming to quit more than one substance at a time, and as a result, many clinicians believe that a shift to a tobacco-free treatment environment is unfeasible. However, the most recent scientific literature suggests the opposite: targeting tobacco use during substance use treatment can increase abstinence rates from both smoking and substances of choice. Therefore, the purpose of the current project is to outline the process by which a residential substance use treatment program within a Veterans Affairs (VA) medical center implemented a tobacco-free policy. In addition, preliminary program evaluation data dispels the myth that eliminating tobacco use in a residential treatment program leads to a decline in patient interest and program utilization.

  4. The JAK2 V617F mutation involves B- and T-lymphocyte lineages in a subgroup of patients with Philadelphia-chromosome negative chronic myeloproliferative disorders

    DEFF Research Database (Denmark)

    Larsen, Thomas Stauffer; Christensen, Jacob Haaber; Hasselbalch, Hans Carl

    2007-01-01

    The JAK2 V617F mutation is a frequent genetic event in the three classical Philadelphia-chromosome negative chronic myeloproliferative disorders (Ph(neg.)-CMPD), polycythemia vera (PV), essential thrombocythemia (ET) and idiopathic myelofibrosis (IMF). Its occurrence varies in frequency in regards...

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

    Directory of Open Access Journals (Sweden)

    Mengnan Wang

    2018-03-01

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

  6. Sofosbuvir and Simeprevir Combination Therapy for HCV Genotype 1 Infection: Results of a Single-Center VA Experience

    Science.gov (United States)

    Hernandez, Maria Del Pilar; Vance, Evan; Gilinski, Dani; Youtseff, Helen; Toro, Maribel; Antoine, Marie; Jeffers, Lennox J.; Peyton, Adam

    2016-01-01

    Treatment of chronic hepatitis C virus (HCV) infection remains a priority in the veterans affairs (VA) health care system nationwide, as there is a high burden of liver disease due to HCV infection among US veterans. The combination of sofosbuvir and simeprevir was the first all-oral antiviral regimen used in clinical practice to treat veterans with HCV infection. In this study, we report a single-center experience showing both the feasibility and effectiveness of this all-oral combination to treat HCV genotype 1 infection. One hundred patients with HCV genotype 1 infection were treated between December 2013 and June 2014. Eighty-six patients were treated with sofosbuvir and simeprevir, with or without ribavirin, for 12 weeks; 12 patients were treated with sofosbuvir, pegylated interferon, and ribavirin for 12 weeks; and 2 patients were treated with sofosbuvir and ribavirin for 24 weeks. Overall, treatment was well tolerated and feasible, with compliance rates over 95% in patients treated with all-oral therapy. The sustained virologic response (SVR) rate for sofosbuvir and simeprevir (88.4%) was superior to the rate for sofosbuvir, pegylated interferon, and ribavirin (50.0%). Subgroup analysis showed diminished SVR rates in cirrhotic patients vs noncirrhotic patients. There were no significant differences in SVR when comparing treatment with or without ribavirin or among genotype subtypes. In conclusion, this study demonstrated excellent completion rates for all-oral treatment of veterans with chronic HCV infection. Additionally, treatment was highly effective, nearing a 90% cure rate. Thus, we recommend that the VA health care system continue to incorporate new HCV medications into its formulary so as to expand HCV treatment for US veterans. PMID:27917084

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

    Science.gov (United States)

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

    2017-02-20

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  10. Exploring Rural Disparities in Medical Diagnoses Among Veterans With Transgender-related Diagnoses Utilizing Veterans Health Administration Care.

    Science.gov (United States)

    Bukowski, Leigh A; Blosnich, John; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Gordon, Adam J

    2017-09-01

    Research shows transgender individuals experience pronounced health disparities compared with their nontransgender peers. Yet, there remains insufficient research about health differences within transgender populations. This study seeks to fill this gap by exploring how current urban/rural status is associated with lifetime diagnosis of mood disorder, alcohol dependence disorder, illicit drug abuse disorder, tobacco use, posttraumatic stress disorder, human immunodeficiency virus, and suicidal ideation or attempt among veterans with transgender-related diagnoses. This study used a retrospective review of The Department of Veterans Affairs (VA) administrative data for transgender patients who received VA care from 1997 through 2014. Transgender patients were defined as individuals that had a lifetime diagnosis of any of 4 International Classification of Diseases-9 diagnosis codes associated with transgender status. Independent multivariable logistic regression models were used to explore associations of rural status with medical conditions. Veterans with transgender-related diagnoses residing in small/isolated rural towns had increased odds of tobacco use disorder (adjusted odds ratio=1.39; 95% confidence intervals, 1.09-1.78) and posttraumatic stress disorder (adjusted odds ratio=1.33; 95% confidence intervals, 1.03-1.71) compared with their urban transgender peers. Urban/rural status was not significantly associated with other medical conditions of interest. This study contributes the first empirical investigations of how place of residence is associated with medical diagnoses among veterans with transgender-related diagnoses. The importance of place as a determinant of health is increasingly clear, but for veterans with transgender-related diagnoses this line of research is currently limited. The addition of self-reported sex identity data within VA electronic health records is one way to advance this line of research.

  11. 77 FR 70708 - VA Acquisition Regulation: Electronic Submission of Payment Requests

    Science.gov (United States)

    2012-11-27

    ... electronic data interchange (EDI) formats; or (3) another electronic form as prescribed by the contract....fsc.va.gov/einvoice.asp .); or, (b) A system that conforms to the X12 electronic data interchange (EDI... Institute (ANSI). The X12 EDI Web site ( http://www.x12.org ) includes additional information on EDI 810 and...

  12. Educational system factors that engage resident physicians in an integrated quality improvement curriculum at a VA hospital: a realist evaluation.

    Science.gov (United States)

    Ogrinc, Greg; Ercolano, Ellyn; Cohen, Emily S; Harwood, Beth; Baum, Karyn; van Aalst, Robertus; Jones, Anne C; Davies, Louise

    2014-10-01

    Learning about quality improvement (QI) in resident physician training is often relegated to elective or noncore clinical activities. The authors integrated teaching, learning, and doing QI into the routine clinical work of inpatient internal medicine teams at a Veterans Affairs (VA) hospital. This study describes the design factors that facilitated and inhibited the integration of a QI curriculum-including real QI work-into the routine work of inpatient internal medicine teams. A realist evaluation framework used three data sources: field notes from QI faculty; semistructured interviews with resident physicians; and a group interview with QI faculty and staff. From April 2011 to July 2012, resident physician teams at the White River Junction VA Medical Center used the Model for Improvement for their QI work and analyzed data using statistical process control charts. Three domains affected the delivery of the QI curriculum and engagement of residents in QI work: setting, learner, and teacher. The constant presence of the QI material on a public space in the team workroom was a facilitating mechanism in the setting. Explicit sign-out of QI work to the next resident team formalized the handoff in the learner domain. QI teachers who were respected clinical leaders with QI expertise provided role modeling and local system knowledge. Integrating QI teaching into the routine clinical and educational systems of an inpatient service is challenging. Identifiable, concrete strategies in the setting, learner, and teacher domains helped integrate QI into the clinical and educational systems.

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

    National Research Council Canada - National Science Library

    2009-01-01

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

  14. Serum globulin electrophoresis

    Science.gov (United States)

    ... plasma proteins. In: Baynes JW, Dominiczak MH, eds. Medical Biochemistry . 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 4. Rajkumar SV. Plasma cell disorders. In: Goldman L, Schafer AI, ... . 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 187.

  15. 77 FR 1716 - James River National Wildlife Refuge, Prince George County, VA

    Science.gov (United States)

    2012-01-11

    ... River National Wildlife Refuge, Prince George County, VA AGENCY: Fish and Wildlife Service, Interior... (the refuge, NWR), which is located in Prince George County, Virginia. We provide this notice in... River NWR, in Prince George County, Virginia. This notice complies with our CCP policy to advise other...

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

    CERN Multimedia

    2002-01-01

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

  17. 76 FR 70345 - Drawbridge Operation Regulations; Elizabeth River, Eastern Branch, Norfolk, VA

    Science.gov (United States)

    2011-11-14

    ... DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Part 117 [Docket No. USCG-2011-1022] Drawbridge Operation Regulations; Elizabeth River, Eastern Branch, Norfolk, VA AGENCY: Coast Guard, DHS. ACTION: Notice... periodic maintenance. The Norfolk Southern 5 Bridge, at mile 1.1, across the Elizabeth River (Eastern...

  18. 33 CFR 80.505 - Cape Henlopen, DE to Cape Charles, VA.

    Science.gov (United States)

    2010-07-01

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

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

    OpenAIRE

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

    2013-01-01

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

  20. VaR and CVaR Implied in Option Prices

    Directory of Open Access Journals (Sweden)

    Giovanni Barone Adesi

    2016-02-01

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

  1. A cluster randomized Hybrid Type III trial testing an implementation support strategy to facilitate the use of an evidence-based practice in VA homeless programs.

    Science.gov (United States)

    Smelson, David A; Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Sawh, Leon; Glickman, Mark

    2015-05-28

    The Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program is one of the largest initiatives to end Veteran homelessness. However, mental health and substance use disorders continue to reduce client stability and impede program success. HUD-VASH programs do not consistently employ evidence-based practices that address co-occurring mental health and substance use disorders. This paper presents a study protocol to evaluate the implementation of an evidence-based, co-occurring disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) in HUD-VASH using an implementation strategy called Getting To Outcomes (GTO). In three large VA Medical Centers, this Hybrid Type III trial will randomize case managers and their clients by HUD-VASH sub-teams to receive either MISSION-Vet Implementation as Usual (IU-standard training and access to the MISSION-Vet treatment manuals) or MISSION-Vet implementation augmented by GTO. In addition to testing GTO, effectiveness of the treatment (MISSION-Vet) will be assessed using existing Veteran-level data from the HUD-VASH data monitoring system. This project will compare GTO and IU case managers and their clients on the following variables: (1) fidelity to the MISSION-Vet intervention; (2) proportion of time the Veteran is housed; (3) mental health, substance use, and functional outcomes among Veterans; and (4) factors key to the successful deployment of a new treatment as specified by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model. This project is an important step for developing an implementation strategy to increase adoption of evidence-based practice use in VA homeless programs, and to further examine efficacy of MISSION-Vet in HUD-VASH. This project has important implications for program managers, policy makers, and researchers within the homelessness field. VA Central IRB approval

  2. Factors associated with having a medical marijuana card among Veterans with recent substance use in VA outpatient treatment.

    Science.gov (United States)

    Davis, Alan K; Bonar, Erin E; Ilgen, Mark A; Walton, Maureen A; Perron, Brian E; Chermack, Stephen T

    2016-12-01

    Psychiatric symptoms, somatic problems, and co-occurring substance use have been associated with medical marijuana consumption among civilian patients with substance use disorders. It is possible that these factors may impact Veterans' ability to engage in or adhere to mental health and substance use disorder treatment. Therefore, we examined whether psychiatric functioning, substance use, and somatic problems were associated with medical marijuana use among Veterans receiving substance use disorder and/or mental health treatment. Participants (n=841) completed screening measures for a randomized controlled trial and 67 (8%) reported that they had a current medical marijuana card. Most of these participants (78%) reported using marijuana to treat severe/chronic pain. Significant bivariate differences revealed that, compared to participants without a medical marijuana card, those with a card were more likely to be in a middle income bracket, unemployed, and they had a significantly higher number of recent days of marijuana use, synthetic marijuana use, and using sedatives prescribed to them. Additionally, a significantly higher proportion of participants with a medical marijuana card scored above the clinical cutoff for posttraumatic stress disorder (PTSD) symptoms, had significantly higher severity of sleep-related problems, and reported a higher level of pain. These findings highlight the co-occurrence of substance use, PTSD symptoms, sleep-related problems, and chronic pain among Veterans who use medical marijuana. Future research should investigate the inter-relationships among medical marijuana use and other clinical issues (e.g., PTSD symptoms, sleep, pain) over time, and potential implications of medical marijuana use on treatment engagement and response. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. 5kVa power inverter design and simulation based on boost ...

    African Journals Online (AJOL)

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

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

    NARCIS (Netherlands)

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

    We report on the use of percutaneous femoral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in a fully awake, non-intubated and spontaneously breathing patient suffering from acute, severe and refractory cardiogenic shock due to a (sub)acute anterior myocardial infarction. Intensified

  5. Creating a sampling frame for population-based veteran research: Representativeness and overlap of VA and Department of Defense databases

    OpenAIRE

    Donna L. Washington, MD, MPH; Su Sun, MPH; Mark Canning, BA

    2010-01-01

    Most veteran research is conducted in Department of Veterans Affairs (VA) healthcare settings, although most veterans obtain healthcare outside the VA. Our objective was to determine the adequacy and relative contributions of Veterans Health Administration (VHA), Veterans Benefits Administration (VBA), and Department of Defense (DOD) administrative databases for representing the U.S. veteran population, using as an example the creation of a sampling frame for the National Survey of Women Vete...

  6. Prevalence, Disparities, and Trends in Obesity and Severe Obesity Among Students in the Philadelphia, Pennsylvania, School District, 2006–2010

    OpenAIRE

    Robbins, Jessica M.; Mallya, Giridhar; Polansky, Marcia; Schwarz, Donald F.

    2012-01-01

    Introduction Epidemic increases in obesity negatively affect the health of US children, individually and at the population level. Although surveillance of childhood obesity at the local level is challenging, height and weight data routinely collected by school districts are valuable and often underused public health resources. Methods We analyzed data from the School District of Philadelphia for 4 school years (2006–2007 through 2009–2010) to assess the prevalence of and trends in obesity and...

  7. [Hungarian Philadelphia negative chronic myeloproliferative neoplasia registry. Evaluation of the Polycythemia vera patients].

    Science.gov (United States)

    Dombi, Péter; Illés, Árpád; Demeter, Judit; Homor, Lajos; Simon, Zsófia; Kellner, Ádám; Karádi, Éva; Valasinyószki, Erika; Udvardy, Miklós; Egyed, Miklós

    2017-06-01

    Intruduction and aim: The Hungarian National Registry for Philadelphia chromosome negative myeloproliferative neoplasms has been developed. The aim of the recent study is to assess the clinical characteristics of Hungarian patients with polycythemia vera. Data of 351 JAK2 V617F and exon 12 mutation positive polycythemia vera patients were collected online from 15 haematology centres reporting epidemiologic, clinical characteristics, diagnostic tools, therapeutic interventions, thromboembolic complications, disease transformations. Vascular events prior to and after diagnosis were evaluated upon the Landolfi risk assessment scale. 116 thromboembolic events were reported in 106 PV patients prior to diagnosis and 152 occasions in 102 patients during follow-up. The frequency of major arterial events were significantly reduced (ppolycythemia vera. The Landolfi risk stratification was proven to be useful. Based on evaluated data, accuracy of diagnostic criteria and compliance to risk-adapted therapeutic guidelines are needed. Orv Hetil. 2017; 158(23): 901-909.

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

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  9. 77 FR 12647 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program

    Science.gov (United States)

    2012-03-01

    ... women veterans with or without the care of dependent children. 2. Funding Priority 2--VA is offering the... homeless veterans (i.e., veterans who are not incarcerated but are involved in the criminal justice system...

  10. Incidental detection of congenital Robertsonian translocation at diagnosis of Philadelphia chromosome-positive acute lymphocytic leukemia.

    Science.gov (United States)

    Yamaguchi, Tsukasa; Igarashi, Aiko; Kawamura, Machiko; Ozasa, Yuka; Yoshida, Masayuki; Kakihana, Kazuhiko; Sakamaki, Hisashi; Ohashi, Kazuteru

    2015-05-01

    A man in his early forties who had undergone 3 years of unsuccessful treatment for infertility due to oligospermia and asthenospermia developed fever and bone pain in December 20XX. He was subsequently diagnosed with acute lymphocytic leukemia. Conventional cytogenetic analysis revealed Robertsonian translocation (RT) with der(13;14)(q10;q10) in addition to the Philadelphia (Ph) chromosome. Dasatinib and prednisolone induced complete remission (CR) with disappearance of the Ph chromosome. However, RT persisted despite achieving CR. We speculate that RT is possibly congenital in our present case and might also have been responsible for the aforementioned infertility. Hematologists should be aware of the possibility that congenital chromosomal disorders might be found incidentally through diagnostic chromosome analysis for leukemia.

  11. Risk Measures and Contagion Matrix: an Application of CoVaR for the Brazilian Financial Market

    Directory of Open Access Journals (Sweden)

    Aléssio Tony Cavalcanti de Almeida

    2012-12-01

    Full Text Available The main point of this work is to assess how a financial distress in return series of the major Brazilian companies assets and relevant domestic market (Ibovespa and main international index (Dow Jones interact with each other, in an attempt to capture spillover effects. We try to capture the systemic risk, the contagion effect and the stress test. This paper uses the methodology CoVaR, described in the Adrian and Brunnermeier (2011 which use quantile regression. The main innovation of this work is the construction and estimation of the contagion matrix to domestic capital market. The results show that there is no relationship between risk measurements given by Value at Risk (VaR and CoVaR, moreover the systemic risk shows those assets that generate more negative externalities for the domestic financial market. The stress test indicates that a distress in domestic market indicator returns have more spillover effects on domestic papers than a distress in the international market returns. Finally, the contagion matrix reveals that the interrelationships of contagion between the firms’ returns are relevant sectorial evidence for assessment and management of risks.

  12. 76 FR 25409 - Privacy Act of 1974

    Science.gov (United States)

    2011-05-04

    ... performing this required function, VA must collect, collate and analyze full statistical data regarding... and timely assess the current health care usage by the patient population served by VA, to forecast future demand for VA medical care by individuals currently eligible for service by VA medical facilities...

  13. 38 CFR 74.25 - What types of personally identifiable information will VA collect?

    Science.gov (United States)

    2010-07-01

    ... DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.25 What types of personally identifiable information will VA collect? In order to establish owner... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false What types of personally...

  14. Comparison of imatinib 400 mg and 800 mg daily in the front-line treatment of high-risk, Philadelphia-positive chronic myeloid leukemia: a European LeukemiaNet Study

    DEFF Research Database (Denmark)

    Baccarani, Michele; Rosti, Gianantonio; Castagnetti, Fausto

    2009-01-01

    Imatinib mesylate (IM), 400 mg daily, is the standard treatment of Philadelphia-positive (Ph(+)) chronic myeloid leukemia (CML). Preclinical data and results of single-arm studies raised the suggestion that better results could be achieved with a higher dose. To investigate whether the systematic...

  15. 76 FR 44279 - Radio Broadcasting Services; Clinchco, VA, and Coal Run, KY

    Science.gov (United States)

    2011-07-25

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

  16. Tail dependence between oil and stocks of major oil-exporting countries using the CoVaR approach

    Directory of Open Access Journals (Sweden)

    Nader Trabelsi

    2017-12-01

    Full Text Available This paper investigates the negative tail risk dependence between oil shocks and stock indices (at aggregated and desegregated levels for Saudi Arabia (KSA, United Arab Emirates (UAE and Russia, over the period between 2007 and 2016. DCC-MGARCH approach and CoVaR measure are employed to assess the oil shock exposure. The results show that the tail dependence is significant and depends on the origin of the oil shocks, with intensity that varies across countries and sectors. Keywords: Oil price shocks, Oil-exporting countries, Conditional VaR, JEL Classification: C58, G11, Q4

  17. 75 FR 28295 - Parkdale Mills (Formerly Hanesbrands, Inc.) Galax, VA; Notice of Affirmative Determination...

    Science.gov (United States)

    2010-05-20

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-72,695] Parkdale Mills (Formerly Hanesbrands, Inc.) Galax, VA; Notice of Affirmative Determination Regarding Application for Reconsideration By application dated February 2, 2010, petitioners requested administrative reconsideration of the negative...

  18. Diagnosis, prevention, and management of bleeding episodes in Philadelphia-negative myeloproliferative neoplasms: recommendations by the Hemostasis Working Party of the German Society of Hematology and Medical Oncology (DGHO) and the Society of Thrombosis and Hemostasis Research (GTH).

    Science.gov (United States)

    Appelmann, Iris; Kreher, Stephan; Parmentier, Stefani; Wolf, Hans-Heinrich; Bisping, Guido; Kirschner, Martin; Bergmann, Frauke; Schilling, Kristina; Brümmendorf, Tim H; Petrides, Petro E; Tiede, Andreas; Matzdorff, Axel; Griesshammer, Martin; Riess, Hanno; Koschmieder, Steffen

    2016-04-01

    Philadelphia-negative myeloproliferative neoplasms (Ph-negative MPN) comprise a heterogeneous group of chronic hematologic malignancies. The quality of life, morbidity, and mortality of patients with MPN are primarily affected by disease-related symptoms, thromboembolic and hemorrhagic complications, and progression to myelofibrosis and acute leukemia. Major bleeding represents a common and important complication in MPN, and the incidence of such bleeding events will become even more relevant in the future due to the increasing disease prevalence and survival of MPN patients. This review discusses the causes, differential diagnoses, prevention, and management of bleeding episodes in patients with MPN, aiming at defining updated standards of care in these often challenging situations.

  19. Kollidon VA64, a membrane-resealing agent, reduces histopathology and improves functional outcome after controlled cortical impact in mice.

    Science.gov (United States)

    Mbye, Lamin H; Keles, Eyup; Tao, Luyang; Zhang, Jimmy; Chung, Joonyong; Larvie, Mykol; Koppula, Rajani; Lo, Eng H; Whalen, Michael J

    2012-03-01

    Loss of plasma membrane integrity is a feature of acute cellular injury/death in vitro and in vivo. Plasmalemma-resealing agents are protective in acute central nervous system injury models, but their ability to reseal cell membranes in vivo has not been reported. Using a mouse controlled cortical impact (CCI) model, we found that propidium iodide-positive (PI+) cells pulse labeled at 6, 24, or 48 hours maintained a degenerative phenotype and disappeared from the injured brain by 7 days, suggesting that plasmalemma permeability is a biomarker of fatal cellular injury after CCI. Intravenous or intracerebroventricular administration of Kollidon VA64, poloxamer P188, or polyethylene glycol 8000 resealed injured cell membranes in vivo (P<0.05 versus vehicle or poloxamer P407). Kollidon VA64 (1 mmol/L, 500 μL) administered intravenously to mice 1  hour after CCI significantly reduced acute cellular degeneration, chronic brain tissue damage, brain edema, blood-brain barrier damage, and postinjury motor deficits (all P<0.05 versus vehicle). However, VA64 did not rescue pulse-labeled PI+ cells from eventual demise. We conclude that PI permeability within 48 hours of CCI is a biomarker of eventual cell death/loss. Kollidon VA64 reduces secondary damage after CCI by mechanisms other than or in addition to resealing permeable cells.

  20. Exercise CAPITAL SHIELD Towards Medical Response Integration in the National Capital Region

    Science.gov (United States)

    2011-01-24

    provided JTF the authority to develop Interagency partnerships  CY09/10: JTF CapMed executed (12) DSCA missions with Fed/State/Local partners...incident site at Lorton Youth Detention Center, VA – admin medical support 4-5 days  FY10, JTF CapMed inserted two-day MASCAL training (onsite only...Use exercise as test-bed for structure/tools: – Joint Critical Care ATLS Team: Modification of ATLS Team w/ attached triage and evac sections

  1. Direct observation of the myosin Va recovery stroke that contributes to unidirectional stepping along actin.

    Directory of Open Access Journals (Sweden)

    Katsuyuki Shiroguchi

    2011-04-01

    Full Text Available Myosins are ATP-driven linear molecular motors that work as cellular force generators, transporters, and force sensors. These functions are driven by large-scale nucleotide-dependent conformational changes, termed "strokes"; the "power stroke" is the force-generating swinging of the myosin light chain-binding "neck" domain relative to the motor domain "head" while bound to actin; the "recovery stroke" is the necessary initial motion that primes, or "cocks," myosin while detached from actin. Myosin Va is a processive dimer that steps unidirectionally along actin following a "hand over hand" mechanism in which the trailing head detaches and steps forward ∼72 nm. Despite large rotational Brownian motion of the detached head about a free joint adjoining the two necks, unidirectional stepping is achieved, in part by the power stroke of the attached head that moves the joint forward. However, the power stroke alone cannot fully account for preferential forward site binding since the orientation and angle stability of the detached head, which is determined by the properties of the recovery stroke, dictate actin binding site accessibility. Here, we directly observe the recovery stroke dynamics and fluctuations of myosin Va using a novel, transient caged ATP-controlling system that maintains constant ATP levels through stepwise UV-pulse sequences of varying intensity. We immobilized the neck of monomeric myosin Va on a surface and observed real time motions of bead(s attached site-specifically to the head. ATP induces a transient swing of the neck to the post-recovery stroke conformation, where it remains for ∼40 s, until ATP hydrolysis products are released. Angle distributions indicate that the post-recovery stroke conformation is stabilized by ≥ 5 k(BT of energy. The high kinetic and energetic stability of the post-recovery stroke conformation favors preferential binding of the detached head to a forward site 72 nm away. Thus, the recovery

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

    Directory of Open Access Journals (Sweden)

    Tayebe Ja’fari

    2016-05-01

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

  3. 77 FR 70805 - Presquile National Wildlife Refuge, Chesterfield County, VA; Final Comprehensive Conservation...

    Science.gov (United States)

    2012-11-27

    .... Mail: Andy Hofmann, Project Leader, Eastern Virginia Rivers NWR Complex, U.S. Fish and Wildlife Service, P.O. Box 1030, 335 Wilna Road, Warsaw, VA 22572. Fax: Attention: Andy Hofmann, 804-333-1470. In-Person Viewing or Pickup: Call Andy Hofmann, Project Leader, at 804-333-1470 extension 112 during regular...

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

    Energy Technology Data Exchange (ETDEWEB)

    Stephen Schey; Jim Francfort

    2014-10-01

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

  5. 75 FR 52989 - Specialty Minerals, Inc., Franklin, VA; Notice of Negative Determination Regarding Application...

    Science.gov (United States)

    2010-08-30

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,057] Specialty Minerals, Inc., Franklin, VA; Notice of Negative Determination Regarding Application for Reconsideration By applications dated July 9, 2010 and July 16, 2010 (filed by a company official and a worker, respectively...

  6. 75 FR 60171 - Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Science.gov (United States)

    2010-09-29

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0521] Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA Guaranteed Loans) Activity: Comment Request AGENCY... comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act...

  7. 78 FR 60379 - Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Science.gov (United States)

    2013-10-01

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0521] Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA Guaranteed Loans) Activity: Comment Request AGENCY... comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act...

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    In this work we have used Fourier transform infrared (FTIR) / vibrational absorption (VA) spectroscopy to study two cancer cell lines: the Henrietta Lacks (HeLa) human cervix carcinoma and 5637 human bladder carcinoma cell lines. Our goal is to experimentally investigate biochemical changes...

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

    Directory of Open Access Journals (Sweden)

    J Dehghanian

    2011-04-01

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

  10. A survey about prophage induction ability in Escherichia coli K-12(λ by ethnic medicinal plants of Kohgiluyeh va Boyerahmad, Iran

    Directory of Open Access Journals (Sweden)

    M. Hamzeloo-Moghadam

    2014-10-01

    Full Text Available Background and objectives: There is a growing trend towards investigating natural products as sources of compounds with biological effects and many researches have been carried out in order to find effective medications against many diseases. Cancer is no exception and studies focusing on evaluating the effects of different materials on DNA, give valuable information in cancer researches and carcinogenicity studies; thus the present study was focused on evaluating the impact of medicinal plants from  Kohgiluyeh va Boyerahmad province, Iran on DNA. Methods: Thirty five plant species collected have been investigated for prophage induction ability in Escherichia coli K-12(λthroughinductest. Results:The assay demonstrated that 8 plants were able to affect DNA. Conclusion: The results confirm the role of natural resources for biologic effects and what’s more, potential drug candidates in new drug discovery.

  11. Classifying medical relations in clinical text via convolutional neural networks.

    Science.gov (United States)

    He, Bin; Guan, Yi; Dai, Rui

    2018-05-16

    Deep learning research on relation classification has achieved solid performance in the general domain. This study proposes a convolutional neural network (CNN) architecture with a multi-pooling operation for medical relation classification on clinical records and explores a loss function with a category-level constraint matrix. Experiments using the 2010 i2b2/VA relation corpus demonstrate these models, which do not depend on any external features, outperform previous single-model methods and our best model is competitive with the existing ensemble-based method. Copyright © 2018. Published by Elsevier B.V.

  12. 75 FR 76082 - Agency Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Science.gov (United States)

    2010-12-07

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0521] Agency Information Collection (Credit Underwriting Standards and Procedures for Processing VA Guaranteed Loans) Activity Under OMB Review AGENCY... information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA...

  13. Fine-scale spatial variability of heat-related mortality in Philadelphia County, USA, from 1983-2008: a case-series analysis

    Directory of Open Access Journals (Sweden)

    Hondula David M

    2012-03-01

    Full Text Available Abstract Background High temperature and humidity conditions are associated with short-term elevations in the mortality rate in many United States cities. Previous research has quantified this relationship in an aggregate manner over large metropolitan areas, but within these areas the response may differ based on local-scale variability in climate, population characteristics, and socio-economic factors. Methods We compared the mortality response for 48 Zip Code Tabulation Areas (ZCTAs comprising Philadelphia County, PA to determine if certain areas are associated with elevated risk during high heat stress conditions. A randomization test was used to identify mortality exceedances for various apparent temperature thresholds at both the city and local scale. We then sought to identify the environmental, demographic, and social factors associated with high-risk areas via principal components regression. Results Citywide mortality increases by 9.3% on days following those with apparent temperatures over 34°C observed at 7:00 p.m. local time. During these conditions, elevated mortality rates were found for 10 of the 48 ZCTAs concentrated in the west-central portion of the County. Factors related to high heat mortality risk included proximity to locally high surface temperatures, low socioeconomic status, high density residential zoning, and age. Conclusions Within the larger Philadelphia metropolitan area, there exists statistically significant fine-scale spatial variability in the mortality response to high apparent temperatures. Future heat warning systems and mitigation and intervention measures could target these high risk areas to reduce the burden of extreme weather on summertime morbidity and mortality.

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

    Index Scriptorium Estoniae

    Tammemäe, Kalle, 1958-

    2011-01-01

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

  15. VA Health Care: Processes to Evaluate, Implement, and Monitor Organizational Structure Changes Needed

    Science.gov (United States)

    2016-09-01

    their families , such as medallions and markers for headstones that signify veterans’ service. Page 3 GAO-16-803 VHA Organizational ... Research Oversight, and Chief Nursing Page 8 GAO-16-803 VHA Organizational Structure Officer. Also, the Chief Financial Officer and...VA HEALTH CARE Processes to Evaluate, Implement, and Monitor Organizational Structure Changes Needed Report to

  16. 30 CFR 57.22202 - Main fans (I-A, I-B, I-C, II-A, III, V-A, and V-B mines).

    Science.gov (United States)

    2010-07-01

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

  17. 75 FR 30782 - Reorganization/Expansion of Foreign-Trade Zone 20; Hampton Roads, VA, Area

    Science.gov (United States)

    2010-06-02

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

  18. Acculturation and Post-Migration Stress in Middle-Aged Chinese Immigrant Women in Philadelphia: Variation between the Fujianese and the non-Fujianese women

    OpenAIRE

    Ying, Yu-Wen; Han, Meekyung; Tseng, Marilyn

    2012-01-01

    The experience of acculturation in Chinese immigrant women from the rural coastal province of Fujian has not been well studied despite of their growing numbers in American cities. This exploratory study is an attempt to examine the experience of acculturation and post-migration stress in Fujianese immigrant women as compared to those from other parts of China. The study is based on a convenience sample 240 Fujianese and 162 non-Fujianese Chinese immigrant women living in Philadelphia.

  19. The role of cytochrome c oxidase subunit Va in non-small cell lung carcinoma cells: association with migration, invasion and prediction of distant metastasis

    International Nuclear Information System (INIS)

    Chen, Wen-Liang; Kuo, Kuang-Tai; Chou, Teh-Ying; Chen, Chien-Lung; Wang, Chih-Hao; Wei, Yau-Huei; Wang, Liang-Shun

    2012-01-01

    Lung cancer is one of the most lethal malignancies worldwide, but useful biomarkers of lung cancer are still insufficient. The aim of this study is to identify some membrane-bound protein(s) associated with migration and invasion in human non-small cell lung cancer (NSCLC) cells. We classified four NSCLC cell lines into high and low migration/invasion groups by Transwell and Matrigel assays. Using two-dimensional gel electrophoresis and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), we identified 10 membrane-associated proteins being significantly overexpressed in the high migration/invasion group. The expression of the target protein in the four NSCLC cell lines was then confirmed by reverse transcription polymerase chain reaction (RT-PCR), western blot and immunostaining. RNA interference technique was applied to observe the influence of the target protein on migration and invasion. Gelatin zymography was also performed to evaluate the activities of matrix metalloproteinase (MMP)-2 and MMP-9. Expression condition of the target protein on surgical specimens was further examined by immunohistochemical staining and the clinicopathologic data were analyzed. We identified a mitochondria-bound protein cytochrome c oxidase subunit Va (COX Va) because of its abundant presence found exclusively in tumorous areas. We also demonstrated that migration and invasion of NSCLC cells decreased substantially after knocking down COX Va by siRNA. Meanwhile, we found a positive correlation between COX Va expression, Bcl-2 expression and activities of MMP-2 and MMP-9 in NSCLC cells. Immunohistochemical staining of surgically resected lung adenocarcinomas in 250 consecutive patients revealed that strong COX Va expression was found in 54.8% (137/250) of patients and correlated positively with the status of lymph node metastasis (P = 0.032). Furthermore, strong COX Va expression was associated with the presence of distant metastasis (P = 0

  20. 78 FR 44881 - Drawbridge Operation Regulation; York River, Between Yorktown and Gloucester Point, VA

    Science.gov (United States)

    2013-07-25

    ... deviation from the operating schedule that governs the operation of the Coleman Memorial Bridge (US 17/George P. Coleman Memorial Swing Bridge) across the York River, mile 7.0, between Gloucester Point and Yorktown, VA. This deviation is necessary to facilitate maintenance work on the moveable spans on the...

  1. 77 FR 19975 - VA Acquisition Regulation: Simplified Acquisition Procedures for Health-Care Resources (Section...

    Science.gov (United States)

    2012-04-03

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

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

    DEFF Research Database (Denmark)

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

    2002-01-01

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

  3. Howell John HARRIS. Bloodless Victories : The Rise and Fall of the Open Shop in the Philadelphia Metal Trades, 1890-1940.

    Directory of Open Access Journals (Sweden)

    Joseph A. McCartin

    2006-03-01

    Full Text Available Howell John Harris’s magisterial history of labor relations in the Philadelphia metal trades has provoked surprisingly little discussion thus far in the United States. Three years after its publication, the book had garnered only a smattering of reviews by labor historians. Indeed, the U.S. journal of record, Labor History, had yet to review the book. Nor had this long-awaited volume by a well-known and passionate participant in U.S. labor historians’ debates drawn the attention of scholarly ...

  4. Transgender Veterans' Satisfaction With Care and Unmet Health Needs.

    Science.gov (United States)

    Lehavot, Keren; Katon, Jodie G; Simpson, Tracy L; Shipherd, Jillian C

    2017-09-01

    Transgender individuals are overrepresented among Veterans. However, little is known regarding their satisfaction with Veterans Administration (VA) care and unmet health needs. This study examined transgender Veterans' satisfaction with VA medical and mental health care, prevalence of delaying care, and correlates of these outcomes. We used data from transgender Veterans collected in 2014 through an online, national survey. In total, 298 transgender Veterans living in the United States. We assessed patient satisfaction with VA medical and mental health care and self-reported delays in seeking medical and mental health care in the past year. Potential correlates associated with these 4 outcomes included demographic, health, and health care variables. Over half of the sample used VA (56%) since their military discharge. Among transgender Veterans who had used VA, 79% were satisfied with medical care and 69% with mental health care. Lower income was associated with dissatisfaction with VA medical care, and being a transgender man was associated with dissatisfaction with VA mental health care. A substantial proportion reported delays in seeking medical (46%) or mental (38%) health care in the past year (not specific to VA). Screening positive for depression and/or posttraumatic stress disorder was associated with delays in seeking both types of care. Although the majority of transgender Veterans are satisfied with VA health care, certain subgroups are less likely to be satisfied with care. Further, many report delaying accessing care, particularly those with depression and/or posttraumatic stress disorder symptoms. Adapting health care settings to better engage these vulnerable Veterans may be necessary.

  5. Power Factor Improvement Using Automatic Power Factor Compensation (APFC Device for Medical Industries in Malaysia

    Directory of Open Access Journals (Sweden)

    Zaidi Maryam Nabihah

    2018-01-01

    Full Text Available This paper present the project designed to correcting power factor for medical industries in Malaysia automatically. Which with hope to make the cost and energy usage efficient, because the energy source are depleting due to increase in population. Power factor is the ratio of real power and apparent power. This definition is mathematically represented as kW/kVA where kW is active power and kVA is apparent power (active + reactive. Reactive power is the non-working power generated by the magnetic and inductive load to generate magnetic flux. The increase in reactive power increase the apparent power so the power factor will decrease. Low pF will cause the industry to meet high demand thus making it less efficient. The main aim of this project is to increasing the current power factor of medical industries from 0.85 to 0.90. Power factor compensation contribute to reduction in current-dependent losses and increase energy efficiency while expanding the reliability of planning for future energy network. As technology develops, the gradual cost and efficiency penalty should reduce. Therefore, automatic power factor compensation device should become cost-effective and smaller device over time. That is the reason this project is using programmable device as it is a miniature architecture device.

  6. The perils of healthcare workforce forecasting: a case study of the Philadelphia metropolitan area.

    Science.gov (United States)

    Smith, David Barton; Aaronson, William

    2003-01-01

    In 1996, a widely circulated and influential forecast for the Philadelphia Metropolitan Area stated that a decline in hospital and healthcare employment in the region would occur over the next five years. It also suggested that this decline would exacerbate the problem of an oversupply of nurses seeking hospital employment. The forecast reflected a regional leadership and expert consensus on the impact of the managed care transformation on workforce needs and was supported by short-term statistical trends in regional utilization and employment. Confounding these predictions was the fact that hospital and healthcare employment actually grew. By the end of 2001, hospitals in the region were experiencing problems in recruiting sufficient numbers of nurses, pharmacists, and technicians. The forecast failed to anticipate the impact of a strong regional economy on supply and underestimated the resilience of underlying forces that have driven the long-term growth in healthcare workforce demand. More effective ongoing monitoring can help moderate the fluctuation of workforce shortages and surpluses.

  7. The genetic architecture of pediatric cognitive abilities in the Philadelphia Neurodevelopmental Cohort

    Science.gov (United States)

    Robinson, Elise B.; Kirby, Andrew; Ruparel, Kosha; Yang, Jian; McGrath, Lauren; Anttila, Verneri; Neale, Benjamin M.; Merikangas, Kathleen; Lehner, Thomas; Sleiman, Patrick M.A.; Daly, Mark J.; Gur, Ruben; Gur, Raquel; Hakonarson, Hakon

    2014-01-01

    The objective of this analysis was to examine the genetic architecture of diverse cognitive abilities in children and adolescents, including the magnitude of common genetic effects and patterns of shared and unique genetic influences. Subjects included 3,689 members of the Philadelphia Neurodevelopmental Cohort, a general population sample of ages 8-21 years who completed an extensive battery of cognitive tests. We used genome-wide complex trait analysis (GCTA) to estimate the SNP-based heritability of each domain, as well as the genetic correlation between all domains that showed significant genetic influence. Several of the individual domains suggested strong influence of common genetic variants (e.g. reading ability, h2g=0.43, p=4e-06; emotion identification, h2g=0.36, p=1e-05; verbal memory, h2g=0.24, p=0.005). The genetic correlations highlighted trait domains that are candidates for joint interrogation in future genetic studies (e.g. language reasoning and spatial reasoning, r(g)=0.72, p=0.007). These results can be used to structure future genetic and neuropsychiatric investigations of diverse cognitive abilities. PMID:25023143

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

    International Nuclear Information System (INIS)

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

    1996-01-01

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

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

    National Research Council Canada - National Science Library

    Melvin, Valerie C

    2008-01-01

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

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

    Science.gov (United States)

    2011-05-09

    ...-AA00 Safety Zone; Air Power Over Hampton Roads, Back River, Hampton, VA AGENCY: Coast Guard, DHS... the safety of life on navigable waters during the Air Power Over Hampton Roads Air Show. This action... Division Chief, Sector Hampton Roads, Coast Guard; telephone 757-668- 5581, e-mail [email protected

  11. Expression of the Grape VaSTS19 Gene in Arabidopsis Improves Resistance to Powdery Mildew and Botrytis cinerea but Increases Susceptibility to Pseudomonas syringe pv Tomato DC3000.

    Science.gov (United States)

    Wang, Yaqiong; Wang, Dejun; Wang, Fan; Huang, Li; Tian, Xiaomin; van Nocker, Steve; Gao, Hua; Wang, Xiping

    2017-09-17

    Stilbene synthase (STS) is a key enzyme that catalyzes the biosynthesis of resveratrol compounds and plays an important role in disease resistance. The molecular pathways linking STS with pathogen responses and their regulation are not known. We isolated an STS gene, VaSTS19 , from a Chinese wild grape, Vitis amurensis Rupr. cv. "Tonghua-3", and transferred this gene to Arabidopsis . We then generated VaSTS19 -expressing Arabidopsis lines and evaluated the functions of VaSTS19 in various pathogen stresses, including powdery mildew, B. cinerea and Pseudomonas syringae pv. tomato DC3000 ( Pst DC3000). VaSTS19 enhanced resistance to powdery mildew and B. cinerea , but increased susceptibility to Pst DC3000. Aniline blue staining revealed that VaSTS19 transgenic lines accumulated more callose compared to nontransgenic control plants, and showed smaller stomatal apertures when exposed to pathogen-associated molecular patterns (flagellin fragment (flg22) or lipopolysaccharides (LPS)). Analysis of the expression of several disease-related genes suggested that VaSTS19 expression enhanced defense responses though salicylic acid (SA) and/or jasmonic acid (JA) signaling pathways. These findings provide a deeper insight into the function of STS genes in defense against pathogens, and a better understanding of the regulatory cross talk between SA and JA pathways.

  12. Microgrid Controller Design, Implementation, and Deployment: A Journey from Conception to Implementation at the Philadelphia Navy Yard

    Energy Technology Data Exchange (ETDEWEB)

    Uluski, R.; Kumar, J.; Venkata, S. S. Mani; Vishwakarma, D.; Schneider, K.; Mehrizi-Sani, Ali; Terry, Rudy; Agate, Will

    2017-07-01

    The Philadelphia Navy Yard is a fast-evolving community microgrid, currently home to over 150 companies and four Navy activity centers occupying nearly 7 million ft2 of buildings in which approximately 12,000 people are employed. The Navy Yard (TNY) is a national center of excellence for energy research, education, and commercialization, focused specifically on community microgrid design and development. TNY microgrid is equipped with the most cost-effective and sustainable means for meeting electric capacity and energy needs through renewable resources, energy efficiency, and distribution grid infrastructure. This article briefly describes how the community microgrid was conceived and planned to produce a great success story of microgrid implementation and the details of the design, development, and implementation of the TNY microgrid controller.

  13. Influence of Islamic Traditions on Breastfeeding Beliefs and Practices Among African American Muslims in West Philadelphia: A Mixed-Methods Study.

    Science.gov (United States)

    Kamoun, Camilia; Spatz, Diane

    2018-02-01

    Little is known regarding the influence of religion on breastfeeding in African American communities. In particular, whether Islamic traditions influence breastfeeding beliefs and practices among African American Muslims has not been studied. Research aim: This study sought to gain understanding of breastfeeding attitudes, rates, and education among African American Muslims in West Philadelphia and to examine if engaging Islamic teachings in breastfeeding education can positively influence breastfeeding attitudes. Open-ended, in-person, digitally recorded qualitative interviews were conducted with 10 community leaders and analyzed by conventional content analysis. A study tool distributed to a convenience sample of 44 community members and 11 leaders was used to gather information about education received from community leaders, breastfeeding attitudes and practices, and the potential for Islamic teachings to positively affect breastfeeding attitudes and practices. To obtain further data on this last topic, preliminary data analysis guided the creation of an education pamphlet, about which feedback was gathered through another study tool. Education surrounding Islamic perspectives on breastfeeding was not prevalent. African American Muslims in West Philadelphia view breastfeeding favorably and have higher rates of breastfeeding than African Americans as a whole. Community education about breastfeeding that engaged Islamic teachings improved respondents' breastfeeding attitudes. Increasing education among providers and African American Muslims about Islamic perspectives on breastfeeding may improve breastfeeding exclusivity and duration. Healthcare providers who care for Muslim women should be aware of Islam's tradition of positive attitudes toward breastfeeding and partner with Muslim leaders to improve breastfeeding rates and duration among such women.

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

    National Research Council Canada - National Science Library

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

    2008-01-01

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

  15. Improving Care for Veterans with PTSD: Comparing Risks and Benefits of Antipsychotics Versus Other Medications to Augment First-Line Pharmacologic Therapy

    Science.gov (United States)

    2017-10-01

    Afghanistan Veterans  seen in VA care receiving this diagnosis. In addition to  counseling  therapies, several medications are effective in treating PTSD...disorder in Veterans, with nearly 1 in 3 returning Iraq and Afghanistan Veterans seen in VA care receiving this diagnosis. In addition to counseling ...than those prescribed non-antipsychotics. 4 Table 1: Characteristics by augmenting medication group Variable AAP (N=24,131) N (column %) NAP

  16. 77 FR 76451 - Designation for the West Sacramento, CA; Frankfort, IN; and Richmond, VA Areas.

    Science.gov (United States)

    2012-12-28

    ... DEPARTMENT OF AGRICULTURE Grain Inspection, Packers and Stockyards Administration Designation for the West Sacramento, CA; Frankfort, IN; and Richmond, VA Areas. AGENCY: Grain Inspection, Packers and...-Agri West Sacramento, CA(916) 374-9700.. 1/1/2013 12/31/2015 Frankfort Frankfort, IN(765) 258-3624...

  17. 76 FR 582 - Elizabeth Hartwell Mason Neck National Wildlife Refuge, Fairfax County, VA, and Featherstone...

    Science.gov (United States)

    2011-01-05

    ...] Elizabeth Hartwell Mason Neck National Wildlife Refuge, Fairfax County, VA, and Featherstone National... comprehensive conservation plan and the environmental assessment (CCP/EA) for Elizabeth Hartwell Mason Neck (Mason Neck) National Wildlife Refuge (NWR) and Featherstone NWR for a 45-day public review and comment...

  18. Fireworks algorithm for mean-VaR/CVaR models

    Science.gov (United States)

    Zhang, Tingting; Liu, Zhifeng

    2017-10-01

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

  19. 20 kHz, 25 kVA node power transformer

    Science.gov (United States)

    Hussey, S.

    1989-01-01

    The electrical and mechanical design information and the electrical and thermal testing performed on the 440-208-V rms, 20-kHz, 25-kVa prototype node transformer are summarized. The calculated efficiency of the node transformer is 99.3 percent based on core loss and copper loss test data, and its maximum calculated load regulation is 0.7 percent. The node transformer has a weight of 19.7 lb and has a power density of 0.8 lb/kW. The hot-spot temperature rise is estimated to be 33 C above the cold plate mounting base. This proof-of-concept transformer design is a viable candidate for the space station Freedom application.

  20. COPD, COOP and BREATH at the VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2011-02-01

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

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

    Science.gov (United States)

    2016-12-01

    of the country. The Fair Market Rent is the cost of standard, non- luxury housing in the community. The payment standard is the maximum subsidy a...access that can be particularly beneficial for those located in high-rent markets . According to the VA’s Fiscal Year 2017 “EUL Consideration...during fiscal year 2017. The draft that VA shared with us requires an analysis of the local market , including current and anticipated supply and

  2. Morphological alteration of the Dráva as the result of human impact

    Directory of Open Access Journals (Sweden)

    Tímea Kiss

    2011-10-01

    Full Text Available The Croatian-Hungarian border section of the Dráva River has been undisturbed for almost a century, and it is characterised by unique fluvial morphology (braided pattern and islands supporting rich habitats and wildlife. However, during the last decades human impact became more and moreintensive. Between 1975 and 1989 three water reservoirs were built on the Croatian section of the river, just 16 km from the beginning of the border-section, altering the hydrology and the sediment characteristics of the river. On a local scale cut-offs, revetments and groynes were built. The aim of the study was to evaluate the effect of these human interventions. As the result of the alteration of the hydrology the channel pattern of the Dráva has been changing from braided to meandering, though on the upstream meandering part the territory and number of islands increased due to the drop of water stages. A cut-off and a groyne influenced only the morphology of a short section. As the result of the cut-off braided pattern became more pronounced, and the groyne caused intensive channel aggradation and gave way to lateral island development.

  3. "Mr Smith's been our problem child today…": anticipatory management communication (AMC) in VA end-of-shift medicine and nursing handoffs.

    Science.gov (United States)

    Bergman, Alicia A; Flanagan, Mindy E; Ebright, Patricia R; O'Brien, Colleen M; Frankel, Richard M

    2016-02-01

    Tools and procedures designed to improve end-of-shift handoffs through standardisation of processes and reliance on technology may miss contextually sensitive information about anticipated events that emerges during face-to-face handoff interactions. Such information, what we refer to as anticipatory management communication (AMC), is necessary to ensure timely and safe patient care, but has been little studied and understood. To investigate AMC and the role it plays in nursing and medicine handoffs. Qualitative thematic analysis based on audio recordings of nurse-to-nurse, medical resident-to-resident and surgical intern-to-intern handoffs. 27 nurse handoff dyads and 18 medical resident and surgical intern handoff dyads at one VA Medical Center. Heads-up information was the most frequent type of AMC across all handoff dyads (N=257; 108 resident and 149 nursing). Indirect instructions AMC was used in a little over half the resident handoff dyads, but occurred in all nursing dyads (292 instances). Direct instructions AMC occurred in roughly equal proportion across all dyads but at a modest frequency (N=45; 28 resident and 17 nursing). Direct (if/then) contingency AMC occurred in resident handoffs more frequently than in nursing handoffs (N=32; 30 resident and 2 nursing). The different frequencies for types of AMC likely reflect differences in how residents and nurses work and disparate professional cultures. But, verbal communication in both groups included important information unlikely to be captured in written handoff tools or the electronic medical record, underscoring the importance of direct communication to ensure safe handoffs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. VA-LCP anterior clavicle plate: the anatomically precontoured fixation system with angular stability for clavicle shaft.

    Science.gov (United States)

    van Olden, G D J

    2014-12-01

    The aim of this investigation was to evaluate the introduction of the VA-LCP anterior clavicle plate in the treatment of clavicle fractures. From March 2011 to March 2013, 42 clavicle fractures were treated; 40 were middle-third and 2 lateral-third, and 13/42 (31 %) patients were treated due to painful nonunion. Patient age ranged from 16 to 81 years. Complications were screw placement through the AC-joint, one superficial wound infection and one neuropraxia of the nervus radialis with dropping hand. We had some difficulties prebending both lateral to low and lateral to high but without clinical consequences. In all cases, the fracture healed with full functionality. After 1 year, 4 patients underwent a removal of the hardware. The VA-LCP anterior plate showed good reliability and sufficient stability with both middle-third, lateral and nonunion fractures of the clavicle.

  5. 77 FR 6587 - Startek USA, Inc. Alexandria, LA; Startek USA, Inc., Collinsville, VA; Amended Certification...

    Science.gov (United States)

    2012-02-08

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-75,089; TA-W-75,089A] Startek USA, Inc. Alexandria, LA; Startek USA, Inc., Collinsville, VA; Amended Certification Regarding Eligibility... for Worker Adjustment Assistance on January 26, 2011, applicable to workers of StarTek USA, Inc...

  6. 76 FR 59153 - Elizabeth Hartwell Mason Neck National Wildlife Refuge, Fairfax County, VA, and Featherstone...

    Science.gov (United States)

    2011-09-23

    ...] Elizabeth Hartwell Mason Neck National Wildlife Refuge, Fairfax County, VA, and Featherstone National... plan (CCP) and finding of no significant impact (FONSI) for Elizabeth Hartwell Mason Neck (Mason Neck...: Download a copy of the document at http://www.fws.gov/northeast/planning/MasonNeck_Featherstone/ccphome...

  7. Expression of the Grape VaSTS19 Gene in Arabidopsis Improves Resistance to Powdery Mildew and Botrytis cinerea but Increases Susceptibility to Pseudomonas syringe pv Tomato DC3000

    Directory of Open Access Journals (Sweden)

    Yaqiong Wang

    2017-09-01

    Full Text Available Stilbene synthase (STS is a key enzyme that catalyzes the biosynthesis of resveratrol compounds and plays an important role in disease resistance. The molecular pathways linking STS with pathogen responses and their regulation are not known. We isolated an STS gene, VaSTS19, from a Chinese wild grape, Vitis amurensis Rupr. cv. “Tonghua-3”, and transferred this gene to Arabidopsis. We then generated VaSTS19-expressing Arabidopsis lines and evaluated the functions of VaSTS19 in various pathogen stresses, including powdery mildew, B. cinerea and Pseudomonas syringae pv. tomato DC3000 (PstDC3000. VaSTS19 enhanced resistance to powdery mildew and B. cinerea, but increased susceptibility to PstDC3000. Aniline blue staining revealed that VaSTS19 transgenic lines accumulated more callose compared to nontransgenic control plants, and showed smaller stomatal apertures when exposed to pathogen-associated molecular patterns (flagellin fragment (flg22 or lipopolysaccharides (LPS. Analysis of the expression of several disease-related genes suggested that VaSTS19 expression enhanced defense responses though salicylic acid (SA and/or jasmonic acid (JA signaling pathways. These findings provide a deeper insight into the function of STS genes in defense against pathogens, and a better understanding of the regulatory cross talk between SA and JA pathways.

  8. VA Suicide Prevention Applications Network

    Science.gov (United States)

    Stephens, Brady; Morley, Sybil; Thompson, Caitlin; Kemp, Janet; Bossarte, Robert M.

    2016-01-01

    Objectives: The US Department of Veterans Affairs’ Suicide Prevention Applications Network (SPAN) is a national system for suicide event tracking and case management. The objective of this study was to assess data on suicide attempts among people using Veterans Health Administration (VHA) services. Methods: We assessed the degree of data overlap on suicide attempters reported in SPAN and the VHA’s medical records from October 1, 2010, to September 30, 2014—overall, by year, and by region. Data on suicide attempters in the VHA’s medical records consisted of diagnoses documented with E95 codes from the International Classification of Diseases, Ninth Revision. Results: Of 50 518 VHA patients who attempted suicide during the 4-year study period, data on fewer than half (41%) were reported in both SPAN and the medical records; nearly 65% of patients whose suicide attempt was recorded in SPAN had no data on attempted suicide in the VHA’s medical records. Conclusion: Evaluation of administrative data suggests that use of SPAN substantially increases the collection of data on suicide attempters as compared with the use of medical records alone, but neither SPAN nor the VHA’s medical records identify all suicide attempters. Further research is needed to better understand the strengths and limitations of both systems and how to best combine information across systems. PMID:28123228

  9. The VA Ostomy Health-Related Quality of Life Study: objectives, methods, and patient sample.

    Science.gov (United States)

    Krouse, Robert S; Mohler, M Jane; Wendel, Christopher S; Grant, Marcia; Baldwin, Carol M; Rawl, Susan M; McCorkle, Ruth; Rosenfeld, Kenneth E; Ko, Clifford Y; Schmidt, C Max; Coons, Stephen Joel

    2006-04-01

    To present the design and methods of a multisite study of health-related quality of life (HR-QOL) in veterans living with ostomies. Veterans from Tucson, Indianapolis, and Los Angeles VA Medical Centers were surveyed using the validated City of Hope ostomy-specific tool (mCOH-QOL-Ostomy) and the SF-36V. Cases (ostomates) had a major gastrointestinal procedure that required an intestinal stoma, while controls had similar procedures for which an ostomy was not required. Ostomy subjects were recruited for four focus groups in each of two sites divided by ostomy type (colostomy versus ileostomy) and overall mCOH-QOL-Ostomy HR-QOL score (highest versus lowest quartile). The focus groups further evaluated barriers, concerns, and adaptation methods and skills. This report presents recruitment results, reliability of survey instruments, and demographic characteristics of the sample. The overall response (i.e., recruitment) rate across all sites was 48% and by site was 53%, 57%, and 37%, respectively (p ostomies had significantly longer time since surgery than controls (p ostomies is an illustration of a successful mixed methods approach to HR-QOL research. We collected meaningful quantitative and qualitative data that will be used in the development of new approaches to care that will lead to improved functioning and well-being in persons living with ostomies. Subsequent reports will provide the results of this research project.

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

    Science.gov (United States)

    2016-12-01

    Congressional Requesters December 2016 GAO-17-52 United States Government Accountability Office United States Government Accountability Office...VHA officials said not all facilities require onsite gynecologists and facilities may authorize gynecological services from non-VA providers. They...including previously closed combat positions, which could contribute to the increase in the women veteran population. See GAO, Military Personnel: DOD Is

  11. Alcohol screening and risk of postoperative complications in male VA patients undergoing major non-cardiac surgery.

    Science.gov (United States)

    Bradley, Katharine A; Rubinsky, Anna D; Sun, Haili; Bryson, Chris L; Bishop, Michael J; Blough, David K; Henderson, William G; Maynard, Charles; Hawn, Mary T; Tønnesen, Hanne; Hughes, Grant; Beste, Lauren A; Harris, Alex H S; Hawkins, Eric J; Houston, Thomas K; Kivlahan, Daniel R

    2011-02-01

    Patients who misuse alcohol are at increased risk for surgical complications. Four weeks of preoperative abstinence decreases the risk of complications, but practical approaches for early preoperative identification of alcohol misuse are needed. To evaluate whether results of alcohol screening with the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) questionnaire-up to a year before surgery-were associated with the risk of postoperative complications. This is a cohort study. Male Veterans Affairs (VA) patients were eligible if they had major noncardiac surgery assessed by the VA's Surgical Quality Improvement Program (VASQIP) in fiscal years 2004-2006, and completed the AUDIT-C alcohol screening questionnaire (0-12 points) on a mailed survey within 1 year before surgery. One or more postoperative complication(s) within 30 days of surgery based on VASQIP nurse medical record reviews. Among 9,176 eligible men, 16.3% screened positive for alcohol misuse with AUDIT-C scores ≥ 5, and 7.8% had postoperative complications. Patients with AUDIT-C scores ≥ 5 were at significantly increased risk for postoperative complications, compared to patients who drank less. In analyses adjusted for age, smoking, and days from screening to surgery, the estimated prevalence of postoperative complications increased from 5.6% (95% CI 4.8-6.6%) in patients with AUDIT-C scores 1-4, to 7.9% (6.3-9.7%) in patients with AUDIT-Cs 5-8, 9.7% (6.6-14.1%) in patients with AUDIT-Cs 9-10 and 14.0% (8.9-21.3%) in patients with AUDIT-Cs 11-12. In fully-adjusted analyses that included preoperative covariates potentially in the causal pathway between alcohol misuse and complications, the estimated prevalence of postoperative complications increased significantly from 4.8% (4.1-5.7%) in patients with AUDIT-C scores 1-4, to 6.9% (5.5-8.7%) in patients with AUDIT-Cs 5-8 and 7.5% (5.0-11.3%) among those with AUDIT-Cs 9-10. AUDIT-C scores of 5 or more up to a year before surgery were

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  13. Association of Myosin Va and Schwann cells-derived RNA in mammal myelinated axons, analyzed by immunocytochemistry and confocal FRET microscopy.

    Science.gov (United States)

    Canclini, Lucía; Wallrabe, Horst; Di Paolo, Andrés; Kun, Alejandra; Calliari, Aldo; Sotelo-Silveira, José Roberto; Sotelo, José Roberto

    2014-03-15

    Evidence from multiple sources supports the hypothesis that Schwann cells in the peripheral nervous system transfer messenger RNA and ribosomes to the axons they ensheath. Several technical and methodological difficulties exist for investigators to unravel this process in myelinated axons - a complex two-cell unit. We present an experimental design to demonstrate that newly synthesized RNA is transferred from Schwann cells to axons in association with Myosin Va. The use of quantitative confocal FRET microscopy to track newly-synthesized RNA and determine the molecular association with Myosin Va, is described in detail. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Staying in the Hood: Black Lesbian and Transgender Women and Identity Management in North Philadelphia.

    Science.gov (United States)

    Brooks, Siobhan

    2016-12-01

    The concept Don't Ask, Don't Tell regarding Black LGBT sexuality in Black communities has been an acceptable form of identity management for Black LGBT people. In other words, Black LGBT people are accepted as long as they are not vocal about their sexuality. However, this is changing with the issue of gay marriage, which is creating a space where Black LGBT people are more open about their gender identity and sexuality in heterosexual Black spaces. This new form of openness allows Black LGBT people to "stay in" their communities, as opposed to coming out. In this article I examine how Black LGBT women in North Philadelphia stay in their communities: being politically active regarding LGBT issues, disengaging from LGBT issues, passing, and educating straight Black people about issues affecting the Black LGBT community. I conclude with implications of staying in and intersectionality among Black heterosexual and LGBT women fighting for social change.

  15. Emissions inventories for urban airshed model application in the Philadelphia Aqcr (Air Quality Control Region)

    Energy Technology Data Exchange (ETDEWEB)

    1982-04-01

    This report documents the procedures used to develop emissions input required by the Urban Airshed photochemical oxidant model. Ambient air quality data were gathered as part of another effort during the summer of 1979 in Philadelphia to be used in the model validation effort. For 1979 and the 1987 projection year, ES compiled hour by hour emissions data for a representative weekday in the oxidant season. The pollutants inventoried are five categories of VOC required by the Airshed model, four categories of VOC defined in RAPS, NO, NO2, CO, SO2, and TSP. Point and area sources were considered with the highway vehicle portion of the inventory being subcontracted to DVRPC. County level area source data were allocated to a 502-cell grid system. Projections were made so that ozone air quality in 1987 could be investigated. ES developed annualized EIS/PandR data and data files containing temporal and VOC/NOx profiles in order to generate the data packets required by the Airshed model.

  16. Creating a business environment in inventory management - The Philadelphia Electric Company experiences

    International Nuclear Information System (INIS)

    Franks, A.J.; Birch, H.

    1992-01-01

    Philadelphia Electric Company's (PECo's) Nuclear Engineering and Services Department was asked to develop a (non-fuel) inventory management philosophy that will optimize inventory dollars at Peach Bottom atomic power station and Limerick generating station. The ultimate goal of the project is to maximize the potential for the correct parts being available at the lowest possible level of investment. There are many factors that make the management of maintenance, repair, and operating (MRO) supply inventories more complicated than managing finished goods, work-in-progress, or raw materials. Determining correct inventory levels for nuclear power plants is complicated by the irregular demand for spare parts and the cyclic nature of demand caused by refueling outages. Based on the information collected, it was determined that PECo's nuclear group needed to develop policies and strategies to address the following issues: (1) inventory classification based on part criticality, usage, and demand forecast; (2) item level ordering policies based on classification system; (3) inventory performance management; and (4) management of obsolete/surplus parts. Currently, policies are being developed to manage surplus and obsolete materials. Opportunities are being explored regarding the potential capitalization of critical components and parts. The policies established for classification, ordering policies, and performance management are being translated into work processes via common procedures and guidelines

  17. Night and day in the VA: associations between night shift staffing, nurse workforce characteristics, and length of stay.

    Science.gov (United States)

    de Cordova, Pamela B; Phibbs, Ciaran S; Schmitt, Susan K; Stone, Patricia W

    2014-04-01

    In hospitals, nurses provide patient care around the clock, but the impact of night staff characteristics on patient outcomes is not well understood. The aim of this study was to examine the association between night nurse staffing and workforce characteristics and the length of stay (LOS) in 138 veterans affairs (VA) hospitals using panel data from 2002 through 2006. Staffing in hours per patient day was higher during the day than at night. The day nurse workforce had more educational preparation than the night workforce. Nurses' years of experience at the unit, facility, and VA level were greater at night. In multivariable analyses controlling for confounding variables, higher night staffing and a higher skill mix were associated with reduced LOS. © 2014 Wiley Periodicals, Inc.

  18. Section 2: Case Studies of the Politics of Privatization: Bringing the Private into the Public--Changing the Rules of the Game and New Regime Politics in Philadelphia Public Education

    Science.gov (United States)

    Bulkley, Katrina E.

    2007-01-01

    Substantial policy and political changes have resulted from a 2001 state takeover of the Philadelphia School District and the subsequent hiring of Paul Vallas as the district's new CEO. Using the lens of urban regime analysis, which emphasizes the importance of public and private actors in forming a governing coalition, this article analyzes the…

  19. Sex differences in brain and behavior in adolescence: Findings from the Philadelphia Neurodevelopmental Cohort.

    Science.gov (United States)

    Gur, Raquel E; Gur, Ruben C

    2016-11-01

    Sex differences in brain and behavior were investigated across the lifespan. Parameters include neurobehavioral measures linkable to neuroanatomic and neurophysiologic indicators of brain structure and function. Sexual differentiation of behavior has been related to organizational factors during sensitive periods of development, with adolescence and puberty gaining increased attention. Adolescence is a critical developmental period where transition to adulthood is impacted by multiple factors that can enhance vulnerability to brain dysfunction. Here we highlight sex differences in neurobehavioral measures in adolescence that are linked to brain function. We summarize neuroimaging studies examining brain structure, connectivity and perfusion, underscoring the relationship to sex differences in behavioral measures and commenting on hormonal findings. We focus on relevant data from the Philadelphia Neurodevelopmental Cohort (PNC), a community-based sample of nearly 10,000 clinically and neurocognitively phenotyped youths age 8-21 of whom 1600 have received multimodal neuroimaging. These data indicate early and pervasive sexual differentiation in neurocognitive measures that is linkable to brain parameters. We conclude by describing possible clinical implications. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Validating the InterVA model to estimate the burden of mortality from verbal autopsy data: a population-based cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Sebsibe Tadesse

    Full Text Available BACKGROUND: In countries with incomplete or no vital registration systems, verbal autopsy data are often reviewed by physicians in order to assign the probable cause of death. But in addition to being time and energy consuming, the method is liable to produce inconsistent results. The aim of this study is to validate the InterVA model for estimating the burden of mortality from verbal autopsy data by using physician review as a reference standard. METHODS AND FINDINGS: A population-based cross-sectional study was conducted from March to April, 2012. All adults aged ≥ 14 years and died between 01 January, 2010 and 15 February, 2012 were included in the study. The verbal autopsy interviews were reviewed by the InterVA model and physicians to estimate cause-specific mortality fractions. Cohen's kappa statistic, sensitivity, specificity, positive predictive value, and negative predictive value were applied to compare the agreement between the InterVA model and the physician review. A total of 408 adult deaths were studied. There was a general similarity and just slight differences between the InterVA model and the physicians in assigning cause-specific mortality. Both approaches showed an overall agreement in 298 (73% cases [kappa = 0.49, 95% CI: 0.37-0.60]. The observed sensitivities and specificities across causes of death categories varied from 13.3% to 81.9% and 77.7% to 99.5%, respectively. CONCLUSIONS: In understanding the burden of disease and setting health intervention priorities in areas that lack reliable vital registration systems, an accurate analysis of verbal autopsies is essential. Therefore, users should be aware of the suboptimal performance of the InterVA model. Similar validation studies need to be undertaken considering the limitation of the physician review as gold standard since physicians may misinterpret some of the verbal autopsy data and finally reach a wrong conclusion of the cause of death.