WorldWideScience

Sample records for va motalea khavase

  1. State of the VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2016-01-01

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

  2. VA Health Care Facilities Locator

    Science.gov (United States)

    ... map [a-z] More VA More VA Health Health Care Information A-Z Health Topic Finder My Health ... General QUICK LIST Apply for Benefits Apply for Health Care Prescriptions My Health e Vet eBenefits Life Insurance ...

  3. Hosn va Del: Sufist Reading of Khosro va Shirin

    Directory of Open Access Journals (Sweden)

    s jabri

    2013-02-01

    Full Text Available The existence of eight imitations and five translations of Hosn va Del into other languages such as English and German shows the importance of this Persian book of verse. Many researchers have sought the sources of this work and some sources have been mentioned, but the imitation of Sibak Neishaburi from Nezami’s Khosrow va Shirin, as the most important source of this work, has not yet been mentioned. Due to the innovative mixing of symbolic story, folk tale and love story which is done by changing the names of characters into abstract concepts resulting in creating two layers of primary and interpretive meaning in the text of Hosn va Del, the similarities between the two books have not yet been discovered. The fruit of such mixing is the creation of a sufist and interpretive reading of Khosrow va Shirin (named Hosn va Del which is a love story at the primary level and is very similar to Nezami’s Khosrow va Shirin. At the interpretive level, it is a mystical book of verse which narrates the story of the Progression and reaching Knowledge and Immortality. This article tries to study the similarities between the two stories through comparing the texts of these two books and using the method of textual criticism. The results show that the love between lover and beloved is common between the two books. The structure and organization of the two books are very similar and there are very causes and motivations in the plot of the two stories. Also, more than half of the characters of the two stories are of common characteristics. There are similar events as well as places in the two stories. Also, many similarities can be seen in the content of dialogues. The results of this study show that Khosrow va Shirin is the main source of Hosn va Del and Sibak Neishaburi is among the imitators of Nezami in composing love story.

  4. The Geometric-VaR Backtesting Method

    DEFF Research Database (Denmark)

    Wei, Wei; Pelletier, Denis

    2014-01-01

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

  5. 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....

  6. Another Phoenix VA director leaves

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2016-08-01

    Full Text Available No abstract available. Article truncated after 150 words. The Arizona Republic reports that the director at the Phoenix VA Medical Center, Deborah Amdur, will retire after only 9 months for health reasons (1. Amdur will be replaced by Barbara Fallen, director of the VA Loma Linda Healthcare System. Fallen will be interim director until a permanent replacement for Amdur can be found. This is the fifth hospital director since former Director Sharon Helman was removed in mid-2014 amid the nationwide veterans health-care scandal that was first exposed at the Phoenix VA. The Veterans Integrated Service Network (VISN in Gilbert, which oversees the VA Medical Center in Arizona, New Mexico and West Texas has also been through a series of 4 directors since Susan Bowers retired under pressure in the wake of the VA scandal. Marie Weldon, current acting regional director, also oversees the Los Angeles-based VA Desert Pacific Healthcare System. Weldon described Fallen as “an experienced leader who ...

  7. VA administrators breahe a sigh of relief

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-06-01

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

  8. 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...

  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. 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...

  11. 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,...

  12. Geographic Distribution of VA Expenditures FY2007

    Data.gov (United States)

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

  13. Geographic Distribution of VA Expenditures FY1999

    Data.gov (United States)

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

  14. Geographic Distribution of VA Expenditures FY2008

    Data.gov (United States)

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

  15. 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,...

  16. Geographic Distribution of VA Expenditures FY2000

    Data.gov (United States)

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

  17. Geographic Distribution of VA Expenditures FY2005

    Data.gov (United States)

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

  18. Geographic Distribution of VA Expenditures FY2003

    Data.gov (United States)

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

  19. 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,...

  20. 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,...

  1. Geographic Distribution of VA Expenditures FY2006

    Data.gov (United States)

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

  2. Geographic Distribution of VA Expenditures FY2011

    Data.gov (United States)

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

  3. 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,...

  4. Geographic Distribution of VA Expenditures FY1997

    Data.gov (United States)

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

  5. 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,...

  6. Geographic Distribution of VA Expenditures FY1996

    Data.gov (United States)

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

  7. 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...

  8. 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...

  9. Geographic Distribution of VA Expenditures Report FY2015

    Data.gov (United States)

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

  10. 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...

  11. Genetics Home Reference: carbonic anhydrase VA deficiency

    Science.gov (United States)

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

  12. A failure of oversight at the VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-09-01

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

  13. 78 FR 32126 - VA Dental Insurance Program

    Science.gov (United States)

    2013-05-29

    ... misinterpretations of eligibility for VA dental benefits, because these misinterpretations seemed to also create... communication channels to notify all eligible persons of their right to voluntarily enroll in VADIP. The...

  14. 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/.

  15. The mechanism of vinylacetylene (VA) hydrochlorination

    Energy Technology Data Exchange (ETDEWEB)

    Shestakov, G.K.; Belskii, F.I.; Airyan, S.M.; Temkin, O.N.

    1978-03-01

    The mechanism of vinylacetylene (VA) hydrochlorination in a cupric chloride solution was studied at 50/sup 0/C in a gradientless flow reactor, and chromatographic analysis identified 2- and 1-chloro-1,3-butadienes as the main products. Analysis of the reaction kinetics showed that CuCl catalyzed both 1,4 and 1,2 (Markovnikov and anti-Markovnikov types) addition of HCl to VA and that no VA conversion occurred without CuCl. The formation of both products occurred via similar many-route mechanisms, with at least one of the routes involving formation and isomerization of 4-chloro-1,2-butadiene (''allene''). Based on the results of this study together with published data on hydrochlorination and hydration of acetylene and methylacetylene, some conclusions on the effect of substituents on the mechanism of hydrochlorination of acetylene compounds were reached. Tables, graphs, and 15 references.

  16. 76 FR 75509 - Autopsies at VA Expense

    Science.gov (United States)

    2011-12-02

    ... Facilities; 64.007, Blind Rehabilitation Centers; 64.008, Veterans Domiciliary Care; 64.009, Veterans Medical Care Benefits; 64.010, Veterans Nursing Home Care; 64.014, Veterans State Domiciliary Care; 64.015...-reference to VA regulations that authorize certain outpatient and ambulatory care. The proposed rule would...

  17. Analysis of VA-1 and VA4 RIA tests with FRAPTRAN and SCANAIR codes

    Energy Technology Data Exchange (ETDEWEB)

    Sagrado, I. C.; Vallejo, I.; Herranz, L. E.

    2012-07-01

    This paper summarizes the CIEMAT results of VA-1 and VA-3 RIA tests modeling with the FRAPTRAN 1.4 (PNNL) and SCANAIR 7.1 (IRSN) codes. This work is framed within the international OECD-CABRI project in which a RIA code benchmarking has been set up with a broad international participation, Both experiments were conducted in the Japanese NSRR experimental reactor.

  18. 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.

  19. 38 CFR 74.27 - How will VA store information?

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false How will VA store... (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.27 How will VA store information? VA... electronically on the Department's secure servers. CVE personnel will compare information provided concerning...

  20. 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 ...

  1. 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...

  2. Gangrenous cholecystitis in an urban VA hospital.

    Science.gov (United States)

    Wilson, A K; Kozol, R A; Salwen, W A; Manov, L J; Tennenberg, S D

    1994-05-01

    Gangrenous cholecystitis is an advanced form of acute cholecystitis associated with increased morbidity and mortality. We sought to determine the incidence of gangrenous cholecystitis in an urban VA hospital patient population and identify any distinguishing characteristics that may aid in its preoperative diagnosis. We retrospectively reviewed all urgent admissions that underwent cholecystectomy (n = 65) over the past 7 years at the Allen Park VAMC. Using histologic criteria, 17 (26%) of these patients had gangrenous cholecystitis. As a group compared to patients with nongangrenous cholecystitis, patients with gangrenous cholecystitis were statistically older (64 vs 54) and had an elevated WBC (15.4 vs 11.5) and increased serum glucose levels (203 vs 141). Preoperative imaging studies (ultrasound and cholescintigraphy) correctly identified only 31% of the gangrenous cholecystitis patients. We conclude that in an urban VA hospital patient population, the diagnosis of gangrenous cholecystitis cannot be accurately made or ruled out among urgent admissions with acute biliary disease. Considering the high incidence (26%) and difficulty confirming the diagnosis of gangrenous cholecystitis in this setting, we recommend early surgical intervention for this and similar patient populations.

  3. 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.

  4. VA/DoD Joint Executive Council Fiscal Year 2010

    Science.gov (United States)

    2010-01-01

    Medical Department (AMEDD) Center and School and the Military Departments to provide training to additional personnel. Joint VA/DoD training in TBI...Capital Region, VA initiated a “ paperless ” program for processing all DES claims electronically. VA worked with the MTFs in the National Capital...Management System for paperless claims processing. On March 29, 2010, DoD implemented a policy entitled “Cross-Service Support and Service Organization

  5. 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 ...

  6. 76 FR 52230 - Establishment of Class E Airspace; Forest, VA

    Science.gov (United States)

    2011-08-22

    ... Federal Aviation Administration 14 CFR Part 71 Establishment of Class E Airspace; Forest, VA AGENCY... Airspace at Forest, VA, to accommodate the new Area Navigation (RNAV) Global Positioning System (GPS... published in the Federal Register a notice of proposed rulemaking to establish Class E airspace at Forest...

  7. 77 FR 70967 - Authorization for Non-VA Medical Services

    Science.gov (United States)

    2012-11-28

    ..., Mental health programs, Nursing homes, Reporting and recordkeeping requirements, Veterans. Dated... may use this authority to provide needed non- VA care using community resources, such as private physicians or community hospitals. Care provided under VA's authority in 38 U.S.C. 1703 is usually referred...

  8. D-Va category phenotype and genotype in Japanese families

    NARCIS (Netherlands)

    Legler, TJ; Wiemann, [No Value; Ohto, H; Matuda, [No Value; Obara, T; Uchikawa, M; Kohler, M

    2000-01-01

    Background and Objectives: The genetic background of the D-Va category phenotype has been described in two Caucasian individuals. We were interested in the RHD sequence of 7 Japanese D-Va individuals and their families. Materials and Methods: With SSP-PCR we tested exons 4, 5 and 7 of the RHD gene

  9. Microcirculatory assessment of patients under VA-ECMO

    NARCIS (Netherlands)

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

    2016-01-01

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

  10. Microcirculatory assessment of patients under VA-ECMO

    NARCIS (Netherlands)

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

    2016-01-01

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

  11. 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.

  12. 76 FR 40453 - Agency Information Collection (Application for VA Education Benefits) Activity Under OMB Review

    Science.gov (United States)

    2011-07-08

    ... AFFAIRS Agency Information Collection (Application for VA Education Benefits) Activity Under OMB Review... INFORMATION: Titles: a. Application for VA Education Benefits, VA Form 22-1990. b. Application for Family Member to Use Transferred Benefits, VA Form 22-1990E. ] c. Application for VA Education Benefits Under...

  13. Time for the VA to clean up its act

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2015-06-01

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

  14. 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...

  15. 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.

  16. 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...

  17. 78 FR 62441 - VA Dental Insurance Program-Federalism

    Science.gov (United States)

    2013-10-22

    ... and their corresponding regulatory paragraphs. Subsection of Paragraph of Sec. Topic section 510 17.... Administrative Procedure Act VA believes this regulatory amendment is non-controversial and anticipates that this...

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

    Data.gov (United States)

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

  19. 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...

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

    Data.gov (United States)

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

  1. A VA medical center's PTSD residential recovery program.

    Science.gov (United States)

    Devaney, Donald E

    2010-01-01

    With the influx of military veterans with Post Traumatic Stress Disorder (PTSD) increasingly affecting all healthcare facilities, including acute care and long term, learning from the experience of VA hospitals in treating those with PTSD may prove valuable. In this article, Tripler/VA Provost Marshal Donald E. Delaney describes a program that has been in operation since 1994. He may be contacted for further in formation at (808) 433-4465 or Donald.devaney@amedd.army .mil

  2. Inpatient Mental Health Recaptre using Dod/VA Sharing

    Science.gov (United States)

    2009-10-03

    Center. Although no diagnostic categories are excluded, common diagnosis include, adjustment disorders, mood disorders, anxiety disorders, psychoses ... definition of acute psychiatry. Staffing The Waco VA has nurse managers who determine the number of RN’s and other support staff based on patient...Enrollment Priority Groups Priority Group Definition 1 • Veterans with VA-rated service-connected disabilities 50% or more disabling • Veterans

  3. 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 ...

  4. VA Health Care: Further Action Needed to Address Weaknesses in Management and Oversight of Non-VA Medical Care

    Science.gov (United States)

    2014-06-18

    medical care when a VA facility is unable to provide certain specialty care services, such as cardiology or orthopedics, or when a veteran would have...needing treatment in several specialties—including audiology, cardiology , and ophthalmology—were referred to non-VA providers for this reason...Government Accountability Office, the audit, evaluation, and investigative arm of Congress , exists to support Congress in meeting its constitutional

  5. 76 FR 24570 - Proposed Information Collection (Application for VA Education Benefits) Activity; Comment Request

    Science.gov (United States)

    2011-05-02

    ... AFFAIRS Proposed Information Collection (Application for VA Education Benefits) Activity; Comment Request.... Titles: a. Application for VA Education Benefits, VA Form 22-1990. b. Application for Transfer of Entitlement (TOE), Basic Educational Assistance Under the Montgomery GI Bill, VA Form 22-1990E. c. Application...

  6. 78 FR 76412 - Agency Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Science.gov (United States)

    2013-12-17

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

  7. 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

  8. 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 ...

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

    Science.gov (United States)

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

    2016-02-01

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

  10. Stratigraphic-structural characteristics of Mačva basin

    Directory of Open Access Journals (Sweden)

    Carević Ivana

    2009-01-01

    Full Text Available The analysis of stratigraphic-structural features of Mačva basin had been conducted in this paper on the basis of data obtained with deep exploratory boring performed for the needs of hydrogeothermal research project for the purpose of identifying the reserves of geothermal energy of Mačva. The research has been carried out with the aim of finding out the relation between the Tertiary and its Triassic bedrock (Ladinian and Carnian stages in which process the considerable realistic image of paleorelief (the bedrock of Tertiary deposits was obtained.

  11. VA-INPC: Linking Department of Veterans Affairs (VA) and Indiana Network for Patient Care (INPC) data to assess surveillance testing among veterans with colorectal cancer.

    Science.gov (United States)

    Haggstrom, David A; Rosenman, Marc; Myers, Laura J; Teal, Evgenia; Doebbeling, Bradley N

    2010-11-13

    The goal of this project was to provide empiric evidence about the benefit to US veterans and the VA of capturing data from a citywide clinical informatics network (INPC) to assess care received outside the VA. We identified 468 veterans diagnosed with colorectal cancer from 2000-2007 in the Indianapolis VA cancer registry. Electronic VA healthcare data were linked with electronic health records from the regional health information organization (RHIO) INPC; 341 matches were found. Both the VA and INPC systems were queried regarding receipt of surveillance tests. The proportion with additional data from INPC varied by test: colonoscopy (3%), CT scan/abdomen (13%), CT scan/chest (79%), carcinoembryonic antigen test (8%), and other laboratory tests (25%-53%). An incremental benefit of linking VA and INPC data was present and may increase when expanded beyond patients with a single condition. New, important information about care outside the VA is obtained through RHIO data linkage.

  12. 76 FR 77270 - Board Meeting; January 9, 2012, Arlington, VA

    Science.gov (United States)

    2011-12-12

    ... at the Ritz- Carlton Hotel, 1250 South Hayes Street, Arlington, Virginia 22202; (Tel) (703) 415-5000... From the Federal Register Online via the Government Publishing Office NUCLEAR WASTE TECHNICAL REVIEW BOARD Board Meeting; January 9, 2012, Arlington, VA The U.S. Nuclear Waste Technical Review Board...

  13. Military and VA General Dentistry Training: A National Resource.

    Science.gov (United States)

    Atchison, Kathryn A.; Bachand, William; Buchanan, C. Richard; Lefever, Karen H.; Lin, Sylvia; Engelhardt, Rita

    2002-01-01

    Compared the program characteristics of the postgraduate general dentistry (PGD) training programs sponsored by the military and the Veterans Health Administration (VA). Gathered information on program infrastructure and emphasis, resident preparation prior to entering the program, and patients served and types of services provided. Programs…

  14. 77 FR 70893 - Authorization for Non-VA Medical Services

    Science.gov (United States)

    2012-11-28

    ..., Mental health programs, Nursing homes, Reporting and recordkeeping requirements, Veterans. Dated... authority to provide needed non- VA care using community resources, such as private physicians or community... such medical services for a veteran who has been furnished hospital care, nursing home care...

  15. 77 FR 67063 - VA Directive 0005 on Scientific Integrity

    Science.gov (United States)

    2012-11-08

    ... interest to strengthen disclosure of and reduce conflict of interest among, employees, and reviewers. Conflict of interest policies should apply to research staff as well as research investigators. VA Response... developing conflict of interest requirements specifically applicable to research. Consequently, no changes...

  16. 76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers

    Science.gov (United States)

    2011-11-21

    ...The Department of Veterans Affairs (VA) proposes to amend its regulation and internal policy documents 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 payment for other non-VA health care providers. Because the newly applicable methodology cannot supersede rates for which VA has specifically contracted, this rulemaking will only affect providers who do not have existing negotiated contracts with VA. The proposed rule would also rescind internal guidance documents that could be interpreted as conflicting with the proposed rule.

  17. EPA, W. Va. DEP File Settlement with Justice Companies to Restore and Protect Monroe Co., W. Va. Waterways

    Science.gov (United States)

    CHARLESTON, W.Va. (Dec. 10, 2015) Today, the U.S. Environmental Protection Agency and the West Virginia Department of Environmental Protection filed a settlement with James C. Justice II, the James C. Justice Companies, Inc. and High Mountain Living

  18. 75 FR 33216 - Payment or Reimbursement for Emergency Treatment Furnished by Non-VA Providers in Non-VA...

    Science.gov (United States)

    2010-06-11

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

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

    Science.gov (United States)

    2016-01-27

    comparison. In this work we introduce a novel network metric, which we call VA-index, for quantify- ing the multi-dimensional assortativity. In a nutshell ...network randomization with statistical hypothesis testing. In a nutshell , the intuition of our approach is based on comparing the pairwise average...1)), we would need to normalize the VA-index with the maximum possible average similarity that Fig 2. The computation of VA-index in a nutshell . VA

  20. 78 FR 26250 - Payment for Home Health Services and Hospice Care to Non-VA Providers

    Science.gov (United States)

    2013-05-06

    ...The Department of Veterans Affairs (VA) amends its regulations concerning the billing methodology for non-VA providers of home health services and hospice care. Because the newly applicable methodology cannot supersede rates for which VA has specifically contracted, this rulemaking will only affect home health and hospice care providers who do not have existing negotiated contracts with VA. This rule also rescinds internal guidance documents that could be interpreted as conflicting with this final rule.

  1. 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.

  2. Implementation of online suicide-specific training for VA providers.

    Science.gov (United States)

    Marshall, Elizabeth; York, Janet; Magruder, Kathryn; Yeager, Derik; Knapp, Rebecca; De Santis, Mark L; Burriss, Louisa; Mauldin, Mary; Sulkowski, Stan; Pope, Charlene; Jobes, David A

    2014-10-01

    Due to the gap in suicide-specific intervention training for mental health students and professionals, e-learning is one solution to improving provider skills in the Veterans Affairs (VA) health system. This study focused on the development and evaluation of an equivalent e-learning alternative to the Collaborative Assessment and Management of Suicidality (CAMS) in-person training approach at a Veteran Health Affairs medical center. The study used a multicenter, randomized, cluster, and three group design. the development of e-CAMS was an iterative process and included pilot testing. Eligible and consenting mental health providers, who completed a CAMS pre-survey, were randomized. Provider satisfaction was assessed using the standard VA evaluation of training consisting of 20 items. Two post training focus groups, divided by learning conditions, were conducted to assess practice adoption using a protocol focused on experiences with training and delivery of CAMS. A total of 215 providers in five sites were randomized to three conditions: 69 to e-learning, 70 to in-person, 76 to the control. The providers were primarily female, Caucasian, midlife providers. Based on frequency scores of satisfaction items, both learning groups rated the trainings positively. In focus groups representing divided by learning conditions, participants described positive reactions to CAMS training and similar individual and institutional barriers to full implementation of CAMS. This is the first evaluation study of a suicide-specific e-learning training within the VA. The e-CAMS appears equivalent to the in-person CAMS in terms of provider satisfaction with training and practice adoption, consistent with other comparisons of training deliveries across specialty areas. Additional evaluation of provider confidence and adoption and patient outcomes is in progress. The e-CAMS has the potential to provide ongoing training for VA and military mental health providers and serve as a tutorial for

  3. Addressing the Health Concerns of VA Women with Sexual Trauma

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-14-1-0368 TITLE: Addressing the Health Concerns of VA Women with Sexual Trauma PRINCIPAL INVESTIGATOR: Caron Zlotnick, PhD...develop and assess a computer-delivered intervention (Safety and Health Experiences Program; SHE) that will provide a screening and brief behavior...intervention for women veterans with any lifetime ST. More specifically, the intervention, SHE, will address interrelated health concerns for women

  4. 75 FR 3541 - Agency Information Collection (Verification of VA Benefits) Activity Under OMB Review

    Science.gov (United States)

    2010-01-21

    ... AFFAIRS Agency Information Collection (Verification of VA Benefits) Activity Under OMB Review AGENCY... INFORMATION: Title: Verification of VA Benefits, VA Form 26-8937. OMB Control Number: 2900-0406. Type of... Veterans Benefits Administration, Department of Veterans Affairs will submit the collection of information...

  5. 77 FR 64383 - Proposed Information Collection (Verification of VA Benefits) Activity: Comment Request

    Science.gov (United States)

    2012-10-19

    ... AFFAIRS Proposed Information Collection (Verification of VA Benefits) Activity: Comment Request AGENCY... techniques or the use of other forms of information technology. Title: Verification of VA Benefits, VA Form... comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act...

  6. Use of VA and Medicare services by dually eligible veterans with psychiatric problems.

    Science.gov (United States)

    Carey, Kathleen; Montez-Rath, Maria E; Rosen, Amy K; Christiansen, Cindy L; Loveland, Susan; Ettner, Susan L

    2008-08-01

    To examine how service accessibility measured by geographic distance affects service sector choices for veterans who are dually eligible for veterans affairs (VA) and Medicare services and who are diagnosed with mental health and/or substance abuse (MH/SA) disorders. Primary VA data sources were the Patient Treatment (acute care), Extended Care (long-term care), and Outpatient Clinic files. VA cost data were obtained from (1) inpatient and outpatient cost files developed by the VA Health Economics and Resource Center and (2) outpatient VA Decision Support System files. Medicare data sources were the denominator, Medicare Provider Analysis Review (MEDPAR), Provider-of-Service, Outpatient Standard Analytic and Physician/Supplier Standard Analytic files. Additional sources included the Area Resource File and Census Bureau data. We identified dually eligible veterans who had either an inpatient or outpatient MH/SA diagnosis in the VA system during fiscal year (FY)'99. We then estimated one- and two-part regression models to explain the effects of geographic distance on both VA and Medicare total and MH/SA costs. Results provide evidence for substitution between the VA and Medicare, demonstrating that poorer geographic access to VA inpatient and outpatient clinics decreased VA expenditures but increased Medicare expenditures, while poorer access to Medicare-certified general and psychiatric hospitals decreased Medicare expenditures but increased VA expenditures. As geographic distance to VA medical facility increases, Medicare plays an increasingly important role in providing mental health services to veterans.

  7. The Impact of VA's Geriatric Research, Education and Clinical Centers on Academic Affiliates

    Science.gov (United States)

    Bragg, Elizabeth J.; Meganathan, Karthikeyan; Shay, Kenneth; Gilman, Stuart C.; Zeiss, Robert A.; Hettler, Debbie L.

    2011-01-01

    The education mission of the Department of Veterans Affairs (VA) is to train health professionals to benefit VA and the United States. One approach for achieving that mission, along with VA's research and clinical missions, was the establishment of Geriatric Research, Education and Clinical Centers (GRECCs) in 1975. These were developed at VA…

  8. 77 FR 12697 - VA Homeless Providers Grant and Per Diem Program

    Science.gov (United States)

    2012-03-01

    ... applicant takes measures to protect the capital securing VA's grant investment. We would remove the... would reduce the redundancy of current application requirements, provide an improved picture of overall... consist primarily of VA clinicians and VA homeless specialists, the current regulation could better...

  9. 78 FR 56271 - FY 2014-2020 Draft VA Strategic Plan

    Science.gov (United States)

    2013-09-12

    ... AFFAIRS FY 2014-2020 Draft VA Strategic Plan AGENCY: Department of Veterans Affairs. ACTION: Notice of... availability of the FY 2014-2020 Draft VA Strategic Plan (Strategic Plan) for public review and comment, as..., and leadership to meet our clients' needs and expectations. DATES: Comments must be received by VA on...

  10. Validation of KENO V.a Comparison with Critical Experiments

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, W.C.

    1999-01-01

    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. Section 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}.

  11. Noncoherent detection of DQPSK in OFDM systems using predictive VA

    Science.gov (United States)

    Veludandi, Vineel K.; Vasudevan, K.

    2017-01-01

    Noncoherent detection of differential quaternary phase shift keying (DQPSK) signals in OFDM systems is efficiently implemented using a predictive Viterbi algorithm (VA) operating on a trellis with just S T = MP-1 states instead of M P states, where M denotes an M-ary PSK constellation and P denotes the order of the prediction filter. The prediction filter coefficients are generated based on the channel DFT alone making a high SNR approximation, since the estimation of the noise-variance using training symbols results in loss of throughput.

  12. The VA Maryland Health Care System's telemental health program.

    Science.gov (United States)

    Koch, Edward F

    2012-05-01

    The VA Maryland Health Care System introduced videoconferencing technology to provide psychiatry, evidenced-based psychotherapy, case management, and patient education at rural clinics where it was difficult to recruit providers. Telemental health services enable rural clinics to offer additional services, such as case management and patient education. Services have been expanded to urban outpatient clinics where a limited number of mental health clinic hours are available. This technology expands the availability of mental health providers and services, allowing patients to receive services from providers located at distant medical centers.

  13. Use of alcoholic beverages in VA medical centers

    Directory of Open Access Journals (Sweden)

    Qadri S Faiz

    2006-10-01

    Full Text Available Abstract Background Benzodiazepines are the first-line choice for the treatment of alcohol withdrawal syndrome. However, several hospitals continue to provide alcoholic beverages through their formulary for the treatment of alcohol withdrawal. While there are data on the prevalence of this practice in academic medical centers, there are no data on the availability of alcoholic beverages at the formularies of the hospitals operated by the department of Veteran's Affairs. Methods In this study, we surveyed the Pharmacy managers at 112 Veterans' Affairs Medical Centers (VAMCs to ascertain the availability of alcohol on the VAMC formularies, and presence or lack of a policy on the use of alcoholic beverages in their VA Medical Center. Results Of the pharmacy directors contacted, 81 responded. 8 did not allow their use, while 20 allowed their use. There was a lack of a consistent policy across the VA medical centers on availability and use of alcoholic beverages for the treatment of alcohol withdrawal syndrome. Conclusion There is lack of uniform policy on the availability of alcoholic beverages across the VAMCs, which may create potential problems with difference in the standards of care.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-04-01

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

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    Shan Liu PhD

    2016-09-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    polyvinylpyrrolidone (PVP) and polyvinyl acetate (PVA) was predicted at 25 °C using a thermal analysis method based on the recrystallization of a supersaturated amorphous dispersion (recrystallization method). These solubilities were compared with a prediction based on the solubility of CCX in the liquid monomeric...... precursors of PVP/VA, N-vinylpyrrolidone (NVP) and vinyl acetate (VA), using the Flory-Huggins lattice theory (liquid monomer solubility approach). The solubilities predicted from the liquid monomer solubility approach increased linearly with increasing VP/VA ratio from 0.03-0.60 w/w. Even though...... the solubilities predicted from the recrystallization method also increased with increasing VP/VA ratio from 0.02-0.40 w/w, the predicted solubility seemed to approach a plateau at high VP/VA ratios. Increasing positive deviations from the Gordon-Taylor equation with increasing VP/VA ratio indicated strong...

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

    Energy Technology Data Exchange (ETDEWEB)

    Busch, R.D.

    2003-01-17

    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.

  19. Penn/VA center for studies of addiction.

    Science.gov (United States)

    O'Brien, Charles P; McLellan, A Thomas; Childress, Anna Rose; Woody, George E

    2009-01-01

    The Penn/VA Center was founded in 1971 because of great concern over the number of Vietnam veterans returning home addicted to heroin. At that time little was known about the science of addiction, so our program from the very beginning was designed to gather data about the nature of addiction and measure the effects of available treatments. In other words, the goals were always a combination of treatment and research. This combination has continued to the present day. A human laboratory for the study of addiction phenomena such as conditioned responses was also founded in 1971. The key clinician investigators in this group have remained in the Center since the 1970s with most of the research staff continuing to work together. Important new investigators have been added over the years. Treatment was empirically based with randomized, controlled clinical trials as the gold standard for determining evidence-based treatment. The patients coming to treatment do not distinguish between abuse of alcohol and other drugs, so the treatment and research programs have always focused on all drugs including ethyl alcohol and the combination of ethyl alcohol with other drugs such as cocaine and opioids. Most of the patients coming for treatment also suffered from additional psychiatric disorders such as depression, anxiety, bipolar disorder or schizophrenia. Thus, the addiction treatment program in 1980 absorbed the rest of the VA Psychiatry Service into the Substance Abuse Program forming a new Behavioral Health Service with responsibility for over 9000 patients. The integration of substance abuse treatment with overall mental health care was the most efficient way to handle patients with complicated combinations of disorders. While this continues to be the best way to treat patients, it has proven difficult in practice. The main reason for this difficulty is that most mental health therapists whether they are psychiatrists, psychologists or social workers feel very inadequate

  20. 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…

  1. Differential patterns of myosin Va expression during the ontogenesis of the rat hippocampus

    Directory of Open Access Journals (Sweden)

    L.S. Brinn

    2010-09-01

    Full Text Available Myosin Va is an actin-based, processive molecular motor protein highly enriched in the nervous tissue of vertebrates. It has been associated with processes of cellular motility, which include organelle transport and neurite outgrowth. The in vivo expression of myosin Va protein in the developing nervous system of mammals has not yet been reported. We describe here the immunolocalization of myosin Va in the developing rat hippocampus. Coronal sections of the embryonic and postnatal rat hippocampus were probed with an affinity-purified, polyclonal anti-myosin Va antibody. Myosin Va was localized in the cytoplasm of granule cells in the dentate gyrus and of pyramidal cells in Ammon's horn formation. Myosin Va expression changed during development, being higher in differentiating rather than already differentiated granule and pyramidal cells. Some of these cells presented a typical migratory profile, while others resembled neurons that were in the process of differentiation. Myosin Va was also transiently expressed in fibers present in the fimbria. Myosin Va was not detected in germinative matrices of the hippocampus proper or of the dentate gyrus. In conclusion, myosin Va expression in both granule and pyramidal cells showed both position and time dependency during hippocampal development, indicating that this motor protein is under developmental regulation.

  2. 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.

  3. Factor Va alternative conformation reconstruction using atomic force microscopy.

    Science.gov (United States)

    Chaves, R C; Dahmane, S; Odorico, M; Nicolaes, G A F; Pellequer, J-L

    2014-12-01

    Protein conformational variability (or dynamics) for large macromolecules and its implication for their biological function attracts more and more attention. Collective motions of domains increase the ability of a protein to bind to partner molecules. Using atomic force microscopy (AFM) topographic images, it is possible to take snapshots of large multi-component macromolecules at the single molecule level and to reconstruct complete molecular conformations. Here, we report the application of a reconstruction protocol, named AFM-assembly, to characterise the conformational variability of the two C domains of human coagulation factor Va (FVa). Using AFM topographic surfaces obtained in liquid environment, it is shown that the angle between C1 and C2 domains of FVa can vary between 40° and 166°. Such dynamical variation in C1 and C2 domain arrangement may have important implications regarding the binding of FVa to phospholipid membranes.

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

    Directory of Open Access Journals (Sweden)

    Ali Noori

    2016-12-01

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

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

    Science.gov (United States)

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

    2004-01-01

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

  6. 75 FR 6098 - VA Veteran-Owned Small Business Verification Guidelines

    Science.gov (United States)

    2010-02-08

    ... verification are brand new and have not yet applied for any Federal or VA contracts. Also VA finds that... of his/her time to managing the concern.'' This commenter further recommended ``permitting the..., environmental, public health and safety, and other advantages; distributive impacts; and equity). The Executive...

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

    Science.gov (United States)

    2016-12-01

    HOMELESS VETERANS Management Improvements Could Help VA Better Identify Supportive-Housing Projects Report to...VETERANS Management Improvements Could Help VA Better Identify Supportive-Housing Projects What GAO Found As of September 2016, for veterans who...disabled veterans. These supportive-housing EULs receive project -based HUD-VASH vouchers, which provide housing subsidies, on-site case management

  8. 78 FR 28949 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program (Rehabilitation)

    Science.gov (United States)

    2013-05-16

    ... Homeless Providers Grant and Per Diem Program, Department of Veterans Affairs, 10770 North 46th Street... AFFAIRS Fund Availability Under VA's Homeless Providers Grant and Per Diem Program (Rehabilitation) AGENCY... grantee facilities originally funded under VA's Homeless Providers Grant and Per Diem Program (see funding...

  9. 77 FR 56709 - Proposed Information Collection (VA Subcontracting Report for Service Disabled Veteran-Owned...

    Science.gov (United States)

    2012-09-13

    ... Information Collection (VA Subcontracting Report for Service Disabled Veteran-Owned Small Business and Veteran... needed to collect information from subcontractors to compare information obtained from subcontracting... collection techniques or the use of other forms of information technology. Title: VA Subcontracting Report...

  10. 77 FR 70210 - Agency Information Collection (VA Subcontracting Report for Service Disabled Veteran-owned Small...

    Science.gov (United States)

    2012-11-23

    ... AFFAIRS Agency Information Collection (VA Subcontracting Report for Service Disabled Veteran-owned Small....'' SUPPLEMENTARY INFORMATION: Title: VA Subcontracting Report for Service Disabled Veteran-owned Small Business and... from subcontractors to compare information obtained from subcontracting plans submitted by prime...

  11. 38 CFR 58.16 - VA Form 10-0144-Certification Regarding Lobbying.

    Science.gov (United States)

    2010-07-01

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

  12. PSO-based optimization of PI regulator and VA loading of a SRF ...

    African Journals Online (AJOL)

    DR OKE

    results show that the proposed PSO technique causes minimum error and minimum VA loading angle by optimally choosing parameters of PI and minimum VA angle as compared to GA technique. Keywords: Active power filter (APF), synchronous reference frame (SRF), Genetic algorithm (GA), Particle Swarm. Optimization ...

  13. 75 FR 25321 - Agency Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Science.gov (United States)

    2010-05-07

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS... Wheelchair Games Application, VA Form 0925a series. c. National Veterans Golden Age Games Application, VA... therapeutic rehabilitation programs such as the National Veterans Wheelchair Games, National Veterans Golden...

  14. 75 FR 9277 - Proposed Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Science.gov (United States)

    2010-03-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS... period, comments may be viewed online through FDMS. FOR FURTHER INFORMATION CONTACT: Matt Bristol at (202... Sports Clinic Application, VA Form 0924--233 hours. b. National Veterans Wheelchair Games Application, VA...

  15. 78 FR 55777 - Proposed Information Collection (VA, National Veterans Sports Programs and Special Events, Event...

    Science.gov (United States)

    2013-09-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS... correspondence. During the comment period, comments may be viewed online through FDMS. FOR FURTHER INFORMATION... Wheelchair Games Event Application, VA Form 0925b. f. Voluntary Service Application, VA Form 0925d. g...

  16. 78 FR 48543 - Veterans Health Administration Fund Availability Under the VA's Homeless Providers Grant and Per...

    Science.gov (United States)

    2013-08-08

    ... AFFAIRS Veterans Health Administration Fund Availability Under the VA's Homeless Providers Grant and Per... continue to deliver services to the homeless Special Need veteran population as outlined in their FY 2009.... Quarles, Director, VA's Homeless Providers GPD Program, Department of Veterans Affairs, 10770 N. 46th...

  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. 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.

  19. 78 FR 77204 - Proposed Information Collection (VA National Veterans Sports Programs and Special Event Surveys...

    Science.gov (United States)

    2013-12-20

    ... AFFAIRS Proposed Information Collection (VA National Veterans Sports Programs and Special Event Surveys... solicits comments on the information needed to evaluate the National Veterans Sports Programs and Special... ``OMB Control No. 2900-NEW (VA National Veterans Sports Programs and Special Event Surveys)'' in any...

  20. 76 FR 44288 - Establishment of Class E Airspace; New Market, VA

    Science.gov (United States)

    2011-07-25

    ... Federal Aviation Administration 14 CFR Part 71 Establishment of Class E Airspace; New Market, VA AGENCY... action 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...

  1. 77 FR 75918 - VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility...

    Science.gov (United States)

    2012-12-26

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO34 VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs AGENCY: Department of Veterans Affairs. ACTION... Professional Scholarship Program (HPSP) regulations. VA also proposes to establish regulations for a new...

  2. 78 FR 51067 - VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility...

    Science.gov (United States)

    2013-08-20

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO34 VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs AGENCY: Department of Veterans Affairs. ACTION... Scholarship Program (HPSP) regulations. VA is also establishing regulations for a new program, the Visual...

  3. 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... of osteopathy duly licensed to practice in the jurisdiction where the prescription is written, shall... contract with VA for filling prescriptions for patients in state homes, provided: (a) The prescription is...

  4. 48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.

    Science.gov (United States)

    2010-10-01

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

  5. 75 FR 60171 - Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Science.gov (United States)

    2010-09-29

    ... AFFAIRS Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA... Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain... publish notice in the Federal Register concerning each proposed collection of information, including each...

  6. 78 FR 60379 - Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Science.gov (United States)

    2013-10-01

    ... AFFAIRS Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA... Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain... publish notice in the Federal Register concerning each proposed collection of information, including each...

  7. 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.

  8. 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.

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

    Science.gov (United States)

    2013-08-20

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

  10. L'Agnese va a morire (novela, fragmento

    Directory of Open Access Journals (Sweden)

    Renata Viganò

    2013-07-01

    Full Text Available RENATA VIGANÒ (Bologna, 1900 - 1976, iniciada en la poesía desde muy pequeña, la mala situación económica familiar y la llegada del fascismo la obligaron a dejar temporalmente sus dos grandes pasiones, la medicina y la literatura, para volcarse, en calidad de correo, enlace y enfermera, a la causa partisana, una verdadera “scuola di partito” a la que llegó de la mano del que sería su compañero por el resto de su vida, Antonio Meluschi. Su experiencia entre los partisanos, primero en la zona de Romagna y luego en el valle de Comacchio, le sirvió de materia para su obra maestra, L’Agnese va a morire, de la que ofrecemos la traducción de su capítulo IV. La obra está considerada una de las novelas más significativas de la posguerra italiana y precursora, en ciertos aspectos, del neorrealismo. Escrita en 1949, la novela le valió ese mismo año el premio Viareggio. Aunque el mismo tema es parte ineludible de otras narraciones como Donne nella Resistenza (1955 o Matrimonio in brigata (1976, todas ellas con un importante transfondo autobiográfico, Renata Viganò sigue siendo hoy en día especialmente recordada por su Agnese va a morire, de la que en 1976 Giuliano Montaldo realizó una exitosa adaptación con la actriz Ingrid Thullin en el papel de Agnese. El fragmento seleccionado, con traducción de Sara Garrote Gutiérrez, se encuentra al inicio de la novela: Agnese acaba de perder a su marido, Palita, muerto en una prisión nazi a la que ha ido a parar tras la denuncia de una vecina que vio cómo escondía a un desertor, y, poco a poco, empieza a colaborar con los grupos partisanos de la zona.

  11. 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

  12. 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.

  13. The use of VA Disability Compensation and Social Security Disability Insurance among working-aged veterans.

    Science.gov (United States)

    Wilmoth, Janet M; London, Andrew S; Heflin, Colleen M

    2015-07-01

    Although there is substantial disability among veterans, relatively little is known about working-aged veterans' uptake of Department of Veterans Affairs (VA) Disability Compensation and Social Security Disability Insurance (DI). This study identifies levels of veteran participation in VA disability and/or DI benefit programs, examines transitions into and out of VA and DI programs among veterans, and estimates the size and composition of the veteran population receiving VA and/or DI benefits over time. Data from the 1992, 1993, 1996, 2001, 2004, and 2008 Survey of Income and Program Participation (SIPP) are used to describe VA and DI program participation among veterans under the age of 65. The majority of working-aged veterans do not receive VA or DI benefits and joint participation is low, but use of these programs has increased over time. A higher percentage of veterans receive VA compensation, which ranges from 4.9% in 1992 to 13.2% in 2008, than DI compensation, which ranges from 2.9% in 1992 to 6.7% in 2008. The rate of joint participation ranges from less than 1% in 1992 to 3.6% in 2008. Veterans experience few transitions between VA and DI programs during the 36-48 months they are observed. The number of veterans receiving benefits from VA and/or DI nearly doubled between 1992 and 2008. There have been substantial shifts in the composition of veterans using these programs, as cohorts who served prior to 1964 are replaced by those who served after 1964. The findings suggest potential gaps in veterans' access to disability programs that might be addressed through improved coordination of VA and DI benefits. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Continuation of Iranshahri Thoughts in Kalileh va Demne

    Directory of Open Access Journals (Sweden)

    Bijan Zahirinav

    2010-10-01

    Full Text Available In this essay, Iranshahri’s thoughts such as ideal king, divine charisma, togetherness of religion and kingdom, justice, truth etc in kalileh va Demneh are investigated. In Kalileh and Demneh, kingdom is a divine gift and the king is at the center of the state affairs. Therefore, affection and kindness must be imprinted on his forehead, otherwise he would be a devilish creature who disturbs governing orders of the universe. He must metaphysically be supported in the circus of governmental affairs, and this is possible only by divine charisma. Such a king must be decorated with justice ornament, so that every body does his best in his own special class and approaches the salvation of soul. The king must also be decorated with accomplishments such as battle assistance and with virtues such as religion assistance. He must strengthen the social connection by “truth”. Basically, without truth life has no harmony because falsehood diverts life form its regular direction. But finally, with the dominance of divine forces over devilish ones, utopia, which is a secure place for releasing from disorder and injustice is proven to be true. Therefore, we conclude that Kalileh and Demneh has a contribution to the continuation of Iranshahri’s thoughts and also to the historical and cultural continuation of Iran in transition to the Islamic period.

  15. Test-retest reliability of the VA National Center for Patient Safety culture questionnaire.

    Science.gov (United States)

    Shiner, Brian; Ronconi, Julia M; McKnight, Scott; Young-Xu, Yinong; Mills, Peter D; Watts, Bradley V

    2016-12-01

    Patient safety culture may have a significant influence on safety processes and outcomes. Therefore, it is important to have valid tools to measure patient safety culture in order to identify potential levers for cultural change that could improve patient safety. The 65-item Department of Veterans Affairs Patient Safety Culture Survey (VA PSCS) consists of 14 dimensions and is administered biannually to VA employees. Test-retest reliability of the VA PSCS has not been established. We conducted repeated administrations of the VA PSCS among 28 VA employees. We measured intraclass correlation coefficients for each item and dimension. Test-retest intraclass correlation coefficient values were 0.7 or greater for 13 out of 14 dimensions of the VA PSCS. Employees had difficulty reliably reporting how others feel about patient safety. In general, the VA PSCS survey showed adequate test-retest reliability. Items asking what others think or feel showed lower reliability. Further work is needed to better understand the relationship between safety culture, safety processes and safety outcomes. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

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

    Directory of Open Access Journals (Sweden)

    Edward Fottrell

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

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

    Science.gov (United States)

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

    2015-01-01

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

  18. 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.

  19. Characteristics and VA Health Care Utilization of U.S. Veterans Who Completed Suicide in Oregon between 2000 and 2005

    Science.gov (United States)

    Basham, Chandra; Denneson, Lauren M.; Millet, Lisa; Shen, Xun; Duckart, Jonathan; Dobscha, Steven K.

    2011-01-01

    Oregon Violent Death Reporting System data were linked with Veterans Affairs (VA) administrative data to identify and describe veterans who completed suicide in Oregon from 2000 to 2005 (n = 968), and to describe their VA health care utilization in the year prior to death. Twenty-two percent had received health care in the VA system. Of these, 57%…

  20. A role for myosin Va in cerebellar plasticity and motor learning: a possible mechanism underlying neurological disorder in myosin Va disease.

    Science.gov (United States)

    Miyata, Mariko; Kishimoto, Yasushi; Tanaka, Masahiko; Hashimoto, Kouichi; Hirashima, Naohide; Murata, Yoshiharu; Kano, Masanobu; Takagishi, Yoshiko

    2011-04-20

    Mutations of the myosin Va gene cause the neurological diseases Griscelli syndrome type 1 and Elejalde syndrome in humans and dilute phenotypes in rodents. To understand the pathophysiological mechanisms underlying the neurological disorders in myosin Va diseases, we conducted an integrated analysis at the molecular, cellular, electrophysiological, and behavioral levels using the dilute-neurological (d-n) mouse mutant. These mice manifest an ataxic gait and clonic seizures during postnatal development, but the neurological disorders are ameliorated in adulthood. We found that smooth endoplasmic reticulum (SER) rarely extended into the dendritic spines of Purkinje cells (PCs) of young d-n mice, and there were few, if any, IP(3) receptors. Moreover, long-term depression (LTD) at parallel fiber-PC synapses was abolished, consistent with our previous observations in juvenile lethal dilute mutants. Young d-n mice exhibited severe impairment of cerebellum-dependent motor learning. In contrast, adult d-n mice showed restoration of motor learning and LTD, and these neurological changes were associated with accumulation of SER and IP(3) receptors in some PC spines and the expression of myosin Va proteins in the PCs. RNA interference-mediated repression of myosin Va caused a reduction in the number of IP(3) receptor-positive spines in cultured PCs. These findings indicate that myosin Va function is critical for subsequent processes in localization of SER and IP(3) receptors in PC spines, LTD, and motor learning. Interestingly, d-n mice had defects of motor coordination from young to adult ages, suggesting that the role of myosin Va in PC spines is not sufficient for motor coordination.

  1. 75 FR 3970 - Fund Availability Under the VA Homeless Providers Grant and Per Diem Program

    Science.gov (United States)

    2010-01-25

    ... accordance with their ranked order until funding is expended (approximately 900 beds). Methodology: VA will... respective funding category based on score and any ranking criteria set forth in that funding category only...

  2. 75 FR 3968 - Fund Availability Under the VA Homeless Providers Grant and Per Diem Program

    Science.gov (United States)

    2010-01-25

    ... accordance with their ranked order until funding is expended (approximately $19 million). Methodology: VA... then be ranked within their respective funding category based on score and any ranking criteria set...

  3. EnviroAtlas -- Virginia Beach/Williamsburg, VA -- Meter-Scale Urban Land Cover (MULC)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Virginia Beach, VA EnviroAtlas Meter-scale Urban Land Cover (MULC) dataset comprises 3,724 km2 of southeast Virginia and includes Hampton, Newport News, Suffolk,...

  4. 75 FR 77664 - Vaughan Furniture Company, Galax, VA; Notice of Affirmative Determination Regarding Application...

    Science.gov (United States)

    2010-12-13

    ... Employment and Training Administration Vaughan Furniture Company, Galax, VA; Notice of Affirmative... apply for Trade Adjustment Assistance (TAA) applicable to workers and former workers of Vaughn Furniture... workers supply administrative and support services in support of furniture production at foreign...

  5. 75 FR 41577 - VBA/VHA Musculoskeletal Forum: Improving VA's Disability Evaluation Criteria

    Science.gov (United States)

    2010-07-16

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

  6. 76 FR 10524 - Restricted Area, Potomac River, Marine Corps Base Quantico, Quantico, VA

    Science.gov (United States)

    2011-02-25

    ... Quantico, Quantico, VA AGENCY: United States Army Corps of Engineers, Department of Defense ACTION: Final... Base Quantico (MCB Quantico), located in Quantico, Virginia. DATES: Effective March 7, 2011. FOR...

  7. 78 FR 18425 - Proposed Information Collection VA Police Officer Pre-Employment Screening Checklist); Comment...

    Science.gov (United States)

    2013-03-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Proposed Information Collection VA Police Officer Pre-Employment Screening Checklist); Comment Request AGENCY: Office of Operations, Security, and Preparedness, Department of Veterans Affairs. ACTION...

  8. 78 FR 38452 - Agency Information Collection (VA Police Officer Pre-Employment Screening Checklist) Activities...

    Science.gov (United States)

    2013-06-26

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

  9. 77 FR 23204 - VA Acquisition Regulation: Electronic Submission of Payment Requests

    Science.gov (United States)

    2012-04-18

    ... Presentment and Payment System; (2) American National Standards Institute (ANSI) X12 electronic data... vendor payment process. The automated data validation, digital transmission, and expedited payment and... payments by including automated invoice data validation checks. VA's electronic invoicing system would...

  10. EnviroAtlas - Virginia Beach/Williamsburg, VA - BenMAP Results by Block Group

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 1057 block groups in Virginia Beach/Williamsburg, VA....

  11. Federal Policy and the Rise in Disability Enrollment: Evidence for the VA's Disability Compensation Program

    OpenAIRE

    Mark Duggan; Robert Rosenheck; Perry Singleton

    2006-01-01

    The U.S. Department of Veterans' Affairs (VA) currently provides disability benefits to 2.72 million veterans of U.S. military service through the Disability Compensation (DC) program. Until recently, the medical eligibility criteria for this program were the same across service eras, with the key condition being that the disability was caused or aggravated by military service. But in July of 2001, the VA relaxed the eligibility criteria for Vietnam veterans by including diabetes in the list ...

  12. 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...

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

    Science.gov (United States)

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

    2015-01-01

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

  14. 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.

  15. 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.

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

    Science.gov (United States)

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

    2017-12-01

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

  17. 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/.

  18. 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

  19. 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.

  20. 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 …

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    Humberto Banda Ortiz

    2014-07-01

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

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

    Science.gov (United States)

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

    2014-05-01

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

  4. 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

    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...member and Veteran X X Allowance for Aid and Attendance for Housebound Veterans VA/ VBA Veteran X X X Appendix III

  5. 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...... changes in the VA and VCD spectra are used as a check of the Becke 3LYP hybrid model to successfully reproduce these fine features in the VA and VCD intensities. Furthermore, several aspects of the isotopomers and the isotope effects on vibrational spectra are discussed in the light of the approximation......, i.e., validity of Born-Oppenheimer approximation. (C) 2002 Elsevier Science B.V. All rights reserved....

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

    Science.gov (United States)

    Tsai, Jack; Rosenheck, Robert A

    2015-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Ja'nel Esterhuysen

    2012-05-01

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

  8. 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.

  9. Performance-based budgeting in the public sector: an illustration from the VA health care system.

    Science.gov (United States)

    Yaisawarng, Suthathip; Burgess, James F

    2006-03-01

    This paper estimates frontier cost functions for US Department of Veterans Affairs (VA) hospitals in FY2000 that are consistent with economic theory and explicitly account for cost differences across patients' risk, level of access to care, quality of care, and hospital-specific characteristics. Results indicate that on average VA hospitals in FY2000 operate at efficiency levels of 94%, as compared to previous studies on US private sector hospitals that average closer to 90% efficient. Using these cost frontiers, management systems potentially could be implemented to enhance the equitable allocation of the VA medical care global budget and systematically distribute funds across hospitals and networks. The paper also provides recommendations to improve the efficiency of delivering health care services applicable to public sector organizations. Copyright 2005 John Wiley & Sons, Ltd.

  10. 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.

  11. 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.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2016-03-31

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

  14. Improving PTSD/substance abuse treatment in the VA: a survey of providers.

    Science.gov (United States)

    Najavits, Lisa M; Norman, Sonya B; Kivlahan, Daniel; Kosten, Thomas R

    2010-01-01

    We surveyed 205 Veterans Affairs (VA) staff on treatment of posttraumatic stress disorder (PTSD), substance use disorder (SUD), and the combination (PTSD/SUD). The survey was anonymous and VA-wide. PTSD/SUD was perceived as more difficult to treat than either disorder alone; gratification in the work was stronger than difficulty (for PTSD, SUD, and PTSD/SUD); and difficulty and gratification appeared separate constructs. Respondents endorsed views that represent expert treatment for the comorbidity; however, there was also endorsement of "myths." Thus, there is a need for more training, policy clarifications, service integration, and adaptations for veterans returning from Iraq and Afghanistan. Limitations are described.

  15. 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... reintegration such as life-skills education, recreational activities, and follow up case management; (3) Ensure... education. Through this NOFA, VA seeks to renew the FY 2009 previous grant and per diem Special Need...

  16. 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

  17. 77 FR 20889 - Proposed Information Collection (Request One-VA Identification Verification Card) Activity...

    Science.gov (United States)

    2012-04-06

    ... AFFAIRS Proposed Information Collection (Request One-VA Identification Verification Card) Activity... certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information...

  18. 77 FR 38396 - Agency Information Collection (One-VA Identification Verification Card) Activities Under OMB Review

    Science.gov (United States)

    2012-06-27

    ... AFFAIRS Agency Information Collection (One-VA Identification Verification Card) Activities Under OMB... Affairs, will submit the collection of information abstracted below to the Office of Management and Budget (OMB) for review and comment. The PRA submission describes the nature of the information collection and...

  19. 78 FR 6849 - Agency Information Collection (Verification of VA Benefits) Activity Under OMB Review

    Science.gov (United States)

    2013-01-31

    ... AFFAIRS Agency Information Collection (Verification of VA Benefits) Activity Under OMB Review AGENCY....gov . Please refer to ``OMB Control No. 2900-0406.'' SUPPLEMENTARY INFORMATION: Title: Verification of... Veterans Benefits Administration, Department of Veterans Affairs will submit the collection of information...

  20. Myosin Va and Endoplasmic Reticulum Calcium Channel Complex Regulates Membrane Export during Axon Guidance

    Directory of Open Access Journals (Sweden)

    Fumitaka Wada

    2016-05-01

    Full Text Available During axon guidance, growth cones navigate toward attractive cues by inserting new membrane on the cue side. This process depends on Ca2+ release from endoplasmic reticulum (ER Ca2+ channels, but the Ca2+ sensor and effector governing this asymmetric vesicle export remain unknown. We identified a protein complex that controls asymmetric ER Ca2+-dependent membrane vesicle export. The Ca2+-dependent motor protein myosin Va (MyoVa tethers membrane vesicles to the ER via a common binding site on the two major ER Ca2+ channels, inositol 1,4,5-trisphosphate and ryanodine receptors. In response to attractive cues, micromolar Ca2+ from ER channels triggers MyoVa-channel dissociation and the movement of freed vesicles to the cue side, enabling growth cone turning. MyoVa-Ca2+ channel interactions are required for proper long-range axon growth in developing spinal cord in vivo. These findings reveal a peri-ER membrane export pathway for Ca2+-dependent attraction in axon guidance.

  1. 38 CFR 74.29 - When will VA dispose of records?

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.29 When will VA dispose of records? The records, including those pertaining to businesses not determined to be eligible for the program... of the last Notice of Verified Status Approval letter. Longer retention will not be required unless a...

  2. 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)

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

    Science.gov (United States)

    Alper, Paul

    2014-01-01

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

  4. Implementing the KiVa Antibullying Program: Recognition of Stable Victims

    Science.gov (United States)

    Haataja, Anne; Sainio, Miia; Turtonen, Mira; Salmivalli, Christina

    2016-01-01

    Teachers do not always recognise students who are victimised by their peers. In this study, we examined the recognition of stable victims in 76 schools beginning to implement the KiVa antibullying programme. We focused on 348 victims (9-15 years) who reported victimisation at the pretest and still at wave 2, after five months of programme…

  5. Instructional Applications of Virginia's Public Education Network (VA PEN): Thomas Jefferson On-Line.

    Science.gov (United States)

    Willett-Smith, Stephanie

    The motivational value of Virginia's Public Education Network (VA PEN), specifically the Thomas Jefferson On-line discussion group, is examined in this study. The instructional value of the network with respect to student motivation in fourth grade students of varied ability was gauged through observation of actual hands-on network experience,…

  6. 77 FR 35848 - Safety Zone, Fourth of July Fireworks Event, Pagan River, Smithfield, VA

    Science.gov (United States)

    2012-06-15

    ..., VA will sponsor a fireworks display on the navigable waters of the Pagan River shoreline centered on... the navigable waters of the Pagan River within the area bounded by a 420-foot radius circle centered.... Small businesses may send comments on the actions of Federal employees who enforce, or otherwise...

  7. 78 FR 56151 - Safety Zone, North Atlantic Ocean; Virginia Beach, VA

    Science.gov (United States)

    2013-09-12

    ... designated area in order to protect the life and property of the maritime public and spectators from the... event area. The Coast Guard will provide advance notifications to users of the affected waterways of the... offshore between 17th and 31st Streets of Virginia Beach, VA. The fireworks debris fallout area will extend...

  8. Data of evolutionary structure change: 1DUIA-2G4VA [Confc[Archive

    Lifescience Database Archive (English)

    Full Text Available 1DUIA-2G4VA 1DUI 2G4V A A --AKCVSYGVSQIKAPALHS-----QGYTGSNVKVAVID...H - HHHHHHHHHH EEE - 0 1DUI... A 1DUIA GTVLA----VAPSA ALA CA 375 ARG CA 304 ASN CA 261 1DUI... A 1DUIA AGNEGTSGSSSTV

  9. 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).

  10. 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).

  11. Data of evolutionary structure change: 1A4VA-1YAPA [Confc[Archive

    Lifescience Database Archive (English)

    Full Text Available 1A4VA-1YAPA 1A4V 1YAP A A KQFTKCELSQLLKDI--DGYGGIALPELICTMFHTSGYDTQAIVEN--NESTEYGL...1YAP A 1YAPA TLKRLGMDGYRG...1YAP A 1YAPA ATNYNAGDRSTD...1YAP A 1YAPA RVVRDPQGIRA ...1YAP A 1YAPA NRCQNRDVRQY

  12. PSO-based optimization of PI regulator and VA loading of a SRF ...

    African Journals Online (AJOL)

    It is desirable to have optimization of PI components and generate the reference compensate voltages for series active filters (SAF) of MC-DVR. Therefore, series active filters help to inject optimal voltages at optimal angle in such a way that a minimum VA loading of MCDVR is possible. The optimal value PI components and ...

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

    NARCIS (Netherlands)

    Garandeau, Claire F.|info:eu-repo/dai/nl/380715066; Lee, Ihno A.; Salmivalli, Christina

    2014-01-01

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

  14. 76 FR 44279 - Radio Broadcasting Services; Clinchco, VA, and Coal Run, KY

    Science.gov (United States)

    2011-07-25

    ... COMMISSION 47 CFR Part 73 Radio Broadcasting Services; Clinchco, VA, and Coal Run, KY AGENCY: Federal... reinstates and grants a rulemaking petition filed by East Kentucky Broadcasting Corporation (``East Kentucky... the Radio Broadcast Services, Report and Order, 71 FR 76208 (December 20, 2006). This document is not...

  15. 76 FR 6327 - Restricted Area, Potomac River, Marine Corps Base Quantico, Quantico, VA

    Science.gov (United States)

    2011-02-04

    ... Quantico, Quantico, VA AGENCY: U.S. Army Corps of Engineers, DoD. ACTION: Final rule. SUMMARY: The U.S... Base Quantico (MCB Quantico), located in Quantico, Virginia. The restricted area will address current security needs at MCB Quantico, including the protection of military assets at MCAF which includes the...

  16. 75 FR 53264 - United States Marine Corps, Marine Corps Base Quantico, Quantico VA; Restricted Area

    Science.gov (United States)

    2010-08-31

    ... Quantico, Quantico VA; Restricted Area AGENCY: U.S. Army Corps of Engineers, Department of Defense. ACTION... River in the vicinity of Marine Corps Base (MCB) Quantico, located in Quantico, Virginia. The... MCB Quantico, including protection of military assets at the Marine Corps Air Facility (MCAF) Quantico...

  17. 78 FR 27882 - VA Veteran-Owned Small Business (VOSB) Verification Guidelines

    Science.gov (United States)

    2013-05-13

    ... be included in the rule, and if so, what should be on the list? 3. Are there changes to VA's... Center for Veterans Enterprise use to distinguish legitimate VOSBs/ SDVOSBs from businesses that... VOSBs/ SDVOSBs help the Government ensure that contracts are awarded to legitimate VOSBs/SDVOSBs...

  18. 75 FR 76953 - Foreign-Trade Zone 238-Dublin, VA Site Renumbering Notice

    Science.gov (United States)

    2010-12-10

    ... Foreign-Trade Zones Board Foreign-Trade Zone 238--Dublin, VA Site Renumbering Notice Foreign-Trade Zone 238 was approved by the Foreign-Trade Zones Board on August 5, 1999 (Board Order 1047). FTZ 238... information, contact Maureen Hinman at [email protected]trade.gov or (202) 482-0627. Dated: December 1, 2010...

  19. 75 FR 76953 - Foreign-Trade Zone 207-Richmond, VA Site Renumbering Notice

    Science.gov (United States)

    2010-12-10

    ... Foreign-Trade Zones Board Foreign-Trade Zone 207--Richmond, VA Site Renumbering Notice Foreign-Trade Zone 207 was approved by the Foreign-Trade Zones Board on March 31, 1995 (Board Order 733) and expanded on... Drive, Ashland. For further information, contact Maureen Hinman at [email protected]trade.gov or (202) 482...

  20. 38 CFR 59.5 - Submissions of information and documents to VA.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Submissions of information and documents to VA. 59.5 Section 59.5 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59.5...

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

    African Journals Online (AJOL)

    The study explores the relevance and quality of the VaRemba initiation school curriculum and analyses its impact on formal education. A case study design was used to come up with a descriptive, interpretive as well as an evaluative account of the initiation curriculum and its impact on formal schooling in Chomusenda ...

  2. Racial and ethnic disparities in the VA health care system: a systematic review.

    Science.gov (United States)

    Saha, Somnath; Freeman, Michele; Toure, Joahd; Tippens, Kimberly M; Weeks, Christine; Ibrahim, Said

    2008-05-01

    To better understand the causes of racial disparities in health care, we reviewed and synthesized existing evidence related to disparities in the "equal access" Veterans Affairs (VA) health care system. We systematically reviewed and synthesized evidence from studies comparing health care utilization and quality by race within the VA. Racial disparities in the VA exist across a wide range of clinical areas and service types. Disparities appear most prevalent for medication adherence and surgery and other invasive procedures, processes that are likely to be affected by the quantity and quality of patient-provider communication, shared decision making, and patient participation. Studies indicate a variety of likely root causes of disparities including: racial differences in patients' medical knowledge and information sources, trust and skepticism, levels of participation in health care interactions and decisions, and social support and resources; clinician judgment/bias; the racial/cultural milieu of health care settings; and differences in the quality of care at facilities attended by different racial groups. Existing evidence from the VA indicates several promising targets for interventions to reduce racial disparities in the quality of health care.

  3. 75 FR 33273 - Final Environmental Impact Statement (FEIS) for Disposal and Reuse of Fort Monroe, VA

    Science.gov (United States)

    2010-06-11

    ... Department of the Army Final Environmental Impact Statement (FEIS) for Disposal and Reuse of Fort Monroe, VA... socioeconomic impacts associated with the disposal and reuse of Fort Monroe, Virginia. DATES: The waiting period... reuse of Fort Monroe. The 2005 BRAC Commission Report directed the closure of Fort Monroe 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. BUILDING A GIS DATABASE FOR A TYPICAL URBAN SETTING v(A ...

    African Journals Online (AJOL)

    Ada

    SETTING v(A CASE STUDY OF THE F.U.T. YOLA MAIN. CAMPUS). A. A. MUSA. (Received 28 August, 2009; Revision Accepted 2 November 2007). ABSTRACT. An attempt is being ... University of Technology Yola (FUTY) campus has made access to .... details of the hostels were collected from the porters of each hostel.

  6. 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

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

    Science.gov (United States)

    2016-04-01

    30According to VA, public order offenses include weapons offenses, prostitution , public intoxication, disorderly conduct, and driving while...Nevada 275 Arkansas 318 New Hampshire 75 California 1,202 New Jersey 53 Colorado 402 New Mexico 92 Connecticut 201 New York 886 Delaware 73

  8. Data of evolutionary structure change: 1A9VA-1NEPA [Confc[Archive

    Lifescience Database Archive (English)

    Full Text Available 1A9VA-1NEPA 1A9V 1NEP A A SQVDVKDCANHE--IKKVLVPGCHGSEPCIIHRGKPFQLEAVFEANQNTKTAKIEI...1NEP A 1NEPA GCKSGIRCPIE ...1NEP A 1NEPA TDDKNQRFFCW ...1NEP A 1NEPA NVSPC-PTQPC ...1NEP A 1NEPA LPVKN-EYPSI

  9. 38 CFR 1.218 - Security and law enforcement at VA facilities.

    Science.gov (United States)

    2010-07-01

    ... not reside in quarters on the property, is prohibited. Acts of prostitution or solicitation for acts of prostitution on VA property is prohibited. For the purposes of this paragraph, an act of prostitution is defined as the performance or the offer or agreement to perform any sexual act for money or...

  10. 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.

  11. 48 CFR 803.7000 - Display of the VA Hotline poster.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Display of the VA Hotline poster. 803.7000 Section 803.7000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS GENERAL IMPROPER BUSINESS PRACTICES AND PERSONAL CONFLICTS OF INTEREST Contractor Responsibility to Avoid...

  12. 77 FR 64388 - Agency Information Collection (Former POW Medical History), VA Form 10-0048 Activities Under OMB...

    Science.gov (United States)

    2012-10-19

    ... comment. The PRA submission describes the nature of the information collection and its expected cost and... AFFAIRS Agency Information Collection (Former POW Medical History), VA Form 10-0048 Activities Under OMB....'' SUPPLEMENTARY INFORMATION: Title: Former POW Medical History, VA Form 10-0048. OMB Control Number: 2900-0427...

  13. 75 FR 24510 - Drug and Drug-Related Supply Promotion by Pharmaceutical Company Sales Representatives at VA...

    Science.gov (United States)

    2010-05-05

    ... ethical conduct. Pharmaceutical sales representatives have heavy interaction with local VA staff each year... de minimis value set forth in the standards of ethical conduct for Federal employees, and would.... Currently, Sec. 1.218, regarding security and law enforcement at VA facilities, describes general behavior...

  14. 33 CFR 334.340 - Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area.

    Science.gov (United States)

    2010-07-01

    ... Island, Hampton, Va.; Air Force precision test area. 334.340 Section 334.340 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.340 Chesapeake Bay off Plumtree Island, Hampton, Va.; Air Force precision test area. (a) The...

  15. 75 FR 32240 - Draft Tier II Environmental Impact Statement: Southeast High Speed Rail Corridor-Richmond, VA...

    Science.gov (United States)

    2010-06-07

    ... Federal Railroad Administration Draft Tier II Environmental Impact Statement: Southeast High Speed Rail... Draft Environmental Impact Statement and public hearings for the Southeast High Speed Rail, Richmond, VA... availability of the Southeast High Speed Rail, Richmond, VA to Raleigh, NC Project Draft Tier II Environmental...

  16. 75 FR 51331 - Draft Tier II Environmental Impact Statement: Southeast High Speed Rail Corridor-Richmond, VA...

    Science.gov (United States)

    2010-08-19

    ... Federal Railroad Administration Draft Tier II Environmental Impact Statement: Southeast High Speed Rail... the Tier II Draft Environmental Impact Statement for the Southeast High Speed Rail, Richmond, VA to... the Draft Tier II Environmental Impact Statement for the Southeast High Speed Rail, Richmond, VA to...

  17. 77 FR 12997 - Drug and Drug-Related Supply Promotion by Pharmaceutical Company Representatives at VA Facilities

    Science.gov (United States)

    2012-03-05

    ... disruption in the patient care environment, manage activities and promotions at VA facilities, and provide... also clarify that this rulemaking does not alter the well-established practice for learning about... commenter requested that VA clarify that the provision of journal articles that increase the reader's...

  18. 78 FR 68364 - Payment for Home Health Services and Hospice Care to Non-VA Providers; Delay of Effective Date

    Science.gov (United States)

    2013-11-14

    ...The Department of Veterans Affairs (VA) published in the Federal Register on May 6, 2013 (78 FR 26250) a final rule to change the billing methodology for non-VA providers of home health services and hospice care. The preamble of that final rule stated the effective date was November 15, 2013. This document delays that effective date to April 1, 2014.

  19. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for emergency cardiac support.

    Science.gov (United States)

    Sun, Terri; Guy, Andrew; Sidhu, Amandeep; Finlayson, Gordon; Grunau, Brian; Ding, Lillian; Harle, Saida; Dewar, Leith; Cook, Richard; Kanji, Hussein D

    2017-10-12

    Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may provide benefit to patients in refractory cardiac arrest and cardiogenic shock. We aim to summarize our center's 6-year experience with resuscitative VA-ECMO. A retrospective medical record review (April 2009 to 2015) was performed on consecutive non-cardiotomy patients who were managed with VA-ECMO due to refractory in- or out-of-hospital cardiac (IHCA/OHCA) arrest (E-CPR) or refractory cardiogenic shock (E-CS) with or without preceding cardiac arrest. Our primary outcome was survival to hospital discharge and good neurological status (Cerebral Performance Category 1-2). There were a total of 22 patients who met inclusion criteria of whom 9 received E-CPR (8 IHCA, 1 OHCA) and 13 received E-CS. The median age for E-CPR patients was 52 [IQR 45, 58] years, and 54 [IQR 38, 64] years for E-CS patients. Cardiac arrest duration was 70.33 (SD 39.56) min for the E-CPR patients, and 24.67 (SD 26.73) min for the 9 patients treated with E-CS who had previously arrested. Initial cardiac arrest rhythms were pulseless electrical activity (39%), ventricular fibrillation (33%), or ventricular tachycardia (28%). A total of 18/22 patients were successfully weaned from VA-ECMO (78%); 16 patients survived to hospital discharge (73%) with 15 in good neurological condition. The initiation of VA-ECMO at our center for treatment of refractory cardiac arrest and cardiogenic shock yielded a high proportion of survivors and favorable neurological outcomes. Copyright © 2017. Published by Elsevier Inc.

  20. 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.

  1. DOE Spent Nuclear Fuel Information In Support of TSPA-VA

    Energy Technology Data Exchange (ETDEWEB)

    A. Brewer; D. Cresap; D. Fillmore; H. Loo; M. Ebner; R. McCormack

    1998-09-01

    RW has started the viability assessment (VA) effort to determine the feasibility of Yucca Mountain as the first geologic repository for spent nuclear fuel (SNF) and high-level waste. One component of the viability assessment will be a total system performance assessment (TSPA), based on the design concept and the scientific data and analysis available, describing the repository's probable behavior relative to the overall system performance standards. Thus, all the data collected from the Exploratory Studies Facility to-date have been incorporated into the latest TSPA model. In addition, the Repository Integration Program, an integrated probabilistic simulator, used in the TSPA has also been updated by Golder Associates Incorporated at December 1997. To ensure that the Department of Energy-owned (DOE-owned) SNF continues to be acceptable for disposal in the repository, it will be included in the TSPA-VA evaluation. A number of parameters are needed in the TSPA-VA models to predict the performance of the DOE-owned SNF materials placed into the potential repository. This report documents all of the basis and/or derivation for each of these parameters. A number of properties were not readily available at the time the TSPA-VA data was requested. Thus, expert judgement and opinion was utilized to determine a best property value. The performance of the DOE-owned SNF will be published as part of the TSPA-VA report. Each DOE site will be collecting better data as the DOE SNF program moves closer to repository license application. As required by the RW-0333P, the National Spent Nuclear Fuel Program will be assisting each site in qualifying the information used to support the performance assessment evaluations.

  2. Evaluation of VA Women's Health Fellowships: developing leaders in academic women's health.

    Science.gov (United States)

    Tilstra, Sarah A; Kraemer, Kevin L; Rubio, Doris M; McNeil, Melissa A

    2013-07-01

    The Department of Veterans Affairs (VA) instituted the VA Women's Health Fellowship (VAWHF) Program in 1994, to accommodate the health needs of increasing numbers of female veterans and to develop academic leaders in women's health. Despite the longevity of the program, it has never been formally evaluated. To describe the training environments of VAWHFs and career outcomes of female graduates. Cross-sectional web-based surveys of current program directors (2010-2011) and VAWHF graduates (1995-2011). Responses were received from six of seven program directors (86 %) and 42 of 74 graduates (57 %). The mean age of graduates was 41.2 years, and mean time since graduation was 8.5 years. Of the graduates, 97 % were female, 74 % trained in internal medicine, and 64 % obtained an advanced degree. Those with an advanced degree were more likely than those without an advanced degree to pursue an academic career (82 % vs. 60 %; Pwomen's health and spend up to 66 % of their time devoted to women's health issues. Thirty percent have held a VA faculty position. Seventy-nine percent remain in academics, with 39 % in the tenure stream. Overall, 94 % had given national presentations, 88 % had received grant funding, 79 % had published in peer-reviewed journals, 64 % had developed or evaluated curricula, 51 % had received awards for teaching or research, and 49 % had held major leadership positions. At 11 or more years after graduation, 33 % of the female graduates in academics had been promoted to the rank of associate professor and 33 % to the rank of full professor. The VAWHF Program has been successful in training academic leaders in women's health. Finding ways to retain graduates in the VA system would ensure continued clinical, educational, and research success for the VA women veteran's healthcare program.

  3. 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.

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

    Science.gov (United States)

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

    2015-10-01

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

  5. 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

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

    Directory of Open Access Journals (Sweden)

    Fenglan Li

    2017-01-01

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

  7. Néhány megjegyzés a pannóniai víznevek legrégibb rétegéhez I. Sáva/Száva/Save [Comments on the oldest layer of Pannonian river-names Part 1: Sáva/Száva/Save

    Directory of Open Access Journals (Sweden)

    Bichlmeier, Harald

    2016-12-01

    Full Text Available Research on Old-European river-names was started some 70 years ago by HANS KRAHE. Unfortunately, the methods of such research have not changed much over the last decades, while Indo-European linguistics has progressed immensely under the same period. The time has come to take a fresh look at the names which form the oldest layer of linguistic material available in Central Europe. As an example of this new methodology the paper presents a thorough probe into the river-name Sáva/Száva/Save. On the one hand, a number of new insights can be gained, on the other hand, the fact that simple, one and only solutions are a thing of the past must be accepted.

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

    Science.gov (United States)

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

    2013-05-01

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

  9. The VA's affiliation with academic medicine: an emergency post-war strategy becomes a permanent partnership.

    Science.gov (United States)

    Gronvall, J A

    1989-02-01

    The creation of a cabinet-level department for veterans' programs is an occasion to review medical care of American military veterans, which dates back to colonial times. To meet the medical care crisis caused by large numbers of returning World War II veterans, the Veterans Administration (VA) entered into affiliations with U.S. medical schools, a partnership that provided physicians for veterans and allowed residents to complete graduate medical education. Increasing medical care needs of veterans of World War II and successive conflicts, and legislatively expanded entitlements, have contributed to sustained growth of the VA workload--which in turn has led to an expanded partnership with schools of medicine and allied health sciences. The affiliations continue to serve both partners well and to contribute substantively to society at large by fostering the production of medical manpower and advances in biomedical research.

  10. 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

    absorption (VA) spectroscopy can be used as a useful tool in medical diagnostics that provides in principle additional information and detail to that which can be obtained/provided from conventional histological studies, and more conventional mass spectroscopic and NMR techniques. The use of high level......In this work we have used Fourier transform infrared (FTIR) / vibrational absorption (VA) spectroscopy to study two cancer cell lines: the Henrietta Lacks (HeLa) human cervix carcinoma and 5637 human bladder carcinoma cell lines. Our goal is to experimentally investigate biochemical changes...... and differences in these cells lines utilizing FTIR spectroscopy. We have used the chemometrical and statistical method principal component analysis (PCA) to investigate the spectral differences. We have been able to identify certain bands in the spectra which are so-called biomarkers for two types of cell lines...

  11. The role of cVA and the Odorant binding protein Lush in social and sexual behavior in Drosophila melanogaster

    Directory of Open Access Journals (Sweden)

    Jean-Christophe eBilleter

    2015-07-01

    Full Text Available Social living is beneficial because it allows conspecifics to interact in ways that increase their chances of survival and reproduction. A key mechanism underlying these benefits is the ability to recognize conspecifics; thus, allowing the production of coordinated social interactions. Identification of such individuals is often through chemical communication: the individuals’ pheromonal profile indicates their sex, species and even past experiences. However we know little about how the chemosensory system of conspecifics detects and how the nervous system processes this information. One of the best documented pheromonal detection mechanism is that of cis-Vaccenyl Acetate (cVA made by male Drosophila melanogaster and transferred to females during mating. Sensing of cVA by males inhibits courtship behavior towards already mated females. Sensing of cVA on other males also inhibits courtship and increases aggression. In this hybrid review/research article, we discuss the pheromonal system of Drosophila putting an emphasis on the molecular and cellular mechanisms involved in cVA sensing by the olfactory system, perception by the nervous system and ultimately the regulation of social interactions. The behavioral effect of cVA is context- as well as experience-dependent leading us to conclude that cVA plays a modulatory role in regulating social interactions rather than being a recognition pheromone. We also provide new behavioral data on the function of the Odorant Binding Protein Lush, which binds cVA in olfactory sensilla and help sensing this chemical. Our data indicate that lush may be involved in the sensing of additional pheromones to cVA and suggest the existence of a lush-independent cVA detecting system. Interpretation of our data in the light of our current knowledge about pheromonal recognition in Drosophila indicates that this system is still incompletely understood.

  12. Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service: 1999–2004

    Science.gov (United States)

    Humensky, Jennifer; Carretta, Henry; de Groot, Kristin; Brown, Melissa M.; Tarlov, Elizabeth; Hynes, Denise M.

    2012-01-01

    Objective To examine care system choices for Veterans dually-eligible for VA and Medicare FFS following changes in VA eligibility policy, which expanded availability of VA health care services. Data Sources VA and Medicare FFS enrollment and outpatient utilization databases in 1999 and 2004. Study Design: Multinomial logistic regression was used to examine odds of VA-only and Medicare-only utilization, relative to dual utilization, in 1999 and 2004. Observational cohort comprising a 5% random sample of dually-eligible Veterans: 73,721 in 1999 and 125,042 in 2004. Principal Findings From 1999 to 2004, persons with the highest HCC risk scores had decreasing odds of exclusive VA reliance (OR=0.26 in 1999 and 0.17 in 2004, p<0.05), but had increasing odds of exclusive Medicare reliance (OR=0.43 in 1999 and 0.56 in 2004, p<0.05).Persons in high VA priority groups had decreasing odds of exclusive VA reliance, as well as decreasing odds of exclusive Medicare reliance, indicating increasing odds of dual use. Newly eligible Veterans with the highest HCC risk scores had higher odds of dual system use, while newly eligible Black Veterans had lower odds of dual system use. Conclusions Veterans newly eligible for VA healthcare services, particularly those with the highest risk scores, had higher odds of dual system use compared to earlier eligibles. Providers should ensure coordination of care for Veterans who may be receiving care from multiple sources. Provisions of the Patient Protection and Affordable Care Act may help to ensure care coordination for persons receiving care from multiple systems. PMID:24800148

  13. DOD and VA Health Care: Medication Needs during Transitions May Not Be Managed for All Servicemembers

    Science.gov (United States)

    2012-11-01

    6.8 Depression 5. Quetiapine (atypical antipsychotic) 6.0 Depression Pain medications 1. Ibuprofen (nonsteroidal anti-inflammatory) 19.0...pain medication , such as ibuprofen , can typically be done by the servicemember without the supervision of a provider; patients do not typically become...would work with VA to identify best practices such as reducing medication errors . As DOD identifies and applies best practices, it should focus on

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

    NARCIS (Netherlands)

    Kärnä, A.; Voeten, M.J.M.; Little, T.D.; Alanen, E.; Poskiparta, E.H.; Salmivalli, C.

    2013-01-01

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

  15. 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.

  16. Spin Rate of Comet 333P/LINEAR (2007 VA85)

    Science.gov (United States)

    Hicks, Michael; Thackeray, Beverly

    2016-04-01

    Comet 333P/LINEAR was discovered as the near-Earth asteroid 2007 VA85 by the LINEAR asteroid survey (MPEC 2007-V72). Although the object's orbital elements, particularly the exceptionally high inclination, (a,e,i = 4.22 AU, 0.736, 132 deg) were recognized as consistent with the Jupiter-family comets, no coma was detected during the discovery apparition (IAUC 8894).

  17. 78 FR 31840 - Safety Zone; USO Patriotic Festival Air Show, Atlantic Ocean; Virginia Beach, VA

    Science.gov (United States)

    2013-05-28

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; USO Patriotic Festival Air Show, Atlantic... Beach, VA. This action is necessary to provide for the safety of life on navigable waters during the USO... Delegation No. 0170.1. 0 2. Add Sec. 165.T05-0377 to read as follows: Sec. 165.T05-0377 Safety Zone; USO...

  18. 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.

  19. Design of PVP/VA S-630 based tadalafil solid dispersion to enhance the dissolution rate.

    Science.gov (United States)

    Choi, Jin-Seok; Park, Jeong-Sook

    2017-01-15

    Tadalafil (TDF) is a Biopharmaceutics Classification System (BCS) class II drug; the efficacy thereof is critically limited by inherent poor water solubility. Solid dispersion (SD) techniques are widely used to improve the bioavailability of drugs that are poorly water-soluble. Herein, we used an SD technique to improve the solubility and in vitro dissolution rate of TDF; a solvent evaporation method was applied involving the use of hydrophilic carriers (PVP/VA S-630) and assistants (malic acid or meglumine). The TDF-SD formulations were evaluated in terms of the solubility, in vitro dissolution, and stability. Physical properties were confirmed by field-emission scanning electron microscopy, differential scanning calorimetry, powder X-ray diffraction, and Fourier transform infrared spectroscopy (FT-IR). TDF-SD formulations containing assistants (malic acid or meglumine) and various solubilizers exhibited significantly enhanced solubility in distilled water (DW) (up to 27.3-fold; 18.5±0.16μg/mL with PVP/VA S-630) compared with TDF alone (0.73±0.08μg/mL). However, the dissolution rate of malic acid based formulation was decreased as the PVP/VA S-630 content increased compared to meglumine based formulation. Thus, the optimal TDF-SD formulation (TDF/meglumine/PVP/VA S-630/Aerosil 200: 1/3/5/3) exhibited a greater dissolution rate (89.1±3.9%) than TDF alone (6.2±2.5%) and Cialis(®) powder (16.0±1.9%) in DW. The final TDF-SD formulation was amorphous in nature and exhibited good stability. In conclusion, TDF-SD was successfully improved in vitro dissolution rate of TDF compared to commercial products (Cialis(®)) in the dissolution media without sodium lauryl sulfate (SLS). Copyright © 2016 Elsevier B.V. All rights reserved.

  20. 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

  1. Factor analysis of the Rudie-McGaughran Essential-Reactive questionnaire for VA alcoholic men.

    Science.gov (United States)

    Braggio, J T; Pishkin, V; Parsons, O A; Fishkin, S M; Tassey, J R; Her, C

    1992-06-01

    In this study factor analysis was used to estimate the validity of the Rudie-McGaughran Essential-Reactive questionnaire. Answers of VA alcoholic men were tape-recorded and scored using the Rudie and McGaughran criteria. Only 2 factors, economic dependence and gastrointestinal symptoms, were validated using factor analysis. Five of the remaining six factors evaluated dimensions of dependence unique to the Essential alcoholic men.

  2. Pitfalls of converting practice guidelines into quality measures: lessons learned from a VA performance measure.

    Science.gov (United States)

    Walter, Louise C; Davidowitz, Natalie P; Heineken, Paul A; Covinsky, Kenneth E

    2004-05-26

    The Department of Veterans Affairs (VA) manages the largest health care system in the United States, and the Institute of Medicine has recommended that many practices of VA quality measurement be applied to the US health care system as a whole. The VA measures quality of care at all of its sites by assessing adherence rates to performance measures, which generally are derived from evidence-based practice guidelines. Higher adherence rates are used as evidence of better quality of care. However, there are problems with converting practice guidelines, intended to offer guidance to clinicians, into performance measures that are meant to identify poor-quality care. We suggest a more balanced perspective on the use of performance measures to define quality by delineating conceptual problems with the conversion of practice guidelines into quality measures. Focusing on colorectal cancer screening, we use a case study at 1 VA facility to illustrate pitfalls that can cause adherence rates to guideline-based performance measures to be poor indicators of the quality of cancer screening. Pitfalls identified included (1) not properly considering illness severity of the sample population audited for adherence to screening, (2) not distinguishing screening from diagnostic procedures when setting achievable target screening rates, and (3) not accounting for patient preferences or clinician judgment when scoring performance measures. For many patients with severe comorbid illnesses or strong preferences against screening, the risks of colorectal cancer screening outweigh the benefits, and the decision to not screen may reflect good quality of care. Performance measures require more thoughtful specification and interpretation to avoid defining high testing rates as good quality of care regardless of who received the test, why it was performed, or whether the patient wanted it.

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

    Science.gov (United States)

    2016-12-01

    that VA medical centers complied with requirements related to the environment of care for women veterans and VHA’s oversight of that compliance; (2...VHA’s oversight of medical facilities’ compliance with these requirements; 2. what is known about the availability of VHA medical providers who can...site visits cannot be generalized to other VAMCs. To examine VHA’s oversight of medical facilities’ compliance with requirements related to the

  4. Effect of common dead space on VA/Q distribution in the dog.

    Science.gov (United States)

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

    1990-06-01

    Several previous studies have shown worsening ventilation-perfusion (VA/Q) relationships in humans during heavy exercise at sea level. However, the mechanism of this deterioration remains unclear because of the correlation with ventilatory and circulatory variables. Our hypothesis was that the decrease in the series dead space-to-tidal volume ratio during exercise might be partly responsible because mixing in the common dead space can reduce apparent inequality. We tested this notion in 10 resting anesthetized normocapnic dogs passively hyperventilated by increase tidal volume and a) inspired CO2 or b) external dead space. We predicted less apparent VA/Q inequality in condition b because of mixing in the added dead space. After base-line measurements, conditions a and b were randomly assigned, and after a second set of base-line measurements they were repeated in the reverse order in each dog. VA/Q inequality was measured by the multiple inert gas elimination technique. Comparison of conditions a and b demonstrated that additional external dead space improved (P less than 0.001) the blood flow distributions as hypothesized [log standard deviation of perfusion = 0.49 +/- 0.02 (SE) in condition b and 0.61 +/- 0.03 in condition a with respect to 0.52 +/- 0.03 at base line]. This study suggests that the increased tidal volume during exercise could uncover VA/Q inequality not evident at rest because of the higher ratio of common dead space to tidal volume at rest.

  5. Military and Veterans’ Benefits: Analysis of VA Compensation Levels for Survivors of Veterans and Servicemembers

    Science.gov (United States)

    2009-11-01

    Supplemental Security Income TSGLI Servicemembers’ Group Life Insurance Traumatic Injury Protection Program TSP Thrift Savings Plan VA Department...assistance is provided by the Servicemembers’ Group Life Insurance Traumatic Injury Protection Program ( TSGLI ). All servicemembers paying SGLI...premiums are automatically enrolled in TSGLI , and pay an additional $1 per month premium. 195 U.S.C. §§ 8331-8351. 205 U.S.C. §§ 8401-8480. In addition

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

    Science.gov (United States)

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

    2016-01-01

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

  7. 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 ...

  8. VA Mental Health: Clearer Guidance on Access Policies and Wait-Time Data Needed

    Science.gov (United States)

    2015-10-01

    psychiatrist, psychologist, social worker, or counselor) in an outpatient setting (i.e., receiving medical treatment without being admitted to a hospital...for mental illnesses including schizophrenia , bipolar disorder, PTSD, and substance abuse. 8We will refer to the selected VAMCs as VAMCs A...such as PTSD, are to be considered for Page 8 GAO-16-24 VA Mental Health evidence-based therapies, such as cognitive processing therapy or

  9. 38 CFR 17.101 - Collection or recovery by VA for medical care or services provided or furnished to a veteran for...

    Science.gov (United States)

    2010-07-01

    ... VA for medical care or services provided or furnished to a veteran for a nonservice-connected... MEDICAL Charges, Waivers, and Collections § 17.101 Collection or recovery by VA for medical care or... section covers collection or recovery by VA, under 38 U.S.C. 1729, for medical care or services provided...

  10. 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/.

  11. Health risk factors and differences in outcomes between younger and older veterans using VA transitional housing.

    Science.gov (United States)

    Brown, Lisa M; Barnett, Scott D; Frahm, Kathryn A; Schinka, John A; Schonfeld, Lawrence; Casey, Roger J

    2015-01-01

    This study examined age-related differences in general medical and mental health risk factors for veterans participating in the U.S. Department of Veterans Affairs (VA) Grant Per Diem (GPD) transitional supportive housing program. The subpopulation of older homeless veterans is growing, and little is known about the implications of this fact for health care providers and for supportive programs intended to meet homeless veterans' needs. Data were obtained from the VA records of all veterans (N=40,820) who used the GPD program during fiscal years 2003 to 2009. Unconditional adjusted and unadjusted odds ratios for general medical and psychiatric characteristics were calculated and were the primary study focus. Significant predictors of homeless program completion assessed from univariate models were then evaluated in multivariate models. Younger (homeless veterans reported an equal number of days homeless before enrollment. Younger veterans averaged 19 fewer days in GPD. Older veterans had more general medical problems and approximately $500 more in program costs. Findings from this study indicate that older homeless veterans are at increased risk of serious medical problems. This group is especially vulnerable to experiencing negative consequences related to homelessness. Addressing these complex needs will allow the VA to provide enhanced care to older homeless veterans.

  12. 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.

  13. 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.

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

    CERN Document Server

    Behner, Frank

    1995-01-01

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

  16. 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.

  17. 76 FR 36955 - West Los Angeles VA Medical Center Veterans Programs Enhancement Act of 1998; Master Plan

    Science.gov (United States)

    2011-06-23

    .... One commenter stated that the ``inclusion of the State Veterans Home as Federal VA land in all maps... of the NHV (i.e., the Pacific Branch of the National Home for Disabled Volunteer Soldiers) in the...

  18. Influence of Copolymer Composition on In Vitro and In Vivo Performance of Celecoxib-PVP/VA Amorphous Solid Dispersions

    DEFF Research Database (Denmark)

    Knopp, Matthias Manne; Nguyen, Julia Hoang; Mu, Huiling

    2016-01-01

    of the copolymer composition of polyvinylpyrrolidone/vinyl acetate (PVP/VA) on the non-sink in vitro dissolution behavior and in vivo performance of celecoxib (CCX) amorphous solid dispersions. The study showed that the hydrophilic monomer vinylpyrrolidone (VP) was responsible for the generation of CCX...... supersaturation whereas the hydrophobic monomer vinyl acetate (VA) was responsible for the stabilization of the supersaturated solution. For CCX, there was an optimal copolymer composition around 50-60% VP content where further replacement of VP monomers with VA monomers did not have any biopharmaceutical...... advantages. A linear relationship was found between the in vitro AUC0-4h and in vivo AUC0-24h for the CCX:PVP/VA systems, indicating that the non-sink in vitro dissolution method applied in this study was useful in predicting the in vivo performance. These results indicated that when formulating a poorly...

  19. 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...... in the molecule, since one has two contributions; one due to the inherent chirality at the four chiral centers, and one due to the chirality of the side chain groups in specific conformers, that is, its helicity. Theoretical simulations for various levels of theory are compared to the experimental VA recorded...... of this molecule, even though the chiral part of the molecule is very rigid and has four chiral centers. In addition to VCD and Raman measurements, Raman optical activity (ROA) measurements would be very enlightening, as in many cases bands which are weak in both the VA and VCD, may be large in the Raman and...

  20. 33 CFR 334.280 - James River between the entrance to Skiffes Creek and Mulberry Point, Va.; army training and...

    Science.gov (United States)

    2010-07-01

    ... harvesting and cultivation of oyster beds or the setting of fish traps within the restricted area under... Eustis, Va., will, to the extent possible give public notice from time to time through local news media...

  1. Toward a VA Women's Health Research Agenda: Setting Evidence-based Priorities to Improve the Health and Health Care of Women Veterans

    Science.gov (United States)

    Yano, Elizabeth M; Bastian, Lori A; Frayne, Susan M; Howell, Alexandra L; Lipson, Linda R; McGlynn, Geraldine; Schnurr, Paula P; Seaver, Margaret R; Spungen, Ann M; Fihn, Stephan D

    2006-01-01

    The expansion of women in the military is reshaping the veteran population, with women now constituting the fastest growing segment of eligible VA health care users. In recognition of the changing demographics and special health care needs of women, the VA Office of Research & Development recently sponsored the first national VA Women's Health Research Agenda-setting conference to map research priorities to the needs of women veterans and position VA as a national leader in Women's Health Research. This paper summarizes the process and outcomes of this effort, outlining VA's research priorities for biomedical, clinical, rehabilitation, and health services research. PMID:16637953

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

    OpenAIRE

    Arun Chaudhury; Vivian Cristofaro; 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 loca...

  3. 38 CFR 17.56 - Payment for non-VA physician and other health care professional services.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Payment for non-VA physician and other health care professional services. 17.56 Section 17.56 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.56 Payment for non-VA physician and other health care...

  4. Les emplois du marqueur discursif « di va » en ancien français

    Directory of Open Access Journals (Sweden)

    Evelyne Oppermann-Marsaux

    2011-07-01

    Full Text Available Cet article porte sur les différents emplois du marqueur discursif « di va » en ancien français. Il s’intéresse plus particulièrement à trois aspects : le figement de la séquence « di va » en comparaison avec les occurrences de « va + di », la pragmaticalisation de l’impératif « di » ainsi que la position et la fonction de « di va » à l’intérieur du discours rapporté. L’étude permet de définir « di va » comme un marqueur discursif polysémique, en distinguant entre les emplois de « di va 1 », dans lesquels le sémantisme premier du verbe « dire » reste présent, et ceux de « di va 2 », où ce sémantisme s’efface. Dans ce dernier cas, « di va » devient compatible avec des contextes injonctifs et déclaratifs. Toujours employé en position initiale (« Di va, P », il traduit souvent une réaction de la part du locuteur face au comportement – verbal ou non verbal – de son allocutaire et peut alors prendre des valeurs expressives différentes, allant de l’opposition à la bienveillance et à l’incrédulité. « Di va 1 » en revanche, figure exclusivement dans le contexte immédiat d’une interrogation (qu’il ne précède pas obligatoirement et se comporte alors « seulement » comme une interjection d’appel, qui attire l’attention de l’allocutaire sur la question posée.This paper deals with the different uses of the discourse marker “di va” in Old French. It focuses on three main points: the fixation of the sequence “di va” compared to the occurrences of “va + di”, the pragmaticalization of the imperative “di”, and the position and the function of “di va” within reported speech. The study defines “di va” as a polysemic discourse marker, and distinguishes between the uses of “di va 1”, where the primary lexical meaning of the verb “dire” is still present, and those of “di va 2”, where this lexical meaning has disappeared

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

    Science.gov (United States)

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

    2016-01-01

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

  6. HIGH PREVALENCE OF AGENT ORANGE EXPOSURE AMONG THYROID CANCER PATIENTS IN THE NATIONAL VA HEALTHCARE SYSTEM.

    Science.gov (United States)

    Le, Karen T; Sawicki, Mark P; Wang, Marilene B; Hershman, Jerome M; Leung, Angela M

    2016-06-01

    Thyroid cancer is the most common endocrine malignancy and the most rapidly increasing cancer in the U.S. Little is known regarding the epidemiology and characteristics of patients with thyroid cancer within the national Veterans Health Administration (VHA) integrated healthcare system. The aim of this study was to further understand the characteristics of thyroid cancer patients in the VHA population, particularly in relation to Agent Orange exposure. This is a descriptive analysis of the VA (Veterans Affairs) Corporate Data Warehouse database from all U.S. VHA healthcare sites from October1, 1999, to December 31, 2013. Information was extracted for all thyroid cancer patients based on International Classification of Diseases-ninth revision diagnosis codes; histologic subtypes of thyroid cancer were not available. There were 19,592 patients (86% men, 76% white, 58% married, 42% Vietnam-era Veteran) in the VHA system with a diagnosis of thyroid cancer within this 14-year study period. The gender-stratified prevalence rates of thyroid cancer among the Veteran population during the study period were 1:1,114 (women) and 1:1,023 (men), which were lower for women but similar for men, when compared to the U.S. general population in 2011 (1:350 for women and 1:1,219 for men). There was a significantly higher proportion of self-reported Agent Orange exposure among thyroid cancer patients (10.0%), compared to the general VHA population (6.2%) (PAgent Orange exposure compared to the overall national VA patient population. T4 = thyroxine TCDD = 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin TSH = thyroid-stimulating hormone VA = Veterans Affairs VHA = Veterans Health Administration.

  7. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  9. 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

  10. Attitudes about the VA health-care setting, mental illness, and mental health treatment and their relationship with VA mental health service use among female and male OEF/OIF veterans.

    Science.gov (United States)

    Fox, Annie B; Meyer, Eric C; Vogt, Dawne

    2015-02-01

    In the present study, the authors explored gender differences in attitudinal barriers to and facilitators of care for Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans and examined the relationship of those factors with VA mental health service use among female and male veterans with probable mental health conditions. Data were collected as part of a national cross-sectional survey of OEF/OIF veterans; the current sample was limited to participants with a probable diagnosis of posttraumatic stress disorder, depression, or alcohol abuse (N = 278). Although negligible gender differences were observed in attitudes about VA care and perceived fit in the VA setting, men reported slightly more negative beliefs about mental illness and mental health treatment than women. In addition, logistic regressions revealed different associations with VA mental health service use for women and men. For women only, positive perceptions of VA care were associated with increased likelihood of seeking mental health treatment. For men only, perceived similarity to other VA care users and negative beliefs about mental health treatment were associated with increased likelihood of service use, whereas negative beliefs about mental illness were associated with lower likelihood of service use. For both women and men, perceived entitlement to VA care was associated with increased likelihood of service use and negative beliefs about treatment-seeking were associated with a reduced likelihood of seeking mental health care in the past 6 months. Results support the need for tailored outreach to address unique barriers to mental health treatment for female and male OEF/OIF veterans.

  11. 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

  12. The Adjustment of VaR to the Empirical Distribution of Returns

    Directory of Open Access Journals (Sweden)

    Radu Lupu

    2006-06-01

    Full Text Available Basel II Recommendations concerning internal rating based models approach for financial institutions and the success of RiskMetrics made Value-at-Risk (VaR is the most important risk measurement instrument at international level. The objective of this paper is to address the problem of adapting this method to the statistical properties of the returns for portfolios that include derivatives in the form of options too. We assume that the returns for the analyzed portfolios are not normally distributed. The methodologies presented are the ones used to capture the percentile when returns follow the features of the empirical distributions reviewed in Cont (2001.

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

    Science.gov (United States)

    Beder, Joan; Postiglione, Paul

    2013-01-01

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

  14. Essential oil composition of Rydingia michauxii (Briq.) Scheen & V.A. Albert endemic of Iran.

    Science.gov (United States)

    Karami, Akbar; Esmaeili, Hassan; Shahbazian, Donya

    2018-01-01

    The chemical composition of the essential oil (EO) obtained from the aerial parts of Rydingia michauxii (Briq.) Scheen & V.A. Albert was analysed by gas chromatography and gas chromatography/mass spectrometry (GC/MS). Eighty components were identified in the oil with caryophyllene oxide (20.1%), trans-verbenol (10.2%), linalool (5.3%) and humulene epoxide II (4.6%) as main constituents. We reported here the chemical compositions of R. michauxii EOs from southern Zagros of Iran with a distinct chemical profile for the first time.

  15. Testing and Development of a 30-kVA Hybrid Inverter: Lessons Learned and Reliability Implications

    Energy Technology Data Exchange (ETDEWEB)

    Ginn, J.W.

    1998-12-21

    A 30-kVA Trace Technologies hybrid power processor was specified and tested at the Sandia inverter test facility. Trace Technologies involving the control system, in response to suggestions made modifications, primarily by Sandia and Arizona Public Service (APS) personnel. The modifications should make the inverter more universally applicable and less site-specific so that it can be applied in various sites with minimal field interaction required from the design engineer. The project emphasized the importance of battery management, generator selection, and site load management to the performance and reliability of hybrid power systems.

  16. Results of the GNSS receiver experiment OCAM-G on Ariane-5 flight VA 219

    OpenAIRE

    Hauschild, Andre; Markgraf, Markus; Montenbruck, Oliver; Pfeuffer, Horst; Dawidowicz, Elie; Rmili, Badr; Conde Reis, Alain

    2016-01-01

    The fifth Automated Transfer Vehicle was launched on 29 July 2014 with Ariane-5 flight VA 219 into orbit from Kourou, French Guiana. For the first time, the ascent of an Ariane rocket was independently tracked with a Global Navigation Satellite System (GNSS) receiver on this flight. The GNSS receiver experiment OCAM-G was mounted on the upper stage of the rocket. Its receivers tracked the trajectory of the Ariane-5 from lift-off until after the separation of the Automated Transfer Vehicle. Th...

  17. 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.

  18. 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

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

    Directory of Open Access Journals (Sweden)

    Raheleh Khorsan

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    C.P. CHANDRASHEKARA, V.C. PATIL

    1995-01-01

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

  1. VA-086 methacrylate gelatine photopolymerizable hydrogels: A parametric study for highly biocompatible 3D cell embedding.

    Science.gov (United States)

    Occhetta, Paola; Visone, Roberta; Russo, Laura; Cipolla, Laura; Moretti, Matteo; Rasponi, Marco

    2015-06-01

    The ability to replicate in vitro the native extracellular matrix (ECM) features and to control the three-dimensional (3D) cell organization plays a fundamental role in obtaining functional engineered bioconstructs. In tissue engineering (TE) applications, hydrogels have been successfully implied as biomatrices for 3D cell embedding, exhibiting high similarities to the natural ECM and holding easily tunable mechanical properties. In the present study, we characterized a promising photocrosslinking process to generate cell-laden methacrylate gelatin (GelMA) hydrogels in the presence of VA-086 photoinitiator using a ultraviolet LED source. We investigated the influence of prepolymer concentration and light irradiance on mechanical and biomimetic properties of resulting hydrogels. In details, the increasing of gelatin concentration resulted in enhanced rheological properties and shorter polymerization time. We then defined and validated a reliable photopolymerization protocol for cell embedding (1.5% VA-086, LED 2 mW/cm2) within GelMA hydrogels, which demonstrated to support bone marrow stromal cells viability when cultured up to 7 days. Moreover, we showed how different mechanical properties, derived from different crosslinking parameters, strongly influence cell behavior. In conclusion, this protocol can be considered a versatile tool to obtain biocompatible cell-laden hydrogels with properties easily adaptable for different TE applications. © 2014 Wiley Periodicals, Inc.

  2. Morphology and metamorphosis of the peptidergic Va neurons and the median nerve system of the fruit fly, Drosophila melanogaster.

    Science.gov (United States)

    Santos, Jonathan G; Pollák, Edit; Rexer, Karl-Heinz; Molnár, László; Wegener, Christian

    2006-10-01

    Metamorphosis is a fundamental developmental process and has been intensively studied for various neuron types of Drosophila melanogaster. However, detailed accounts of the fate of identified peptidergic neurons are rare. We have performed a detailed study of the larval morphology and pupal remodelling of identified peptidergic neurons, the CAPA-expressing Va neurons of D. melanogaster. In the larva, Va neurons innervate abdominal median and transverse nerves that are typically associated with perisympathetic organs (PSOs), major neurohaemal release sites in insects. Since median and transverse nerves are lacking in the adult, Va neurites have to undergo substantial remodelling during metamorphosis. We have examined the hitherto uncharacterised gross morphology of the thoracic PSOs and the abdominal median and transverse nerves by scanning electron microscopy and found that the complete reduction of these structures during metamorphosis starts around pupal stage P7 and is completed at P9. Concomitantly, neurite pruning of the Va neurons begins at P6 and is preceded by the high expression of the ecdysone receptor (EcR) subtype B1 in late L3 larvae and the first pupal stages. New neuritic outgrowth mainly occurs from P7-P9 and coincides with the expression of EcR-A, indicating that the remodelling of the Va neurons is under ecdysteroid control. Immunogold-labelling has located the CAPA peptides to large translucent vesicles, which are released from the transverse nerves, as suggested by fusion profiles. Hence, the transverse nerves may serve a neurohaemal function in D. melanogaster.

  3. Enhanced T-lymphocyte blastogenic response to tuberculin (PPD) in children of northeast (NE) Thailand supplemented with vitamin A (VA) and zinc (Zn)

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, T.R.; Udomkesmalee, E.; Dhanamitta, S.; Sirisinha, S.; Charoenkiatkul, S.; Tantipopipat, S.; Banjong, O.; Rojroongwasinkul, N.; Smith, J.C. Jr. (Dept. of Agriculture, Beltsville, MD (United States) Mahidol Univ., Nakhon Pathom (Thailand))

    1991-03-15

    Beneficial effects of Va and/or Zn supplementation of children in NE Thailand are described in a companion abstract. In the same study, blastogenic response (BR) of T-lymphocytes to concanavalin-A (ConA) and PPD were assayed in cultures containing mononuclear cells (MNC) or whole blood (WB). Methods were previously described. Children were previously vaccinated with BCG. BR to ConA of MNC or WB from children supplemented with VA, Zn, VA + Zn or placebo were similar. BR to PPD of MNC was higher in children receiving VA + Zn than placebo, but not in children supplemented with VA or Zn alone. Data indicate that children with suboptimal VA and Zn nutriture supplemented with < 2 times RDA of these nutrients showed enhanced cellular immunity to PPD. This observation is relevant to BCG immunization program and thus may benefit public health.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-01-01

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

  5. Intensivvårdssjuksköterskors erfarenheter av att vårda patienter i livets slutskede : En intervjustudie

    OpenAIRE

    Vestling, Sara; Isaksson, Lisa

    2016-01-01

    Syfte. Intensivvårdssjuksköterskors erfarenheter av att vårda patienter i livets slutskede. Bakgrund. På intensivvårdsavdelningar i Sverige avlider 3-4000 patienter per år vilket föranleder att palliativ vård har börjat uppmärksammas inom intensivvården. Målet med vård i livets slutskede är att skapa bästa möjliga livskvalité för patient och anhöriga där sjuksköterskan med sin helhetssyn har en central roll. Design. Kvalitativ innehållsanalys. Metod. Semistrukturerade in...

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

    Directory of Open Access Journals (Sweden)

    Haroon Ashfaq

    2017-07-01

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

  7. Myosin Va plays a role in nitrergic smooth muscle relaxation in gastric fundus and corpora cavernosa of penis.

    Directory of Open Access Journals (Sweden)

    Arun Chaudhury

    Full Text Available 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.

  8. 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

  9. 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.

  10. 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 (D1-D9). 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.

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    Nyaguara O. Amek

    2014-10-01

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

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

    Science.gov (United States)

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

    2015-07-30

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

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

    Science.gov (United States)

    2014-09-01

    timelines and procedures for application processing and home visits, and the identification of additional ways to provide staffing support. If the...application processing and home visits, as well as the identification of additional ways to provide staffing support, and • use data from the IT...Temple and Waco , TX 3 256 1:85 18 Southern Arizona VA HCS Tucson, AZ 1 86 1:86 22 VA San Diego HCS San Diego, CA 3 271 1:90 12 Tomah VAMC Tomah

  15. Lessons learned from usability testing of the VA's personal health record.

    Science.gov (United States)

    Haggstrom, David A; Saleem, Jason J; Russ, Alissa L; Jones, Josette; Russell, Scott A; Chumbler, Neale R

    2011-12-01

    In order to create user-centered design information to guide the development of personal health records (PHRs), 24 patients participated in usability assessments of VA's MyHealtheVet program. Observational videos and efficiency measures were collected among users performing four PHR scenarios: registration and log-in, prescription refill, tracking health, and searching for health information. Twenty-five percent of users successfully completed registration. Individuals preferred prescription numbers over names, sometimes due to privacy concerns. Only efficiency in prescription refills was significantly better than target values. Users wanted to print their information to share with their doctors, and questioned the value of MyHealtheVet search functions over existing online health information. In summary, PHR registration must balance simplicity and security, usability tests guide how PHRs can tailor functions to individual preferences, PHRs add value to users' data by making information more accessible and understandable, and healthcare organizations should build trust for PHR health content.

  16. Comparison of Grouping Methods for Template Extraction from VA Medical Record Text.

    Science.gov (United States)

    Redd, Andrew M; Gundlapalli, Adi V; Divita, Guy; Tran, Le-Thuy; Pettey, Warren B P; Samore, Matthew H

    2017-01-01

    We investigate options for grouping templates for the purpose of template identification and extraction from electronic medical records. We sampled a corpus of 1000 documents originating from Veterans Health Administration (VA) electronic medical record. We grouped documents through hashing and binning tokens (Hashed) as well as by the top 5% of tokens identified as important through the term frequency inverse document frequency metric (TF-IDF). We then compared the approaches on the number of groups with 3 or more and the resulting longest common subsequences (LCSs) common to all documents in the group. We found that the Hashed method had a higher success rate for finding LCSs, and longer LCSs than the TF-IDF method, however the TF-IDF approach found more groups than the Hashed and subsequently more long sequences, however the average length of LCSs were lower. In conclusion, each algorithm appears to have areas where it appears to be superior.

  17. 3D Digitisation and Visualisation of the Vače Situla

    Directory of Open Access Journals (Sweden)

    Gregor Vidmar

    2013-09-01

    Full Text Available EXTENDED ABSTRACT:The project of 3D digitisation and visualisation of the Vače situla was implemented at the beginning of 2011 in cooperation with the National Museum of Slovenia where the situla is kept and the company MFC.2 which, among other services, develops and implements 3 D digitisation and visualisation projects. The purpose of the project was to digitise and visualise a famous and precious piece of cultural heritage and to  1. show what modern 3D shape and texture scanning technologies allow us to do,  2. show how to ensure safety and reach high quality in digitising cultural heritage objects.  3. measure the added value of the 3 D visualisation of cultural heritage as a powerful tool for preservation, conservation, research, education, knowledge sharing and promotion of cultural heritage objects. Furthermore, the aims of the project were:  1. 3D capture of the shape and texture of the situla using the 3D scanning method.  2. 3D image of the situla and its details with expert descriptions.  3. 3D stereoscopic projection of the situla viewed with 3D glasses and with the possibility of controlling it remotely.  4. 3D animation giving professional interpretation of certain facts about the situla.  5. Public presentation of the project results on Slovenian cultural holiday, 8th February 2011, at the National Museum of Slovenia. The 3D capture of the shape and texture of the situla was carried out using the white light 3D scanning method followed by 3D flesh animation to show the object and its details. A touch screen was used to provide user access to the content. Reality based model enabled vertical rotation of the situla as well as the interactive display of individual engravings. By clicking a situla detail a photo with an extensive professional explanation of the scene was displayed in a new browser window. For attractive public presentation of the exhibition a 3D stereoscopic animation of the situla rotating and seemingly

  18. Extracting Concepts Related to Homelessness from the Free Text of VA Electronic Medical Records.

    Science.gov (United States)

    Gundlapalli, Adi V; Carter, Marjorie E; Divita, Guy; Shen, Shuying; Palmer, Miland; South, Brett; Durgahee, B S Begum; Redd, Andrew; Samore, Matthew

    2014-01-01

    Mining the free text of electronic medical records (EMR) using natural language processing (NLP) is an effective method of extracting information not always captured in administrative data. We sought to determine if concepts related to homelessness, a non-medical condition, were amenable to extraction from the EMR of Veterans Affairs (VA) medical records. As there were no off-the-shelf products, a lexicon of terms related to homelessness was created. A corpus of free text documents from outpatient encounters was reviewed to create the reference standard for NLP training and testing. V3NLP Framework was used to detect instances of lexical terms and was compared to the reference standard. With a positive predictive value of 77% for extracting relevant concepts, this study demonstrates the feasibility of extracting positively asserted concepts related to homelessness from the free text of medical records.

  19. ¿Hacia dónde va la integración?

    Directory of Open Access Journals (Sweden)

    Alberto Acosta

    2015-01-01

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

  20. Myosin-Va-dependent cell-to-cell transfer of RNA from Schwann cells to axons.

    Science.gov (United States)

    Sotelo, José R; Canclini, Lucía; Kun, Alejandra; Sotelo-Silveira, José R; Xu, Lei; Wallrabe, Horst; Calliari, Aldo; Rosso, Gonzalo; Cal, Karina; Mercer, John A

    2013-01-01

    To better understand the role of protein synthesis in axons, we have identified the source of a portion of axonal RNA. We show that proximal segments of transected sciatic nerves accumulate newly-synthesized RNA in axons. This RNA is synthesized in Schwann cells because the RNA was labeled in the complete absence of neuronal cell bodies both in vitro and in vivo. We also demonstrate that the transfer is prevented by disruption of actin and that it fails to occur in the absence of myosin-Va. Our results demonstrate cell-to-cell transfer of RNA and identify part of the mechanism required for transfer. The induction of cell-to-cell RNA transfer by injury suggests that interventions following injury or degeneration, particularly gene therapy, may be accomplished by applying them to nearby glial cells (or implanted stem cells) at the site of injury to promote regeneration.

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

    DEFF Research Database (Denmark)

    Schümann, Michael; Dobbelstein, Matthias

    2006-01-01

    Adenoviruses lacking their PKR-antagonizing VA RNAs replicate poorly in primary cells. It has been suggested that these virus recombinants still replicate efficiently in tumor cells with Ras mutations and might therefore be useful in tumor therapy. The ability of interferon-sensitive viruses......-less viruses replicated with higher efficiency in Ras-mutant cells, as compared to cell lines without Ras mutation. However, several exceptions to this rule were observed, arguing against a direct inhibition of PKR by mutant Ras. Phosphorylation of the PKR-substrate eIF2alpha was observed regardless of the Ras...... the oncolytic effect of interferon-sensitive viruses. We propose that Ras mutations predispose tumor cells to undergo secondary changes that sometimes enable the replication of interferon-sensitive viruses....

  2. ¿adónde va a caer este globo? acerca del futuro de la tierra

    OpenAIRE

    Mesa Sánchez, Óscar José

    2009-01-01

    Por considerarlo de la mayor relevancia, en esta edición reproducimos el capítulo de Introducción del libro “¿Adónde va a caer este globo? Acerca del futuro de la Tierraâ€�, del Profesor Óscar José Mesa Sánchez, y seguidamente publicamos la reseña del mismo libro, escrita por el Profesor Darío Valencia Restrepo, y publicada en el periódico El Mundo de Medellín. Agradecemos a los Profesores Mesa Sánchez y Valencia Restrepo por su colaboración con la revista. Germán Poveda Jaramillo Di...

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

    Science.gov (United States)

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

    2015-01-01

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

  4. Transportation – A Vehicle or Roadblock to Cancer Care for VA Colorectal Cancer Patients?

    Science.gov (United States)

    Zullig, Leah L.; Jackson, George L.; Provenzale, Dawn; Griffin, Joan M.; Phelan, Sean; van Ryn, Michelle

    2011-01-01

    Introduction Patients must have transportation to the treatment site before they can access appropriate cancer care. This paper describes factors associated with patients experiencing transportation-related barriers to accessing cancer care. Patients and Methods The Cancer Care Assessment & Responsive Evaluation Studies (C-CARES) questionnaire was mailed to VA colorectal cancer (CRC) patients during fall 2009. Eligible patients were diagnosed at any VA facility in 2008, male, and alive at time of mailing. A total of 1,409 surveys were returned (approximately 67% response rate). To assess transportation barriers, patients were asked how often it was difficult to get transportation to or from treatment. Symptoms were assessed using validated PROMIS scales for fatigue, pain, and depression. Multivariate logistic regression was used to examine determinants of transportation barriers. Results A minority (19%) of respondents reported transportation barriers. Patients experiencing pain (OR 1.04, 95% CI 1.02, 1.06) had greater odds of transportation barriers than patients without this symptom. Patients who reported no primary social support (OR 6.13, 95% CI 3.10, 12.14) or non-spousal support (OR 2.00, 95% CI 1.40, 2.87) were more likely to experience transportation barriers than patients whose spouse provided social support. Discussion Patients with uncontrolled pain or less social support have greater odds of transportation barriers. The directional association between social support, symptoms, and transportation cannot be determined in this data. Conclusion Inquiring about accessible transportation should become a routine part of cancer care, particularly for patients with known risk factors. PMID:21803001

  5. 77 FR 17086 - Section 8 Housing Choice Vouchers: Revised Implementation of the HUD-VA Supportive Housing Program

    Science.gov (United States)

    2012-03-23

    ... Appropriations Act, 2010 (Pub. L. 111- 117, approved December 16, 2009); the Department of Defense and Full-Year... VA. The process relies primarily on three sets of data: (1) HUD's point-in-time data submitted by... type that must be recorded on line 2a is ``1'' for a new admission (a family that is new to the HCV...

  6. 76 FR 54770 - Public Meeting: Notification by Capital One Financial Corporation, McLean, VA, To Acquire ING...

    Science.gov (United States)

    2011-09-02

    ... Public Meeting: Notification by Capital One Financial Corporation, McLean, VA, To Acquire ING Bank, FSB, Wilmington, DE, and Indirectly To Acquire Shares of Sharebuilder Advisors, LLC and ING Direct Investing, Inc... Financial Corporation, McLean, Virginia, to acquire ING Bank, FSB, Wilmington, Delaware, and indirectly to...

  7. Effects of the KiVa Anti-bullying Program on Adolescents' Depression, Anxiety, and Perception of Peers

    Science.gov (United States)

    Williford, Anne; Boulton, Aaron; Noland, Brian; Little, Todd D.; Karna, Antti; Salmivalli, Christina

    2012-01-01

    The present study investigated the effects of the KiVa antibullying program on students' anxiety, depression, and perception of peers in Grades 4-6. Furthermore, it was investigated whether reductions in peer-reported victimization predicted changes in these outcome variables. The study participants included 7,741 students from 78 schools who were…

  8. 77 FR 38497 - Safety Zone; Richmond-Essex County Fourth of July Fireworks, Rappahannock River, Tappahannock, VA

    Science.gov (United States)

    2012-06-28

    ... over the navigable waters of the Rappahannock River in Tappahannock, VA centered on position 37 55'12... bounded by a 400-foot radius circle centered on position 37 55'12'' N/ 076 49'12'' W (NAD 1983). This... rulemaking process. Small businesses may send comments on the actions of Federal employees who enforce, or...

  9. Bayer CropScience to Enhance Safeguards at Chemical Facilities in Four States to Settle Violations at W. Va. Plant

    Science.gov (United States)

    CHARLESTOWN, W.Va. (Sept. 21, 2015) - The U.S. Environmental Protection Agency and the U.S. Department of Justice today announced a $5.6 million settlement with Bayer CropScience LP to resolve violations of federal chemical accident preventio

  10. 77 FR 18984 - Special Local Regulation for Marine Events; Yorktown Parade of Sail, York River; Yorktown, VA

    Science.gov (United States)

    2012-03-29

    ... Tourism. River bounded by the north and south shores of the York River and to the west by the Coleman... River; Yorktown, VA AGENCY: Coast Guard, DHS. ACTION: Notice of proposed rulemaking. [[Page 18985..., a parade of five tall ships and 195 other vessels, to be held on the waters of York River, Yorktown...

  11. 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.

  12. Assessing the Pedagogical Impact of the VaNTH Engineering Research Center on Faculty and Postdoctoral Professionals

    Science.gov (United States)

    Cox, Monica; Cawthorne, James; McNeill, Nathan; Cekic, Osman; Frye, Matthew; Stacer, Melissa

    2011-01-01

    From 1999 to 2007, the Vanderbilt-Northwestern-Texas-Harvard/MIT (VaNTH) Engineering Research Center focused on improving bioengineering education through the applications of learning science, learning technology, and assessment and evaluation within the domain of bioengineering. This paper discusses results from a survey to explore the impact of…

  13. 78 FR 59861 - VA Acquisition Regulation: Service-Disabled Veteran-Owned and Veteran-Owned Small Business Status...

    Science.gov (United States)

    2013-09-30

    ... VOSBs to increase their Federal contracting and subcontracting. VA solicited comments on an interim... bears the risk that the delivery method chosen will not result in timely receipt by the Executive... and disruption of services for the benefit of veterans or a construction project may be so extensive...

  14. Cultural competence: a framework for promoting voluntary medical male circumcision among VaRemba communities in Zimbabwe.

    Science.gov (United States)

    Shumba, Kemist; Lubombo, Musara

    2017-07-01

    Almost a decade after the formal introduction of voluntary medical male circumcision (VMMC) as an important technology for HIV prevention, its implementation is still fraught with acceptability challenges. This is especially true among ethnic groups where male circumcision is conducted as a rite of passage into adulthood. In this article we question why VMMC is being met with resistance despite widespread awareness of its promise to reduce HIV incidence in a culturally circumcising community in Zimbabwe. In-depth and key informant interviews were conducted with selected VaRemba initiation graduates and surgeons respectively in Mposi area in Mberengwa to explore why VMMC has not been readily accepted in their community. Findings suggest that male circumcision among VaRemba is not only the removal of prepuce but comprises a secretive and rich curriculum rooted in their culture and identity. Such a conceptualisation renders some social and programmatic impediments for VMMC uptake. To scale up VMMC uptake among VaRemba, we argue for a reorganisation and adaptation of VMMC services in a culturally competent way that accounts for local conceptions of circumcision and respect for the cultural beliefs and practices of VaRemba communities.

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

    Science.gov (United States)

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

    2013-08-01

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

  16. Serving homeless Veterans in the VA Desert Pacific Healthcare Network: A needs assessment to inform quality improvement endeavors

    OpenAIRE

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

    2013-01-01

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

  17. 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

  18. 75 FR 26160 - Drug and Drug-Related Supply Promotion by Pharmaceutical Company Sales Representatives at VA...

    Science.gov (United States)

    2010-05-11

    ... compliance with standards of ethical conduct. Pharmaceutical sales representatives have heavy interaction... gifts above the de minimis value set forth in the standards of ethical conduct for Federal employees..., describes general behavior that is prohibited on the grounds of VA property. Proposed Sec. 1.220, would...

  19. 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

    and Budget, Capital Programming Guide, Supplement to Office of Management Budget Circular A-11, Planning, Budgeting, and Acquisition of Capital...the 2012 Institute of Medicine report (see Institute of Medicine, Evaluation of the Lovell Federal Health Care Center Merger : Findings, Conclusions...VA Teams Governance X Acquisition and Contracting X Manpower X Quality Assurancea X Budget X Education and Training X

  20. 75 FR 38979 - Expansion/Reorganization of Foreign-Trade Zone 204, Tri-Cities Area, TN/VA

    Science.gov (United States)

    2010-07-07

    ... Foreign-Trade Zones Board Expansion/Reorganization of Foreign-Trade Zone 204, Tri-Cities Area, TN/VA...), the Foreign-Trade Zones Board (the Board) adopts the following Order: Whereas, the Tri-Cities Airport... FTZ 204 to include a site in Bristol, Tennessee, adjacent to the Tri-Cities Customs and Border...

  1. Un juego serio en que se va la vida. Fragmentos, citas, reescrituras en Zettel, de Hector Libertella

    National Research Council Canada - National Science Library

    Perez, Agustina

    2015-01-01

    ... serio en que se va la vida, o llega. Se revisara Zettel a la luz de otros textos de Libertella para indagar su vinculo con el fragmento como tipo de exposicion que no aspira a la exhaustividad sino a lo inacabado, siendo siempre en germen...

  2. Mitochondrial carbonic anhydrase VA deficiency resulting from CA5A alterations presents with hyperammonemia in early childhood.

    Science.gov (United States)

    van Karnebeek, Clara D; Sly, William S; Ross, Colin J; Salvarinova, Ramona; Yaplito-Lee, Joy; Santra, Saikat; Shyr, Casper; Horvath, Gabriella A; Eydoux, Patrice; Lehman, Anna M; Bernard, Virginie; Newlove, Theresa; Ukpeh, Henry; Chakrapani, Anupam; Preece, Mary Anne; Ball, Sarah; Pitt, James; Vallance, Hilary D; Coulter-Mackie, Marion; Nguyen, Hien; Zhang, Lin-Hua; Bhavsar, Amit P; Sinclair, Graham; Waheed, Abdul; Wasserman, Wyeth W; Stockler-Ipsiroglu, Sylvia

    2014-03-06

    Four children in three unrelated families (one consanguineous) presented with lethargy, hyperlactatemia, and hyperammonemia of unexplained origin during the neonatal period and early childhood. We identified and validated three different CA5A alterations, including a homozygous missense mutation (c.697T>C) in two siblings, a homozygous splice site mutation (c.555G>A) leading to skipping of exon 4, and a homozygous 4 kb deletion of exon 6. The deleterious nature of the homozygous mutation c.697T>C (p.Ser233Pro) was demonstrated by reduced enzymatic activity and increased temperature sensitivity. Carbonic anhydrase VA (CA-VA) was absent in liver in the child with the homozygous exon 6 deletion. The metabolite profiles in the affected individuals fit CA-VA deficiency, showing evidence of impaired provision of bicarbonate to the four enzymes that participate in key pathways in intermediary metabolism: carbamoylphosphate synthetase 1 (urea cycle), pyruvate carboxylase (anaplerosis, gluconeogenesis), propionyl-CoA carboxylase, and 3-methylcrotonyl-CoA carboxylase (branched chain amino acids catabolism). In the three children who were administered carglumic acid, hyperammonemia resolved. CA-VA deficiency should therefore be added to urea cycle defects, organic acidurias, and pyruvate carboxylase deficiency as a treatable condition in the differential diagnosis of hyperammonemia in the neonate and young child. Copyright © 2014 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  3. 75 FR 23800 - Notice of Intent to Repatriate a Cultural Item: Virginia Museum of Fine Arts, Richmond, VA

    Science.gov (United States)

    2010-05-04

    ... National Park Service Notice of Intent to Repatriate a Cultural Item: Virginia Museum of Fine Arts... to repatriate a cultural item in the possession of the Virginia Museum of Fine Arts, Richmond, VA.... 3003(d)(3). The determinations in this notice are the sole responsibility of the museum, institution...

  4. EPA Settles with Natural Gas Company for Oil Spill in Ohio River Tributary in Marshall Co., W. Va.

    Science.gov (United States)

    PHILADELPHIA (March 23, 2016) - The U.S. Environmental Protection Agency announced today that Williams Ohio Valley Midstream, the owner and operator of a natural gas pipe line in Moundsville, W. Va. has paid a $14,440 penalty to settle an all

  5. Going to scale: A nonrandomized nationwide trial of the KiVa Antibullying Program for Grades 1-9

    NARCIS (Netherlands)

    Kärnä, A.; Voeten, M.J.M.; Little, T.D.; Poskiparta, E.H.; Alanen, E.; Salmivalli, C.

    2011-01-01

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

  6. 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.

  7. A nationwide VA palliative care quality measure: the family assessment of treatment at the end of life.

    Science.gov (United States)

    Casarett, David; Pickard, Amy; Bailey, F Amos; Ritchie, Christine Seel; Furman, Christian Davis; Rosenfeld, Ken; Shreve, Scott; Shea, Judy

    2008-01-01

    To evaluate the FATE (Family Assessment of Treatment at End of Life) Survey for use as a nationwide quality measure in the VA health care system. Nationwide telephone survey. Five VA medical centers. Eligible patients received inpatient or outpatient care from a participating VA facility in the last month of life. One respondent/patient was selected using predefined eligibility criteria and invited to participate. The FATE survey consists of 32 items in 9 domains: Well-being and dignity (4 items), Information and communication (5 items), Respect for treatment preferences (2 items), Emotional and spiritual support (3 items), Management of symptoms (4 items), Choice of inpatient facility (1 item), Care around the time of death (6 items), Access to VA services (4 items), and Access to VA benefits after the patient's death (3 items). Interviews were completed with 309 respondents. The FATE showed excellent psychometric characteristics, with good homogeneity (e.g., Cronbach (alpha = 0.91) and no evidence of significant ceiling effects. The FATE also demonstrated good discriminant validity. For instance, FATE scores varied across facilities (range 44-72; Kruskal Wallis test p < 0.001). Patients who were seen by a palliative care service had better scores (mean 66 versus 52; rank sum test p < 0.001), as did patients who were referred to hospice (67 versus 49; rank sum test p < 0.001). The FATE survey offers an important source of quality data that can be used to improve the end-of-life care of all veterans, regardless of the type of care they receive or their site of death.

  8. Implementing goals of care conversations with veterans in VA long-term care setting: a mixed methods protocol.

    Science.gov (United States)

    Sales, Anne E; Ersek, Mary; Intrator, Orna K; Levy, Cari; Carpenter, Joan G; Hogikyan, Robert; Kales, Helen C; Landis-Lewis, Zach; Olsan, Tobie; Miller, Susan C; Montagnini, Marcos; Periyakoil, Vyjeyanthi S; Reder, Sheri

    2016-09-29

    The program "Implementing Goals of Care Conversations with Veterans in VA LTC Settings" is proposed in partnership with the US Veterans Health Administration (VA) National Center for Ethics in Health Care and the Geriatrics and Extended Care Program Offices, together with the VA Office of Nursing Services. The three projects in this program are designed to support a new system-wide mandate requiring providers to conduct and systematically record conversations with veterans about their preferences for care, particularly life-sustaining treatments. These treatments include cardiac resuscitation, mechanical ventilation, and other forms of life support. However, veteran preferences for care go beyond whether or not they receive life-sustaining treatments to include issues such as whether or not they want to be hospitalized if they are acutely ill, and what kinds of comfort care they would like to receive. Three projects, all focused on improving the provision of veteran-centered care, are proposed. The projects will be conducted in Community Living Centers (VA-owned nursing homes) and VA Home-Based Primary Care programs in five regional networks in the Veterans Health Administration. In all the projects, we will use data from context and barrier and facilitator assessments to design feedback reports for staff to help them understand how well they are meeting the requirement to have conversations with veterans about their preferences and to document them appropriately. We will also use learning collaboratives-meetings in which staff teams come together and problem-solve issues they encounter in how to get veterans' preferences expressed and documented, and acted on-to support action planning to improve performance. We will use data over time to track implementation success, measured as the proportions of veterans in Community Living Centers (CLCs) and Home-Based Primary Care (HBPC) who have a documented goals of care conversation soon after admission. We will work with

  9. ”no en mä löis, mut...” – viihteellistä historiakulttuuria paljon kuluttavien nuorten käsityksiä väkivallan oikeutuksesta

    OpenAIRE

    Aalto, Heikki

    2016-01-01

    Nuorten väkivaltaisuus on ollut julkisen keskustelun aiheena vuosikymmenten ajan. Väkival- taviihteestä on etsitty syyllistä nuorten väkivaltaiseen käytökseen ja väkivallan hyväksymi- seen. Tämän tutkielman tavoitteena oli kartoittaa nuorten viihteellisen historiakulttuurin suur- kuluttajien käsityksiä väkivallan oikeutuksesta. Tutkielman hypoteesina oli se, että paljon viihteellistä historiakulttuuria kuluttavat nuoret eivät hyväksyisi väkivallan käyttöä ongelmien ratka...

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

    Science.gov (United States)

    Bastawrous, Sarah; Carney, Benjamin

    2017-06-01

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

  11. Development of robots for rehabilitation therapy: the Palo Alto VA/Stanford experience.

    Science.gov (United States)

    Burgar, C G; Lum, P S; Shor, P C; Machiel Van der Loos, H F

    2000-01-01

    For over 25 years, personal assistant robots for severely disabled individuals have been in development. More recently, using robots to deliver rehabilitation therapy has been proposed. This paper summarizes the development and clinical testing of three mechatronic systems for post-stroke therapy conducted at the VA Palo Alto in collaboration with Stanford University. We describe the philosophy and experiences that guided their evolution. Unique to the Palo Alto approach is provision for bimanual, mirror-image, patient-controlled therapeutic exercise. Proof-of-concept was established with a 2-degree-of-freedom (DOF) elbow/forearm manipulator. Tests of a second-generation therapy robot producing planar forearm movements in 19 hemiplegic and control subjects confirmed the validity and reliability of interaction forces during mechanically assisted upper-limb movements. Clinical trials comparing 3-D robot-assisted therapy to traditional therapy in 21 chronic stroke subjects showed significant improvement in the Fugl-Meyer (FM) measure of motor recovery in the robot group, which exceeded improvements in the control group.

  12. Design of a 100 kVA high temperature superconducting demonstration synchronous generator

    Science.gov (United States)

    Al-Mosawi, M. K.; Beduz, C.; Goddard, K.; Sykulski, J. K.; Yang, Y.; Xu, B.; Ship, K. S.; Stoll, R.; Stephen, N. G.

    2002-08-01

    The paper presents the main features of a 100 kVA high temperature superconducting (HTS) demonstrator generator, which is designed and being built at the University of Southampton. The generator is a 2-pole synchronous machine with a conventional 3-phase stator and a HTS rotor operating in the temperature range 57-77 K using either liquid nitrogen down to 65 K or liquid air down to 57 K. Liquid air has not been used before in the refrigeration of HTS devices but has recently been commercialised by BOC as a safe alternative to nitrogen for use in freezing of food. The generator will use an existing stator with a bore of 330 mm. The rotor is designed with a magnetic core (invar) to reduce the magnetising current and the field in the coils. For ease of manufacture, a hybrid salient pole construction is used, and the superconducting winding consists of twelve 50-turn identical flat coils. Magnetic invar rings will be used between adjacent HTS coils of the winding to divert the normal component of the magnetic field away from the Bi2223 superconducting tapes. To avoid excessive eddy-current losses in the rotor pole faces, a cold copper screen will be placed around the rotor core to exclude ac magnetic fields.

  13. The Effect of Mantram Repetition on Burnout and Stress Among VA Staff.

    Science.gov (United States)

    Leary, Sheryl; Weingart, Kimberly; Topp, Robert; Bormann, Jill

    2017-05-01

    In this study, the authors determined the effect of a structured Internet-delivered Mantram Repetition Program (MRP) on burnout and stress of conscience (SOC), stress related to ambiguity from ethical or moral conflicts among health care workers (HCWs) within the Veteran Affairs (VA) Healthcare System. A secondary purpose was to determine whether practicing meditation prior to the study combined with MRP affected burnout or SOC. The MRP teaches the mindful practices of repeating a mantram, slowing down, and one-pointed attention for managing stress. Thirty-nine HCW volunteers who provided direct patient care completed the Internet-delivered MRP. The outcomes of burnout (i.e., exhaustion, cynicism, and professional efficacy) and SOC (i.e., frequency of stressful events and troubled conscience about those events) were measured at baseline (T1), postintervention (T2), and 3-months postintervention (T3). Repeated measures ANOVA indicated that exhaustion significantly ( p stressful events significantly declined between T1 and T2 and troubled conscience declined between T1 and T3. Secondary analysis demonstrated that individuals who did not practice meditation at baseline ( n = 16, 41%) significantly decreased exhaustion, frequency of stressful events, and troubled conscience between T1 and T3, and improved professional efficacy between T1 and T2. Individuals who practiced meditation at baseline ( n = 23, 59%) did not demonstrate significant change on any study outcomes. An MRP intervention may reduce burnout and SOC in those individuals who are naïve to practicing meditation.

  14. Augu izcelsmes produktu automatizēta preparatīva cietfāzes ekstrakcija

    OpenAIRE

    Kļaviņa, Ketlīna

    2015-01-01

    Augu izcelsmes produktu automatizēta preparatīva cietfāzes ekstrakcija. Kļaviņa K., zinātniskais vadītājs Dr.habil.chem. Šatcs V., zinātniskais vadītājs Dr.chem. Vīksna A. Maģistra darbs, 42 lappuses, 22 attēli, 12 tabulas, 38 literatūras avoti. Latviešu valodā. Darbā iekļauts īss literatūras apskats par trīs biežāk izmantotajām vielu attīrīšanas un koncentrēšanas metodēm – šķīdumu-šķīdumu ekstrakciju, šķidrumu hromatogrāfiju un cietfāzu ekstrakciju, kā arī par dažiem ekstrakcijai izvēlēti...

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

    Science.gov (United States)

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

    2016-06-01

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

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

    Science.gov (United States)

    2009-08-01

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

  17. Does Evidence-Based PTS Treatment Reduce PTS Symptoms and Suicide in Iraq and Afghanistan Veterans Seeking VA Care

    Science.gov (United States)

    2016-05-01

    AWARD NUMBER: W81XWH-15-1-0038 TITLE: Does Evidence-Based PTS Treatment Reduce PTS Symptoms and Suicide in Iraq and Afghanistan Veterans... Suicide in Iraq and Afghanistan Veterans Seeking VA Care? 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-15-1-0038 5c. PROGRAM ELEMENT NUMBER 6...cohort with two or more suicide screenings during the post-deployment period. 15. SUBJECT TERMS Key words or phrases identifying major concepts in

  18. Proceedings of the Tenth Annual National Conference on Ada Technology. Held in Arlington, VA, on February 24-28, 1992

    Science.gov (United States)

    1992-02-01

    Ruth Rudolph CSC Alan Salisbury U.S. Army Jim Schell CENTACS Lawrence Straw RCA Ken Taormina Teledyne Putnam Texel SofTech, Inc. Dennis Turner CENTACS... Hilary 7. Allers is a Senior Menlo Park, CA 1987. Member of the Technical Staff with TRW, Inc. in Fairfax, VA. 6. D’Ippolito, R., "Using Models Ms...relationships between Interrelationships of a software development project cost for Instance productivity and product and Putnam 3. These parameters

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

    Science.gov (United States)

    2016-06-10

    Administration Mentor, and David Austin, VA Learning University. This thesis is dedicated to my wonderful daughters , Sheila Marie and Sarah Jane, whose love has...and best friend, Stephanie, thank you all for your support with all the challenges along the way. Thanks to you for being there for my daughters ...as life happened, when I couldn’t be while I attended CGSC at Fort Leavenworth in Kansas. Thank you to my earthly fathers , Douglas and Rudy, for their

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

    Directory of Open Access Journals (Sweden)

    Fortney John

    2012-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Pablo González

    2000-06-01

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

  2. National dissemination of supported housing in the VA: model adherence versus model modification.

    Science.gov (United States)

    O'Connell, Maria; Kasprow, Wesley; Rosenheck, Robert A

    2010-01-01

    The continuing development and dissemination of emerging evidence-based practices may be facilitated by the availability of descriptive information on the actual delivery of the service, and its variability, across sites. This paper presents data on the participation of 2,925 homeless veterans in the Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program at 36 sites across the country, for up to five years. While most conceptual models emphasize rapid placement, sustained intensive case management, rehabilitation services, and "permanent" housing, no program has yet presented empirical data on the actual delivery of such services over an extended period of time. Using extensive longitudinal data from the VA's national homeless outreach program, the Health Care for Homeless Veterans (HCHV) program, a quantitative portrait presents what happens in supported housing in a large real-world dissemination effort. Program entry to HUD-VASH was generally slow with 108 days (sd = 92 days) on average passing between program entry and housing placement. Total program participation lasted 2.6 years on average (sd = 1.6 years)-just half of the possible 5 years. Service delivery became substantially less intensive over time by several measures, and three-fourths of the veterans terminated within five years, although the vast majority (82%) were housed at the time. Few veterans received rehabilitation services (6%) or employment assistance (17%) and most service delivery focused on obtaining housing. These data suggest that real-world supported housing programs may not adhere to the prevalent model descriptions either because of implementation failure or because veteran needs and preferences differ from those suggested by that model.

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

    Directory of Open Access Journals (Sweden)

    Mazilov V.A.

    2017-03-01

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

  4. Subjective measures of hearing aid benefit in the NIDCD/VA Clinical Trial.

    Science.gov (United States)

    Haskell, George B; Noffsinger, Douglas; Larson, Vernon D; Williams, David W; Dobie, Robert A; Rogers, Janette L

    2002-08-01

    Subjective measures of performance were assessed on three different hearing aid circuits as part of a large clinical trial. These measurements included the Profile of Hearing Aid Performance and a subjective ranking of individual preference. A multi-center, double-masked clinical trial of hearing aids was conducted at eight VA Medical Centers. Three hearing aid circuits, a linear peak-clipper, a linear compression limiter and a wide dynamic range compressor, were investigated. The experimental design was a three-period, three-treatment crossover design. Subjects (N = 360) were stratified by site and randomized to one of six sequences for the hearing aid circuits. All fittings were binaural and involved a 3-mo trial with each of the three circuits. All subjective measures were administered for unaided and aided conditions at the end of each trial period. While all of the circuits resulted in improved scores on the aided versus the unaided PHAP, there were few conditions in which one circuit outperformed the others. An exception was the aversiveness of sound subscale where the peak clipper frequently scored worse than either the compression limiter or the wide dynamic range compressor. In the subjective ranking scale the compression limiter received more first place rankings than the other two circuits, especially for one subgroup of patients with moderate flat hearing loss. All circuits were perceived as beneficial by these subjects in most situations. The peak clipper scored worse on aversiveness of sound than did the other two circuits for most subjects, while the compression limiter seemed to have a slight advantage in subjective rankings. Most subjects perceived considerable aided benefit in situations involving background noise and reverberation, situations where hearing aid benefit is often questioned.

  5. Effect of pH on structure, function, and stability of mitochondrial carbonic anhydrase VA.

    Science.gov (United States)

    Idrees, Danish; Shahbaaz, Mohd; Bisetty, Krishna; Islam, Asimul; Ahmad, Faizan; Hassan, Md Imtaiyaz

    2017-02-01

    Mitochondrial carbonic anhydrase VA (CAVA) catalyzes the hydration of carbon dioxide to produce proton and bicarbonate which is primarily expressed in the mitochondrial matrix of liver, and involved in numerous physiological processes including lipogenesis, insulin secretion from pancreatic cells, ureagenesis, gluconeogenesis, and neuronal transmission. To understand the effect of pH on the structure, function, and stability of CAVA, we employed spectroscopic techniques such as circular dichroism, fluorescence, and absorbance measurements in wide range of pH (from pH 2.0 to pH 11.5). CAVA showed an aggregation at acidic pH range from pH 2.0 to pH 5.0. However, it remains stable and maintains its secondary structure in the pH range, pH 7.0-pH 11.5. Furthermore, this enzyme has an appreciable activity at more than pH 7.0 (7.0 pH ≤ 11.5) with maximum activity at pH 9.0. The maximal values of kcat and kcat/Km at pH 9.0 are 3.7 × 10(6) s(-1) and 5.5 × 10(7) M(-1) s(-1), respectively. However, this enzyme loses its activity in the acidic pH range. We further performed 20-ns molecular dynamics simulation of CAVA to see the dynamics at different pH values. An excellent agreement was observed between in silico and in vitro studies. This study provides an insight into the activity of CAVA in the pH range of subcellular environment.

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

    Science.gov (United States)

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

    2017-06-01

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

  7. A Survey of Physicians' Attitudes toward Decision-Making Authority for Initiating and Withdrawing VA-ECMO: Results and Ethical Implications for Shared Decision Making.

    Science.gov (United States)

    Meltzer, Ellen C; Ivascu, Natalia S; Stark, Meredith; Orfanos, Alexander V; Acres, Cathleen A; Christos, Paul J; Mangione, Thomas; Fins, Joseph J

    2016-01-01

    Although patients exercise greater autonomy than in the past, and shared decision making is promoted as the preferred model for doctor-patient engagement, tensions still exist in clinical practice about the primary locus of decision-making authority for complex, scarce, and resource-intensive medical therapies: patients and their surrogates, or physicians. We assessed physicians' attitudes toward decisional authority for adult venoarterial extracorporeal membrane oxygenation (VA-ECMO), hypothesizing they would favor a medical locus. A survey of resident/fellow physicians and internal medicine attendings at an academic medical center, May to August 2013. We used a 24-item, internet-based survey assessing physician-respondents' demographic characteristics, knowledge, and attitudes regarding decisional authority for adult VA-ECMO. Qualitative narratives were also collected. A total of 179 physicians completed the survey (15 percent response rate); 48 percent attendings and 52 percent residents/fellows. Only 32 percent of the respondents indicated that a surrogate's consent should be required to discontinue VA-ECMO; 56 percent felt that physicians should have the right to discontinue VA-ECMO over a surrogate's objection. Those who self-reported as "knowledgeable" about VA-ECMO, compared to those who did not, more frequently replied that there should not be presumed consent for VA-ECMO (47.6 percent versus 33.3 percent, p = 0.007), that physicians should have the right to discontinue VA-ECMO over a surrogate's objection (76.2 percent versus 50 percent, p = 0.02) and that, given its cost, the use of VA-ECMO should be restricted (81.0 percent versus 54.4 percent, p = 0.005). Surveyed physicians, especially those who self-reported as knowledgeable about VA-ECMO and/or were specialists in pulmonary/critical care, favored a medical locus of decisional authority for VA-ECMO. VA-ECMO is complex, and the data may (1) reflect physicians' hesitance to cede authority to presumably

  8. Training satisfaction for subspecialty fellows in internal medicine: Findings from the Veterans Affairs (VA Learners' Perceptions Survey

    Directory of Open Access Journals (Sweden)

    Byrne John M

    2011-05-01

    Full Text Available Abstract Background Learner satisfaction assessment is critical in the design and improvement of training programs. However, little is known about what influences satisfaction and whether trainee specialty is correlated. A national comparison of satisfaction among internal medicine subspecialty fellows in the Department of Veterans Affairs (VA provides a unique opportunity to examine educational factors associated with learner satisfaction. We compared satisfaction across internal medicine fellows by subspecialty and compared factors associated with satisfaction between procedural versus non-procedural subspecialty fellows, using data from the Learners' Perceptions Survey (LPS, a validated survey tool. Methods We surveyed 2,221 internal medicine subspecialty fellows rotating through VA between 2001 and 2008. Learners rated their overall training satisfaction on a 100-point scale, and on a five-point Likert scale ranked satisfaction with items within six educational domains: learning, clinical, working and physical environments; personal experience; and clinical faculty/preceptor. Results Procedural and non-procedural fellows reported similar overall satisfaction scores (81.2 and 81.6. Non-procedural fellows reported higher satisfaction with 79 of 81 items within the 6 domains and with the domain of physical environment (4.06 vs. 3.85, p Conclusions Internal medicine fellows are highly satisfied with their VA training. Nonprocedural fellows reported higher satisfaction with most items. For both procedural and non-procedural fellows, clinical faculty/preceptor and personal experience have the strongest impact on overall satisfaction.

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

    Science.gov (United States)

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

    2017-09-25

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

  10. Rehospitalization in the First Year Following Veteran and Service Member TBI: A VA TBI Model Systems Study.

    Science.gov (United States)

    Tran, Johanna; Hammond, Flora; Dams-OʼConnor, Kristen; Tang, Xinyu; Eapen, Blessen; McCarthy, Marissa; Nakase-Richardson, Risa

    To determine the incidence and causes of rehospitalization following military or Veteran traumatic brain injury (TBI). Department of Veterans Affairs (VA) Veterans Health Administration Polytrauma Rehabilitation Centers (VHA PRCs). Consecutive sample of VHA TBI Model System participants (N = 401). Prospective observational cohort study. Number and type of rehospitalizations in first year post-TBI. Forty-one percent of 401 participants were rehospitalized. Rehospitalization status was associated with greater injury severity and receipt of TBI while active duty. Of those rehospitalized, 30% had 2 or more readmissions. Participants experiencing multiple rehospitalizations (2+) were more likely to have sustained their TBI during deployment than those with none or single rehospitalization. This group also sustained more severe injuries and spent more time in VA PRC inpatient rehabilitation. Common reasons for rehospitalization included inpatient rehabilitation (33%), unspecified (26%), orthopedic (10%), seizures (8%), infection (8%), and psychiatric (7%). This is the first study examining military and Veteran rehospitalization following TBI requiring inpatient rehabilitation at a VA PRC. Findings indicate frequent rehospitalizations in the first year postinjury, suggesting the need for preventive models of health maintenance following inpatient rehabilitation discharge. Greater surveillance of those with deployment-related TBI or active duty at the time of injury and greater TBI severity may be warranted.

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

    Science.gov (United States)

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

    2017-04-01

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

  12. The in vitro effect of Viscum album (VA) extract on DNA repair of peripheral blood mononuclear cells (PBMC) in cancer patients.

    Science.gov (United States)

    Kovacs, Eva

    2002-03-01

    Viscum album (VA) extract as an immunomodulator was tested in an in vitro model to investigate DNA repair in damaged peripheral blood mononuclear cells (PBMC) of ten breast cancer patients. The cells were exposed by gamma rays or 4-hydroxycyclophosphamide (4-HCy). Two hours after exposure the following were measured, without or with VA extract (1) DNA repair using the alkaline sucrose gradient for the sedimentation of DNA strand breaks, (2) DNA-gamma-production in the supernatant of the cultured cells. The VA extract led to an improvement of DNA repair in gamma-ray or 4-HCy damaged PBMC and to a significant increase of the IFN-gamma-production both in undamaged and in damaged cells. The results indicate that the VA extract affects positively DNA repair in PBMC damaged by two different agents and suggest that an increased IFN-gamma-production may play an important role in the DNA repair process. Copyright 2002 John Wiley & Sons, Ltd.

  13. 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

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

    Directory of Open Access Journals (Sweden)

    Munjanja Stephan P

    2011-08-01

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

  15. Quality rating test of hearing aid benefit in the NIDCD/VA Clinical Trial.

    Science.gov (United States)

    Noffsinger, Douglas; Haskell, George B; Larson, Vernon D; Williams, David W; Wilson, Eleanor; Plunkett, Sheril; Kenworthy, Diane

    2002-08-01

    As part of a large clinical trial that compared three hearing aid circuits using several evaluation methods, judgments about quality of listening experiences were sought from all subjects. Three dimensions were examined: loudness, noise interference and overall liking (quality). Eight Audiology units in VA Medical Centers participated. Three hearing aid circuits were compared: linear peak clipper, compression limiter, and wide dynamic range compressor. The experimental design was a three-period, three-treatment crossover design. Baseline measures were made using a battery of tests in unaided conditions. Subjects (N = 360) were then stratified by participating site and randomized to one of six sequences of the three hearing aid circuits. Each circuit was fit binaurally and all subjects used each of the three circuits for 3 mo. All outcome measures were administered in unaided and aided conditions after each 3-mo period. The study used a double-blind strategy, i.e., neither the audiologist giving the tests nor the subject knew which circuit was being used. A different audiologist programmed the devices. For loudness judgments, soft and loud presentations of speech in quiet and in babble competition were judged more comfortable via the wide dynamic range circuit. The noise interference tasks and overall liking of the listening experience showed few significant differences across circuits. All circuits made the listening experience more comfortably loud for soft and conversation-level speech. Differences across circuits in terms of the overall quality of the listening experience and how noise interference was rated were small. Only isolated conditions, usually favoring the WDRC circuit, reached significance levels. The loudness dimension results were clearer. The WDRC circuit made sounds at either the loud or soft extreme more comfortable. When subjects were grouped by amount and configuration of hearing loss, the advantages for the WDRC and to a lesser extent the

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

    Directory of Open Access Journals (Sweden)

    Blevins Dean

    2010-10-01

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

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

    Science.gov (United States)

    2015-11-01

    with dog tag tassels—further emphasizes higher education to the exclusion of other types of GI Bill benefits . VA’s GI Bill Comparison Tool also uses...VA BENEFITS Increasing Outreach and Measuring Outcomes Would Improve the Post- 9/11 GI Bill On-the- Job Training and...2. REPORT TYPE 3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE VA Benefits : Increasing Outreach and Measuring Outcomes Would

  18. Reproductive and other health outcomes in Iraq and Afghanistan women veterans using VA health care: association with mental health diagnoses.

    Science.gov (United States)

    Cohen, Beth E; Maguen, Shira; Bertenthal, Daniel; Shi, Ying; Jacoby, Vanessa; Seal, Karen H

    2012-09-01

    An increasing number of women serve in the military and are exposed to trauma during service that can lead to mental health problems. Understanding how these mental health problems affect reproductive and physical health outcomes will inform interventions to improve care for women veterans. We analyzed national Department of Veterans Affairs (VA) data from women Iraq and Afghanistan veterans who were new users of VA healthcare from October 7, 2001, through December 31, 2010 (n = 71,504). We used ICD-9 codes to categorize veterans into five groups by mental health diagnoses (MH Dx): Those with no MH Dx, posttraumatic stress disorder (PTSD), depression, comorbid PTSD and depression, and a MH Dx other than PTSD and depression. We determined the association between mental health category and reproductive and other physical health outcomes defined by ICD-9 codes. Categories included sexually transmitted infections, other infections (e.g., urinary tract infections), pain-related conditions (e.g., dysmenorrhea and dsypareunia), and other conditions (e.g., polycystic ovarian syndrome, infertility, sexual dysfunction). Models were adjusted for sociodemographic and military service factors. There were 31,481 patients (44%) who received at least one mental health diagnosis. Women veterans with any mental health diagnosis had significantly higher prevalences of nearly all categories of reproductive and physical disease diagnoses (p mental health diagnoses had significantly greater prevalences of several important reproductive and physical health diagnoses. These results provide support for VA initiatives to address mental and physical health concerns and improve comprehensive care for women veterans. Published by Elsevier Inc.

  19. Suicide-related behaviors in older patients with new anti-epileptic drug use: data from the VA hospital system

    Directory of Open Access Journals (Sweden)

    Dersh Jeffrey J

    2010-01-01

    Full Text Available Abstract Background The U.S. Food and Drug Administration (FDA recently linked antiepileptic drug (AED exposure to suicide-related behaviors based on meta-analysis of randomized clinical trials. We examined the relationship between suicide-related behaviors and different AEDs in older veterans receiving new AED monotherapy from the Veterans Health Administration (VA, controlling for potential confounders. Methods VA and Medicare databases were used to identify veterans 66 years and older, who received a care from the VA between 1999 and 2004, and b an incident AED (monotherapy prescription. Previously validated ICD-9-CM codes were used to identify suicidal ideation or behavior (suicide-related behaviors cases, epilepsy, and other conditions previously associated with suicide-related behaviors. Each case was matched to controls based on prior history of suicide-related behaviors, year of AED prescription, and epilepsy status. Results The strongest predictor of suicide-related behaviors (N = 64; Controls N = 768 based on conditional logistic regression analysis was affective disorder (depression, anxiety, or post-traumatic stress disorder (PTSD; Odds Ratio 4.42, 95% CI 2.30 to 8.49 diagnosed before AED treatment. Increased suicide-related behaviors were not associated with individual AEDs, including the most commonly prescribed AED in the US - phenytoin. Conclusion Our extensive diagnostic and treatment data demonstrated that the strongest predictor of suicide-related behaviors for older patients newly treated with AED monotherapy was a previous diagnosis of affective disorder. Additional, research using a larger sample is needed to clearly determine the risk of suicide-related behaviors among less commonly used AEDs.

  20. La Lola se va a los puertos. Corazón por escenografía y mar por escenario

    OpenAIRE

    Martínez Vicente, Benito

    2017-01-01

    Actas del V Congreso Internacional de Historia y Cine celebrado en la Universidad Carlos III de Madrid del 5 al 7 de Septiembre de 2016. La obra de los hermanos Machado, La Lola se va a los puertos, ha sido lleva al cine en dos ocasiones, 1947 y 1993. Sus escenarios, artificiales y naturales, y escenografía, nos conducen al intento de entender un país, sus vaivenes y el corazón de una mujer, por el que rivalizan un padre y un hijo, y que es interpretada por dos artistas bien disti...

  1. A Comparison of Collaborative Care Outcomes in Two Health Care Systems: VA Clinics and Federally Qualified Health Centers.

    Science.gov (United States)

    Grubbs, Kathleen M; Fortney, John C; Pyne, Jeffrey; Mittal, Dinesh; Ray, John; Hudson, Teresa J

    2018-01-16

    Collaborative care for depression results in symptom reduction when compared with usual care. No studies have systematically compared collaborative care outcomes between veterans treated at Veterans Affairs (VA) clinics and civilians treated at publicly funded federally qualified health centers (FQHCs) after controlling for demographic and clinical characteristics. Data from two randomized controlled trials that used a similar collaborative care intervention for depression were combined to conduct post hoc analyses (N=759). The Telemedicine-Enhanced Antidepressant Management intervention was delivered in VA community-based outpatient clinics (CBOCs), and the Outreach Using Telemedicine for Rural Enhanced Access in Community Health intervention was delivered in FQHCs. Multivariate logistic regression was used to determine whether veteran status moderated the effect of the intervention on treatment response (>50% reduction in symptoms). There was a significant main effect for intervention (odds ratio [OR]=5.23, p<.001) and a moderating effect for veteran status, with lower response rates among veterans compared with civilians (OR=.21, p=.01). The addition of variables representing medication dosage and number of mental health and general health appointments did not influence the moderating effect. A sensitivity analysis stratified by gender found a significant moderating effect of veteran status for men but not women. Veteran status was a significant moderator of collaborative care effectiveness for depression, indicating that veterans receiving collaborative care at a CBOC are at risk of nonresponse. Unmeasured patient- or system-level characteristics may contribute to poorer response among veterans.

  2. Tout va bien ! méthode de français : cahier d'exercices 1

    CERN Document Server

    Augé, H; Marlhens, C; Martin, L

    2005-01-01

    Tout va bien ! est une méthode de français destinée aux grands adolescents et adultes débutants ou faux-débutants. Ses objectifs respectent scrupuleusement les recommandations du Cadre européen commun de référence pour les langues, comme en témoigne le portfolio qui accompagne le livre de l'élève. Tout va bien ! propose : Des supports et des situations de communication authentiques ou proches de l'authentique, permettant à l'élève de se sensibiliser aux différents registres et de découvrir certains aspects de la culture francophone tout autant que la langue. De très nombreuses activités visant l'acquisition des quatre compétences de communication et l'utilisation de stratégies spécifiques. Un travail sur la grammaire et le vocabulaire associés aux situations et au service de la communication faisant une large place à l'observation et à la réflexion. Une invitation régulière à l'évaluation, au travail an autonomie et à l'auto-évaluation.

  3. Tout va bien ! méthode de français : cahier d'exercices 2

    CERN Document Server

    Augé, H; Marlhens, C; Martin, L

    2005-01-01

    Tout va bien ! est une méthode de français destinée aux grands adolescents et adultes débutants ou faux-débutants. Ses objectifs respectent scrupuleusement les recommandations du Cadre européen commun de référence pour les langues, comme en témoigne le portfolio qui accompagne le livre de l'élève. Tout va bien ! propose : Des supports et des situations de communication authentiques ou proches de l'authentique, permettant à l'élève de se sensibiliser aux différents registres et de découvrir certains aspects de la culture francophone tout autant que la langue. De très nombreuses activités visant l'acquisition des quatre compétences de communication et l'utilisation de stratégies spécifiques. Un travail sur la grammaire et le vocabulaire associés aux situations et au service de la communication faisant une large place à l'observation et à la réflexion. Une invitation régulière à l'évaluation, au travail an autonomie et à l'auto-évaluation.

  4. The Feasibility of Using Large-Scale Text Mining to Detect Adverse Childhood Experiences in a VA-Treated Population.

    Science.gov (United States)

    Hammond, Kenric W; Ben-Ari, Alon Y; Laundry, Ryan J; Boyko, Edward J; Samore, Matthew H

    2015-12-01

    Free text in electronic health records resists large-scale analysis. Text records facts of interest not found in encoded data, and text mining enables their retrieval and quantification. The U.S. Department of Veterans Affairs (VA) clinical data repository affords an opportunity to apply text-mining methodology to study clinical questions in large populations. To assess the feasibility of text mining, investigation of the relationship between exposure to adverse childhood experiences (ACEs) and recorded diagnoses was conducted among all VA-treated Gulf war veterans, utilizing all progress notes recorded from 2000-2011. Text processing extracted ACE exposures recorded among 44.7 million clinical notes belonging to 243,973 veterans. The relationship of ACE exposure to adult illnesses was analyzed using logistic regression. Bias considerations were assessed. ACE score was strongly associated with suicide attempts and serious mental disorders (ORs = 1.84 to 1.97), and less so with behaviorally mediated and somatic conditions (ORs = 1.02 to 1.36) per unit. Bias adjustments did not remove persistent associations between ACE score and most illnesses. Text mining to detect ACE exposure in a large population was feasible. Analysis of the relationship between ACE score and adult health conditions yielded patterns of association consistent with prior research. Copyright © 2015 International Society for Traumatic Stress Studies.

  5. Going to scale: a nonrandomized nationwide trial of the KiVa antibullying program for grades 1-9.

    Science.gov (United States)

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

    2011-12-01

    The effects of school-based antibullying programs have typically been examined on small samples, with number of schools ranging from 1 to 78 (Farrington & Ttofi, 2009). This study investigated the effectiveness of the KiVa antibullying program in the beginning of its nationwide implementation in Finland. At each time point, the participants included 888 schools with approximately 150,000 students in 11,200 classrooms in Grades 1-9 (8-16 years of age; 51% boys and 49% girls). Victims and bullies were identified with the global questions from the Revised Olweus Bully/Victim Questionnaire (Olweus, 1996), utilizing the criteria suggested by Solberg and Olweus (2003). The program effects were examined by calculating odds ratios based on a cohort-longitudinal design, correcting the standard errors for clustering. During the first 9 months of implementation, the KiVa program reduced both victimization and bullying, with a control/intervention group odds ratio of 1.22 (95% CI [1.19, 1.24]) for victimization and 1.18 (95% CI [1.15, 1.21]) for bullying. Generalized to the Finnish population of 500,000 students, this would mean a reduction of approximately 7,500 bullies and 12,500 victims.

  6. Rab10 and myosin-Va mediate insulin-stimulated GLUT4 storage vesicle translocation in adipocytes

    Science.gov (United States)

    Chen, Yu; Wang, Yan; Zhang, Jinzhong; Deng, Yongqiang; Jiang, Li; Song, Eli; Wu, Xufeng S.; Hammer, John A.

    2012-01-01

    Rab proteins are important regulators of insulin-stimulated GLUT4 translocation to the plasma membrane (PM), but the precise steps in GLUT4 trafficking modulated by particular Rab proteins remain unclear. Here, we systematically investigate the involvement of Rab proteins in GLUT4 trafficking, focusing on Rab proteins directly mediating GLUT4 storage vesicle (GSV) delivery to the PM. Using dual-color total internal reflection fluorescence (TIRF) microscopy and an insulin-responsive aminopeptidase (IRAP)-pHluorin fusion assay, we demonstrated that Rab10 directly facilitated GSV translocation to and docking at the PM. Rab14 mediated GLUT4 delivery to the PM via endosomal compartments containing transferrin receptor (TfR), whereas Rab4A, Rab4B, and Rab8A recycled GLUT4 through the endosomal system. Myosin-Va associated with GSVs by interacting with Rab10, positioning peripherally recruited GSVs for ultimate fusion. Thus, multiple Rab proteins regulate the trafficking of GLUT4, with Rab10 coordinating with myosin-Va to mediate the final steps of insulin-stimulated GSV translocation to the PM. PMID:22908308

  7. Development of a 1000 kVA oxide superconducting transformer cooled by liquid nitrogen. 4. Ac loss properties.; Ekitai chisso reikyaku 1000 kVA sankabutsu chodendo hen'atsuki no kaihatsu 4. Koryu sonshitsu tokusei

    Energy Technology Data Exchange (ETDEWEB)

    Iwakuma, M.; Fukuda, Y.; Matsumura, K. [Kyushu Univ., Fukuoka (JP)] [and others

    2000-05-29

    In this study group, it developed the liquid nitrogen cooling 22kV/6.9kV-1000kVA single phase superconducting transformer using the Bi2223 superconducting wire rod with the aim of the superconduction of the transformer for urban area underground substation this time. In this paper, ac loss characteristics of the superconductive winding are reported. In developed superconductive winding, the ac loss occupies over half of all thermal load, and it becomes important characteristics, which decide necessary cooling unit capacity and equipment efficiency. In this study, it put principal objective for the establishment of ac loss evaluation technique in the design and ac loss measuring technique of actual equipment. (NEDO)

  8. Interdisciplinary Quality Improvement Conference: Using a Revised Morbidity and Mortality Format to Focus on Systems-Based Patient Safety Issues in a VA Hospital: Design and Outcomes.

    Science.gov (United States)

    Gerstein, Wendy H; Ledford, Judith; Cooper, Jacqueline; Lloyd, Melissa G; Moore, Timothy; Harji, Farzana; Twitty, Vivian; Brooks, Annette; Oliver, Rosalinda C; Goff, James M

    2016-01-01

    The Veterans Healthcare Administration (VA) has embraced patient safety and quality improvement in the quest to improve care for veterans. The New Mexico VA Health Care System introduced a new morbidity and mortality conference, called the Interdisciplinary Quality Improvement Conference (IQIC), using patient case presentations to focus on underlying systems in the clinical care environment. The revised conference design also effectively teaches the 6 Accreditation Council for Graduate Medical Education (ACGME) core requirements for resident education. A formal process was established for case selection, presentation, systems issue identification, tracking, and follow-up. The IQIC has enabled the identification of more than 20 system issues at the study institution. Outcome data show lasting improvement in system issues that were addressed by this mechanism. The VA IQIC is an effective method to both identify and correct systems issues that affect patient care and is an effective method for teaching residents the 6 ACGME requirements for residency education. © The Author(s) 2014.

  9. Search for V+A current in top quark decay in p anti-p collisions at s**(1/2) = 1.96-TeV

    Energy Technology Data Exchange (ETDEWEB)

    Abulencia, A.; Adelman, J.; Affolder, T.; Akimoto, T.; Albrow, M.G.; Ambrose, D.; Amerio, S.; Amidei, D.; Anastassov, A.; Anikeev, K.; Annovi, A.; /Taiwan, Inst. Phys.

    2006-08-01

    The authors report an upper limit on the fraction of V + A current, f{sub V+A}, in top quark decays, using approximately 700 pb{sup -1} of p{bar p} collisions at {radical}s = 1.96 TeV acquired by the upgraded Collider Detector at Fermilab. For the decay t {yields} wb {yields} {ell}vb (where {ell} = e or {mu}), the invariant mass of the charged lepton and the bottom quark jet is sensitive to the polarization of the W boson. They determine f{sub V+A} = -0.06 {+-} 0.25 given a top quark mass of 175 GeV/c{sup 2}. They set an upper limit on f{sub V+A} of 0.29 at the 95% confidence level, which represents an improvement by a factor of two on the previous best direct limit.

  10. Prescription and repair rates of prosthetic limbs in the VA healthcare system: implications for national prosthetic parity.

    Science.gov (United States)

    Etter, Katherine; Borgia, Matthew; Resnik, Linda

    2014-05-22

    Abstract Purpose: To quantify prescription and repair rates of prosthetic limbs in the Department of Veterans Affairs (VA) and explore differences by level, type, and age. Methods: Veterans (N = 32 440) with an initial prosthetic prescription between 2000 and 2010 were classified by amputation level and type. Annual rates of prescription and repair were calculated using person-time and compared by group. Results: Veterans with upper limb amputation had lower annual prescription and repair rates (0.28 and 0.21) compared with those with lower limb amputation (0.40 and 0.56). Myoelectric devices users had higher prescription rates. However, body-powered users had higher repair rates. Prescription and repair rates for microprocessor knee joints were higher than for fluid and friction devices. Veterans under 65 had 0.07 and 0.16 higher rates of prescription and repair than those over 65 (p < 0.0001). Conclusions: Because the VA is unconstrained by co-pays or caps, data on prosthetic prescription and repair can be used to estimate rates that might occur if national prosthetic parity laws were adopted. Given the rates found, it is likely that annual costs would exceed the typical annual and/or lifetime caps in most insurance plans. In states without prosthetic parity laws, such costs likely limit access to needed devices. Implications for Rehabilitation For the almost 2 million people in the United States living with an amputation or congenital limb loss, purchasing and maintaining a prosthetic limb can be costly, with insurances often imposing annual or lifetime caps. Data on prosthetic purchasing and repair is limited and reliant on self-reported information. Because the VA is unconstrained by co-pays or caps, claims data on prosthetic prescription and repair can be used to estimate rates that might occur if national prosthetic parity laws were adopted. Given the rates found, it is likely that annual costs would exceed the typical annual and/or lifetime caps

  11. Tailoring an educational program on the AHRQ Patient Safety Indicators to meet stakeholder needs: lessons learned in the VA.

    Science.gov (United States)

    Shin, Marlena H; Rivard, Peter E; Shwartz, Michael; Borzecki, Ann; Yaksic, Enzo; Stolzmann, Kelly; Zubkoff, Lisa; Rosen, Amy K

    2018-02-14

    Given that patient safety measures are increasingly used for public reporting and pay-for performance, it is important for stakeholders to understand how to use these measures for improvement. The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) are one particularly visible set of measures that are now used primarily for public reporting and pay-for-performance among both private sector and Veterans Health Administration (VA) hospitals. This trend generates a strong need for stakeholders to understand how to interpret and use the PSIs for quality improvement (QI). The goal of this study was to develop an educational program and tailor it to stakeholders' needs. In this paper, we share what we learned from this program development process. Our study population included key VA stakeholders involved in reviewing performance reports and prioritizing and initiating quality/safety initiatives. A pre-program formative evaluation through telephone interviews and web-based surveys assessed stakeholders' educational needs/interests. Findings from the formative evaluation led to development and implementation of a cyberseminar-based program, which we tailored to stakeholders' needs/interests. A post-program survey evaluated program participants' perceptions about the PSI educational program. Interview data confirmed that the concepts we had developed for the interviews could be used for the survey. Survey results informed us on what program delivery mode and content topics were of high interest. Six cyberseminars were developed-three of which focused on two content areas that were noted of greatest interest: learning how to use PSIs for monitoring trends and understanding how to interpret PSIs. We also used snapshots of VA PSI reports so that participants could directly apply learnings. Although initial interest in the program was high, actual attendance was low. However, post-program survey results indicated that perceptions about the

  12. VaCPK20, a calcium-dependent protein kinase gene of wild grapevine Vitis amurensis Rupr., mediates cold and drought stress tolerance.

    Science.gov (United States)

    Dubrovina, Alexandra S; Kiselev, Konstantin V; Khristenko, Valeriya S; Aleynova, Olga A

    2015-08-01

    Abiotic stresses, such as drought, salinity, cold and heat, are major environmental factors that limit crop productivity. Vitis amurensis Rupr. is a wild grapevine species displaying a high level of abiotic and biotic stress resistance. Protein kinases, including Ca(2+)-dependent protein kinases (CDPKs), are known to mediate plant acclimation to various environmental changes. However, the functions of most grape CDPKs have not been clarified. A recent CDPK gene expression analysis revealed that 10 CDPK genes of V. amurensis were up-regulated under different abiotic stress treatments. The expression of the VaCPK20 gene was significantly up-regulated under low and high temperature stress in V. amurensis. In the current study, the effects of overexpressing the VaCPK20 gene in callus cell lines of V. amurensis and transgenic plants of A. thaliana on their responses to abiotic stresses were investigated. Transgenic Arabidopsis overexpressing the VaCPK20 gene showed higher tolerance to freezing and drought stresses, and transgenic grape cell cultures overexpressing the VaCPK20 gene showed higher resistance to cold stress in comparison with the controls transformed by the "empty" vector. Heat and salt stress resistance of the transgenic V. amurensis calli and A. thaliana was comparable to that of the wild type and vector controls. Overexpression of the VaCPK20 gene increased the expression of stress-responsive genes, such as COR47, NHX1, KIN1, or ABF3, in the transgenic Arabidopsis plants under non-stress conditions, after freezing, and under drought stress. The results imply that VaCPK20 may act as a regulatory factor involved in cold and drought stress response pathways. Copyright © 2015 Elsevier GmbH. All rights reserved.

  13. Overexpression of a stress-responsive U-box protein gene VaPUB affects the accumulation of resistance related proteins in Vitis vinifera 'Thompson Seedless'.

    Science.gov (United States)

    Jiao, Li; Zhang, Yali; Lu, Jiang

    2017-03-01

    Many U-box proteins have been identified and characterized as important factors against environmental stresses such as chilling, heat, salinity and pathogen attack in plant. Our previous research reported the cloning of a novel U-box protein gene VaPUB from Vitis amurensis 'Zuoshanyi' grape and suggested a function of it in related to cold stress in the model plant Arabidopsis system. In this study, the role of VaPUB in response to biotic and abiotic stress was further analyzed in the homologous grapevine system by studying the transcript regulation and the protein accumulation in VaPUB transgenic vines. The expression analysis assay shown that VaPUB was significantly up-regulated 6 h after cold treatment and as early as 2 h post inoculation with Plasmopara viticola, a pathogen causing downy mildew disease in grapevine. Over-expressing VaPUB in V. Vinifera 'Thompson Seedless' affected the microstructure of leaves. The proteome assay shown that the accumulation of pathogenesis-related protein PR10 and many proteins involved in carbon and energy metabolism, oxidation reaction and protein metabolism were significantly altered in transgenic vines. In comparison with wild type plants, the expression level of PR10 family genes was significantly decreased in VaPUB transgenic vines under P. viticola treatment or cold stress. Results from this study showed that the U-box protein gene PUB quickly responded to both biotic stress and abiotic stress and significantly influenced the accumulation of resistance related proteins in grapevine. Copyright © 2016. Published by Elsevier Masson SAS.

  14. Preparation and physicochemical characterization of a solid dispersion of (3, 5, 6-trimethylpyrazin-2-yl) methyl 3-methoxy-4-[(3, 5, 6-trimethylpyrazin-2-yl) methoxy] benzoate (VA-T) and polyvinylpyrrolidone.

    Science.gov (United States)

    Cao, Sa-Li; Hou, Peng; Li, Bin; Fu, Jing; Yin, Xing-Bin; Dang, Xiao-Fang; Yang, Chun-Jing; Zhang, Jin; Zhang, Hui; Lei, Hai-Min; Ni, Jian

    2015-11-01

    Ischemic brain injury is a major disease which threatens human health and safety. (3, 5, 6-trimethylpyrazin-2-yl) methyl 3-methoxy-4-[(3, 5, 6-trimethylpyrazin-2-yl) methoxy] benzoate (VA-T), a newly discovered lead compound, is effective for the treatment of ischemic brain injury and its sequelae. But the poor solubility of VA-T leads to poor dissolution and limited clinical application. In order to improve the dissolution of VA-T, the pharmaceutical technology of solid dispersions was used in the present study. VA-T/polyvinylpyrrolidone (PVP) solid dispersion was prepared by the solvent method. The dissolution studies were carried out and solid state characterization was evaluated by differential scanning calorimetry (DSC), infrared spectroscopy (IR), x-ray diffraction (XRD) and scanning electron microscopy (SEM). The dissolution rate of VA-T was significantly improved by solid dispersion compared to that of the pure drug and physical mixture. The results of DSC and XRD indicated that the VA-T solid dispersion was amorphous. The IR spectra showed the possible interaction between VA-T and PVP was the formulation of hydrogen bonding. The SEM analysis demonstrated that there was no VA-T crystal observed in the solid dispersions. The ideal drug-to-PVP ratio was 1:5. In conclusion, the solid dispersion technique can be successfully used for the improvement of the dissolution profile of VA-T. Copyright © 2015 China Pharmaceutical University. Published by Elsevier B.V. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-10-01

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

  16. InterVA-4 as a public health tool for measuring HIV/AIDS mortality: a validation study from five African countries

    Directory of Open Access Journals (Sweden)

    Peter Byass

    2013-10-01

    Full Text Available Background: Reliable population-based data on HIV infection and AIDS mortality in sub-Saharan Africa are scanty, even though that is the region where most of the world’s AIDS deaths occur. There is therefore a great need for reliable and valid public health tools for assessing AIDS mortality. Objective: The aim of this article is to validate the InterVA-4 verbal autopsy (VA interpretative model within African populations where HIV sero-status is recorded on a prospective basis, and examine the distribution of cause-specific mortality among HIV-positive and HIV-negative people. Design: Data from six sites of the Alpha Network, including HIV sero-status and VA interviews, were pooled. VA data according to the 2012 WHO format were extracted, and processed using the InterVA-4 model into likely causes of death. The model was blinded to the sero-status data. Cases with known pre-mortem HIV infection status were used to determine the specificity with which InterVA-4 could attribute HIV/AIDS as a cause of death. Cause-specific mortality fractions by HIV infection status were calculated, and a person-time model was built to analyse adjusted cause-specific mortality rate ratios. Results: The InterVA-4 model identified HIV/AIDS-related deaths with a specificity of 90.1% (95% CI 88.7–91.4%. Overall sensitivity could not be calculated, because HIV-positive people die from a range of causes. In a person-time model including 1,739 deaths in 1,161,688 HIV-negative person-years observed and 2,890 deaths in 75,110 HIV-positive person-years observed, the mortality ratio HIV-positive:negative was 29.0 (95% CI 27.1–31.0, after adjustment for age, sex, and study site. Cause-specific HIV-positive:negative mortality ratios for acute respiratory infections, HIV/AIDS-related deaths, meningitis, tuberculosis, and malnutrition were higher than the all-cause ratio; all causes had HIV-positive:negative mortality ratios significantly higher than unity. Conclusions

  17. Vibrational analysis of various irotopes of L-alanyl-L-alanine in aqueous solution: Vibrational Absorption (VA), Vibrational Circular Dichroism (VCD), Raman and Raman Optical Activity (ROA) Spectra

    DEFF Research Database (Denmark)

    Jalkanen, Karl J.; Nieminen, R.M.; Knapp-Mohammady, M.

    2003-01-01

    been reported. Subsequently, the vibrational absorption (VA) and vibrational circular dichroism (VCD) and the Raman and Raman Optical Activity (ROA) spectra have been reported. In this work an analysis of the aqueous solution VA, VCD, Raman, and ROA spectra for various isotopomers of LALA are reported...... with the experimentally measured spectra. With the DFT, explicit water molecules, and a continuum solvent model we are better able to reproduce the vibrational absorption and Raman spectra than previously reported. The AAT have been implemented at the DFT level, although not within the continuum treatment. The VCD sign...

  18. 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.

  19. ICD discrimination of SVT versus VT with 1:1 V-A conduction: A review of the literature.

    Science.gov (United States)

    Cardoso, Rhanderson N; Healy, Chris; Viles-Gonzalez, Juan; Coffey, James O

    2015-01-01

    Inappropriate ICD shocks are associated with increased mortality. They also impair patients' quality of life, increase hospitalizations, and raise health-care costs. Nearly 80% of inappropriate ICD shocks are caused by supraventricular tachycardia. Here we report the case of a patient who received a single-lead dual-chamber sensing ICD for primary prevention of sudden cardiac death and experienced inappropriate ICD shocks. V-A time, electrogram morphology, and response to antitachycardia pacing suggested atrioventricular nodal reentry tachycardia, which was confirmed in an electrophysiology study. Inspired by this case, we performed a literature review to discuss mechanisms for discrimination of supraventricular tachycardia with 1:1 A:V relationship from ventricular tachycardia with 1:1 retrograde conduction.

  20. Optimisasi Portofolio Mean-VaR di bawah CAPM Transformasi Koyck dengan Volatilitas Tak Konstan dan Efek Long Memory

    Directory of Open Access Journals (Sweden)

    Sukono Sukono

    2010-01-01

    Full Text Available In this paper we formulated mean-VaR portfolio optimization through CAPM Koyck transformation. We assumed that lagged of risk premium which have highly influence on stock returns is infinite, while model parameters decrease geometrically. We also assumed that rate of return in risk premium market index is not constant, in other word has a non-constant volatility rate, and also has a long memory effect. The later was analyzed using ARFIMA. Non constant volatility rate was modeled via GARCH model. The portfolio optimization was constructed using Langrangian multiplier and the Kuhn-Tucker theorem was employed to obtain the solution by the least square method. Finally, we provide a numerical example of the optimization model based on several stocks traded in Indonesian capital market.

  1. Viveret Patrick, 2005, Pourquoi ça ne va pas plus mal?, Fayard, 264 p.

    Directory of Open Access Journals (Sweden)

    Fabien Thurette

    2008-05-01

    Full Text Available Patrick Viveret est philosophe de formation et Conseiller-maître à la Cour des comptes. Il a, en outre, été chargé d’une mission, confiée par l'éphémère Secrétaire d'État à l'économie solidaire Guy Hascoët, puis prolongée par le Président Chirac sur une « autre approche de la richesse », dont le rapport final a été publié sous le titre Reconsidérer la richesse (2004.Dans son essai Pourquoi ça ne va pas plus mal ? publié en 2005, Patrick Viveret nous livre une analyse philosophique sur le « m...

  2. Prevalence of depressive and alcohol abuse symptoms among women VA outpatients who report experiencing sexual assault while in the military.

    Science.gov (United States)

    Hankin, C S; Skinner, K M; Sullivan, L M; Miller, D R; Frayne, S; Tripp, T J

    1999-10-01

    Among a national sample of 3,632 women VA outpatients, we determined self-reported prevalence of sexual assault experienced during military service and compared screening prevalence for current symptoms of depression and alcohol abuse between those who did and did not report this history. Data were obtained by mailed questionnaire. Military-related sexual assault was reported by 23%. Screening prevalence for symptoms of current depression was 3 times higher and for current alcohol abuse was 2 times higher among those who reported experiencing military-related sexual assault. Recent mental health treatment was reported by 50% of those who reported experiencing sexual assault during military service and screened positive for symptoms of depression, and by 40% of those who screened positive for symptoms of alcohol abuse.

  3. Production of electricity through biomass gasification system downdraft and generator group with a capacity of 50 kVA

    Directory of Open Access Journals (Sweden)

    Fabrízio Luiz Figueiredo

    2012-11-01

    Full Text Available This paper presents the results of tests performed with an internal combustion engine adapted to MWM Otto cycle, coupled to an electricity generator with a capacity of 50 kVA, fed exclusively with synthesis gas from a biomass gasifier downdraft, using wood eucalyptus. Also featured are the characteristics and efficiency of the generator set, in order to assess the feasibility of applying the system in remote locations, where biomass is available and the system of conventional electric power transmission is hampered by distance. The synthesis gas generated showed the average composition of 16,9% H2, 20% CO, 10,9% CO2, CH4, 2% and 50,1% N2. The performance of the span was monitored by applying loads of 0, 7, 13, 20,1 and 26,4 kW, the generator, keeping the average voltage of 222 V and currents of 0, 18,5, 33, 51, 84 and 67 A.

  4. Housing first on a large scale: Fidelity strengths and challenges in the VA's HUD-VASH program.

    Science.gov (United States)

    Kertesz, Stefan G; Austin, Erika L; Holmes, Sally K; DeRussy, Aerin J; Van Deusen Lukas, Carol; Pollio, David E

    2017-05-01

    Housing First (HF) combines permanent supportive housing and supportive services for homeless individuals and removes traditional treatment-related preconditions for housing entry. There has been little research describing strengths and shortfalls of HF implementation outside of research demonstration projects. The U.S. Department of Veterans Affairs (VA) has transitioned to an HF approach in a supportive housing program serving over 85,000 persons. This offers a naturalistic window to study fidelity when HF is adopted on a large scale. We operationalized HF into 20 criteria grouped into 5 domains. We assessed 8 VA medical centers twice (1 year apart), scoring each criterion using a scale ranging from 1 (low fidelity) to 4 (high fidelity). There were 2 HF domains (no preconditions and rapidly offering permanent housing) for which high fidelity was readily attained. There was uneven progress in prioritizing the most vulnerable clients for housing support. Two HF domains (sufficient supportive services and a modern recovery philosophy) had considerably lower fidelity. Interviews suggested that operational issues such as shortfalls in staffing and training likely hindered performance in these 2 domains. In this ambitious national HF program, the largest to date, we found substantial fidelity in focusing on permanent housing and removal of preconditions to housing entry. Areas of concern included the adequacy of supportive services and adequacy in deployment of a modern recovery philosophy. Under real-world conditions, large-scale implementation of HF is likely to require significant additional investment in client service supports to assure that results are concordant with those found in research studies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Opioid Dose Reduction in a VA Health Care System--Implementation of a Primary Care Population-Level Initiative.

    Science.gov (United States)

    Westanmo, Anders; Marshall, Peter; Jones, Elzie; Burns, Kevin; Krebs, Erin E

    2015-05-01

    To describe processes and outcomes of a health system quality improvement initiative designed to reduce opioid-related harms. The initiative was a primary care population-level intervention to reduce high-dose opioid prescribing, which was locally defined as >200 morphine-equivalent mg (MED) daily. We describe the implementation process and report prescribing rates and primary care provider (PCP) attitudes and beliefs before and after implementation. A VA health care system comprising one large, urban teaching hospital and 11 outpatient clinics in surrounding suburban and rural locations. All patients who received any prescription from the outpatient pharmacy (unique pharmacy patients) were included in the population. PCPs at the main hospital were surveyed. Prescribing outcomes were determined from merged VA databases by examining rates of opioid dispensing within 90-day time windows before and after implementation. PCP beliefs and attitudes were evaluated with preimplementation and postimplementation surveys. Following implementation, the number of patients prescribed >200 MED daily decreased from 342 (0.65% of unique pharmacy patients) to 65 (0.12%). Overall, the number of unique pharmacy patients who received at least one opioid prescription within 90 days decreased from 6,942 (13.7%) on April 1, 2011 to 5,981 (11.0%) on October 1, 2014 (13.8% decrease). Most PCPs agreed it was reasonable for the medical center to set a 200 MED limit (76% at baseline and 87% at follow up). Opioid Safety Initiative implementation was associated with a substantial reduction in high-dose opioid prescribing. Factors that contributed to initiative success included leadership support and active clinical pharmacy engagement. Wiley Periodicals, Inc.

  6. Computational studies on the interaction of ABO-active saccharides with the norovirus VA387 capsid protein can explain experimental binding data

    Science.gov (United States)

    Koppisetty, Chaitanya A. K.; Nasir, Waqas; Strino, Francesco; Rydell, Gustaf E.; Larson, Göran; Nyholm, Per-Georg

    2010-05-01

    Norovirus strains are known to cause recurring epidemics of winter vomiting disease. The crystal structure of the capsid protein of VA387, a representative of the clinically important GII.4 genocluster, was recently solved in complex with histo-blood group A- and B-trisaccharides. However, the VA387 strain is known to bind also to other natural carbohydrates for which detailed structural information of the complexes is not available. In this study we have computationally explored the fit of the VA387 with a set of naturally occurring carbohydrate ligands containing a terminal α1,2-linked fucose. MD simulations both with explicit and implicit solvent models indicate that type 1 and 3 extensions of the ABO-determinant including ALeb and BLeb pentasaccharides can be well accommodated in the site. Scoring with Glide XP indicates that the downstream extensions of the ABO-determinants give an increase in binding strength, although the α1,2-linked fucose is the single strongest interacting residue. An error was discovered in the geometry of the GalNAc-Gal moiety of the published crystal structure of the A-trisaccharide/VA387 complex. The present modeling of the complexes with histo-blood group A-active structures shows some contacts which provide insight into mutational data, explaining the involvement of I389 and Q331. Our results can be applicable in structure-based design of adhesion inhibitors of noroviruses.

  7. SCC-TB, DFT/B3LYP, MP2, AM1, PM3 and RHF study of ethylene oxide and propylene oxide structures, VA and VCD spectra

    DEFF Research Database (Denmark)

    Jalkanen, Karl J.; Frimand, Kenneth

    2002-01-01

    -binding method for equilibrium structures, VA and VCD spectra of ethylene oxide and propylene oxide in the gas-phase. Comparison to conventional methods AM1, PM3, MP2, RHF and DFT/B3LYP is carried out. We report results over a wider range of frequencies than previous work. In particular, we find indications...

  8. Limited variation during circulation of a polyomavirus in the human population involves the COCO-VA toggling site of Middle and Alternative T-antigen(s)

    NARCIS (Netherlands)

    S. Kazem (Siamaque); C. Lauber (Chris); E. van der Meijden (Els); S. Kooijman (Sander); A.A. Kravchenko (Alexander A.); M.C.W. Feltkamp (Mariet C.W.); A.E. Gorbalenya (Alexander); J.C. Browning (John C.); K. Busam (Klaus); S. Bialasiewicz (Seweryn); T. Benoit (Taylor); P. Fleckman (Philip); L.C. Hughey (Lauren C.); R.W.A. Janssens (René W.A.); F. Mechinaud (Francoise); E. Pope (Elena); A.S. Rosenberg (Arlene S.); E. Rácz (Emoke); G. Sadler (Genevieve); S.N. Tabrizi (Sepehr N.); E. de Vries (E.); R.C. Wang (Richard C.)

    2016-01-01

    textabstractWe have recently shown that the trichodysplasia spinulosa-associated polyomavirus (TSPyV) belongs to a large monophyletic group of mammalian polyomaviruses that experienced accelerated codon-constrained Val-Ala (COCO-VA) toggling at a protein site common to both Middle and Alternative

  9. U.S. Department of Energy Hydrogen and Fuel Cells Program 2012 Annual Merit Review and Peer Evaluation Report: May 14-18, 2012, Arlington, VA

    Energy Technology Data Exchange (ETDEWEB)

    2012-09-01

    This document summarizes the comments provided by peer reviewers on hydrogen and fuel cell projects presented at the fiscal year (FY) 2012 U.S. Department of Energy (DOE) Hydrogen and Fuel Cells Program and Vehicle Technologies Program Annual Merit Review and Peer Evaluation Meeting (AMR), held May 14-18, 2012, in Arlington, VA.

  10. Predicting Glycerophosphoinositol Identities in Lipidomic Datasets Using VaLID (Visualization and Phospholipid Identification)—An Online Bioinformatic Search Engine

    Science.gov (United States)

    McDowell, Graeme S. V.; Taylor, Graeme P.; Fai, Stephen; Bennett, Steffany A. L.

    2014-01-01

    The capacity to predict and visualize all theoretically possible glycerophospholipid molecular identities present in lipidomic datasets is currently limited. To address this issue, we expanded the search-engine and compositional databases of the online Visualization and Phospholipid Identification (VaLID) bioinformatic tool to include the glycerophosphoinositol superfamily. VaLID v1.0.0 originally allowed exact and average mass libraries of 736,584 individual species from eight phospholipid classes: glycerophosphates, glyceropyrophosphates, glycerophosphocholines, glycerophosphoethanolamines, glycerophosphoglycerols, glycerophosphoglycerophosphates, glycerophosphoserines, and cytidine 5′-diphosphate 1,2-diacyl-sn-glycerols to be searched for any mass to charge value (with adjustable tolerance levels) under a variety of mass spectrometry conditions. Here, we describe an update that now includes all possible glycerophosphoinositols, glycerophosphoinositol monophosphates, glycerophosphoinositol bisphosphates, and glycerophosphoinositol trisphosphates. This update expands the total number of lipid species represented in the VaLID v2.0.0 database to 1,473,168 phospholipids. Each phospholipid can be generated in skeletal representation. A subset of species curated by the Canadian Institutes of Health Research Training Program in Neurodegenerative Lipidomics (CTPNL) team is provided as an array of high-resolution structures. VaLID is freely available and responds to all users through the CTPNL resources web site. PMID:24701584

  11. Leg for life? The use of sartorius muscle flap for the treatment of an infected vascular reconstructions after VA-ECMO use. A case report

    Directory of Open Access Journals (Sweden)

    George V. Patrut

    2015-01-01

    Conclusion: Although ischemic complications associated with VA-ECMO are accepted by intensivists under the slogan “leg for life”, for the repair of the femoral artery in the presence of groin infection the sartorius muscle remains an efficient solution for limb salvage.

  12. VA residential substance use disorder treatment program providers' perceptions of facilitators and barriers to performance on pre-admission processes.

    Science.gov (United States)

    Ellerbe, Laura S; Manfredi, Luisa; Gupta, Shalini; Phelps, Tyler E; Bowe, Thomas R; Rubinsky, Anna D; Burden, Jennifer L; Harris, Alex H S

    2017-04-04

    In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics. The first aim sought to supplement the VA's existing facility-level performance metrics with SUD program-level metrics in order to identify high-value targets for quality improvement. The second aim recognized that not all key processes are reflected in the administrative data, and even when they are, new insight may be gained from viewing these data in the context of day-to-day clinical practice. VA administrative data from fiscal year 2012 were used to calculate pre-admission metrics for 97 programs (63 SUD Residential Rehabilitation Treatment Programs (SUD RRTPs); 34 Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs) with a SUD track). Interviews were then conducted with management and front-line staff to learn what factors may have contributed to high or low performance, relative to the national average for their program type. We hypothesized that speaking directly to residential program staff may reveal innovative practices, areas for improvement, and factors that may explain system-wide variability in performance. Average wait time for admission was 16 days (SUD RRTPs: 17 days; MH RRTPs with a SUD track: 11 days), with 60% of Veterans waiting longer than 7 days. For these Veterans, engagement while waiting occurred in an average of 54% of the waiting weeks (range 3-100% across programs). Fifty-nine interviews representing 44 programs revealed factors perceived to potentially impact performance in

  13. Psychoactive substances belonging to the amphetamine class potently activate brain carbonic anhydrase isoforms VA, VB, VII, and XII.

    Science.gov (United States)

    Angeli, Andrea; Vaiano, Fabio; Mari, Francesco; Bertol, Elisabetta; Supuran, Claudiu T

    2017-12-01

    Identifying possible new biological activities of psychoactive substances belonging to various chemical classes may lead to a better understanding of their mode of action and side effects. We report here that amines structurally related to amphetamine, a widely used psychoactive substance, such as amphetamine, methamphetamine, phentermine, mephentermine, and chlorphenteramine, potently activate several carbonic anhydrase (CA, EC 4.2.1.1) isoforms involved in important physiological functions. Of the 11 investigated human (h) isoforms, the widespread hCA I and II, the secreted hCA VI, as well as the cytosolic hCA XIII, and membrane-bound hCA IX and XIV were poorly activated by these amines, whereas the extracellular hCA IV, the mitochondrial enzymes hCA VA/VB, the cytosolic hCA VII, and the transmembrane isoform hCA XII were potently activated. Some of these enzymes are abundant in the brain, raising the possibility that some of the cognitive effects of such psychoactive substances might be related to their activation of these enzymes.

  14. Visualization and Phospholipid Identification (VaLID): online integrated search engine capable of identifying and visualizing glycerophospholipids with given mass

    Science.gov (United States)

    Figeys, Daniel; Fai, Stephen; Bennett, Steffany A. L.

    2013-01-01

    Motivation: Establishing phospholipid identities in large lipidomic datasets is a labour-intensive process. Where genomics and proteomics capitalize on sequence-based signatures, glycerophospholipids lack easily definable molecular fingerprints. Carbon chain length, degree of unsaturation, linkage, and polar head group identity must be calculated from mass to charge (m/z) ratios under defined mass spectrometry (MS) conditions. Given increasing MS sensitivity, many m/z values are not represented in existing prediction engines. To address this need, Visualization and Phospholipid Identification is a web-based application that returns all theoretically possible phospholipids for any m/z value and MS condition. Visualization algorithms produce multiple chemical structure files for each species. Curated lipids detected by the Canadian Institutes of Health Research Training Program in Neurodegenerative Lipidomics are provided as high-resolution structures. Availability: VaLID is available through the Canadian Institutes of Health Research Training Program in Neurodegenerative Lipidomics resources web site at https://www.med.uottawa.ca/lipidomics/resources.html. Contacts: lipawrd@uottawa.ca Supplementary Information: Supplementary data are available at Bioinformatics online. PMID:23162086

  15. Un juego serio en que se va la vida. Fragmentos, citas, reescrituras en Zettel, de Héctor Libertella

    Directory of Open Access Journals (Sweden)

    Agustina Pérez

    2015-06-01

    Full Text Available Los papeles sueltos de Zettel, último libro Héctor Libertella, tienen algo de la tarea obstinada que Antoine Compagnon encuentra en niños y ancianos, trabajo del papel como cortar y pegar, juego serio en que se va la vida, o llega. Se revisará Zettel a la luz de otros textos de Libertella para indagar su vínculo con el fragmento como tipo de exposición que no aspira a la exhaustividad sino a lo inacabado, siendo siempre en germen (Lacoue-Labarthe y Nancy y con el trabajo de la citación (Compagnon, donde el texto se vuelve producto de la fuerza del desplazamiento. The loose papers of Zettel, Héctor Libertella’s last book, involve some of the stubborn task that Antoine Compagnon finds in children and the eldery, working paper as cut and paste, serious game in which life slips away, or arrives. This work reads Zettel in the light of another of his works to examine their connection with the fragment as a type of exposition that doesn’t looks for exhaustivity but the unfinished, being always in germ (Lacoue-Labarthe y Nancy and with the work of citation (Compagnon in which text becomes the result of the force of displacement.

  16. The ecotoxicological recovery of Ely Creek and tributaries (Lee County, VA) after remediation of acid mine drainage.

    Science.gov (United States)

    Simon, Mathew L; Cherry, Donald S; Currie, Rebecca J; Zipper, Carl E

    2012-04-01

    The Ely Creek watershed (Lee County, VA) was determined in 1995 to be the most negatively affected by acid mine drainage (AMD) within the Virginia coalfield. This determination led the US Army Corps of Engineers to design and build passive wetland remediation systems at two major AMD seeps affecting Ely Creek. This study was undertaken to determine if ecological recovery had occurred in Ely Creek. The results indicate that remediation had a positive effect on all monitoring sites downstream of the remediated AMD seeps. At the site most impacted by AMD, mean pH was 2.93 prior to remediation and improved to 7.14 in 2004. Benthic macroinvertebrate surveys revealed that one AMD influenced site had increased taxa richness from zero taxa in 1997 to 24 in 2004. While in situ testing of Asian clams resulted in zero survival at five of seven AMD influenced sites prior to remediation, some clams survived at all sites after. Clam survival was found to be significantly less than upstream references at only two sites, both downstream of un-mitigated AMD seeps in 2004. An ecotoxicological rating (ETR) system that combined ten biotic and abiotic parameters was developed as an indicator of the ecological status for each study site. A comparison of ETRs from before and after remediation demonstrated that all sites downstream of the remediation had experienced some level of recovery. Although the remediation has improved the ecological health of Ely Creek, un-mitigated AMD discharges are still negatively impacting the watershed.

  17. Lessons from Initiating the First Veterans Health Administration (VA) Women's Health Practice-based Research Network (WH-PBRN) Study.

    Science.gov (United States)

    Pomernacki, Alyssa; Carney, Diane V; Kimerling, Rachel; Nazarian, Deborah; Blakeney, Jill; Martin, Brittany D; Strehlow, Holly; Yosef, Julia; Goldstein, Karen M; Sadler, Anne G; Bean-Mayberry, Bevanne A; Bastian, Lori A; Bucossi, Meggan M; McLean, Caitlin; Sonnicksen, Shannan; Klap, Ruth; Yano, Elizabeth M; Frayne, Susan M

    2015-01-01

    The Veterans Health Administration (VA) Women's Health Practice-Based Research Network (WH-PBRN) was created to foster innovations for the health care of women veterans. The inaugural study by the WH-PBRN was designed to identify women veterans' own priorities and preferences for mental health services and to inform refinements to WH-PBRN operational procedures. Addressing the latter, this article reports lessons learned from the inaugural study. WH-PBRN site coordinators at the 4 participating sites convened weekly with the study coordinator and the WH-PBRN program manager to address logistical issues and identify lessons learned. Findings were categorized into a matrix of challenges and facilitators related to key study elements. Challenges to the conduct of PBRN-based research included tracking of regulatory documents; cross-site variability in some regulatory processes; and troubleshooting logistics of clinic-based recruitment. Facilitators included a central institutional review board, strong relationships between WH-PBRN research teams and women's health clinic teams, and the perception that women want to help other women veterans. Our experience with the inaugural WH-PBRN study demonstrated the feasibility of establishing productive relationships between local clinicians and researchers, and of recruiting a special population (women veterans) in diverse sites within an integrated health care system. This identified strengths of a PBRN approach. © Copyright 2015 by the American Board of Family Medicine.

  18. Isolation and identification of Salmonella typhimurium from raw cow, sheep and goat milk in Chahamaha Va Bakhteyari Province

    Directory of Open Access Journals (Sweden)

    F Tajbakhsh

    2014-05-01

    Full Text Available Salmonella typhimurium and S. enteritidisare known as the major causes of food-borne infection throughout the world. The present study was carried out to investigate the prevalence of S. typhimurium in raw milks of Chahamaha Va Bakhteyari province. For this reason, a total of 550 raw milks (consisting of 200 cow, 175 sheep and 175 goat milk samples were collected through October 2011 to March 2012 from dairy herds around Shahrekord. The samples were cultured and the isolated colonies were confirmed by PCR using species-specific ST11 and ST15 primers. According to the results, a total of 20 samples (3.63% were found positive for Salmonellaspp.Amongst, 14 (2.54% of cow milk, 2 (0.36% of sheep milk and 4 (0.72% of goat milk samples were contaminated. Using PCR, 9 (1.63% samples were contaminated with S. typhimurium. The results indicated a relatively high occurrence of S. typhimurium in raw milks. Therefore, it is essential to maintain hygienic measures during milking and handling. Besides, it is recommended not to use raw milk for the manufacturing of dairy products such as cheese and ice-cream.

  19. Implementing and evaluating a regional strategy to improve testing rates in VA patients at risk for HIV, utilizing the QUERI process as a guiding framework: QUERI Series

    Directory of Open Access Journals (Sweden)

    Osborn Teresa

    2008-03-01

    Full Text Available Abstract Background We describe how we used the framework of the U.S. Department of Veterans Affairs (VA Quality Enhancement Research Initiative (QUERI to develop a program to improve rates of diagnostic testing for the Human Immunodeficiency Virus (HIV. This venture was prompted by the observation by the CDC that 25% of HIV-infected patients do not know their diagnosis – a point of substantial importance to the VA, which is the largest provider of HIV care in the United States. Methods Following the QUERI steps (or process, we evaluated: 1 whether undiagnosed HIV infection is a high-risk, high-volume clinical issue within the VA, 2 whether there are evidence-based recommendations for HIV testing, 3 whether there are gaps in the performance of VA HIV testing, and 4 the barriers and facilitators to improving current practice in the VA. Based on our findings, we developed and initiated a QUERI step 4/phase 1 pilot project using the precepts of the Chronic Care Model. Our improvement strategy relies upon electronic clinical reminders to provide decision support; audit/feedback as a clinical information system, and appropriate changes in delivery system design. These activities are complemented by academic detailing and social marketing interventions to achieve provider activation. Results Our preliminary formative evaluation indicates the need to ensure leadership and team buy-in, address facility-specific barriers, refine the reminder, and address factors that contribute to inter-clinic variances in HIV testing rates. Preliminary unadjusted data from the first seven months of our program show 3–5 fold increases in the proportion of at-risk patients who are offered HIV testing at the VA sites (stations where the pilot project has been undertaken; no change was seen at control stations. Discussion This project demonstrates the early success of the application of the QUERI process to the development of a program to improve HIV testing rates

  20. Issues in defining and measuring veteran community reintegration: proceedings of the Working Group on Community Reintegration, VA Rehabilitation Outcomes Conference, Miami, Florida.

    Science.gov (United States)

    Resnik, Linda; Bradford, Daniel W; Glynn, Shirley M; Jette, Alan M; Johnson Hernandez, Caitlin; Wills, Sharon

    2012-01-01

    In January 2010, the Department of Veterans Affairs (VA) Rehabilitation Research and Development Service convened a State of the Art (SOTA) conference to advance the field of outcome measurement for rehabilitation-related studies. This article reports on the proceedings of the SOTA Working Group on Community Reintegration. We explored the use of the International Classification of Health, Disability, and Functioning as a theoretical framework for measuring community reintegration; identified key dimensions of community reintegration that could and/or should be measured; discussed challenges in measuring community reintegration; suggested steps to enhance community reintegration measurement; proposed future research that focuses on outcomes measures for community reintegration and the study of community reintegration outcomes; and made policy recommendations that would facilitate community reintegration research within the VA.

  1. The distribution of low and high-risk HPV types in vulvar and vaginal intraepithelial neoplasia (VIN and VaIN).

    Science.gov (United States)

    Srodon, Monica; Stoler, Mark H; Baber, Gwen B; Kurman, Robert J

    2006-12-01

    It has been proposed that low-grade vulvar and vaginal lesions (VIN 1 and VaIN 1) are flat condylomas and should be designated as such. Moreover, their relationship to high-grade lesions (VIN 3 and VaIN 3) is unclear. Accordingly, this study was undertaken to address these issues by comparing the distribution of human papillomavirus (HPV) types in vulvar and vaginal intraepithelial lesions. We identified 33 cases of VIN 1, 34 cases of VIN 3, 17 cases of VaIN 1, and 16 cases of VaIN 3. In addition, 36 cases of low-grade squamous intraepithelial lesion (LSIL) in the cervix and 116 cases of cervical high-grade squamous intraepithelial lesion were used for comparison. Polymerase chain reaction analysis was performed using both the Roche PGMY and DDL SPF 10 systems. In cases where HPV was detected, the majority of low-grade and high-grade lesions contained a single HPV type. However, a minority of cases were found to have multiple HPV types. Of the VIN 1 cases, a low-risk virus was seen in 22 (67%), with HPV 6 or 11 accounting for 14 (42%). A high-risk virus was detected in 14 (42%) of cases of which 2 (6%) contained HPV 16. Of the VIN 3 cases, all had high-risk HPV of which 31 (91%) were found to have HPV 16. Of the VaIN 1 cases, 6 (35%) were found to have low-risk HPV types. HPV 6 or 11 were not found in these cases. High-risk virus was seen in 13 (76%) VaIN 1 cases, with 1 (6%) containing HPV 16. HPV was detected in 15 of 16 (94%) VaIN 3 lesions, all of which had high-risk types. HPV 16 was found in 8 (50%). In contrast, 2 (6%) of cervical LSIL had low-risk HPV (HPV 6 and 11), whereas 34 (94%) of LSIL cases had high-risk HPVs. Of the cervical high-grade squamous intraepithelial lesion cases, 100% had high-risk HPVs of which 87 (75%) were found to have HPV 16. The findings demonstrate that a significant number of low-grade vulvar and vaginal lesions contain high-risk HPV types, supporting their designation as low-grade intraepithelial lesions rather than flat

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

    OpenAIRE

    Gaete, J; Valenzuela, D; Rojas-Barahona, C; Valenzuela, E.; Araya, R.; Salmivalli, C

    2017-01-01

    Background Bullying is a major problem worldwide and Chile is no exception. Bullying is defined as a systematic aggressive behavior against a victim who cannot defend him or herself. Victims suffer social isolation and psychological maladjustment, while bullies have a higher risk for conduct problems and substance use disorders. These problems appear to last over time. The KiVa antibullying program has been evaluated in Finland and other European countries, showing preventive effects on victi...

  3. Mechanical support with venoarterial extracorporeal membrane oxygenation (ECMO-VA): Short-term and long-term prognosis after a successful weaning.

    Science.gov (United States)

    García-Gigorro, R; Renes-Carreño, E; Pérez-Vela, J L; Marín-Mateos, H; Gutiérrez, J; Corrés-Peiretti, M A; Delgado, J F; Pérez-de la Sota, E; Cortina-Romero, J M; Montejo-González, J C

    2017-12-01

    Extracorporeal membrane oxygenation (ECMO) affords mechanical circulatory assistance associated to high mortality. However, weaning from such mechanical support may not imply improved short- or long-term survival. This study describes the characteristics and evolution of patients with refractory cardiogenic shock (RCS) subjected to venoarterial ECMO (VA-ECMO) in a hospital with a heart transplant program. A single-center, retrospective cohort study was carried out. The cardiovascular ICU of a tertiary hospital. Forty-six patients consecutively subjected to VA-ECMO over 6 years. Hospital mortality after weaning from ECMO and overall survival (OS) were analyzed. Fifteen patients (33%) died with VA-ECMO and 31 (67%) were weaned after 8 days of support (IQR: 5-15). Fourteen patients under went transplantation. Hospital mortality in these patients was 32% (10/31), and was associated to age (P=.001), SAPS II score (P=.009), cannulation bleeding (P=.01) and post-acute myocardial infarction RCS (P=.001). After a median follow-up of 27 months (IQR: 11-49), 91% of the patients discharged from hospital were still alive. Overall survival after weaning from assistance was associated to the type of cardiac disease (P=.002). Patients with RCS after acute myocardial infarction had a poorer prognosis. In our experience, VA-ECMO can be used as mechanical assistance in the management of RCS. The technique is associated to high early mortality, though the long-term survival rate after hospital discharge is good. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  4. 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/m2 (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

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

    Science.gov (United States)

    2016-10-01

    Chou, PhD Org : Modus Health LLC Award Amount: $465,470 Study/Product Aim(s) •  To determine the magnitude of clinically relevant change in...Rating scale for determining small and substantial meaningful change . Data will be analyzed to determine each metrics small and substantial change ...AWARD NUMBER: W81XWH-15-1-0522 TITLE: Determining Clinically Relevant Changes in Community Walking Metrics to Be Tracked by the VA as Part of

  6. Tackling acute cases of school bullying in the KiVa anti-bullying program: a comparison of two approaches.

    Science.gov (United States)

    Garandeau, Claire F; Poskiparta, Elisa; Salmivalli, Christina

    2014-08-01

    Whether cases of bullying should be handled in a direct, condemning mode or in a manner that does not involve blaming the perpetrator is a controversial issue among school professionals. This study compares the effectiveness of a Confronting Approach where the bully is openly told that his behavior must cease immediately to a Non-Confronting Approach where the adult shares his concern about the victim with the bully and invites him to provide suggestions on what could improve the situation. We analysed 339 cases of bullying involving 314 children from grades 1 to 9 (mean age = 11.95). Cases were handled in 65 schools as part of the implementation of the KiVa anti-bullying program. In each school, a team of three teachers addressed cases coming to their attention by organizing discussions with the bullies using either a Confronting or a Non-Confronting Approach; schools were randomly assigned to one of the two conditions. Victims reported that bullying stopped in 78 % of the cases. Logistic regression analyses indicated that neither approach was overall more effective than the other, controlling for grade level, duration of victimization and type of aggression. The Confronting Approach worked better than the Non-Confronting Approach in secondary school (grades 7 to 9), but not in primary school (grades 1 to 6). The Confronting Approach was more successful than the Non-Confronting Approach in cases of short-term victimization, but not in cases of long-term victimization. The type of aggression used did not moderate the effectiveness of either approach.

  7. Developing a toolkit for panel management: improving hypertension and smoking cessation outcomes in primary care at the VA.

    Science.gov (United States)

    Savarimuthu, Stella M; Jensen, Ashley E; Schoenthaler, Antoinette; Dembitzer, Anne; Tenner, Craig; Gillespie, Colleen; Schwartz, Mark D; Sherman, Scott E

    2013-11-21

    As primary care practices evolve into medical homes, there is an increasing need for effective models to shift from visit-based to population-based strategies for care. However, most medical teams lack tools and training to manage panels of patients. As part of a study comparing different approaches to panel management at the Manhattan and Brooklyn campuses of the VA New York Harbor Healthcare System, we created a toolkit of strategies that non-clinician panel management assistants (PMAs) can use to enhance panel-wide outcomes in smoking cessation and hypertension. We created the toolkit using: 1) literature review and consultation with outside experts, 2) key informant interviews with staff identified using snowball sampling, 3) pilot testing for feasibility and acceptability, and 4) further revision based on a survey of primary care providers and nurses. These steps resulted in progressively refined strategies for the PMAs to support the primary care team. Literature review and expert consultation resulted in an extensive list of potentially useful strategies. Key informant interviews and staff surveys identified several areas of need for assistance, including help to manage the most challenging patients, providing care outside of the visit, connecting patients with existing resources, and providing additional patient education. The strategies identified were then grouped into 5 areas - continuous connection to care, education and connection to clinical resources, targeted behavior change counseling, adherence support, and patients with special needs. Although panel management is a central aspect of patient-centered medical homes, providers and health care systems have little guidance or evidence as to how teams should accomplish this objective. We created a toolkit to help PMAs support the clinical care team for patients with hypertension or tobacco use. This toolkit development process could readily be adapted to other behaviors or conditions. Clinical

  8. Associations between changes in city and address specific temperature and QT interval--the VA Normative Aging Study.

    Directory of Open Access Journals (Sweden)

    Amar J Mehta

    Full Text Available BACKGROUND: The underlying mechanisms of the association between ambient temperature and cardiovascular morbidity and mortality are not well understood, particularly for daily temperature variability. We evaluated if daily mean temperature and standard deviation of temperature was associated with heart rate-corrected QT interval (QTc duration, a marker of ventricular repolarization in a prospective cohort of older men. METHODS: This longitudinal analysis included 487 older men participating in the VA Normative Aging Study with up to three visits between 2000-2008 (n = 743. We analyzed associations between QTc and moving averages (1-7, 14, 21, and 28 days of the 24-hour mean and standard deviation of temperature as measured from a local weather monitor, and the 24-hour mean temperature estimated from a spatiotemporal prediction model, in time-varying linear mixed-effect regression. Effect modification by season, diabetes, coronary heart disease, obesity, and age was also evaluated. RESULTS: Higher mean temperature as measured from the local monitor, and estimated from the prediction model, was associated with longer QTc at moving averages of 21 and 28 days. Increased 24-hr standard deviation of temperature was associated with longer QTc at moving averages from 4 and up to 28 days; a 1.9°C interquartile range increase in 4-day moving average standard deviation of temperature was associated with a 2.8 msec (95%CI: 0.4, 5.2 longer QTc. Associations between 24-hr standard deviation of temperature and QTc were stronger in colder months, and in participants with diabetes and coronary heart disease. CONCLUSION/SIGNIFICANCE: In this sample of older men, elevated mean temperature was associated with longer QTc, and increased variability of temperature was associated with longer QTc, particularly during colder months and among individuals with diabetes and coronary heart disease. These findings may offer insight of an important underlying mechanism of

  9. Do Geriatric Conditions Increase Risk of Adverse Drug Reactions in Ambulatory Elders? Results From the VA GEM Drug Study

    Science.gov (United States)

    Hanlon, Joseph T.; Sloane, Richard J.; Boscardin, W. John; Schmader, Kenneth E.

    2011-01-01

    Background. Many clinicians prescribe cautiously to older adults with common geriatric conditions for fear of causing adverse drug reactions (ADRs). However, little is known about the association between these conditions and risk of ADRs. Methods. Using data from the VA Geriatric Evaluation and Management Drug Study, we determined any, preventable, and serious ADRs in 808 elders for 12 months after hospital discharge using a validated process involving patient self-report and chart review adjudicated by two health care professionals. Eight common geriatric conditions (activities of daily living, dementia, incontinence, falls, difficulty ambulating, malnourishment, depression, and prolonged bed rest) were evaluated at study baseline through self-report and structured assessments. We used Poisson regression to model the relationship between these geriatric conditions and ADRs. Results. Participants had a mean of 2.9 ± 1.2 geriatric conditions. Over the 12-month follow-up period, 497 ADRs occurred in 269 participants, including 187 ADRs considered preventable and 127 considered severe. On multivariable analyses, participants with dependency in one or more activities of daily living were less likely to suffer ADRs than those who were fully independent (incidence rate ratio: 0.78, 95% confidence interval = 0.62–1.00). None of the other seven geriatric conditions assessed were associated with ADR risk. Results were similar for preventable and serious ADRs, although participants with a history of falls were more likely to develop serious ADRs (incidence rate ratio: 1.49, 95% confidence interval = 1.00–2.21). Conclusions. Many geriatric conditions were not associated with risk of ADRs. Although it is prudent to prescribe judiciously in patients with these conditions, excessive caution may not be warranted. PMID:21321003

  10. Decreasing 30-day surgical mortality in a VA Medical Center utilizing the ACS NSQIP Surgical Risk Calculator.

    Science.gov (United States)

    Kuy, SreyRam; Romero, Ramon A L

    2017-07-01

    The Overton Brooks VA Medical Center Surgical Service had a high mortality. In an effort to reduce surgical mortality, we implemented a series of quality improvement interventions, including utilization of the ACS Surgical Risk Calculator to identify high-risk surgical patients for discussion in a multidisciplinary Pre-Operative Consultation Committee. Retrospective study describing the implementation of a risk stratification intervention incorporating the ACS Surgical Risk Calculator Tool and a multidisciplinary Pre-Operative Consultation Committee to target high-risk patients. Measurement of 30 day surgical mortality and risk adjusted Observed to Expected (O/E) mortality ratio. From May 2013 to September 2014, 614 high-risk patients were selected utilizing the ACS Risk Calculator and presented at the Pre-Operative Consultation Committee. Following implementation of this risk stratification intervention, 30-day mortality decreased by 66% from 0.9% to 0.3%, and risk adjusted O/E mortality ratio decreased from 2.5 to 0.8. Among the high risk patients presented, there was no increase in referrals to other facilities. There was a significant increase in cases requiring further preoperative optimization, from 6.3% at the beginning of the study period to 17.5% at the end of the study period. Implementation of a preoperative risk stratification intervention utilizing the ACS Surgical Risk Calculator along with a multidisciplinary Pre-Operative Consultation Committee can be successfully accomplished, with a significant decrease in 30-day surgical mortality. This is the first published report of utilization of the ACS Risk calculator as part of a systematic quality improvement tool to decrease surgical mortality. Published by Elsevier Inc.

  11. Whole-Genome SNP Association in the Horse: Identification of a Deletion in Myosin Va Responsible for Lavender Foal Syndrome

    Science.gov (United States)

    Brooks, Samantha A.; Gabreski, Nicole; Miller, Donald; Brisbin, Abra; Brown, Helen E.; Streeter, Cassandra; Mezey, Jason; Cook, Deborah; Antczak, Douglas F.

    2010-01-01

    Lavender Foal Syndrome (LFS) is a lethal inherited disease of horses with a suspected autosomal recessive mode of inheritance. LFS has been primarily diagnosed in a subgroup of the Arabian breed, the Egyptian Arabian horse. The condition is characterized by multiple neurological abnormalities and a dilute coat color. Candidate genes based on comparative phenotypes in mice and humans include the ras-associated protein RAB27a (RAB27A) and myosin Va (MYO5A). Here we report mapping of the locus responsible for LFS using a small set of 36 horses segregating for LFS. These horses were genotyped using a newly available single nucleotide polymorphism (SNP) chip containing 56,402 discriminatory elements. The whole genome scan identified an associated region containing these two functional candidate genes. Exon sequencing of the MYO5A gene from an affected foal revealed a single base deletion in exon 30 that changes the reading frame and introduces a premature stop codon. A PCR–based Restriction Fragment Length Polymorphism (PCR–RFLP) assay was designed and used to investigate the frequency of the mutant gene. All affected horses tested were homozygous for this mutation. Heterozygous carriers were detected in high frequency in families segregating for this trait, and the frequency of carriers in unrelated Egyptian Arabians was 10.3%. The mapping and discovery of the LFS mutation represents the first successful use of whole-genome SNP scanning in the horse for any trait. The RFLP assay can be used to assist breeders in avoiding carrier-to-carrier matings and thus in preventing the birth of affected foals. PMID:20419149

  12. Whole-genome SNP association in the horse: identification of a deletion in myosin Va responsible for Lavender Foal Syndrome.

    Directory of Open Access Journals (Sweden)

    Samantha A Brooks

    2010-04-01

    Full Text Available Lavender Foal Syndrome (LFS is a lethal inherited disease of horses with a suspected autosomal recessive mode of inheritance. LFS has been primarily diagnosed in a subgroup of the Arabian breed, the Egyptian Arabian horse. The condition is characterized by multiple neurological abnormalities and a dilute coat color. Candidate genes based on comparative phenotypes in mice and humans include the ras-associated protein RAB27a (RAB27A and myosin Va (MYO5A. Here we report mapping of the locus responsible for LFS using a small set of 36 horses segregating for LFS. These horses were genotyped using a newly available single nucleotide polymorphism (SNP chip containing 56,402 discriminatory elements. The whole genome scan identified an associated region containing these two functional candidate genes. Exon sequencing of the MYO5A gene from an affected foal revealed a single base deletion in exon 30 that changes the reading frame and introduces a premature stop codon. A PCR-based Restriction Fragment Length Polymorphism (PCR-RFLP assay was designed and used to investigate the frequency of the mutant gene. All affected horses tested were homozygous for this mutation. Heterozygous carriers were detected in high frequency in families segregating for this trait, and the frequency of carriers in unrelated Egyptian Arabians was 10.3%. The mapping and discovery of the LFS mutation represents the first successful use of whole-genome SNP scanning in the horse for any trait. The RFLP assay can be used to assist breeders in avoiding carrier-to-carrier matings and thus in preventing the birth of affected foals.

  13. The Association of Team-Specific Workload and Staffing with Odds of Burnout Among VA Primary Care Team Members.

    Science.gov (United States)

    Helfrich, Christian D; Simonetti, Joseph A; Clinton, Walter L; Wood, Gordon B; Taylor, Leslie; Schectman, Gordon; Stark, Richard; Rubenstein, Lisa V; Fihn, Stephan D; Nelson, Karin M

    2017-07-01

    Work-related burnout is common in primary care and is associated with worse patient safety, patient satisfaction, and employee mental health. Workload, staffing stability, and team completeness may be drivers of burnout. However, few studies have assessed these associations at the team level, and fewer still include members of the team beyond physicians. To study the associations of burnout among primary care providers (PCPs), nurse care managers, clinical associates (MAs, LPNs), and administrative clerks with the staffing and workload on their teams. We conducted an individual-level cross-sectional analysis of survey and administrative data in 2014. Primary care personnel at VA clinics responding to a national survey. Burnout was measured with a validated single-item survey measure dichotomized to indicate the presence of burnout. The independent variables were survey measures of team staffing (having a fully staffed team, serving on multiple teams, and turnover on the team), and workload both from survey items (working extended hours), and administrative data (patient panel overcapacity and average panel comorbidity). There were 4610 respondents (estimated response rate of 20.9%). The overall prevalence of burnout was 41%. In adjusted analyses, the strongest associations with burnout were having a fully staffed team (odds ratio [OR] = 0.55, 95% CI 0.47-0.65), having turnover on the team (OR = 1.67, 95% CI 1.43-1.94), and having patient panel overcapacity (OR = 1.19, 95% CI 1.01-1.40). The observed burnout prevalence was 30.1% lower (28.5% vs. 58.6%) for respondents working on fully staffed teams with no turnover and caring for a panel within capacity, relative to respondents in the inverse condition. Complete team staffing, turnover among team members, and panel overcapacity had strong, cumulative associations with burnout. Further research is needed to understand whether improvements in these factors would lower burnout.

  14. Binge-drinking and non-partner aggression are associated with gambling among Veterans with recent substance use in VA outpatient treatment.

    Science.gov (United States)

    Davis, Alan K; Bonar, Erin E; Goldstick, Jason E; Walton, Maureen A; Winters, Jamie; Chermack, Stephen T

    2017-11-01

    Gambling is relatively under-assessed in Veterans Affairs (VA) substance use disorder (SUD) treatment settings, yet shared characteristics with substance addiction suggest the importance of understanding how gambling behaviors present in Veterans seeking SUD care. We evaluated substance use, mental health, and violence-related correlates of past 30-day gambling among 833 Veterans (93% male, M age 48years, 72% Caucasian) seeking treatment in VA outpatient mental health and SUD clinics who completed screening for a randomized clinical trial. A total of 288 (35%) Veterans reported past 30-day gambling. Among those who gambled, 79% had cravings/urges to gamble, whereas between 20%-27% of gamblers reported perceived relationship, legal, and daily life problems related to gambling, as well as difficulty controlling gambling. A logistic regression analysis revealed that age, recent binge-drinking, and non-partner physical aggression were associated with recent gambling. Gambling was associated with binge-drinking and non-partner physical aggression, supporting potential shared characteristics among these behaviors such as impulsivity and risk-taking, which may complicate SUD treatment engagement and effectiveness. Findings support the need to screen for gambling in the VA, and to adapt treatments to include gambling as a potential behavioral target or relapse trigger, particularly among heavy drinking patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Pilot KaVA monitoring on the M 87 jet: Confirming the inner jet structure and superluminal motions at sub-pc scales

    Science.gov (United States)

    Hada, Kazuhiro; Park, Jong Ho; Kino, Motoki; Niinuma, Kotaro; Sohn, Bong Won; Ro, Hyun Wook; Jung, Taehyun; Algaba, Juan-Carlos; Zhao, Guang-Yao; Lee, Sang-Sung; Akiyama, Kazunori; Trippe, Sascha; Wajima, Kiyoaki; Sawada-Satoh, Satoko; Tazaki, Fumie; Cho, Ilje; Hodgson, Jeffrey; Lee, Jeong Ae; Hagiwara, Yoshiaki; Honma, Mareki; Koyama, Shoko; Oh, Junghwan; Lee, Taeseak; Yoo, Hyemin; Kawaguchi, Noriyuki; Roh, Duk-Gyoo; Oh, Se-Jin; Yeom, Jae-Hwan; Jung, Dong-Kyu; Oh, Chungsik; Kim, Hyo-Ryoung; Hwang, Ju-Yeon; Byun, Do-Young; Cho, Se-Hyung; Kim, Hyun-Goo; Kobayashi, Hideyuki; Shibata, Katsunori M.

    2017-08-01

    We report the initial results of our high-cadence monitoring program on the radio jet in the active galaxy M 87, obtained by the KVN and VERA Array (KaVA) at 22 GHz. This is a pilot study that preceded a larger KaVA-M 87 monitoring program, which is currently ongoing. The pilot monitoring was mostly performed every two to three weeks from 2013 December to 2014 June, at a recording rate of 1 Gbps, obtaining data for a total of ten epochs. We successfully obtained a sequence of good quality radio maps that revealed the rich structure of this jet from ≲1 mas to 20 mas, corresponding to physical scales (projected) of ∼0.1-2 pc (or ∼140-2800 Schwarzschild radii). We detected superluminal motions at these scales, together with a trend of gradual acceleration. The first evidence for such fast motions and acceleration near the jet base were obtained from recent VLBA studies at 43 GHz, and the fact that very similar kinematics are seen at a different frequency and time with a different instrument suggests that these properties are fundamental characteristics of this jet. This pilot program demonstrates that KaVA is a powerful VLBI array for studying the detailed structural evolution of the M 87 jet and also other relativistic jets.

  16. Enhanced dissolution rate of dronedarone hydrochloride via preparation of solid dispersion using vinylpyrrolidone-vinyl acetate copolymer (Kollidone® VA 64)

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hyuck Jun; Kang, Myung Joo [College of Pharmacy, Dankook University, Cheonan (Korea, Republic of); Han, Sang Duk [Dong-A ST Rese arch Institute, Pharmaceutical Product Research Laboratories, Yongin (Korea, Republic of)

    2015-09-15

    Solid dispersion (SD) systems have been widely used to increase the dissolution rate and oral absorption of poorly water-soluble compounds. In order to enhance the dissolution rate of dronedarone hydrochloride (DRN), a recent antiarrhythmic agent, SDs of DRN were formulated using conventional solvent evaporation method with amorphous polymers including hydroxypropyl methyl cellulose (HPMC), poly(vinyl pyrrolidone) (PVP), and vinylpyrrolidone-vinyl acetate copolymer (VA64). The prepared SDs were characterized in terms of drug crystallinity, morphology, and in vitro dissolution profile in aqueous medium. The physical characterization using differential scanning calorimetry and X-ray powder diffraction revealed that the active compound was molecularly dispersed in all polymeric carriers tested, in a stable amorphous form in drug to polymer ratios ranging from 1:0.5 to 1:2. The dissolution rates of DRN in all SDs were much higher than those from the corresponding physical mixture and drug powder alone. In particular, the greatest dissolution enhancement was obtained from the VA64-based SD in a drug to polymer weight ratio of 1:1, achieving almost complete drug release after 120 min at pH 1.2. Thus, VA64-based SD with higher drug dissolution rate along with a simple preparation process is suggested as an alternative for the oral formulation of the benzofuran derivative.

  17. Transparent image generator by using vertically aligned polymer-stabilized liquid crystal (VA-PSLC) for see-through display applications

    Science.gov (United States)

    Wang, Mu-Hao; Choi, Wing-Kit; Su, Guo-Dung

    2012-10-01

    We demonstrate the feasibility of using a Vertically-Aligned Polymer-Stabilized Liquid Crystal (VA-PSLC) film, which is also known as LC gel, as a transparent image generator to form a see-through display system. This is achieved, in its simplest form, by projecting a collimated LED light source onto a transparent glass screen, with the image generated by the scattered light from the VA-PSLC. By moving the observer's head slightly away from the incident light specular reflection direction, a clear image can be observed on the transparent glass screen together with the background objects that are behind the screen. From our experimental results, this see-through display system using VA-PSLC transparent image generator can achieve a fast response time (with rise time of ~10 ms and fall time of ~5ms) and an acceptable contrast ratio (< ~100:1). The driving voltage is about 15~20V. Further improvements can be achieved by further optimizing the LC material/monomer parameters, device fabrication process/conditions and the optical system setup. In this system, polarizers are not required so that very high light efficiency can be obtained.

  18. Antioxidant N-Acetylcysteine and Glutathione Increase the Viability and Proliferation of MG63 Cells Encapsulated in the Gelatin Methacrylate/VA-086/Blue Light Hydrogel System.

    Science.gov (United States)

    Lin, Chih-Hsin; Lin, Kai-Fung; Mar, Kwei; Lee, Shyh-Yuan; Lin, Yuan-Min

    2016-08-01

    Photoencapsulation of cells inside a hydrogel system can provide a suitable path to establish a gel in situ for soft tissue regeneration applications. However, the presence of photoinitiators and blue or UV light irradiation can result in cell damage and an increase of reactive oxygen species. We here evaluate the benefits of an antioxidant pretreatment on the photoencapsulated cells. We study this by evaluating proliferation and viability of MG63 cells, which we combined with a gelatin methacrylate (GelMA) hydrogel system, using the photoinitiator, VA-086, cured with 440 nm blue light. We found that blue light irradiation as well as the presence of 1% VA-086 reduced MG63 cell proliferation rates. Adding a short pretreatment step to the MG63 cells, consisting of the antioxidant molecules N-acetylcysteine (NAC) and reduced glutathione (GSH), and optimizing the GelMA encapsulation steps, we found that both NAC and GSH pretreatments of MG63 cells significantly increased both proliferation and viability of the cells, when using a 15% GelMA hydrogel, 1% VA-086, and 1-min blue light exposure. These findings suggest that the use of antioxidant pretreatment can counteract the negative presence of the photoinitiators and blue light exposure and result in a suitable environment for photoencapsulating cells in situ for tissue engineering and soft tissue applications.

  19. Female Veterans of Iraq and Afghanistan seeking care from VA specialized PTSD Programs: comparison with male veterans and female war zone veterans of previous eras.

    Science.gov (United States)

    Fontana, Alan; Rosenheck, Robert; Desai, Rani

    2010-04-01

    Differences in the characteristics and mental health needs of female veterans of the Iraq/Afghanistan war compared with those of veterans of other wars may have useful implications for VA program and treatment planning. Female veterans reporting service in the Iraq/Afghanistan war were compared with women reporting service in the Persian Gulf and Vietnam wars and to men reporting service in the Iraq/Afghanistan war. Subjects were drawn from VA administrative data on veterans who sought outpatient treatment from specialized posttraumatic stress disorder (PTSD) treatment programs. A series of analyses of covariance (ANCOVA) was used to control for program site and age. In general, Iraq/Afghanistan and Persian Gulf women had less severe psychopathology and more social supports than did Vietnam women. In turn, Iraq/Afghanistan women had less severe psychopathology than Persian Gulf women and were exposed to less sexual and noncombat nonsexual trauma than their Persian Gulf counterparts. Notable differences were also found between female and male veterans of the Iraq/Afghanistan war. Women had fewer interpersonal and economic supports, had greater exposure to different types of trauma, and had different levels of diverse types of pathology than their male counterparts. There appear to be sufficient differences within women reporting service in different war eras and between women and men receiving treatment in VA specialized treatment programs for PTSD that consideration should be given to program planning and design efforts that address these differences in every program treating female veterans reporting war zone service.

  20. Persistent Serious Mental Illness Among Former Applicants for VA PTSD Disability Benefits and Long-Term Outcomes: Symptoms, Functioning, and Employment.

    Science.gov (United States)

    Murdoch, Maureen; Spoont, Michele Roxanne; Kehle-Forbes, Shannon Marie; Harwood, Eileen Mae; Sayer, Nina Aileen; Clothier, Barbara Ann; Bangerter, Ann Kay

    2017-02-01

    Millions of U.S. veterans have returned from military service with posttraumatic stress disorder (PTSD), for which a substantial number receive U.S. Department of Veterans Affairs (VA) disability benefits. Although PTSD is treatable, comorbid serious mental illness (defined here as schizophrenia, schizoaffective disorder, and bipolar spectrum disorders) could complicate these veterans' recovery. Using VA administrative data, we examined the burden of persistent serious mental illness in a nationally representative cohort of 1,067 men and 1,513 women who applied for VA PTSD disability benefits between 1994 and 1998 and served during or after the Vietnam conflict. Self-reported outcomes were restricted to the 713 men and 1,015 women who returned surveys at each of 3 collection points. More than 10.0% of men and 20.0% of women had persistent serious mental illness; of these, more than 80.0% also had persistent PTSD. On repeated measures modeling, those with persistent serious mental illness consistently reported more severe PTSD symptoms and poorer functioning in comparison to other participants (ps employment rate did not exceed 21.0%. Interactions between persistent serious mental illness and PTSD were significant only for employment (p = .002). Persistent serious mental illness in this population was almost 2 to 19 times higher than in the general U.S. The implications of these findings are discussed. Copyright © 2017 International Society for Traumatic Stress Studies.

  1. VA Enterprise Data Inventory

    Data.gov (United States)

    Department of Veterans Affairs — The Department of Veterans Affairs Enterprise Data Inventory accounts for all of the datasets used in the agency's information systems. This entry was approved for...

  2. VA Caregiver Support

    Science.gov (United States)

    ... Monthly Calls Caregiver Stories More Tips & Tools Managing Medicines Talking with Providers Caring for Oneself Plan Ahead for Disasters More Publications & Resources Seriously Injured Post-9/11 ...

  3. Coastal Analysis, Accomack, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Coastal study as defined in FEMA Guides and Specifications, Appendix D: Guidance for coastal Flooding Analyses and Mapping submitted as a result of a coastal study....

  4. ORTHOIMAGERY, Alleghany County, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Digital orthographic imagery datasets contain georeferenced images of the Earth's surface, collected by a sensor in which object displacement has been removed for...

  5. ORTHOIMAGERY, Botetourt County, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Digital orthographic imagery datasets contain georeferenced images of the Earth's surface, collected by a sensor in which object displacement has been removed for...

  6. VA~ GII5RALTAR

    African Journals Online (AJOL)

    those who shall live and dwell in the town or its territory shall never be threatened nor have injury done to them: not being traitors to their lord, breakers of the king's ..... dige mars (terwille van die Suid-Afrikaners het hulle 'Sarie Marais' gespeel), wat dan oorgaan in gewone pas. Die orkes keer dan terselfdertyd terug na sy ...

  7. [)IE VAL VA~ ()RETORIA

    African Journals Online (AJOL)

    Sonder behoorlike grof- geskut in die forte en terwyl sy burgers reeds orals tekens van oorlogsmoegheid getoon het, het hy ook besluit om Pretoria self nie te ver- dedig nie: 'n antiklimaks vir die vooruitsigte van menige strydende burger. Die vyand is egter op strategiese punte tus- sen Johannesburg en Pretoria ingewag.

  8. FLOODPLAIN, Northumberland COUNTY, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Floodplain Mapping/Redelineation study deliverables depict and quantify the flood risks for the study area. The primary risk classifications used are the...

  9. Advanced Battery Manufacturing (VA)

    Energy Technology Data Exchange (ETDEWEB)

    Stratton, Jeremy

    2012-09-30

    LiFeBATT has concentrated its recent testing and evaluation on the safety of its batteries. There appears to be a good margin of safety with respect to overheating of the cells and the cases being utilized for the batteries are specifically designed to dissipate any heat built up during charging. This aspect of LiFeBATT’s products will be even more fully investigated, and assuming ongoing positive results, it will become a major component of marketing efforts for the batteries. LiFeBATT has continued to receive prismatic 20 Amp hour cells from Taiwan. Further testing continues to indicate significant advantages over the previously available 15 Ah cells. Battery packs are being assembled with battery management systems in the Danville facility. Comprehensive tests are underway at Sandia National Laboratory to provide further documentation of the advantages of these 20 Ah cells. The company is pursuing its work with Hybrid Vehicles of Danville to critically evaluate the 20 Ah cells in a hybrid, armored vehicle being developed for military and security applications. Results have been even more encouraging than they were initially. LiFeBATT is expanding its work with several OEM customers to build a worldwide distribution network. These customers include a major automotive consulting group in the U.K., an Australian maker of luxury off-road campers, and a number of makers of E-bikes and scooters. LiFeBATT continues to explore the possibility of working with nations that are woefully short of infrastructure. Negotiations are underway with Siemens to jointly develop a system for using photovoltaic generation and battery storage to supply electricity to communities that are not currently served adequately. The IDA has continued to monitor the progress of LiFeBATT’s work to ensure that all funds are being expended wisely and that matching funds will be generated as promised. The company has also remained current on all obligations for repayment of an IDA loan and lease payments for space to the IDA. A commercial venture is being formed to utilize the LiFeBATT product for consumer use in enabling photovoltaic powered boat lifts. Field tests of the system have proven to be very effective and commercially promising. This venture is expected to result in significant sales within the next six months.

  10. ORTHOIMAGERY, Pittsylvania County, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Digital orthographic imagery datasets contain georeferenced images of the Earth's surface, collected by a sensor in which object displacement has been removed for...

  11. ORTHOIMAGERY, Dinwiddie County, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — These files contain Digital Orthophoto files for the State of Virginia developed from imagery acquired in spring 2006 and 2007. In the spring of 2006, the...

  12. Causes of death in two rural demographic surveillance sites in Bangladesh, 2004–2010: automated coding of verbal autopsies using InterVA-4

    Directory of Open Access Journals (Sweden)

    Nurul Alam

    2014-10-01

    Full Text Available Objective: Population-based information on causes of death (CoD by age, sex, and area is critical for countries with limited resources to identify and address key public health issues. This study analysed the demographic surveillance and verbal autopsy (VA data to estimate age- and sex-specific mortality rates and cause-specific mortality fractions in two well-defined rural populations within the demographic surveillance system in Abhoynagar and Mirsarai subdistricts, located in different climatic zones. Design: During 2004–2010, the sample demographic surveillance system registered 1,384 deaths in Abhoynagar and 1,847 deaths in Mirsarai. Trained interviewers interviewed the main caretaker of the deceased with standard VA questionnaires to record signs and symptoms of diseases or conditions that led to death and health care experiences before death. The computer-automated InterVA-4 method was used to analyse VAs to determine probable CoD. Results: Age- and sex-specific death rates revealed a higher neonatal mortality rate in Abhoynagar than Mirsarai, and death rates and sex ratios of male to female death rates were higher in the ages after infancy. Communicable diseases (CDs accounted for 16.7% of all deaths in Abhoynagar and 21.2% in Mirsarai – the difference was due mostly to more deaths from acute respiratory infections, pneumonia, and tuberculosis in Mirsarai. Non-communicable diseases (NCDs accounted for 56.2 and 55.3% of deaths in each subdistrict, respectively, with leading causes being stroke (16.5–19.3%, neoplasms (13.2% each, cardiac diseases (8.9–11.6%, chronic obstructive pulmonary diseases (5.1–6.3%, diseases of the digestive system (3.1–4.1%, and diabetes (2.8–3.5%, together accounting for 49.2–51.2% points of the NCD deaths in the two subdistricts. Injury and other external causes accounted for another 7.5–7.7% deaths, with self-harm being higher among females in Abhoynagar. Conclusions: The computer

  13. Isolation of bioactive compound from marine seaweeds against fish pathogenic bacteria Vibrio alginolyticus (VA09 and characterisation by FTIR

    Directory of Open Access Journals (Sweden)

    Rajasekar Thirunavukkarasu

    2013-08-01

    Full Text Available Objective: Fresh marine seaweeds Gracilaria edulis, Gracillaria verrcosa, Acanthospora spicifera, Ulva facita, Ulva lacta (U. lacta, Kappaphycus spicifera, Sargassum ilicifolium, Sargassum wightii (S. wightii, Padina tetramatica and Padina gymonospora were collected from Mandapam (Rameshwaram, Tamil Nadu of South East coast of India and were screened for antibacterial activity. Methods: All the collected seaweeds were extracted by using five different solvent (methanol, isopropanol, acetone, chloroform, diethyl ether to study their extracts against fish pathogenic bacteria V. alginolyticus (VA09 purchased from MTCC. And minimum inhibition carried out by using Resazurin micro-titre assay. Crude extract of S. wightii analysied by FTIR. Results: The methanolic extract of S. wightii produced a maximum zone of inhibition (1.95±0.11 cm, isopropanol extract maximum inhibition was produced by S. wightii (1.93±0.78 cm, Acetone extract of Gracilaria verrcosa showed maximum zone of inhibition (1.36±0.05 cm, chloroform extract of S. wightii produced a maximum zone (1.56±0.25 cm and diethyl ether extract of S. wightii produced maximum zone of inhibition(1.86±0.11 cm. Based on the antibacterial activity S. wightii, U. lacta and Padina tetramatica showed best antibacterial activity against Vibrio harveyi. In this three seaweeds were taken for MIC study. The S. wightii methanolic extract, U. lacta diethyl ether extract and Padina tetramatica methanolic extract showed a higher MIC values, and despectively were 25 mg/mL, 50 mg/mL and 50 mg/mL. FTIR result showed that mostly phenolic compounds were present in the S. wightii. Conclusions: Based on the FTIR result S. wightii have high amount of phenolic compound. Phenolic compound have the good antimicrobial activity. The results clearly show that seaweed S. wightii is an interesting source for biologically active compounds that may be applied for prophylaxis and therapy of bacterial fish diseases and it should

  14. Towards Predicting Street-Level Inundation: using Operational Forecast Modeling Techniques during 2011 Hurricane Irene in Hampton Roads, VA

    Science.gov (United States)

    Loftis, D.; Loftis, J. D.; Stiles, W. A.

    2016-02-01

    Storm surge-induced coastal inundation poses numerous personal, commercial, industrial, and sociopolitical challenges for society. Flooding can be caused by the combination of storm surge and river-induced inland flooding in many locations throughout the coastal plain. The cross-disciplinary nature of the hydrodynamics involved (hydraulics, oceanography, and hydrology), coupled with the complexity of the atmospheric forcing, makes a numerical model the best approach for a comprehensive study of the dynamics of coastal inundation. This study builds upon the lessons learned from forecast modeling experiences during 2011 Hurricane Irene in Tidewater Virginia, to ascertain the most effective way to approach predicting street-level inundation. During the storm event, an open-source large-scale ocean model, SCHISM, was provided atmospheric forcing from the National Oceanic and Atmospheric Administration's Global Forecast System, updated every 6 hours to simulate 9 separate 30-hour simulations, which were provided to emergency managers and the National Weather Service in Wakefield, VA. To accurately predict street-level inundation, water elevations at key points near the mouths of vulnerable tributaries can be used to drive a separate street-level high-resolution sub-grid model (UnTRIM) to simulate localized flooding events on the scale of 5-meter resolution. To this end, high-resolution Digital Elevation Models including building and roadway infrastructure were developed from Lidar-derived topography for the Hampton Roads Region of Virginia, and used to accurately predict flooding in low-lying areas of the Cities of Norfolk, Portsmouth, and Chesapeake along the Elizabeth and Lafayette Rivers, the City of Virginia Beach along the Lynnhaven River, and along Hampton, York, and Poquoson along the Back River. Tropical storm surge flood heights were validated via temporal comparison with water level observations from NOAA, the USGS, and NASA aggregated to an average R2

  15. A pilot study of a heuristic algorithm for novel template identification from VA electronic medical record text.

    Science.gov (United States)

    Redd, Andrew M; Gundlapalli, Adi V; Divita, Guy; Carter, Marjorie E; Tran, Le-Thuy; Samore, Matthew H

    2017-07-01

    Templates in text notes pose challenges for automated information extraction algorithms. We propose a method that identifies novel templates in plain text medical notes. The identification can then be used to either include or exclude templates when processing notes for information extraction. The two-module method is based on the framework of information foraging and addresses the hypothesis that documents containing templates and the templates within those documents can be identified by common features. The first module takes documents from the corpus and groups those with common templates. This is accomplished through a binned word count hierarchical clustering algorithm. The second module extracts the templates. It uses the groupings and performs a longest common subsequence (LCS) algorithm to obtain the constituent parts of the templates. The method was developed and tested on a random document corpus of 750 notes derived from a large database of US Department of Veterans Affairs (VA) electronic medical notes. The grouping module, using hierarchical clustering, identified 23 groups with 3 documents or more, consisting of 120 documents from the 750 documents in our test corpus. Of these, 18 groups had at least one common template that was present in all documents in the group for a positive predictive value of 78%. The LCS extraction module performed with 100% positive predictive value, 94% sensitivity, and 83% negative predictive value. The human review determined that in 4 groups the template covered the entire document, with the remaining 14 groups containing a common section template. Among documents with templates, the number of templates per document ranged from 1 to 14. The mean and median number of templates per group was 5.9 and 5, respectively. The grouping method was successful in finding like documents containing templates. Of the groups of documents containing templates, the LCS module was successful in deciphering text belonging to the template

  16. Une façon d’indiquer la « non-coïncidence entre les mots et les choses », on va dire...

    Directory of Open Access Journals (Sweden)

    Labeau Emmanuelle

    2012-07-01

    Full Text Available Nous souhaitons nous pencher ici sur un emploi particulier de la périphrase en aller + infinitif qui n’a fait l’objet – à notre connaissance – que d’un article (Lansari 2010. Cet emploi « modalisant » que Lansari limite à la formule 'on va dire' mériterait d’être approfondi pour plusieurs raisons. D’une part, l’emploi n’est décrit que sur base de « vingt exemples tirés d’internet, de blogs ou de forums » (Lansari 2010: 120 alors que, de l’aveu de Lansari elle-même, l’emploi relève de l’oral. Il serait donc utile d’enrichir – quantitativement et qualitativement - le corpus et d’y intégrer des occurrences d’oral authentique. D’autre part, Lansari restreint l’emploi modalisant à la séquence 'on va dire' ; on pourrait s’interroger sur la capacité de séquences comme 'je vais dire' à remplir les mêmes fonctions discursives. Dans cet article, nous commencerons par un – forcément bref – état de la question. Après avoir présenté le corpus, nous testerons les hypothèses précédemment défendues à la lueur du corpus rassemblé: (a Le corpus CFPP2000 issu du projet Discours sur la ville. Corpus de Français Parlé Parisien des années 2000 (disponible en ligne à http://cfpp2000.univ-paris3.fr/Corpus.html. CFPP2000 donne la parole à 41 informateurs en 28 interviews (2198 min et a généré 96 occurrences de on va dire modalisant. (b Le corpus CLAPI comprenant 45 heures d’interactions interrogeables en ligne à http://clapi.univ-lyon2.fr/analyse_requete_aide.php?menu=outils. On y a relevé 12 exemples de on va dire modalisant. (c Un corpus personnel d’interviews (163min réalisées pendant l’année académique 2009-10 auprès de cinq étudiants Erasmus français grâce au soutien d’une bourse de la Délégation Générale à la Langue Française et aux Langues de France (DGLFLF. Les entretiens avec une assistante de recherche, basés sur les thèmes suivants, étaient suppos

  17. Neuropsychiatric symptoms (NPS in patients with pure vascular dementia (VaD and mixed dementia (MD from a memory outpatient clinic in Southeast Brazil

    Directory of Open Access Journals (Sweden)

    José Ibiapina Siqueira-Neto

    Full Text Available ABSTRACT Vascular Dementia (VaD and Vascular Cognitive Impairment (VCI are increasingly common worldwide. Nevertheless, the clinical-neuropsychiatric profile of these patients at presentation is still poorly characterized in developing countries. Objective: We aimed to characterize the prevalence of neuropsychiatric symptoms, as well as the clinical and cognitive profile of patients with VaD and VCI in our tertiary University outpatient cognitive clinic. Methods: We reviewed data on 253 patients diagnosed with VaD or VCI at our center between January 1996 and December 2005, located in an industrial region of the state of Sao Paulo, southeast Brazil. We excluded 19 patients who did not complete the medical investigation or who did not meet the clinical or neuroimaging criteria for vascular dementia. We collected socio-demographic data, educational level, vascular risk factors, behavioral and neuropsychological symptoms and cognitive complaints at presentation. Results: Two hundred and thirty-four cases were included in this analysis. The mean age was 67.77±10.35 years; 72% were males and 82% had less than four years of education (average 2.84±2.96 years. The initial Clinical Dementia Rating score was 2 & 3 in 68%. A total of 185 patients had neuropsychiatric symptoms distributed in main categories as follows: psychosis (52.6%, hallucinations (23.5%, psychomotor agitation (22.5%, depression (17.5% and apathy (17.5%. Hypertension and previous stroke were the most prevalent risk factors. Conclusion: We found a high prevalence of neuropsychiatric symptoms. The clinical-neuropsychiatric profile of patients presenting to cognitive clinics in developing countries may differ greatly to that of more developed nations. These characteristics may have implications for public health strategies.

  18. Screening of three common mtDNA mutations among subjects with autosomal recessive non-syndromic hearing loss in Sistan va Baluchestan province, Iran

    Directory of Open Access Journals (Sweden)

    Fartemeh Azadegan-Dehkordi

    2011-10-01

    Full Text Available Background: Non-syndromic hearing loss may be induced by mutations in both nuclear and mitochondrial genes. Mutations in mtDNA are present in less than 1% of the children with pre-lingual deafness but are more prevalent later. Most of the molecular defects responsible for mitochondrial disorder, associated with hearing loss may be induced by mutations in the 12SrRNA and tRNA genes. This aim of this study was to investigate the frequency of three common mtDNA mutations including A1555G, A3243G and A7445G in a cohort of autosomal recessive non-syndromic hearing loss (ARNSHL subjects in Sistan va Baluchestan province. Material and Methods: In this descriptive- experimental based study, a total of 110. ARNSHL subjects from Sistan va Baluchestan province were investigated for three common mtDNA mutations using PCR-RFLP procedure. The possible mutations were confirmed by direct sequencing.Results: None of the A1555G and A7445G mutations were detected in this study. However, we found one sample to carry A3243G mutation (0.9%. Moreover abolishing a MTTL1 restriction site close to A3243G mutation revealed a G3316A allelic variant in 0.9% of patients studied.Conclusion: This study showed that mtDNA mutations are responsible for less than 1% of pre-lingual ARNSHL associated subjects. The present study will improve the genetic counseling of hearing impaired patients in Sistan va Baluchestan province, Iran

  19. 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.

  20. Effects of VA Facility Dog on Hospitalized Veterans Seen by a Palliative Care Psychologist: An Innovative Approach to Impacting Stress Indicators.

    Science.gov (United States)

    Krause-Parello, Cheryl A; Levy, Cari; Holman, Elizabeth; Kolassa, John E

    2018-01-01

    The United States is home to 23 million veterans. In many instances, veterans with serious illness who seek healthcare at the VA receive care from a palliative care service. Animal-assisted intervention (AAI) is gaining attention as a therapeutic stress reducing modality; however, its effects have not been well studied in veterans receiving palliative care in an acute care setting. A crossover repeated-measures study was conducted to examine the effects of an animal-assisted intervention (AAI) in the form of a therapy dog on stress indicators in 25 veterans on the palliative care service at the VA Eastern Colorado Healthcare System in Denver, CO. Veterans had a visit from a therapy dog and the dog's handler, a clinical psychologist (experimental condition) and an unstructured visit with the clinical psychologist alone (control condition). Blood pressure, heart rate, and the salivary biomarkers cortisol, alpha-amylase, and immunoglobulin A were collected before, after, and 30-minutes after both the experimental and control conditions. Significant decreases in cortisol were found when the before time period was compared to the 30-minutes after time period for both the experimental ( p = 0.007) and control condition ( p = 0.036). A significant decrease in HR was also found when the before time period was compared to the 30-minutes after time period for both the experimental ( p = 0.0046) and control ( p = 0.0119) condition. Results of this study supported that a VA facility dog paired with a palliative care psychologist had a measurable impact on salivary cortisol levels and HR in veterans.

  1. [Results of the utilization of the ECMO-VA following cardiac surgery, in the Department of Cardiothoracic Surgery of Santa Maria Hospital].

    Science.gov (United States)

    Junqueira, Nádia; Côrte-Real, Hugo; Gallego, Javier; Ferreira, Ricardo; Guerra, Nuno; Carvalheiro, Catarina; Ferreira, Hugo; Sena, André; Arruda, Ricardo; Mendes, Mário; Lucas Nobre, Angelo

    2015-01-01

    Extracorporeal membrane oxygenation through a veno-arterial circuit (ECMO-VA) is an organ support option in refractory cardiogenic shock, when the primary cause of decompensation is thought to be reversible. We report the clinical results of this technique in patients submitted to cardiac surgery at our center. We present a retrospective study of patients that underwent ECMO-VA after cardiac surgery and subsequent admission at the intensive care unit (ICU), in our center. The data were collected from clinical records. The statistical analysis was made with an SPSS 22.0 data base. We report data on 7 patients with an average age of 62 years. The mean SAPS II was 56 points, the Euroscore II was 17% and the British Columbia Cardiac Surgery Intensive Care Score was 71%. 57% of patiens underwent myocardial revascularization surgery, 29% were submitted to valvular surgery and 14% of the patients underwent an aortic surgery. All of the patients underwent peripheral cannulation, 71% of which was placed during surgery and in the remaining 29%, immediately after. All of the patients were put on mechanical ventilation and 86% needed an intra-aortic baloon and renal support. The main complications were acute renal injury (100%), coagulopathy (86%), emergency re-sternothomy (43%) ischaemia of the cannulated limb (29%) and central nervous system complications (29%). The average time of ECMO-VA use was 5 days and the mean stay in the ICU was 19 days. In 57% of patients, the de-cannulation was successful. The average in-patient survival was 43%. Extracorporeal membrane oxygenation through a veno-arterial circuit (ECMO-VA) is an organ support option in refractory cardiogenic shock, when the primary cause of decompensation is thought to be reversible. The timely utilization of the procedure is crucial in cases with high probability of reversible causes of cardiogenic shock, where the rational for its use is to allow time for the myocardium to recover. The main difficulty identified

  2. posttraumatic stress and its relationship to physical health functioning in a sample of Iraq and Afghanistan War veterans seeking postdeployment VA health care.

    Science.gov (United States)

    Jakupcak, Matthew; Luterek, Jane; Hunt, Stephen; Conybeare, Daniel; McFall, Miles

    2008-05-01

    The relationship between posttraumatic stress and physical health functioning was examined in a sample of Iraq and Afghanistan War veterans seeking postdeployment VA care. Iraq and Afghanistan War veterans (N = 108) who presented for treatment to a specialty postdeployment care clinic completed self-report questionnaires that assessed symptoms of posttraumatic stress disorder (PTSD), chemical exposure, combat exposure, and physical health functioning. As predicted, PTSD symptom severity was significantly associated with poorer health functioning, even after accounting for demographic factors, combat and chemical exposure, and health risk behaviors. These results highlight the unique influence of PTSD on the physical health in treatment seeking Iraq and Afghanistan War veterans.

  3. 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

  4. Causes of death among persons of all ages within the Kilifi Health and Demographic Surveillance System, Kenya, determined from verbal autopsies interpreted using the InterVA-4 model

    Directory of Open Access Journals (Sweden)

    Carolyne Ndila

    2014-10-01

    Full Text Available Background: The vast majority of deaths in the Kilifi study area are not recorded through official systems of vital registration. As a result, few data are available regarding causes of death in this population. Objective: To describe the causes of death (CODs among residents of all ages within the Kilifi Health and Demographic Surveillance System (KHDSS on the coast of Kenya. Design: Verbal autopsies (VAs were conducted using the 2007 World Health Organization (WHO standard VA questionnaires, and VA data further transformed to align with the 2012 WHO VA instrument. CODs were then determined using the InterVA-4 computer-based probabilistic model. Results: Five thousand one hundred and eighty seven deaths were recorded between January 2008 and December 2011. VA interviews were completed for 4,460 (86% deaths. Neonatal pneumonia and birth asphyxia were the main CODs in neonates; pneumonia and malaria were the main CODs among infants and children aged 1–4, respectively, while HIV/AIDS was the main COD for adult women of reproductive age. Road traffic accidents were more commonly observed among men than women. Stroke and neoplasms were common CODs among the elderly over the age of 65. Conclusions: We have established the main CODs among people of all ages within the area served by the KHDSS on the coast of Kenya using the 2007 WHO VA questionnaire coded using InterVA-4. We hope that our data will allow local health planners to estimate the burden of various diseases and to allocate their limited resources more appropriately.

  5. Autoridades tradicionais vaNdau de Moçambique: o regresso do indirect rule ou uma espécie de neo-indirect rule?

    Directory of Open Access Journals (Sweden)

    Fernando Florêncio

    2008-04-01

    Full Text Available Neste artigo, partindo do exemplo Ndau de Moçambique, pretende-se compreender a importância do lugar social que as autoridades tradicionais detêm na actualidade e qual o seu papel no processo de formação do Estado ao nível distrital. Pretende-se demonstrar que, à semelhança do passado colonial, o Estado moçambicano tem procurado usar as autoridades tradicionais vaNdau em processos administrativos que se podem caracterizar como uma espécie de neo-indirect rule.Using the example of the Ndau of Mozambique, this article seeks to interpret the significance of the social standing of traditional authorities in modern life and their role in state formation at the district level. It endeavours to show how, as in the colonial past, the Mozambican state has sought to use the traditional vaNdau authorities in administrative roles which can best be described as a kind of neo-indirect rule.

  6. Vizuālā naratīva loma Džana Imou un Anga Lī wuxia filmu satura veidošanā

    OpenAIRE

    Volkova, Darja

    2016-01-01

    Bakalaura darba tēma ir “Vizuālā naratīva loma Džana Imou un Anga Lī wuxia filmu satura veidošanā”. Darbs ietver filmu “Tīģeris un Drakons” (“Crouching Tiger, Hidden Dragon”, 2000), “Varonis” (“Hero”, 2002) un “Lidojošo dunču nams” (“House of Flying Daggers”, 2004) analīzi ar mērķi noskaidrot wuxia žanra unikālo stilu, tā elementu pielietojumu uz ekrāna, kā arī vizuālā naratīva un kino valodas kopējās un atšķirīgās iezīmes pētāmo filmu satura veidošanā. Darba teorētiskajā daļā tiek sīkāk ...

  7. National integration of mental health providers in VA home-based primary care: an innovative model for mental health care delivery with older adults.

    Science.gov (United States)

    Karlin, Bradley E; Karel, Michele J

    2014-10-01

    To promote mental health (MH) service access and quality for veterans with complex and chronic medical, social, and behavioral conditions, the U.S. Department of Veterans Affairs (VA) has integrated a full-time MH provider into each VA home-based primary care (HBPC) team. The goal of the current evaluation is to examine the nature and extent to which MH care processes and practices have been integrated into HBPC nationally. Separate surveys assessing the integration of a wide range of MH care practices and HBPC team processes were sent to MH providers and program directors in each HBPC program in 2010. A total of 132 MH providers representing 119 HBPC programs, and 112 program directors completed the surveys. The most common clinical issues addressed by MH providers were depression, coping with illness and disability, anxiety, caregiver/family stress, and cognitive evaluation. Other team members typically conducted initial MH screenings, with MH providers' time focusing on cases with identified needs. Approximately 40% of MH providers' time was devoted to direct clinical care. Significant time was also spent on team activities, driving, and charting. Integration of MH services into HBPC is feasible and facilitates service access for a vulnerable population. Mental health care delivery in HPBC generally involves a high degree of interdisciplinary practice. Mental health integration into HBPC may serve as a model for other systems interested in promoting MH care delivery among homebound and other older individuals. Published by Oxford University Press on behalf of The Gerontological Society of America 2013.

  8. Optimalizace uložení ložisek převodovky domíchávače

    OpenAIRE

    Górnisiewicz, Tomáš

    2015-01-01

    Předložená diplomová práce se zabývá návrhem a optimalizací ložisek v převodovce pro domíchávač. Převodovka je důležitou komponentou autodomíchávače, jelikož slouží k pohonu a uložení bubnu. Hlavní pozornost je v této práci věnována návrhu a optimalizaci geometrie ložiska výstupní hřídele, což je klíčová a nejvíce zatížená komponenta převodovky. Ložisko bylo navrhováno při uvažování dvou základních kritérií – dynamické radiální únosnosti a kontaktního napětí v kontaktu valivého elementu a obě...

  9. Avaliação nutricional de crianças indígenas Pakaanóva (Wari', Rondônia, Brasil

    Directory of Open Access Journals (Sweden)

    Escobar Ana Lúcia

    2003-01-01

    Full Text Available OBJETIVOS: apresentar os resultados de um inquérito transversal sobre o estado nutricional de crianças Pakaanóva (Wari', povo indígena localizado em Rondônia, na Amazônia, Brasil. MÉTODOS: inquérito transversal em que foram coletadas medidas de peso/massa corporal e estatura de 131 crianças entre 2-10 anos (69 meninos e 62 meninas. Os dados foram comparados com as curvas do NCHS, tomando-se como ponto de corte -2 escores z. RESULTADOS: são muito pronunciadas as freqüências de baixa estatura (45,8% e de massa corporal para idade (26,0%, notando-se a manutenção da proporcionalidade corporal (somente 1,6% abaixo de -2 escores z para massa corporal para estatura. Diferenças entre os sexos foram observadas somente para o indicador massa corporal para a idade, com uma maior freqüência de meninos apresentando baixo peso. CONCLUSÕES: os achados são discutidos levando-se em consideração as condições de vida dos Pakaanóva, em particular aspectos epidemiológicos e de saneamento, concluindo-se que a desnutruição é de ampla ocorrência no grupo indígena investigado.

  10. Ammonium Oxidation Kinetics in the Presence of Nitrification Inhibitor Dicyandiamide (DCD in some Calcareous Soils of Chaharmahal va Bakhtiari Province

    Directory of Open Access Journals (Sweden)

    roza kazemi

    2017-02-01

    Full Text Available Introduction: Nitrification inhibitors (NIs are compounds that retard the biological oxidation of ammonium to nitrite by depressing the activity of Nitrosomonas bacteria in the soil. Many popular NIs such as nitrapyrine (NP, dicyandiamide (DCD and 3,4-dimethylpyrazole phosphate (DMPP are produced and used in agricultural soils. Dicyandiamide is a very popular NI in some of the world countries. It delays nitrification process in the soil through its bacterial static property. It is easy to blend with commercial fertilizers such as urea, due to its low volatile nature. Application of urea in combination with nitrification inhibitor DCD lengthens nitrogen presence in soil as ammonium form. It has several beneficial effects for agriculture and enhances environmental protection. Studying the ammonium oxidation kinetics in the presence of nitrification inhibitor DCD can provide the experts in agriculture with very useful information regarding the ammoniumdurability in different soils. This research has been done to study the effect of using NI dicyandiamide on the kinetics of ammoniumloss in some calcareous soils of Chaharmahal Va Bakhtiari province, Iran. Materials and Methods: This research was conducted as factorial using completely randomized design with two factors of nitrogen fertilizer type and soil type with three replications at laboratory conditions. In this experiment, nitrogen fertilizer type included 2 levels of: 1- urea 2- urea plus nitrification inhibitor DCD (3.2%. A no added nitrogen fertilizer was considered as control treatment.The soil factor also consisted of 5different soils with a wide variation in soil physical and chemical characteristics. Five selected soils were non-saline (EC1:2=0.14-0.76 dS m-1 and alkaline (pH1:2=7.5-8.2. Organic carbon and cation exchange capacity (CEC ranged from 0.48 to 2.34% and 10 to 30 cmolc kg-1, respectively. The dose of applied nitrogen in all experimental treatments was 50 mg kg-1 N as urea

  11. Who died of what in rural KwaZulu-Natal, South Africa: a cause of death analysis using InterVA-4

    Directory of Open Access Journals (Sweden)

    Joël Mossong

    2014-10-01

    Full Text Available Background: For public health purposes, it is important to see whether men and women in different age groups die of the same causes in South Africa. Objective: We explored sex- and age-specific patterns of causes of deaths in a rural demographic surveillance site in northern KwaZulu-Natal in South Africa over the period 2000–2011. Design: Deaths reported through the demographic surveillance were followed up by a verbal autopsy (VA interview using a standardised questionnaire. Causes of death were assigned likelihoods using the publicly available tool InterVA-4. Cause-specific mortality fractions were determined by age and sex. Results: Over the study period, a total of 5,416 (47% and 6,081 (53% deaths were recorded in men and women, respectively. Major causes of death proportionally affecting more women than men were (all p<0.0001: human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS (20.1% vs. 13.6%, other and unspecified cardiac disease (5.9% vs. 3.2%, stroke (4.5% vs. 2.7%, reproductive neoplasms (1.7% vs. 0.4%, diabetes (2.4% vs. 1.2%, and breast neoplasms (0.4% vs. 0%. Major causes of deaths proportionally affecting more men than women were (all p<0.0001 assault (6.1% vs. 1.7%, pulmonary tuberculosis (34.5% vs. 30.2%, road traffic accidents (3.0% vs. 1.0%, intentional self-harm (1.3% vs. 0.3%, and respiratory neoplasms (2.5% vs. 1.5%. Causes of death due to communicable diseases predominated in all age groups except in older persons. Conclusions: While mortality during the 2000s was dominated by tuberculosis and HIV/AIDS, we found substantial sex-specific differences both for communicable and non-communicable causes of death, some which can be explained by a differing sex-specific age structure. InterVA-4 is likely to be a valuable tool for investigating causes of death patterns in other similar Southern African settings.

  12. Etno parks in the function of cultural tourism development in the Mačva, Šabačka Posavina and Pocerina

    Directory of Open Access Journals (Sweden)

    Grčić Ljiljana

    2010-01-01

    Full Text Available The monuments of folk architecture have its historical, artistic and tourist value. They illustrate the characteristics of local culture and way of life, and therefore should be preserved for the future. The main touristic functions in them can be cognitive, educational, fun, and also vacation and recreation. If we would like to keep the traditional folk architecture, it is necessary to protect vulnerable areas at the source or in the open air museums. This paper presents an overview of the ethno-parks and other facilities in the Mačva, Šabac, Šabačka Pocerina and Posavina, which seems preserved examples of folk architecture and architecture from the nineteenth and early twentieth century, are part of the cultural heritage not only of these areas, but also the whole of Serbia.

  13. El bosón de Higgs no te va a hacer la cama la física como nunca te la han contado

    CERN Document Server

    Santaolalla, Javier

    2016-01-01

    Viajes en el tiempo, agujeros negros, motores de antimateria, aceleración del universo… La física moderna suena a película, pero es ciencia, de la de verdad verdadera, la que nos cuenta una historia fascinante de descubrimientos y sueños cumplidos, de luchas y disputas, de pasión por comprender la naturaleza. Este divertido libro te ayudará a entender de una vez por todas lo que nos rodea, desde lo más pequeño a lo más grande, y a saber que el bosón de Higgs no te va a hacer la cama, ¡ni aunque le insistas!

  14. THE 50th ANNIVERSARY OF THE DEPARTMENT OF ORTHOPEDIC RHEUMATOLOGY, V.A. NASONOVA RESEARCH INSTITUTE OF RHEUMATOLOGY: RESULTS AND PROSPECTS

    Directory of Open Access Journals (Sweden)

    V. P. Pavlov

    2015-01-01

    Full Text Available The paper describes basic steps in the establishment (1964 and development of orthopedic rheumatology and discusses its present-day status. The 50th anniversary of this discipline that is a component of modern rheumatology was celebrated in 2014. In connection with such a remarkable date the author sums up some results of the scientific and practical activities of the orthopedic rheumatologists of the V.A. Nasonova Research Institute of Rheumatology and considers the prospects for further research developments, the possible evolution of minimally invasive surgery (arthroscopic technology for the treatment of large and small joints, and the issues of rehabilitation in a wide range of rheumatic diseases, by applying high technology. 

  15. Asertivnost kao važna komunikacijska vještina knjižničara u školskoj knjižnici

    OpenAIRE

    Škrobica, Vanja

    2008-01-01

    Škola nije samo mjesto gdje djeca uče čitati i računati, to je i mjesto socijalizacije i učenja socijalnih vještina koje su potrebne za interakciju i adaptaciju u kulturnom okruženju. U radu se objašnjavaju temeljni stilovi ponašanja (komunikacije) te se ističe njihova važnost za radnu sredinu, poglavito školsku. Glavni dio rada bavi se razlikama između neasertivnog i asertivnog načina ponašanja u školskoj knjižnici te donosi nekoliko korisnih asertivnih tehnika. Kako je izučavanje i istraživ...

  16. The pew versus the couch: relationship between mental health and faith communities and lessons learned from a VA/clergy partnership project.

    Science.gov (United States)

    Sullivan, Steve; Pyne, Jeffrey M; Cheney, Ann M; Hunt, Justin; Haynes, Tiffany F; Sullivan, Greer

    2014-08-01

    The history of the relationship between religion and mental health is one of commonality, conflict, controversy, and distrust. An awareness of this complex relationship is essential to clinicians and clergy seeking to holistically meet the needs of people in our clinics, our churches, and our communities. Understanding this relationship may be particularly important in rural communities. This paper briefly discusses the history of this relationship and important areas of disagreement and contention. The paper moves beyond theory to present some current practical tensions identified in a brief case study of VA/Clergy partnerships in rural Arkansas. The paper concludes with a framework of three models for understanding how most faith communities perceive mental health and suggests opportunities to overcome the tensions between "the pew" and "the couch."

  17. Performance analysis of electric power group of 50 kVA with MWM engine adapted to Otto cycle, using natural gas

    Directory of Open Access Journals (Sweden)

    Fabrízio L. Figueiredo

    2014-02-01

    Full Text Available This paper presents the data of tests with an internal combustion engine MWM adapted to Otto cycle, coupled to an electric generator with a capacity of 50 kVA, using natural gas . It is presented the characteristics and efficiency of the set for the purpose of comparison with its future operation using synthesis gas produced by a gasifier (biomass gas, to evaluate the feasibility of applying the system in remote locations, where biomass is available and system for transmitting electricity from other generation systems hampered by distance. The performance of the assembly was monitored at 0, 25, 50, 75 and 100% of its power capacity presented in increasing order of load voltages 220, 220, 221, 221 and 222 volts and currents 0, 25, 50, 75 and 100 amperes respectively for the load of 0, 9,5, 19, 27,5 and 38 kW the latter being the maximum output developed by the group.

  18. Nivel de corte de los ELISAs para cuantificación de anticuerpos inducidos por la vacuna antimeningocócica VA-MENGOC-BC

    Directory of Open Access Journals (Sweden)

    Rolando Ochoa

    2001-06-01

    Full Text Available Para medir el grado de protección inducido por vacunas antimeningocócicas se ha establecido el Ensayo Bactericida en Suero (EBS y se perfeccionan otros ensayos inmunobiológicos, sin embargo, es necesario contar con pruebas sencillas como el ELISA, capaz de evaluar un gran número de muestras. Se estimó el nivel de corte de los ELISAs para la cuantificación de IgG humana contra los antígenos de VA-MENGOC-BC, vacuna antimeningocócica compuesta por vesículas proteicas de membrana externa de meningococo B y polisacárido capsular de meningococo C, con respecto a un panel de muestras de suero de lactantes, caracterizado por Ensayo Bactericida en Sangre Total (EBST. Los valores correspondientes a la máxima sensibilidad y especificidad fueron respectivamente; 2 μg/mL y 12 μg/mL para antipolisacárido C, y 1000 U/mL y 7000 U/mL para antiproteínas de membrana externa. La mayor coincidencia se obtuvo con 6 μg/mL y 2500 U/mL. Se evaluó otro panel de muestras de suero de adolescentes entre 14 y 18 años, por ELISA y EBS para Neisseria meningitidis serogrupos B y C, alcanzándose una buena concordancia. Doce años después de la inmunización con VA-MENGOC-BC persiste una importante concentración de anticuerpos contra los antígenos vacunales en los sueros estudiados.

  19. Summary of Mercury and Trace Element Results in Precipitation from the Culpeper, Virginia, Mercury Deposition Network Site (VA-08), 2002-2006

    Science.gov (United States)

    Engle, Mark A.; Kolker, Allan; Mose, Douglas E.; East, Joseph A.; McCord, Jamey D.

    2008-01-01

    The VA-08 Mercury Deposition Network (MDN) site, southwest of Culpeper, Virginia, was established in autumn of 2002. This site, along with nearby VA-28 (~31 km west) at Big Meadows in Shenandoah National Park, fills a spatial gap in the Mid-Atlantic region of the MDN network and provides Hg deposition data immediately west of the Washington, D.C., metropolitan area. Results for the Culpeper site from autumn of 2002 to the end of 2006 suggest that the highest mercury (Hg) deposition (up to 5.0 ug/m2 per quarter of the 6.5-12.6 ug/m2 annual Hg deposition) is measured during the second and third quarters of the year (April-September). This is a result of both elevated Hg precipitation concentrations (up to 27 ng/L) and greater precipitation during these months. The data also exhibit a general statistically significant (pBig Meadows sites indicates that although quarterly Hg deposition was not significantly different (pdata identified 3 primary source categories, each with large loadings of characteristic elements: 1) Ca, Al, Mg, Sr, La, and Ce (crustal sources); 2) V, Na, and Ni (local wintertime heating oil); and 3) Zn, Cd, Mn, and Hg (regional anthropogenic emission sources). HYSPLIT air mass trajectory modeling and enrichment factor calculations are consistent with this interpretation. A preliminary source attribution model suggests that ~51% of the Hg in wet deposition is due to regional anthropogenic sources, while crustal sources and local oil combustion account for 9.5% and accounts for ~40% of the Hg in wet deposition.

  20. Comparison of DSM-IV and DSM-5 criteria for alcohol use disorders in VA primary care patients with frequent heavy drinking enrolled in a trial.

    Science.gov (United States)

    Takahashi, Traci; Lapham, Gwen; Chavez, Laura J; Lee, Amy K; Williams, Emily C; Richards, Julie E; Greenberg, Diane; Rubinsky, Anna; Berger, Douglas; Hawkins, Eric J; Merrill, Joseph O; Bradley, Katharine A

    2017-07-18

    Criteria for alcohol use disorders (AUD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) were intended to result in a similar prevalence of AUD as DSM-IV. We evaluated the prevalence of AUD using DSM-5 and DSM-IV criteria, and compared characteristics of patients who met criteria for: neither DSM-5 nor DSM-IV AUD, DSM-5 alone, DSM-IV alone, or both, among Veterans Administration (VA) outpatients in the Considering Healthier drinking Options In primary CarE (CHOICE) trial. VA primary care patients who reported frequent heavy drinking and enrolled in the CHOICE trial were interviewed at baseline using the DSM-IV Mini International Neuropsychiatric Interview for AUD, as well as questions about socio-demographics, mental health, alcohol craving, and substance use. We compared characteristics across 4 mutually exclusive groups based on DSM-5 and DSM-IV criteria. Of 304 participants, 13.8% met criteria for neither DSM-5 nor DSM-IV AUD; 12.8% met criteria for DSM-5 alone, and 73.0% met criteria for both DSM-IV and DSM-5. Only 1 patient (0.3%) met criteria for DSM-IV AUD alone. Patients meeting both DSM-5 and DSM-IV criteria had more negative drinking consequences, mental health symptoms and self-reported readiness to change compared with those meeting DSM-5 criteria alone or neither DSM-5 nor DSM-IV criteria. In this sample of primary care patients with frequent heavy drinking, DSM-5 identified 13% more patients with AUD than DSM-IV. This group had a lower mental health symptom burden and less self-reported readiness to change compared to those meeting criteria for both DSM-IV and DSM-5 AUD. Trial Registration ClinicalTrials.gov NCT01400581. 2011 February 17.

  1. STUDIES DEVOTED TO ANTIPHOSPHOLIPID SYNDROME AT THE V.A. NASONOVA RESEARCH INSTITUTE OF RHEUMATOLOGY: MAIN ACHIEVEMENTS (ON THE OCCASION OF THE 40th ANNIVERSARY OF THE DISSERTATION BOARD

    Directory of Open Access Journals (Sweden)

    T. M. Reshetnyak

    2016-01-01

    Full Text Available The paper presents achievements associated with the study of antiphospholipid syndrome from its description to the present time, i.e. over the last 30 years, worldwide and at the V.A. Nasonova Research Institute of Rheumatology.

  2. Cuantificación de IGG contra los componentes inmunogénicos de VA-ENGOC-BC en plasma de lactantes vacunados

    Directory of Open Access Journals (Sweden)

    José Rodríguez Canosa

    1997-04-01

    Full Text Available Debido a las características particulares de la respuesta inmune en lactantes, así como a la eficacia mostrada por la vacuna cubana antimeningocóccica VA-MENGOC-BC, nos propusimos cuantificar la respuesta de la inmunoglobulina G contra los componentes inmunogénicos de los meningococos B y C presentes en la vacuna, en lactantes vacunados. Se tomó muestra por punción capilar a 109 lactantes entre 3 y 6 meses de edad antes de la vacunación a los 31,4 ± 2 días después de la primera y 32,3 ± días después de la segunda dosis vacunal. Se determinaron las concentraciones de inmunoglobulina G contra cada inmunógeno de la vacuna. Los niveles de inmunoglobulina G específica prevacunación, fueron elevadas contra el meningococo C. Se produjo un incremento estadísticamente significativo de anticuerpos para ambos inmunógenos después de la primera y segunda dosis, más marcado contra el meningococo C en la primera y para el meningococo B en la segunda, lo que apoya la presencia de memoria inmunológicaDue to the particular characteristics of the immune response in infants and to the efficacy shown by the Cuban antimeningococcal vaccine denominated VA-MENGOC-BC, we propose ourselves to quantify the response of immunoglobulin G against the immunogenic components of the meningococci B and C present in the vaccine among the vaccinated infants. The sample was taken by capillary puncture from 109 infants between 3 and 6 months before vaccination, at 31.4±2 days after the first dose and at 32.3± days after the second one. The concentrations of immunoglobulin G against each immunogen of the vaccine were determined. The levels of prevaccination specific immunoglobulin G were elevated against meningococcus C. There was a statistically significant increase of atibodies for both immunogens after the first and second dose. It was more marked against meningococcus C in the first, and for meningococcus B in the secons one, which supports the presence of

  3. Avaliação dos níveis de exposição ao mercúrio entre índios Pakaanóva, Amazônia, Brasil Mercury exposure among Pakaanóva Indians, Amazon Region, Brazil

    Directory of Open Access Journals (Sweden)

    Elisabeth C. Oliveira Santos

    2003-02-01

    Full Text Available Um estudo seccional foi realizado para avaliar os níveis de exposição ao mercúrio (Hg entre 910 índios Pakaanóva, residentes nos municípios de Guajará Mirim e Nova Marmoré no Estado de Rondônia, Brasil. Amostras de cabelo da região occipital foram coletadas de cada participante do estudo e os teores de Hg determinados por Espectrofotometria de Absorção Atômica com Geração de Vapor Frio. Os teores médios de Hg nas amostras de cabelo foram de 8,37µg/g (0,52-83,89µg/g, indicando exposição elevada. Crianças de até 2 anos e entre 3 e 5 anos de idade apresentaram médias de 10,54µg/g e 9,34µg/g, respectivamente. Os teores médios de Hg nas mulheres (8,91µg/g são mais elevados do que os valores observados nos homens (7,55µg/g, sendo esta diferença estatisticamente significante (t = 3,26; p A cross-sectional study was conducted to evaluate mercury (Hg exposure among 910 Pakaanóva Indians from the counties of Guajará Mirim and Nova Marmoré, Rondônia State, Brazil. Individual hair samples were taken from the occipital region, and Hg was measured by atomic absorption spectrometry with cold vapor generation. Mean Hg in hair samples was 8.37 µg/g (range 0.52-83.89, indicating high exposure. Young children (< 2 years old showed a mean Hg of 10.54 µg/g, and children from 3 to 5 years old had a mean Hg of 9.34µg/g. Mercury levels in women (8,91µg/g were higher than in men (7.55µg/g, and this difference was significant (t = 3.26; p < 0.01. These results indicate the need for surveillance programs and complementary studies including the Pakaanóva Indians in Rondônia State.

  4. Laboratory Load Model Based on 150 kVA Power Frequency Converter and Simulink Real-Time – Concept, Implementation, Experiments

    Directory of Open Access Journals (Sweden)

    Robert Małkowski

    2016-09-01

    Full Text Available First section of the paper provides technical specification of laboratory load model basing on 150 kVA power frequency converter and Simulink Real-Time platform. Assumptions, as well as control algorithm structure is presented. Theoretical considerations based on criteria which load types may be simulated using discussed laboratory setup, are described. As described model contains transformer with thyristor-controlled tap changer, wider scope of device capabilities is presented. Paper lists and describes tunable parameters, both: tunable during device operation and changed only before starting the experiment. Implementation details are given in second section of paper. Hardware structure is presented and described. Information about used communication interface, data maintenance and storage solution, as well as used Simulink real-time features are presented. List and description of all measurements is provided. Potential of laboratory setup modifications is evaluated. Third section describes performed laboratory tests. Different load configurations are described and experimental results are presented. This includes simulation of under frequency load shedding, frequency and voltage dependent characteristics of groups of load units, time characteristics of group of different load units in a chosen area and arbitrary active and reactive power regulation basing on defined schedule. Different operation modes of control algorithm are described: apparent power control, active and reactive power control, active and reactive current RMS value control.

  5. Impact of emotional approach coping and hope on PTSD and depression symptoms in a trauma exposed sample of Veterans receiving outpatient VA mental health care services.

    Science.gov (United States)

    Hassija, Christina M; Luterek, Jane A; Naragon-Gainey, Kristin; Moore, Sally A; Simpson, Tracy

    2012-01-01

    The present investigation evaluates the relationship between coping style, dispositional hope, and posttraumatic stress disorder (PTSD) and depression symptom severity in a trauma-exposed Veteran sample. Specifically, we evaluated the adaptive value of emotional avoidant and approach coping strategies and perceptions of hope in a sample of 209 trauma-exposed Veterans receiving outpatient mental health care at a VA facility. Participants completed a life events questionnaire and inventories assessing coping, dispositional hope, and PTSD and depression symptom severity. Hierarchical regression analyses were conducted controlling for relevant demographic variables. Greater levels of emotional avoidance and lower levels of emotional expression were significantly associated with increased PTSD and depression symptom severity. Dispositional hope was positively associated with depression symptoms only and perceptions of hope moderated the association between emotional avoidance coping and depression symptoms. Findings highlight the value of emotional coping strategies and perceptions of hope in posttraumatic adjustment. Specifically, employing coping techniques that encourage emotional expression may promote improved adjustment among trauma-exposed individuals, while reduced perceptions of hope and the use of avoidant coping strategies may place individuals at greater risk for depression following exposure to traumatic events.

  6. Advanced Glycation End Products, Oxidation Products, and the Extent of Atherosclerosis During the VA Diabetes Trial and Follow-up Study.

    Science.gov (United States)

    Saremi, Aramesh; Howell, Scott; Schwenke, Dawn C; Bahn, Gideon; Beisswenger, Paul J; Reaven, Peter D

    2017-04-01

    To determine whether plasma levels of advanced glycation end products and oxidation products play a role in the development of atherosclerosis in patients with type 2 diabetes (T2D) over nearly 10 years of the VA Diabetes Trial and Follow-up Study. Baseline plasma levels of methylglyoxal hydroimidazolone, Nε-carboxymethyl lysine, Nε-carboxyethyl lysine (CEL), 3-deoxyglucosone hydroimidazolone and glyoxal hydroimidazolone (G-H1), 2-aminoadipic acid (2-AAA), and methionine sulfoxide were measured in a total of 411 participants, who underwent ultrasound assessment of carotid intima-media thickness (CIMT), and computed tomography scanning of coronary artery calcification (CAC) and abdominal aortic artery calcification (AAC) after an average of 10 years of follow-up. In risk factor-adjusted multivariable regression models, G-H1 was associated with the extent of CIMT and CAC. In addition, 2-AAA was strongly associated with the extent of CAC, and CEL was strongly associated with the extent of AAC. The combination of specific advanced glycation end products and oxidation products (G-H1 and 2-AAA) was strongly associated with all measures of subclinical atherosclerosis. Specific advanced glycation end products and metabolic oxidation products are associated with the severity of subclinical atherosclerosis over the long term and may play an important role in the "negative metabolic memory" of macrovascular complications in people with long-standing T2D. © 2017 by the American Diabetes Association.

  7. Investigation of the flora, life forms and chorotypes of the plants in the Meymand Protected Area, Kohkilouyeh va Boyer Ahmad provice, Iran

    Directory of Open Access Journals (Sweden)

    Ali-Asghar Naghipour Borj

    2014-11-01

    Full Text Available Floristic studies have great importance as it represent the existence and the status of all plant species in an area. This study aimed to investigate the flora of Meymand Protected Area, located in central Zagros and in Kohkilouyeh va Boyer Ahmad provice with an elevation range of 1806 to 2730 meters from sea level. Plant families, genera and species were identified using taxonomic methods and available resources. According to the results, the flora of this area included 279 plant species belonging to 198 genera from 48 families. The richest families were Asteraceae with 50 species (17.9%, Poaceae, Lamiaceae with each 23 species (8.2% and Fabaceae with 22 species (7.8%. The dominance of hemicryptophytes and therophytes (totally, 82% life forms in the flora, were the characteristics of mountainous regions in central part of Iran. The high proportion of hemicryptophytes plants in the flora also indicated the dominance of a cold and montinious climates in the study area. The chorotypes of plants species showed that 57 percent (160 species of the plant species belonged to Irano-Touranian zone but other remaining species (119 speciecs grew in other geobotanical zones too. There were 5 vulnerable, 24 lower risks and 1 data deficient species in this protected area.

  8. Mortality after presentation with stent thrombosis is associated with time from index percutaneous coronary intervention: a report from the VA CART program.

    Science.gov (United States)

    Armstrong, Ehrin J; Maddox, Thomas M; Carey, Evan P; Grunwald, Gary K; Shunk, Kendrick A

    2014-10-01

    The risk of mortality for patients presenting to the cardiac catheterization laboratory with stent thrombosis (ST) may differ as a function of the timing from initial stent implantation. We hypothesized that the 30-day mortality would differ for angiographically defined early ST (EST), late ST (LST), and very late ST (VLST). All patients undergoing angiography for diagnosis and treatment of ST were identified by the Department of Veterans Affairs (VA) Clinical Assessment, Reporting, and Tracking (CART) Program from 2006 to 2012. Stent thrombosis occurring ≤30 days after stent implantation were defined as EST; 31 to 365 days as LST; and >365 days as VLST. Log-rank test and Cox proportional hazard regression modeling were used to describe unadjusted and adjusted differences in mortality between groups. A total of 656 patients were diagnosed with angiographic definite ST with known timing. This cohort consisted of 129 (20%), 138 (21%), and 389 (59%) patients with EST, LST, and VLST, respectively. Over three fourths (76%) of VLST cases occurred >2 years after stent implantation. Stent thrombosis timing was significantly associated with 30-day mortality risk in unadjusted (P presentation is associated with time from index percutaneous coronary intervention to ST. This relationship potentially reflects the differing mechanisms of ST that are postulated to predominate at different timeframes. Published by Elsevier Inc.

  9. "Film med undertext" : - "En studie om tillgänglighet av film för döva och personer med hörselnedsättning."

    OpenAIRE

    Tärnskär, Filip; Jonatan, Helgason

    2016-01-01

    Den här uppsatsen utforskar döva och hörselnedsattas upplevelse av film. Syftet är att undersöka möjligheter i hur man kan öka tillgängligheten av film då man inte längre kan förlita sig på ett ljudberättande. Den undersökande delen av uppsatsen består av två delar. Arbetet med kandidaten inleddes med en enkätundersökning där målgruppen, döva och personer med hörselnedsättning, fick beskriva sin upplevelse av film. Den andra delen av undersökningen bestod av att praktiskt testa resultatet av ...

  10. Do You Really Expect Me to Get MST Care in a VA Where Everyone is Male? Innovative Delivery of Evidence-Based Psychotherapy to Women with Military Sexual Trauma

    Science.gov (United States)

    2015-08-01

    Based Psychotherapy to Women with Military Sexual Trauma PRINCIPAL INVESTIGATOR: Ronald Acierno, PhD CONTRACTING ORGANIZATION: Medical University of...a VA Where Everyone is Male? Innovative Delivery of Evidence-Based Psychotherapy to Women with Military Sexual Trauma 5a. CONTRACT NUMBER 5b...Military Sexual Trauma (MST) related PTSD using videoconferencing technology, which allows a therapist and patient, who are at great distance from

  11. 30 CFR 57.22201 - Mechanical ventilation (I-A, I-B, I-C, II-A, II-B, III, IV, V-A, and V-B mines).

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Mechanical ventilation (I-A, I-B, I-C, II-A, II...-UNDERGROUND METAL AND NONMETAL MINES Safety Standards for Methane in Metal and Nonmetal Mines Ventilation § 57.22201 Mechanical ventilation (I-A, I-B, I-C, II-A, II-B, III, IV, V-A, and V-B mines). All mines shall...

  12. Characterization of the recalcitrant CYP1 phenotype found in Atlantic killifish (Fundulus heteroclitus) inhabiting a Superfund site on the Elizabeth River, VA.

    Science.gov (United States)

    Wills, Lauren P; Matson, Cole W; Landon, Chelsea D; Di Giulio, Richard T

    2010-08-01

    Fundulus heteroclitus (Atlantic killifish) found at the Atlantic Wood Industries Superfund site on the Elizabeth River (ER) in Portsmouth, VA (USA), have been shown to be resistant to the teratogenic effects of creosote-contaminated sediments found at this highly contaminated site. Many of the polycyclic aromatic hydrocarbons (PAHs) found at the ER are known to activate the aryl hydrocarbon receptor (AHR), and are thought to mediate their toxic effects through this pathway. Activation of the AHR results in the induction of several Phase I and II metabolic enzymes. It has been previously shown that the AHR of killifish from the ER are refractory to induction by AHR agonists. To more fully characterize this altered AHR response, we exposed embryos from the ER and from a reference site on King's Creek, VA (KC) to two PAHs, benzo[alpha]pyrene (BaP) and benzo[k]fluoranthene (BkF), and to the dioxin-like compound (DLC), 3,3',4,4',5-pentachlorobiphenyl (PCB126). We compared their developmental and molecular responses by screening the embryos for CYP1A enzyme activity, cardiac deformities, and mRNA expression of CYP1A, CYP1B1, CYP1C1, and AHR2. Basal gene expression of both CYP1A and CYP1B1 was 40% higher in the KC control embryos compared to those from the ER, while AHR2 and CYP1C1 were not significantly different between the populations. Exposure of KC embryos to BaP, BkF, and PCB126 induced CYP1A activity and cardiac deformities. In contrast, CYP1A activity was induced in ER embryos only in response to BkF exposure, although this induction in ER embryos was significantly lower than that observed in KC fish at comparable concentrations. ER embryos did not develop cardiac deformities in response to any of the chemicals tested. CYP1A, CYP1B1 and CYP1C1 mRNA were all significantly induced in the KC embryos after exposure to BaP, BkF and PCB126. Exposure to BaP and BkF in ER embryos resulted in a significant induction of CYP1A mRNA, albeit significantly lower than observed

  13. "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/

  14. Correlates of VA mental health treatment utilization among OEF/OIF/OND veterans: Resilience, stigma, social support, personality, and beliefs about treatment.

    Science.gov (United States)

    DeViva, Jason C; Sheerin, Christina M; Southwick, Steven M; Roy, Alicia M; Pietrzak, Robert H; Harpaz-Rotem, Ilan

    2016-05-01

    Veterans of Operations Iraqi Freedom/Enduring Freedom/New Dawn (OEF/OIF/OND) tend not to engage in mental health care. Identifying modifiable factors related to mental health service utilization could facilitate development of interventions to increase utilization. The current study examined the relationship between mental health care utilization and measures of PTSD symptoms, resilience, stigma, beliefs about mental health care, perceived barriers to mental health care, posttraumatic growth and meaning, social support, and personality factors in a sample of 100 OEF/OIF/OND veterans with PTSD symptoms referred to VA mental health care. Participants who received psychotherapy and pharmacotherapy (PP) scored higher on measures of PTSD symptoms, stigma, and adaptive beliefs about mental health treatment, and lower on measures of resilience, postdeployment social support, emotional stability, and conscientiousness, than participants who received no treatment (NT). Participants who received psychotherapy only (PT) scored higher on a measure of PTSD symptoms than NT participants. PT participants scored higher on an emotional stability measure and lower on measures of PTSD symptoms and stigma than PP participants. Multinomial logistic regression including all variables significantly related to treatment utilization indicated that PTSD symptoms and adaptive beliefs about psychotherapy and pharmacotherapy were higher in the PT and PP groups than in the NT group, and concerns about discrimination were higher in the PP group than the NT group. Interventions targeting beliefs about mental health care could increase mental health treatment utilization among OEF/OIF/OND veterans. Concerns about stigma may affect the utilization process differently at different decision points. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  15. Using Getting To Outcomes to facilitate the use of an evidence-based practice in VA homeless programs: a cluster-randomized trial of an implementation support strategy.

    Science.gov (United States)

    Chinman, Matthew; McCarthy, Sharon; Hannah, Gordon; Byrne, Thomas Hugh; Smelson, David A

    2017-03-09

    Incorporating evidence-based integrated treatment for dual disorders into typical care settings has been challenging, especially among those serving Veterans who are homeless. This paper presents an evaluation of an effort to incorporate an evidence-based, dual disorder treatment called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking-Veterans Edition (MISSION-Vet) into case management teams serving Veterans who are homeless, using an implementation strategy called Getting To Outcomes (GTO). This Hybrid Type III, cluster-randomized controlled trial assessed the impact of GTO over and above MISSION-Vet Implementation as Usual (IU). Both conditions received standard MISSION-Vet training and manuals. The GTO group received an implementation manual, training, technical assistance, and data feedback. The study occurred in teams at three large VA Medical Centers over 2 years. Within each team, existing sub-teams (case managers and Veterans they serve) were the clusters randomly assigned. The trial assessed MISSION-Vet services delivered and collected via administrative data and implementation barriers and facilitators, via semi-structured interview. No case managers in the IU group initiated MISSION-Vet while 68% in the GTO group did. Seven percent of Veterans with case managers in the GTO group received at least one MISSION-Vet session. Most case managers appreciated the MISSION-Vet materials and felt the GTO planning meetings supported using MISSION-Vet. Case manager interviews also showed that MISSION-Vet could be confusing; there was little involvement from leadership after their initial agreement to participate; the data feedback system had a number of difficulties; and case managers did not have the resources to implement all aspects of MISSION-Vet. This project shows that GTO-like support can help launch new practices but that multiple implementation facilitators are needed for successful execution of a complex evidence

  16. A direct thrombin inhibitor suppresses protein C activation and factor Va degradation in human plasma: Possible mechanisms of paradoxical enhancement of thrombin generation.

    Science.gov (United States)

    Kamisato, Chikako; Furugohri, Taketoshi; Morishima, Yoshiyuki

    2016-05-01

    We have demonstrated that antithrombin (AT)-independent thrombin inhibitors paradoxically increase thrombin generation (TG) in human plasma in a thrombomodulin (TM)- and protein C (PC)-dependent manner. We determined the effects of AT-independent thrombin inhibitors on the negative-feedback system, activation of PC and production and degradation of factor Va (FVa), as possible mechanisms underlying the paradoxical enhancement of TG. TG in human plasma containing 10nM TM was assayed by means of the calibrated automated thrombography. As an index of PC activation, plasma concentration of activated PC-PC inhibitor complex (aPC-PCI) was measured. The amounts of FVa heavy chain and its degradation product (FVa(307-506)) were examined by western blotting. AT-independent thrombin inhibitors, melagatran and dabigatran (both at 25-600nM) and 3-30μg/ml active site-blocked thrombin (IIai), increased peak levels of TG. Melagatran, dabigatran and IIai significantly decreased plasma concentration of aPC-PCI complex at 25nM or more, 75nM or more, and 10 and 30μg/ml, respectively. Melagatran (300nM) significantly increased FVa and decreased FVa(307-506). In contrast, a direct factor Xa inhibitor edoxaban preferentially inhibited thrombin generation (≥25nM), and higher concentrations were required to inhibit PC activation (≥150nM) and FVa degradation (300nM). The present study suggests that the inhibitions of protein C activation and subsequent degradation of FVa and increase in FVa by antithrombin-independent thrombin inhibitors may contribute to the paradoxical TG enhancement, and edoxaban may inhibit PC activation and FVa degradation as a result of TG suppression. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. A deeper mining on the protein composition of VA-MENGOC-BC®: An OMV-based vaccine against N. meningitidis serogroup B and C.

    Science.gov (United States)

    Masforrol, Yordanka; Gil, Jeovanis; García, Darien; Noda, Jesús; Ramos, Yassel; Betancourt, Lázaro; Guirola, Osmany; González, Sonia; Acevedo, Boris; Besada, Vladimir; Reyes, Osvaldo; González, Luis Javier

    2017-11-02

    The protein composition of an Outer Membrane Vesicle (OMV) preparation that constitutes the active pharmaceutical ingredient of VA-MENGOC-BC®, an effective vaccine against Neisseria meningitidis serogroups B, and C is presented. This preparation has a high lipid content and five abundant membrane proteins (FetA, PorA, PorB, RmpM, and Opc), constituting approximately 70% of the total protein mass. The protein composition was determined by combining the use of the Hexapeptide Ligand Library and an orthogonal tandem fractionation of tryptic peptides by reverse-phase chromatography at alkaline and acid pH. This approach equalizes the concentration of tryptic peptides derived from low- and high-abundance proteins as well as considerably simplifying the number of peptides analyzed by LC-MS/MS, enhancing the possibility of identifying low-abundance species. Fifty-one percent of the proteins originally annotated as membrane proteins in the genome of the MC58 strain were identified. One hundred and sixty-eight low-abundance cytosolic proteins presumably occluded within OMV were also identified. Four (NadA, NUbp, GNA2091, and fHbp), out of the five antigens constituting the Bexsero® vaccine, were detected in this OMV preparation. In particular, fHbp is also the active principle of the Trumenba® vaccine developed by Pfizer. The HpuA and HpuB gene products (not annotated in the MC58 genome) were identified in the CU385 strain, a clinical isolate that is used to produce this OMV. Considering the proteins identified here and previous work done by our group, the protein catalogue of this OMV preparation was extended to 266 different protein species.

  18. Screening by imaging: scaling up single-DNA-molecule analysis with a novel parabolic VA-TIRF reflector and noise-reduction techniques.

    Science.gov (United States)

    van 't Hoff, Marcel; Reuter, Marcel; Dryden, David T F; Oheim, Martin

    2009-09-21

    Bacteriophage lambda-DNA molecules are frequently used as a scaffold to characterize the action of single proteins unwinding, translocating, digesting or repairing DNA. However, scaling up such single-DNA-molecule experiments under identical conditions to attain statistically relevant sample sizes remains challenging. Additionally the movies obtained are frequently noisy and difficult to analyse with any precision. We address these two problems here using, firstly, a novel variable-angle total internal reflection fluorescence (VA-TIRF) reflector composed of a minimal set of optical reflective elements, and secondly, using single value decomposition (SVD) to improve the signal-to-noise ratio prior to analysing time-lapse image stacks. As an example, we visualize under identical optical conditions hundreds of surface-tethered single lambda-DNA molecules, stained with the intercalating dye YOYO-1 iodide, and stretched out in a microcapillary flow. Another novelty of our approach is that we arrange on a mechanically driven stage several capillaries containing saline, calibration buffer and lambda-DNA, respectively, thus extending the approach to high-content, high-throughput screening of single molecules. Our length measurements of individual DNA molecules from noise-reduced kymograph images using SVD display a 6-fold enhanced precision compared to raw-data analysis, reaching approximately 1 kbp resolution. Combining these two methods, our approach provides a straightforward yet powerful way of collecting statistically relevant amounts of data in a semi-automated manner. We believe that our conceptually simple technique should be of interest for a broader range of single-molecule studies, well beyond the specific example of lambda-DNA shown here.

  19. Associations of cumulative Pb exposure and longitudinal changes in Mini-Mental Status Exam scores, global cognition and domains of cognition: The VA Normative Aging Study.

    Science.gov (United States)

    Farooqui, Zishaan; Bakulski, Kelly M; Power, Melinda C; Weisskopf, Marc G; Sparrow, David; Spiro, Avron; Vokonas, Pantel S; Nie, Linda H; Hu, Howard; Park, Sung Kyun

    2017-01-01

    Lead (Pb) exposure has been associated with poorer cognitive function cross-sectionally in aging adults, however the association between cumulative Pb exposure and longitudinal changes in cognition is little characterized. In a 1993-2007 subcohort of the VA Normative Aging Study (Mini-mental status exam (MMSE) n=741; global cognition summary score n=715), we used linear mixed effects models to test associations between cumulative Pb exposure (patella or tibia bone Pb) and repeated measures of cognition (MMSE, individual cognitive tests, and global cognition summary). Cox proportional hazard modeling assessed the risk of an MMSE score falling below 25. Among men 51-98 at baseline, higher patella Pb concentration (IQR: 21μg/g) was associated with -0.13 lower baseline MMSE (95% CI: -0.25, -0.004) and faster longitudinal MMSE decline (-0.016 units/year, 95% CI: -0.032, -0.0004) over 15 years. Each IQR increase in patella Pb was associated with increased risk of a MMSE score below 25 (HR=1.21, 95% CI: 0.99, 1.49; p=0.07). There were no significant associations between Pb and global cognition (both baseline and longitudinal change). Patella Pb was associated with faster longitudinal decline in Word List Total Recall in the language domain (0.014 units/year, 95% CI: -0.026, -0.001) and Word List Delayed Recall in the memory domain (0.014 units/year, 95% CI: -0.027, -0.002). We found weaker associations with tibia Pb. Cumulative Pb exposure is associated with faster declines in MMSE and Word List Total and Delayed Recall tests. These findings support the hypothesis that Pb exposure accelerates cognitive aging. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Trends in non-communicable disease mortality among adult residents in Nairobi's slums, 2003-2011: applying InterVA-4 to verbal autopsy data.

    Science.gov (United States)

    Oti, Samuel O; van de Vijver, Steven; Kyobutungi, Catherine

    2014-01-01

    About 80% of deaths from non-communicable diseases (NCDs) occur in developing countries such as Kenya. However, not much is known about the burden of NCDs in slums, which account for about 60% of the residences of the urban population in Kenya. This study examines trends in NCD mortality from two slum settings in Nairobi. We use verbal autopsy data on 1954 deaths among adults aged 35 years and older who were registered in the Nairobi Urban Health and Demographic Surveillance System between 2003 and 2011. InterVA-4, a computer-based program, was used to assign causes of death for each case. RESULTS are presented as annualized cause-specific mortality rates (CSMRs) and cause-specific mortality fractions (CSMFs) by sex. The CSMRs for NCDs did not appear to change significantly over time for both males and females. Among males, cardiovascular diseases (CVDs) and neoplasms were the leading NCDs--contributing CSMFs of 8 and 5%, respectively, on average over time. Among females, CVDs contributed a CSMF of 14% on average over time, while neoplasms contributed 8%. Communicable diseases and related conditions remained the leading causes of death, contributing a CSMF of over 50% on average in males and females over time. Our findings are consistent with the Global Burden of Disease 2010 study which shows that communicable diseases remain the dominant cause of death in Africa, although NCDs were still significant contributors to mortality. We recommend an integrated approach towards disease prevention that focuses on health systems strengthening in resource-limited settings such as slums.

  1. 2013 USGS Lidar: Norfolk (VA)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Laser Mapping Specialist, Inc (LMSI) and The Atlantic Group (Atlantic) provided high accuracy, calibrated multiple return LiDAR for roughly 1,130 square miles around...

  2. Va-Room: Motorcycle Safety.

    Science.gov (United States)

    Keller, Rosanne

    One of a series of instructional materials produced by the Literacy Council of Alaska, this booklet provides information about motorcycle safety. Using a simplified vocabulary and shorter sentences, it offers statistics concerning motorcycle accidents; information on how to choose the proper machine; basic information about the operation of the…

  3. SURVEY, King George County, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The field survey data for this coastal study includes a field report that exhibits photos and transect information collected in the field survey phase of the study....

  4. SURVEY, Newport News City, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The field survey data for this coastal study includes a field report that exhibits photos and transect information collected in the field survey phase of the study....

  5. VA Atlantic Coast Recreational Use

    Data.gov (United States)

    Virginia Department of Environmental Quality — As a member of the Mid-Atlantic Regional Council on the Ocean (MARCO), Virginia, through its Coastal Zone Management (CZM) Program, collected information on how the...

  6. 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

  7. Coastal Analysis, Virginia Beach, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Coastal study as defined in FEMA Guides and Specifications, Appendix D: Guidance for coastal Flooding Analyses and Mapping submitted as a result of a coastal study....

  8. Coastal Analysis, Mathews County, VA

    Data.gov (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Coastal study as defined in FEMA Guides and Specifications, Appendix D: Guidance for coastal Flooding Analyses and Mapping submitted as a result of a coastal study....

  9. Effectiveness and micro-costing of the KiVa school-based bullying prevention programme in Wales: study protocol for a pragmatic definitive parallel group cluster randomised controlled trial.

    Science.gov (United States)

    Clarkson, Suzy; Axford, Nick; Berry, Vashti; Edwards, Rhiannon Tudor; Bjornstad, Gretchen; Wrigley, Zoe; Charles, Joanna; Hoare, Zoe; Ukoumunne, Obioha C; Matthews, Justin; Hutchings, Judy

    2016-02-01

    Bullying refers to verbal, physical or psychological aggression repeated over time that is intended to cause harm or distress to the victims who are unable to defend themselves. It is a key public health priority owing to its widespread prevalence in schools and harmful short- and long-term effects on victims' well-being. There is a need to strengthen the evidence base by testing innovative approaches to preventing bullying. KiVa is a school-based bullying prevention programme with universal and indicated elements and an emphasis on changing bystander behaviour. It achieved promising results in a large trial in Finland, and now requires testing in other countries. This paper describes the protocol for a cluster randomised controlled trial (RCT) of KiVa in Wales. The study uses a two-arm waitlist control pragmatic definitive parallel group cluster RCT design with an embedded process evaluation and calculation of unit cost. Participating schools will be randomised a using a 1:1 ratio to KiVa plus usual provision (intervention group) or usual provision only (control group). The trial has one primary outcome, child self-reported victimisation from bullying, dichotomised as 'victimised' (bullied at least twice a month in the last couple of months) versus 'not victimised'. Secondary outcomes are: bullying perpetration; aspects of child social and emotional well-being (including emotional problems, conduct, peer relations, prosocial behaviour); and school attendance. Follow-up is at 12 months post-baseline. Implementation fidelity is measured through teacher-completed lesson records and independent school-wide observation. A micro-costing analysis will determine the costs of implementing KiVa, including recurrent and non-recurrent unit costs. Factors related to the scalability of the programme will be examined in interviews with head teachers and focus groups with key stakeholders in the implementation of school-based bullying interventions. The results from this trial

  10. Portadores de Neisseria meningitidis, caracterización de las cepas aisladas y respuesta inmune basal a VA-MENGOC-BC

    Directory of Open Access Journals (Sweden)

    María J. Valdés

    2008-08-01

    Full Text Available Con el propósito de conocer la prevalencia de portadores de Neisseria meningitidis en un grupo de adolescentes, los marcadores epidemiológicos de las cepas aisladas, así como los factores de riesgo asociados con el estado de portador y la respuesta inmune basal a VA-MENGOC-BC , se realizó un estudio transversal descriptivo de portadores en 189 estudiantes de 12-19 años de un politécnico de Ciego de Ávila, siguiendo las Normas Bioéticas establecidas. A los estudiantes se les realizó un exudado faríngeo y una extracción de sangre para la obtención de suero, así como una encuesta relacionada con aspectos de la investigación. La identificación de N. meningitidis se hizo por el sistema API NH (bioMérieux. Los serosubtipos e inmunotipos se clasificaron por ELISA de células enteras con anticuerpos monoclonales y la respuesta inmune basal se detectó por el Ensayo Bactericida del Suero. Se determinó la susceptibilidad antimicrobiana de las cepas frente a la penicilina, cloranfenicol, rifampicina, sulfadiacina sódica, ceftriaxona y ciprofloxacina. La prevalencia de portadores de N. meningitidis fue del 17%. Predominaron las cepas no agrupables (84,7%, seguidas por los serogrupos B (12,5% y Z (3,1%, destacándose la ausencia del C. Prevaleció el fenotipo NA:NT:P1.NST:L3,7,9 (12,5%, las cepas resistentes a la sulfadiacina (78,2% y sensibles a penicilina (81,3%, aunque el 18,7% mostró sensibilidad intermedia a este fármaco. Al resto de los antimicrobianos todas fueron sensibles. Se constató una respuesta inmune de memoria a la vacuna antimeningocócica (VAMENGOC-BC®, 12 años después de su aplicación, con títulos bactericidas anti C y B de 25 y 42%, respectivamente, resultados que pudieran estar influenciados por la inmunización sistemática que se realiza en Cuba con esta vacuna desde 1991.

  11. Determinación de la vulnerabilidad física natural actual en las áreas de interés (VA-04-02): Sub-cuenca de San Francisco

    OpenAIRE

    Instituto Nacional de Recursos Naturales - INRENA; Programa de Fortalecimiento de Capacidades Nacionales para manejar el Impacto del Cambio Climático y la Contaminación del Aire - PROCLIM; Perú. Consejo Nacional del Ambiente

    2005-01-01

    Subproyecto VA-04: Evaluación de la vulnerabilidad física natural futura y medidas de adaptación en áreas de interés en la cuenca del río Piura (actividad del componente vulnerabilidad y adaptación). Contiene: 1. Generalidades. 2. Metodología. 3. Diagnóstico de áreas de interés. 4. Vulverabilidad física natural actual en áreas de interés Propone el Modelo de Vulnerabilidad para la Subcuenca San Francisco. Las Unidades de Vulnerabilidad están cartografiadas en el Mapa correspondie...

  12. Determinación de la vulnerabilidad física natural actual en las áreas de interés (VA-04-02): Sub-cuenca de Yapatera

    OpenAIRE

    Instituto Nacional de Recursos Naturales (Perú); Programa de Fortalecimiento de Capacidades Nacionales para manejar el Impacto del Cambio Climático y la Contaminación del Aire - PROCLIM; Consejo Nacional del Ambiente - CONAM

    2005-01-01

    Subproyecto VA-04: Evaluación de la vulnerabilidad física natural futura y medidas de adaptación en áreas de interés en la cuenca del río Piura (actividad del componente vulnerabilidad y adaptación). Contiene: 1. Generalidades. 2. Metodología. 3. Diagnóstico físico natural de la Subcuenca Yapatera. 4. Vulverabilidad física natural actual en áreas de interés Propone el Modelo de Vulnerabilidad para la Subcuenca Yapatera. Las Unidades de Vulnerabilidad están cartografiadas en el Mapa corr...

  13. The preface by João Cabral de Melo Neto to Em Va Fer Joan Brossa: Theory and practice of realism in two poets from the post-war.

    Directory of Open Access Journals (Sweden)

    Melcion Mateu

    2009-12-01

    Full Text Available In 1951, the book Em va fer Joan Brossa [Joan Brossa  Made me] was published in Barcelona, with a preface by João Cabral de Melo Neto. It is a useful text to better understand Brossa as well as Cabral; it is a significant text in order to grasp the individual response of these poets to the problem of returning to realism for the early post-war period. A translation of João Cabral de Melo Neto's preface, previously unpublished in Portuguese, is presented here.

  14. Evaluación de la eficacia de VA-MENGOC-BC® en ratón Balb/c retados frente a los serogrupos A, B y C

    OpenAIRE

    Juan Francisco Infante; Sergio Sifontes; Eddy Caro; Mildrey Fariñas; Armando Cádiz; Armando Acosta; Marielena Sarmiento

    2003-01-01

    Hasta la fecha se han desarrollado varios modelos experimentales para la reproducción experimental de la enfermedad meningocócica humana, cuya utilidad en la evaluación de la eficacia de medios de inmunización y terapia, así como en el estudio de la patogenia de la enfermedad es incuestionable. En el presente trabajo se describe la evaluación de la eficacia de VA-MENGOC-BC® y la Inmunoglobulina Humana Antimeningocócica BC frente a Neisseria meningitidis de los serogrupos A, B y C, empleando e...

  15. Thermal Quantitative Sensory Testing in Fibromyalgia Patients / Termāla Kvantitatīva Sensora Testēšana Fibromialģijas Pacientiem

    Directory of Open Access Journals (Sweden)

    Mihailova Marija

    2015-09-01

    Full Text Available Fibromialģija (FM ir hroniska slimība, kas izpaužas ar difūzām muskuloskeletālām sāpēm, nogurumu, miega un emocionāliem traucējumiem. Slimība, iespējams, ir saistīta ar A delta un C nervu šķiedru disfunkciju. Termāla kvantitatīva sensora testēšana (QST analizē mazmielinizētas A delta nervu šķiedras un nemielinizētas C nervu šķiedras, kas atbild par nociceptīvo sensoru sistēmu un spinotalāmisko ceļu. Pieņemot, ka FM sāpēm ir neiropātisks raksturs, pieaug arī QST vērtība kā papildus diagnostiskam testam. Pētījumā tika iekļauts 51 pacients. Slimības simptomi tika objektivizēti, izmantojot Noguruma smaguma skalu (Fatigue Severity Scale, Fibromialģijas ietekmes anketu (Fibromialgia Impact Questionnaire un 2010. gada American College of Rheumatology (ACR FM diagnostiskos kritērijus. QST tika veikta ar termālo stimulu pēdu un plaukstu dorsālajās virsmās. QST rezultāti tika salīdzināti ar 20 atbilstoša vecuma un dzimuma kontroles grupas pacientiem. FM pacientiem tika konstatēta ievērojama aukstuma un siltuma percepcijas un sāpju sliekšņu atšķirība, salīdzinot ar kontroles grupas pacientiem, un tas norāda uz neiropātisko sāpju raksturu FM pacientiem. Izmaiņas ir vairāk izteiktas siltuma percepcijas un karstuma sāpju sliekšņos. Iespējams, tas liecina, ka FM pacientiem C šķiedras ir vairāk skartas un siltuma percepcijas un karstuma sāpju sliekšņi ir jūtīgākas modalitātes, ko var izmantot FM diagnostikā. Tika arī atklātas statistiski ticamas negatīvas korelācijas starp siltuma un aukstuma percepcijas sliekšņiem un starp karstuma un aukstuma sāpju sliekšņiem, kas var norādīt uz centrālo sensibilizāciju vai defektīvo sāpju inhibējošu sistēmu FM pacientiem.

  16. Feasibility Analysis and Simulation of a Stand-Alone Photovoltaic Energy System for Electricity Generation and Environmental Sustainability – equivalent to 650VA fuel-powered generator - popularly known as I pass my neighbour

    Directory of Open Access Journals (Sweden)

    Vincent Anayochukwu Ani

    2015-09-01

    Full Text Available Photovoltaic (PV power system can be used to replace wholly 650VA generator for electricity generation for household use in Nigeria. This paper presented the feasibility analysis of load data and simulation study of a stand-alone PV power system that produced the electrical needs of a household. This study is based on designing of PV energy system for household use. The patterns of load consumption within the household were studied and suitably modeled for simulation. The simulation study indicates that energy requirements to provide electricity which is equivalent to 650VA generator for household use in Nigeria can be accomplished by 520W solar PV array, 2312 Ah nominal capacity battery, and a 1kW DC/AC inverter. This would be suitable for deployment of 100% clean energy for environmental sustainability and uninterruptable power performance in the household. The results of this research show that, with a low-power consuming appliances, it is possible to meet the entire annual electricity demand of a single household solely through a stand-alone PV energy supply. Installing solar panels by most Nigerian home can significantly reduce home reliance on government power thereby reduce the strain on the current capacity of our power generation infrastructure. A detailed design and description of the system were presented in this paper.

  17. Nima’s Recreation of “Kerme Shabtab” Tale of Kelile va Demne in “Mahtab”

    Directory of Open Access Journals (Sweden)

    N Dinmohammadi

    2011-06-01

    Resorting to a comparative study of two totally different literary works, the present article seeks to answer the question whether Nima Youshij’s poem under the title of “Mahtab” is the recreation of the allegoric anecdote from Kelile va Demne, namely “Shabtab”. Undoubtedly, one of Nima’s thought sources was his attention to ancient Persian literature. He has mostly taken the essence of his contents from the ancient Persian literary works. But those ancient thoughts and ideas have been dressed newly and have changed their inner and outer figure after being processed in the creative mind of a thoughtful creator like Nima. Due to a large number of similarities between these two literary works, including their characters, dialogues, manners, events, time, space and other features, one can come to such a conclusion that Nima’s “Mahtab” has doubtlessly been influenced by “Shabtab” in Kelile va Demne, i.e. Nima’s “Mahtab” is the recreation of “Shabtab”.

  18. A comparative study of MP2, B3LYP, RHF and SCC-DFTB force fields in predicting the vibrational spectra of N-acetyl-L-alanine-N'-methyl amide: VA and VCD spectra

    DEFF Research Database (Denmark)

    Bohr, Henrik; Jalkanen, Karl J.; Elstner, M.

    1999-01-01

    Recently we have looked for spectroscopic probes for secondary structural elements in the vibrational spectra of N-acetyl-L-alanine N'-methyl amide (NALANMA), L-alanine (LA), N-acetyl-L-alanyl-L-alanine N'-methyl amide (NALALANMA) and L-alanyl-L-alanine (LALA). Our goal has been to identify...... spectroscopic probes which can be used to identify specific secondary structural elements in peptides, polypeptides and proteins. In this work we present our comparative analysis of the MP2, B3LYP, RHF and SCC-DFTB quantum force fields to predict the vibrational absorption (VA) and vibrational circular...... dichroism (VCD) spectra of NALANMA. We have utilised MP2/6-31G*, B3LYP/6-31G*, RHF/6-31G* and SCC-DFTB level theory to determine the geometries and Hessians, atomic polar tensors (APT) and atomic axial tensors (AAT) which are required for simulating the VA and VCD spectra. We have also calculated the AAT...

  19. Evaluación de la eficacia de VA-MENGOC-BC® en ratón Balb/c retados frente a los serogrupos A, B y C

    Directory of Open Access Journals (Sweden)

    Juan Francisco Infante

    2003-09-01

    Full Text Available Hasta la fecha se han desarrollado varios modelos experimentales para la reproducción experimental de la enfermedad meningocócica humana, cuya utilidad en la evaluación de la eficacia de medios de inmunización y terapia, así como en el estudio de la patogenia de la enfermedad es incuestionable. En el presente trabajo se describe la evaluación de la eficacia de VA-MENGOC-BC® y la Inmunoglobulina Humana Antimeningocócica BC frente a Neisseria meningitidis de los serogrupos A, B y C, empleando el ratón Balb/c tratado con mucina y dextrana férrica como estimulantes de la virulencia. Los ratones fueron inmunizados por vía intraperitoneal con una, dos o tres dosis de 0,5 mL de VA-MENGOC-BC®. El intervalo entre dosis fue de tres semanas entre la primera y segunda dosis y de 15 días entre la segunda y la tercera. El reto se realizó con dosis letales (1-3 x DL50 de N. meningitidis A, B ó C a los 15 ó 21 días después de aplicada la última dosis de vacuna. Para evaluar la actividad de la Inmunoglobulina Antimeningocócica BC como medio de inmunización pasiva, se trató otro grupo de ratones, 30 min, 2 y 6 h después habérseles inoculado los gérmenes. Se administraron en cada caso 5 mg de la inmunoglobulina por vía intraperitoneal o intravenosa en un volumen de 0,1 mL. Los resultados demostraron que tanto VA-MENGOC-BC® como la Globulina Antimeningocócica BC confieren protección significativa contra un reto letal con N. meningitidis en el modelo de ratón tratado con factores estimulantes de la virulencia.

  20. Spore Heat Activation Requirements and Germination Responses Correlate with Sequences of Germinant Receptors and with the Presence of a SpecificspoVA2mobOperon in Foodborne Strains of Bacillus subtilis.

    Science.gov (United States)

    Krawczyk, Antonina O; de Jong, Anne; Omony, Jimmy; Holsappel, Siger; Wells-Bennik, Marjon H J; Kuipers, Oscar P; Eijlander, Robyn T

    2017-04-01

    Spore heat resistance, germination, and outgrowth are problematic bacterial properties compromising food safety and quality. Large interstrain variation in these properties makes prediction and control of spore behavior challenging. High-level heat resistance and slow germination of spores of some natural Bacillus subtilis isolates, encountered in foods, have been attributed to the occurrence of the spoVA 2mob operon carried on the Tn 1546 transposon. In this study, we further investigate the correlation between the presence of this operon in high-level-heat-resistant spores and their germination efficiencies before and after exposure to various sublethal heat treatments (heat activation, or HA), which are known to significantly improve spore responses to nutrient germinants. We show that high-level-heat-resistant spores harboring spoVA 2mob required higher HA temperatures for efficient germination than spores lacking spoVA 2mob The optimal spore HA requirements additionally depended on the nutrients used to trigger germination, l-alanine (l-Ala), or a mixture of l-asparagine, d-glucose, d-fructose, and K + (AGFK). The distinct HA requirements of these two spore germination pathways are likely related to differences in properties of specific germinant receptors. Moreover, spores that germinated inefficiently in AGFK contained specific changes in sequences of the GerB and GerK germinant receptors, which are involved in this germination response. In contrast, no relation was found between transcription levels of main germination genes and spore germination phenotypes. The findings presented in this study have great implications for practices in the food industry, where heat treatments are commonly used to inactivate pathogenic and spoilage microbes, including bacterial spore formers. IMPORTANCE This study describes a strong variation in spore germination capacities and requirements for a heat activation treatment, i.e., an exposure to sublethal heat that increases