Health Care Opinion Leaders' Views on the Future of Long-Term Care

Presents findings from a survey of experts on the challenges for long-term care -- securing adequate financing, developing the required healthcare workforce, and improving the quality of long-term care -- and strategies for addressing them

A midterm report on the state of the Dry Forest Zone and its communities

2 pagesThe Dry Forest Zone (DFZ) project is a five-year collaborative effort to foster an integrated approach to forest stewardship and economic development in eastern Oregon and northern California. The DFZ project invests in capacities for community-based natural resource management at multiple scales, creating enabling conditions for transformative change. We conducted a mid-term assessment to document the impacts of the DFZ project to date.This briefing paper was made possible with funding from the US Endowment for Forestry and Communities, USDA Rural Development

Sensitive detection of methane at 3.3 μm using an integrating sphere and interband cascade laser

Detection of methane at 3.3μm using a DFB Interband Cascade Laser and gold coated integrating sphere is performed. A 10cm diameter sphere with effective path length of 54.5cm was adapted for use as a gas cell. A comparison between this system and one using a 25cm path length single-pass gas cell is made using direct TDLS and methane concentrations between 0 and 1000 ppm. Initial investigations suggest a limit of detection of 1.0ppm for the integrating sphere and 2.2ppm for the single pass gas cell. The system has potential applications in challenging or industrial environments subject to high levels of vibration

Location, safety and (non) strangers in gay men’s narratives on ‘hook-up’ apps

Hook-up websites and apps are said to be transforming the sexual lives of gay men and have been linked with the apparent erosion of gay publics as the basis for identity politics and social action. This article examines these dynamics in the interview and focus-group talk of gay men living on the economic and geographical margins of metropolitan gay culture. It offers perspectives on the importance of location – class, generation and space – for the experience of digital media, the negotiation of safety, and the new codifications and elaborations on sex with the (non) stranger; a figure who is not alien, yet not familiar, in sexual sociality. Reflecting on these situated perspectives in connection with debates on the erosion of gay publics, this article argues against monolithic framings of gay men’s sexual lives after digital media

Load rating of the stone arch bridge at Poniklá using 2D and 3D models.

Zděné klenbové mosty jsou jedinečnou a důležitou částí světové silniční sítě. Mnohé byly postaveny před více než 100 lety a od té doby měnící se dopravní zátěž vyžaduje obnovení informací o jejich bezpečnosti. Zatížitelnost mostu určuje jeho přípustné zatížení k ověření bezpečnosti a v normách a směrnicích existují metody k jejímu stanovení. Platí to pro ocelové, železobetonové a dřevěné mosty ale pro zděné klenbové mosty není přijata žádná konsistentní metoda. Práce nejprve identifikuje existující metody a sofware použitelné k určení zatížitelnosti zděných klenbových mostů. Lze je shrnout do těchto kategorií: normy, semiempirické metody, metody založené na mezní únosnosti a numerické metody. Mnohé z nich používají jednodušší 2D modely místo 3D modelů protože nelineární 3D výpočet je mnohem obtížnější a dražší. Třídimensionální podstata mostů se často nerespektuje a příčné efekty se zanedbávají . V tomto kontextu je cílem práce je poskytnout opravné koeficienty pro 2D nelineární výpočty které pokryjí odchylky v příčném směru v případové studii mostu v Poniklé v severních Čechách v České republice.M odely jsou vytvořeny v software RFEM. Kompletní je analýza v lineárně pružném režimu při nesymetrickém zatížení. Opravné faktory jsou vypočteny pro několik příčných řezů podél rozpětí jednoho pole, kde mohou vzniknout mechanismy. Byla provedena analýza senzitivity na změny materiálovýchparametrů k ověření konsistence výsledků. Konečným cílem disertace je použít tento přístup na 2D nelineární model vytvořený v nekomerčním software stavební fakulty ČVUT a poskytnout aktualizovanou zatížitelnost zděného klenbového mostu v Poniklé. Rozšíření znalostí o očekávaných rozdílech mezi 2D a3D modely může pomoci vytvořit přesnější modely zatížitelnosti a snížit nároky na vstupní data. Je tedy naším zájmem porozumět rozdílům mezi 2D a 3D modely. Hlavním cílem diplomové práce je srovnat tyto rozdíly na případu mostu v Poniklé v severních Čechách v České republice.Masonry arch bridges are a unique and important part of the world’s bridge stock. Many were built over 100 years ago, and in that time changing traffic patterns and loading conditions require updated information of their current usage. Bridge load rating is the method of determining the load carrying capacity of all bridges, to verify safety, and methods exist in codes that can be applied. However, the applicability of these load rating techniques is limited to steel, reinforced concrete, and timber bridges. For masonry arch bridges, no one method is adopted consistently to examine these bridges. The work herein presented, first identifies all of the methods and software that exist in order to determine the load rating of masonry arch bridges. Load rating methods typically fall under the following categories: codes, semi-empirical methods, limit analysis-based methods, and numerical methods. Many of these methods utilize 2D models instead of 3D models, as it is much more difficult and expensive to perform a nonlinear 3D analysis. The intrinsic nature of bridges in three-dimensions is often not considered, disregarding any transverse effect due to their components. In this context, the primary objective of this thesis is to provide correction factors for nonlinear 2D solutions which cover the transverse fluctuations the case study of the Poniklá Bridge located in Bohemia in the Czech Republic. Models are created in the software RFEM. The analysis completed is linear elastic under unsymmetrical live loading. Correction factors are calculated at locations along the span of the arch where possible failure mechanisms can be created. A sensitivity analysis of material properties was carried out to validate the model. The final objective of this thesis is to apply this approach to a 2D nonlinear model, created using a non-commercial software designed in the CTU Faculty of Civil Engineering, and to provide an updated load rating for the masonry arch bridge at Poniklá. The growth of knowledge regarding the expected difference between 2D and 3D models can help to make load rating models more accurate and easier to carry out with less input data

The Third Coast

The Third Coast is a photographic exploration of the vernacular landscape of the US Gulf Coast. Stretching some 1,600 miles from the mouth of the Rio Grande in Texas to the Florida Everglades, America\u27s southernmost shore is vast and complex. The region is a patchwork of both the natural and built environments, a tangled combination of history and geography, culture and ecology that reflects an intimate and ever-evolving relationship between man, land and sea. The Gulf Coast resists tidy hierarchies or easy classification. Rather, the rhythms of the region comprise its own syntax, a way in which seemingly dissimilar locations speak to one another with awareness and familiarity. More than just describing the landscape, this body of work looks to explore the Third Coast\u27s visual vocabulary, it’s sense of place, and the recurrent themes that create the area\u27s distinct material and cultural identity

Educators\u27 Perceptions of Assistive Technology for Students With Severe or Multiple Disabilities

Assistive technology (AT) is defined as any tool that can help integrate students with severe or multiple disabilities (SMD) into learning activities. As mandated by federal law, AT must be considered for all students with disabilities. Educators, however, do not consistently embrace low and mid tech AT devices in reading and the language arts, thus limiting student engagement in learning activities. The purpose of this study was to explore educators\u27 perceptions of their experiences regarding the acquisition and the use of low and mid tech assistive devices with students with SMD. This study builds on the existing literature base of using AT to increase student participation in literacy activities, thus moving students through Vygotsky\u27s zone of proximal development from limited performance to independent performance. Research questions in this study addressed (a) educators\u27 experiences regarding the use of AT for students with SMD, (b) educators\u27 perceptions of AT use for students with SMD, and (c) strategies educators use to match AT to students with SMD. A qualitative phenomenological research design utilizing interviews with educators and unobtrusive data collection was used to determine the effectiveness of the incorporation of AT devices in learning activities for students with SMD. Results indicate that educators have limited AT use and little or no training. This study indicates the need for formal and informal AT training for educators and contributes to social change by enhancing the literature on academic modifications and adaptations with the use of low and mid tech assistive device interventions. Implications for social change include improving teaching practices for students with SMD

Health Professionals\u27 Access to Hospitals: A Retrospective and Prospective Analysis

The professional interdependence of the hospital institution and practicing physicians is a phenomenon of post-World War II society. This Note first examines the historical development of that interdependence and explores its erosion into a hospital-dominant mode. Next it examines the most important forces that influence and complicate the question of hospital privileges for the physician within the modern hospital: the interrelated pressures of intraprofessional restraints, pertinent government regulation, and medical technology. Then it sketches the internal procedures that have engendered and defined the relationship between physician and hospital, with special attention to the weaknesses within the procedures that have led to past litigation. Finally, this Note looks closely at significant emergent legal challenges in the area of the medical professional\u27s hospital privileges and examines the health policy implications of the available alternatives. The Note concludes that the historical balance of power that has defined hospital access has been displaced. It proposes a diversification of institutional providers and a utilization of the newly-available autonomous health professionals

Psychological factors that influence patient participation in cancer clinical trials

The accrual of patients to cancer clinical trials has been noted by a number of authors as a significant problem. Research to date has examined a range of patient and physician related factors that may account for the low accrual rate. Patient refusal as a reason for non-participation has been found by previous research to account for a significant proportion of patients who are not entered onto a trial. This project aimed to explore the differences in attitudes and psychological variables between patients who refused a clinical trial and those who consented.A cross sectional, single point, postal questionnaire design was employed. Patients who were medically eligible for current phase I, II or III cancer chemotherapy clinical trials received a series of self-report questionnaires. These assessed personality, mood status, emotional expression and health locus of control, and patients' attitudes to research and hypothetical clinical trials. Follow up semi-structured interviews were held with a subsample of participants.During the data collection period, 48 patients were identified as eligible for clinical trials. Of these, 95.9% consented to a trial. The results query previous fmdings that patient refusal is a significant problem in accrual to trials. Thirty-one patients (63%) returned the questionnaires and of these, none refused entry to a clinical trial. Statistical analyses showed that patients' attitudes to research were related to their willingness to enter hypothetical clinical trials. An effect of personality and health locus of control on patients' perception of choice when offered a trial was found. Qualitative analysis revealed that the decision to enter a clinical trial was not difficult for patients, as hadbeen previously proposed. Recruitment and methodological difficulties are discussed

A study of the cases referred to the Brockton Child Guidance Clinic by the Schools of Brockton and the surrounding townships in 1945

Thesis (M.S.)--Boston University, 1947. This item was digitized by the Internet Archive