A new analysis of debris mitigation and removal using networks

Modelling studies have shown that the implementation of mitigation guidelines, which aim to reduce the amount of new debris generated on-orbit, is an important requirement of future space activities but may be insufficient to stabilise the near-Earth debris environment. The role of a variety of mitigation practices in stabilising the environment has been investigated over the last decade, as has the potential of active debris removal (ADR) methods in recent work. We present a theoretical approach to the analysis of the debris environment that is based on the study of networks, composed of vertices and edges, which describe the dynamic relationships between Earth satellites in the debris system. Future projections of the 10 cm and larger satellite population in a non-mitigation scenario, conducted with the DAMAGE model, are used to illustrate key aspects of this approach. Information from the DAMAGE projections are used to reconstruct a network in which vertices represent satellites and edges encapsulate conjunctions between collision pairs. The network structure is then quantified using statistical measures, providing a numerical baseline for this future projection scenario. Finally, the impact of mitigation strategies and active debris removal, which can be mapped onto the network by altering or removing edges and vertices, can be assessed in terms of the changes from this baseline. The paper introduces the network methodology, highlights the ways in which this approach can be used to formalise criteria for debris mitigation and removal. It then summarises changes to the adopted network that correspond to an increasing stability and changes that represent a decreasing stability of the future debris environment

Hallucinations Are Real to Patients With Dementia

In this case study, we present a patient with preexistent posttraumatic stress disorder and psychosis who has been recently diagnosed with Dementia with Lewy Bodies. He is experiencing vivid hallucinations. What went wrong between him and his wife as a result of these hallucinations is presented. Alternative actions that could have been used are suggested

The financial costs of registered nurse-led relationship-centred care : a single-case Australian feasibility study

People with intellectual disability are accommodated and cared for in a variety of settings in Australia. Direct care is delivered by a mixture of qualified health professionals (nurses) and unlicenced disability support workers in varying combinations depending on the complexity and chronicity of comorbidities experienced by people with intellectual disability. Although some of these disability services continue to employ registered nurses, the size and specialised education of this workforce is decreasing due to a myriad of policy changes, which has the effect of compromising continuity of care and adverse effects on health outcomes. The objective of this study was to compare the differences on the financial cost of a single case using different models of care with, and without, specialised registered nursing input. The single case had profound intellectual disability and multiple chronic and complex health problems and was cared for by a model that included 24 h registered nurse care and support. Four financial scenarios are presented, and the differences both in terms of actual cost, and potential health outcomes are discussed. This study has set the scene for a large study where health economic data can be compared against multiple cases, across a range of care contexts, in order to advance evidence about which models provide the better health outcomes for people with intellectual disability and associated multiple chronic and complex health problems

Variation de la masse et des caractères morphologiques des lémuriens nocturnes dans les forêts primaires et dégradées de Menabe Sud, Belo sur Mer, Madagascar

Forest structure effects primate morphology because it determines the availability and characteristics of resources, such as substrates for locomotion, sleeping trees, and trees food. However, forest degradation may alter environmental condition of habitats and influence lemur behavior and morphology. We evaluated the links between forest degradation, lemur body mass, and lemur morphometric. We surveyed red-tailed sportive lemurs (Lepilemur ruficaudatus) and gray mouse lemurs (Microcebus murinus) in the dry, deciduous forest of southern Menabe, Morondava, Madagascar. The study was conducted in the dry season in 2014 (November–December) and 2015 (July–September). Lemur captures were conducted in five forest sites: two primary forest and three disturbed forest. Sherman and Tomahawk style traps were used to capture mouse lemurs. We conducted three capture sessions in site B in 2014 and three capture sessions for each site in 2015, for a total of 5616 night traps. During each capture session, 80 Sherman traps and 24 Tomahawk traps were installed for three consecutive nights. To capture the red-tailed sportive lemur, we used a gun (Dan Inject Model JM air rifle) with a tranquillizer dart to immobilize the animal. We collected morphometric measurements from 232 mouse lemurs and 31 red-tailed sportive lemurs. Botanic plots (5m x 5m) allowed us to characterize the forest characteristics: tree diameter at breast height (DBH), tree height, tree abundance, tree crown height and diameter. Tree abundance with DBH ≥ 5 cm and trees diversity varied significantly between sites (P < 0.001). Mouse lemur body mass did not vary with seasonality of the capture (P > 0.05). For mouse lemurs, all morphometric from two populations in the pristine forest were similar (P > 0.05). Mouse lemurs in one disturbed habitat had greater body length and body mass than mouse lemurs in the pristine forest (P < 0.05). The difference may be linked with fruit abundance of two trees species (Tamarindus indica and Ziziphus mauritiana) and more insect availability in the disturbed site. In the altered habitat, mouse lemur females had longest body size and heavier than males (P < 0.05). Red-tailed sportive lemur body mass and length did not change between sites (P > 0.05). Our study is consistent with the hypothesis that lemur morphometric and body mass may change with forest degradation in southern forest of Menabe. Additionally, the range of the response varies between species and sex: mouse lemurs had a wider reaction norm to the habitat disturbance than did red-tailed sportive lemurs. Mouse lemurs may have higher ecological flexibility and tolerance for forest changes, specifically the alteration of forest habitats. Understanding how lemur morphology responds to habitat disturbance may be used as a tool to prioritize lemur conservation.   Résumé La perte d’habitat due à l’activité humaine est une menace qui affecte tous les primates à Madagascar. Les lémuriens, primates arboricoles, ont des réponses variées face au changement de leur habitat. La présente recherche vise à déterminer le lien entre la dégradation forestière, la masse et les caractères morphologiques des lémuriens nocturnes de Menabe Sud : Lepilemur ruficaudatus et Microcebus murinus. L’étude a été effectuée dans cinq sites dont deux sites sont des forêts primaires et trois autres sont des forêts perturbées. La capture et la mesure des caractères morphologiques des lémuriens ont été réalisées entre novembre et décembre 2014, puis entre juillet et septembre 2015. Des parcelles botaniques (5m x 5m) ont été utilisées pour décrire les caractéristiques des sites dont l’abondance des arbres, le diamètre à hauteur de poitrine ou la hauteur et le diamètre de la couronne. La masse de M. murinus n’était pas influencée par la saison de capture (P > 0,05), mais elle variait avec le sexe (P < 0,005) et le site (P < 0,001). Tous les caractères morphologiques de M. murinus dans les deux forêts primaires étaient similaires (P > 0,05). Par contre, dans les forêts perturbées, les femelles de M. murinus étaient plus lourdes et avaient des corps plus longs que les mâles (P < 0,05). La masse et la longueur du corps de L. ruficaudatus entre les différents sites étaient similaires (P > 0,05). Comparé à L. ruficaudatus, M. murinus répondrait davantage à la dégradation forestière. Comprendre l’étendue de la réponse morphologique des lémuriens face à la dégradation de leur habitat pourrait être utilisé comme outil pour prioriser leur conservation

Social Justice Counseling and Advocacy: Developing New Leadership Roles and Competencies

The fusion of scholarship and activism represents an opportunity to reflect on ways in which counselors and psychologists can begin to address the multilevel context faced by clients and client communities. Counselors and psychologists have embraced, and sometimes resisted, the wide range of roles including that of advocate and activist. This article reflects on a process that engaged workshop participants in examining the American Counseling Association Advocacy Competencies and exploring the possibilities of advocacy on behalf of their own clients. Further, the article presents recommendations for actions developed by participants through application of workshop principles regarding social action in the larger public arena. The workshop was a part of the National Multicultural and Social Justice Leadership Academy in 2010

Behavior change interventions: the potential of ontologies for advancing science and practice

A central goal of behavioral medicine is the creation of evidence-based interventions for promoting behavior change. Scientific knowledge about behavior change could be more effectively accumulated using "ontologies." In information science, an ontology is a systematic method for articulating a "controlled vocabulary" of agreed-upon terms and their inter-relationships. It involves three core elements: (1) a controlled vocabulary specifying and defining existing classes; (2) specification of the inter-relationships between classes; and (3) codification in a computer-readable format to enable knowledge generation, organization, reuse, integration, and analysis. This paper introduces ontologies, provides a review of current efforts to create ontologies related to behavior change interventions and suggests future work. This paper was written by behavioral medicine and information science experts and was developed in partnership between the Society of Behavioral Medicine's Technology Special Interest Group (SIG) and the Theories and Techniques of Behavior Change Interventions SIG. In recent years significant progress has been made in the foundational work needed to develop ontologies of behavior change. Ontologies of behavior change could facilitate a transformation of behavioral science from a field in which data from different experiments are siloed into one in which data across experiments could be compared and/or integrated. This could facilitate new approaches to hypothesis generation and knowledge discovery in behavioral science

Safety and physiological effects of two different doses of elosulfase alfa in patients with morquio a syndrome: A randomized, double-blind, pilot study.

The primary treatment outcomes of a phase 2, randomized, double-blind, pilot study evaluating safety, physiological, and pharmacological effects of elosulfase alfa in patients with Morquio A syndrome are herewith presented. Patients aged ≥7 years and able to walk ≥200 m in the 6-min walk test (6MWT) were randomized to elosulfase alfa 2.0 or 4.0 mg/kg/week for 27 weeks. The primary objective was to evaluate the safety of both doses. Secondary objectives were to evaluate effects on endurance (6MWT and 3-min stair climb test [3MSCT]), exercise capacity (cardio-pulmonary exercise test [CPET]), respiratory function, muscle strength, cardiac function, pain, and urine keratan sulfate (uKS) levels, and to determine pharmacokinetic parameters. Twenty-five patients were enrolled (15 randomized to 2.0 mg/kg/week and 10 to 4.0 mg/kg/week). No new or unexpected safety signals were observed. After 24 weeks, there were no improvements versus baseline in the 6MWT, yet numerical improvements were seen in the 3MSCT with 4.0 mg/kg/week. uKS and pharmacokinetic data suggested no linear relationship over the 2.0-4.0 mg/kg dose range. Overall, an abnormal exercise capacity (evaluated in 10 and 5 patients in the 2.0 and 4.0 mg/kg/week groups, respectively), impaired muscle strength, and considerable pain were observed at baseline, and there were trends towards improvements in all domains after treatment. In conclusion, preliminary data of this small study in a Morquio A population with relatively good endurance confirmed the acceptable safety profile of elosulfase alfa and showed a trend of increased exercise capacity and muscle strength and decreased pain

Too Many Choices Confuse Patients With Dementia

Choices are often difficult to make by patients with Alzheimer Dementia. They often become acutely confused when faced with too many options because they are not able to retain in their working memory enough information about the various individual choices available. In this case study, we describe how an essentially simple benign task (choosing a dress to wear) can rapidly escalate and result in a catastrophic outcome. We examine what went wrong in the patient/caregiver interaction and how that potentially catastrophic situation could have been avoided or defused

Repetitive Questioning II

Repetitive questioning is a major problem for caregivers, particularly taxing if they are unable to recognize and understand the reasons why their loved one keeps asking the same question over and over again. Caregivers may be tempted to believe that the patient does not even try to remember the answer given or is just getting obnoxious. This is incorrect. Repetitive questioning is due to the underlying disease: The patient’s short term memory is impaired and he is unable to register, encode, retain and retrieve the answer. If he is concerned about a particular topic, he will keep asking the same question over and over again. To the patient each time she asks the question, it is as if she asked it for the first time. Just answering repetitive questioning by providing repeatedly the same answer is not sufficient. Caregivers should try to identify the underlying cause for this repetitive questioning. In an earlier case study, the patient was concerned about her and her family’s safety and kept asking whether the doors are locked. In this present case study, the patient does not know how to handle the awkward situation he finds himself in. He just does not know what to do. He is not able to adjust to the new unexpected situation. So he repeatedly wants to reassure himself that he is not intruding by asking the same question over and over again. We discuss how the patient’s son-in-law could have avoided this situation and averted the catastrophic ending