Telehealth Group Interactions in the Hospice Setting: Assessing Technical Quality Across Platforms

Objective: This study aims to examine the technical quality of videoconferencing used in hospice to engage caregivers as “virtual” members of interdisciplinary team meetings and their impressions of telehealth. Furthermore, it aims to compare the quality of plain old telephone service (POTS) and Web-based videoconferencing and provide recommendations for assessing video quality for telehealth group interactions. Materials and Methods: Data were obtained from an ongoing randomized clinical trial exploring Web-based videoconferencing and a completed prospective study of POTS-based videoconferencing in hospice. For the assessment of the technical quality, an observation form was used. Exit interviews with caregivers assessed impressions with the use of telehealth. A retrospective analysis of video-recorded team meetings was conducted rating attributes essential for the quality of videoconferencing (e.g., video artifacts, sharpness). Results: In total, 200 hospice team meetings were analyzed, including 114 video-recorded team meetings using Web-based videoconferencing and 86 meetings using POTS videophones. A direct comparison between the two modalities indicates the superiority of Web-based video in image quality but less so in audio quality. Transcripts of 19 caregiver interviews were analyzed. Caregivers found the use of videoconferencing to be a positive experience and a useful and essential tool to communicating with the hospice team. Conclusions: This study highlights the potential of telehealth to improve communication in hospice and the need for new tools that capture the quality of video-mediated communication among multiple stakeholders and strategies to improve the ongoing documentation of telehealth group sessions\u27 technical quality

The Impact of Citizen Environmental Science in the United States

An increasingly sophisticated public, rapid changes in monitoring technology, the ability to process large volumes of data, and social media are increasing the capacity for members of the public and advocacy groups to gather, interpret, and exchange environmental data. This development has the potential to alter the government-centric approach to environmental governance; however, citizen science has had a mixed record in influencing government decisions and actions. This Article reviews the rapid changes that are going on in the field of citizen science and examines what makes citizen science initiatives impactful, as well as the barriers to greater impact. It reports on 10 case studies, and evaluates these to provide findings about the state of citizen science and recommendations on what might be done to increase its influence on environmental decisionmaking

Awaking the vacuum in relativistic stars

Void of any inherent structure in classical physics, the vacuum has revealed to be incredibly crowded with all sorts of processes in relativistic quantum physics. Yet, its direct effects are usually so subtle that its structure remains almost as evasive as in classical physics. Here, in contrast, we report on the discovery of a novel effect according to which the vacuum is compelled to play an unexpected central role in an astrophysical context. We show that the formation of relativistic stars may lead the vacuum energy density of a quantum field to an exponential growth. The vacuum-driven evolution which would then follow may lead to unexpected implications for astrophysics, while the observation of stable neutron-star configurations may teach us much on the field content of our Universe.Comment: To appear in Phys. Rev. Let

Evaluation of Commercial Off-the-Shelf Sorbents and Catalysts for Control of Ammonia and Carbon Monoxide

Designers of future space vehicles envision simplifying the Atmosphere Revitalization (AR) system by combining the functions of trace contaminant (TC) control and carbon dioxide removal into one swing-bed system. Flow rates and bed sizes of the TC and CO2 systems have historically been very different. There is uncertainty about the ability of trace contaminant sorbents to adsorb adequately in high-flow or short bed length configurations, and to desorb adequately during short vacuum exposures. There is also concern about ambient ammonia levels in the absence of a condensing heat exchanger. In addition, new materials and formulations have become commercially available, formulations never evaluated by NASA for purposes of trace contaminant control. The optimal air revitalization system for future missions may incorporate a swing-bed system for carbon dioxide (CO2) and partial trace contaminant control, with a reduced-size, low-power, targeted trace contaminant system supplying the remaining contaminant removal capability. This paper describes the results of a comparative experimental investigation into materials for trace contaminant control that might be part of such a system. Ammonia sorbents and low temperature carbon monoxide (CO) oxidation catalysts are the foci. The data will be useful to designers of AR systems for future flexible path missions. This is a continuation of work presented in a prior year, with extended test results

Executive Order of 1870

This Executive Order, issued by President Ulysses S. Grant on April 12, 1870, established the Fort Berthold Reservation. In addition to Grant’s Executive Order, this document includes a series of letters, proposals, and endorsements for the creation of a reservation for the Mandan, Hidatsa, and Arikara. Importantly, this document also contains the original map outlining the proposed boundaries and the president’s diagram which significantly reducing the size of the reservation.https://commons.und.edu/indigenous-gov-docs/1195/thumbnail.jp

The Dipole Anisotropy of the 2mass Redshift Survey

We estimate the flux weighted acceleration on the Local Group (LG) from the near-infrared Two Micron All Sky Redshift Survey (2MRS). The near-infrared flux weighted dipoles are very robust because they closely approximate a mass weighted dipole, bypassing the effects of redshift distortions and require no preferred reference frame. We use this method with the redshift information to determine the change in dipole with distance. The LG dipole seemingly converges by 60 Mpc/h. Assuming convergence, the comparison of the 2MRS flux dipole and the CMB dipole provides a value for the combination of the mass density and luminosity bias parameters Omega_m^0.6/b_L= 0.40+/-0.09.Comment: 4 pages, 2 figures, Contribution to Rencontres de Moriond: Contents and Structures of the Universe, March 18-25, 2006, La Thuil

Synthesis of the elements in stars: forty years of progress

Forty years ago Burbidge, Burbidge, Fowler, and Hoyle combined what we would now call fragmentary evidence from nuclear physics, stellar evolution and the abundances of elements and isotopes in the solar system as well as a few stars into a synthesis of remarkable ingenuity. Their review provided a foundation for forty years of research in all of the aspects of low energy nuclear experiments and theory, stellar modeling over a wide range of mass and composition, and abundance studies of many hundreds of stars, many of which have shown distinct evidence of the processes suggested by B2FH. In this review we summarize progress in each of these fields with emphasis on the most recent developments

Linked Autonomous Interplanetary Satellite Orbit Navigation

A navigation technology known as LiAISON (Linked Autonomous Interplanetary Satellite Orbit Navigation) has been known to produce very impressive navigation results for scenarios involving two or more cooperative satellites near the Moon, such that at least one satellite must be in an orbit significantly perturbed by the Earth, such as a lunar halo orbit. The two (or more) satellites track each other using satellite-to-satellite range and/or range-rate measurements. These relative measurements yield absolute orbit navigation when one of the satellites is in a lunar halo orbit, or the like. The geometry between a lunar halo orbiter and a GEO satellite continuously changes, which dramatically improves the information content of a satellite-to-satellite tracking signal. The geometrical variations include significant out-of-plane shifts, as well as inplane shifts. Further, the GEO satellite is almost continuously in view of a lunar halo orbiter. High-fidelity simulations demonstrate that LiAISON technology improves the navigation of GEO orbiters by an order of magnitude, relative to standard ground tracking. If a GEO satellite is navigated using LiAISON- only tracking measurements, its position is typically known to better than 10 meters. If LiAISON measurements are combined with simple radiometric ground observations, then the satellite s position is typically known to better than 3 meters, which is substantially better than the current state of GEO navigation. There are two features of LiAISON that are novel and advantageous compared with conventional satellite navigation. First, ordinary satellite-to-satellite tracking data only provides relative navigation of each satellite. The novelty is the placement of one navigation satellite in an orbit that is significantly perturbed by both the Earth and the Moon. A navigation satellite can track other satellites elsewhere in the Earth-Moon system and acquire knowledge about both satellites absolute positions and velocities, as well as relative positions and velocities in space. The second novelty is that ordinarily one requires many satellites in order to achieve full navigation of any given customer s position and velocity over time. With LiAISON navigation, only a single navigation satellite is needed, provided that the satellite is significantly affected by the gravity of the Earth and the Moon. That single satellite can track another satellite elsewhere in the Earth- Moon system and obtain absolute knowledge of both satellites states

Assessment of a novel, capsid-modified adenovirus with an improved vascular gene transfer profile

<p>Background: Cardiovascular disorders, including coronary artery bypass graft failure and in-stent restenosis remain significant opportunities for the advancement of novel therapeutics that target neointimal hyperplasia, a characteristic of both pathologies. Gene therapy may provide a successful approach to improve the clinical outcome of these conditions, but would benefit from the development of more efficient vectors for vascular gene delivery. The aim of this study was to assess whether a novel genetically engineered Adenovirus could be utilised to produce enhanced levels of vascular gene expression.</p> <p>Methods: Vascular transduction capacity was assessed in primary human saphenous vein smooth muscle and endothelial cells using vectors expressing the LacZ reporter gene. The therapeutic capacity of the vectors was compared by measuring smooth muscle cell metabolic activity and migration following infection with vectors that over-express the candidate therapeutic gene tissue inhibitor of matrix metalloproteinase-3 (TIMP-3).</p> <p>Results: Compared to Adenovirus serotype 5 (Ad5), the novel vector Ad5T*F35++ demonstrated improved binding and transduction of human vascular cells. Ad5T*F35++ mediated expression of TIMP-3 reduced smooth muscle cell metabolic activity and migration in vitro. We also demonstrated that in human serum samples pre-existing neutralising antibodies to Ad5T*F35++ were less prevalent than Ad5 neutralising antibodies.</p> <p>Conclusions: We have developed a novel vector with improved vascular transduction and improved resistance to human serum neutralisation. This may provide a novel vector platform for human vascular gene transfer.</p&gt