71 research outputs found
Designing a Better Day: Adult Day Centers: Comparative Case Studies
The Adult Day Center (ADC) is emerging as a new and important social institution and place type in the continuum of care environments. Nine case studies representing the range of ADC\u27s currently operating in the United States are considered from a holistic, systemic perspective. Each case is presented in terms of place profile, program, physical setting and the place in use. The results are not a matter of ADC best practices or good/bad ways of doing things, but rather a method of identifying characteristics and components that appear to contribute to making a positive difference in the experience of adult day care.https://dc.uwm.edu/caupr_mono/1008/thumbnail.jp
Eddy-resolving simulation of plankton ecosystem dynamics in the California Current System
Author Posting. © Elsevier B.V., 2006. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Deep Sea Research Part I: Oceanographic Research Papers 53 (2006): 1483-1516, doi:10.1016/j.dsr.2006.06.005.We study the dynamics of the planktonic ecosystem in the coastal upwelling zone
within the California Current System using a three-dimensional, eddy-resolving circulation model coupled to an ecosystem/biogeochemistry model. The physical model
is based on the Regional Oceanic Modeling System (ROMS), configured at a resolution of 15 km for a domain covering the entire U.S. West Coast, with an embedded
child grid covering the central California upwelling region at a resolution of 5 km.
The model is forced with monthly mean boundary conditions at the open lateral
boundaries as well as at the surface. The ecological/biogeochemical model is nitrogen based, includes single classes for phytoplankton and zooplankton, and considers
two detrital pools with different sinking speeds. The model also explicitly simulates
a variable chlorophyll-to-carbon ratio. Comparisons of model results with either remote sensing observations (AVHRR, SeaWiFS) or in situ measurements from the
CalCOFI program indicate that our model is capable of replicating many of the
large-scale, time averaged features of the coastal upwelling system. An exception is
the underestimation of the chlorophyll levels in the northern part of the domain,
perhaps because of the lack of short-term variations in the forcing from the atmosphere. Another shortcoming is that the modeled thermocline is too diffuse, and that
the upward slope of the isolines toward the coast is too small. Detailed time-series
comparisons with observations from Monterey Bay reveal similar agreements and
discrepancies. We attribute the good agreement between the modeled and observed
ecological properties in large part to the accuracy of the physical fields. In turn,
many of the discrepancies can be traced back to our use of monthly mean forcing.
Analysis of the ecosystem structure and dynamics reveal that the magnitude and
pattern of phytoplankton biomass in the nearshore region are determined largely
by the balance of growth and zooplankton grazing, while in the offshore region,
growth is balanced by mortality. The latter appears to be inconsistent with in situ
observations and is a result of our consideration of only one zooplankton size class
(mesozooplankton), neglecting the importance of microzooplankton grazing in the
offshore region. A comparison of the allocation of nitrogen into the different pools
of the ecosystem in the 3-D results with those obtained from a box model configuration of the same ecosystem model reveals that only a few components of the
ecosystem reach a local steady-state, i.e. where biological sources and sinks balance
each other. The balances for the majority of the components are achieved by local
biological source and sink terms balancing the net physical divergence, confirming
the importance of the 3-D nature of circulation and mixing in a coastal upwelling
system.Most of this work has been made possible by two grants from NASA. Additional support is acknowledged from NSF’s ITR program
Utility and Validity of Pulfrich's Phenomenon in Optic Neuropathy
The stereoillusion of an oscillating object in the frontal plane that appears to be circling, Pulfrich's phenomenon, can be used to identify an optic neuropathy. Recently, this stereoillusion has been reported with epiretinal membranes and serous detachment of the macula
A Treatable Cause of Visual Loss in Fibrous Dysplasia
Fibrous dysplasia is a rare cause of compressive optic neuropathy. We report a case of acute cystic degeneration of the sphenoid sinus due to fibrous dysplasia causing optic nerve compression. This finding was unexpected and not apparent on CT scanning
Comment on Purifying air over the operating field with a new mobile laminar airflow device to reduce the possibility of airborne contamination
Malingering and Secondary Gain in the Afghanistan and Iraq Conflicts (.pdf)
Functional or non-organic visual loss (NOVL) is defined as a loss or decrease in visual acuity or visual field range with no identifiable organic cause. NOVL can be a difficult diagnosis to make and requires a high index of suspicion. This can be especially difficult in the setting of true organic pathology, as was the experience with several patients presenting to an Ophthalmology clinic after sustaining either ocular or non-ocular injuries. This case series examines several such patients with NOVL that were either injured or developed an ocular condition while serving in Iraq or Afghanistan. The aim of this series is to provide a review of several possible presentations of NOVL and the various modalities that the ophthalmologist can use to arrive at a diagnosis of NOVL
Visual and anatomic outcomes of vitrectomy with temporary keratoprosthesis or endoscopy in ocular trauma with opaque cornea
■BACKGROUND AND OBJECTIVE: To examine the outcomes of vitrectomy in ocular trauma with opaque cornea. ■PATIENTS AND METHODS: This retrospective study included 17 eyes of 16 patients who underwent vitrectomy with temporary keratoprosthesis or endoscopy at Walter Reed Army Medical Center, Washington, DC, from March 2003 to October 2010. ■RESULTS: A temporary keratoprosthesis was used in 8 eyes (47%) and endoscopy in 9 eyes (53%). Overall, the number of eyes with visual acuity of 20/200 or better improved from 0 at baseline to 5 (29%) at 6 months. The number of eyes with retinal detachment also improved from 10 (59%) at baseline to 3 (18%) at 6 months. ■CONCLUSION: Vitrectomy may be safely performed in ocular trauma with opaque cornea using a temporary keratoprosthesis or endoscopy with comparable outcomes. Endoscopy allows earlier diagnosis and treatment of occult pathology and requires less time and fewer procedures to implement than the temporary keratoprosthesis. Copyright © SLACK Incorporated
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