Risk Factors for Physical Restraint Use in Nursing Homes: The Impact of the Nursing Home Reform Act

This study examined the impact of the Nursing Home Reform Act of 1987 on resident-and-facility-level risk factors for physical restraint use in nursing homes. Data on the 1990 and 1993 cohorts were obtained from 268 facilities in 10 states, and data on a 1996 cohort were obtained from the Medical Expenditure Panel Survey, which sampled more than 800 nursing homes nationwide. Multivariate logistic regression models were generated for each cohort to identify the impact of resident- and facility-level risk factors for restraint use. The results indicate that the use of physical restraints continues to decline. Thirty-six percent of the 1990 cohort, 26 percent of the 1993 cohort, and 17 percent of the 1996 cohort were physically restrained. Although there was a reduced rate of restraint use from 1990 to 1996, similar resident-level factors but different facility-level factors were associated with restraint use at different points in time.

Reduced Bayesian Hierarchical Models: Estimating Health Effects of Simultaneous Exposure to Multiple Pollutants

Quantifying the health effects associated with simultaneous exposure to many air pollutants is now a research priority of the US EPA. Bayesian hierarchical models (BHM) have been extensively used in multisite time series studies of air pollution and health to estimate health effects of a single pollutant adjusted for potential confounding of other pollutants and other time-varying factors. However, when the scientific goal is to estimate the impacts of many pollutants jointly, a straightforward application of BHM is challenged by the need to specify a random-effect distribution on a high-dimensional vector of nuisance parameters, which often do not have an easy interpretation. In this paper we introduce a new BHM formulation, which we call "reduced BHM", aimed at analyzing clustered data sets in the presence of a large number of random effects that are not of primary scientific interest. At the first stage of the reduced BHM, we calculate the integrated likelihood of the parameter of interest (e.g. excess number of deaths attributed to simultaneous exposure to high levels of many pollutants). At the second stage, we specify a flexible random-effect distribution directly on the parameter of interest. The reduced BHM overcomes many of the challenges in the specification and implementation of full BHM in the context of a large number of nuisance parameters. In simulation studies we show that the reduced BHM performs comparably to the full BHM in many scenarios, and even performs better in some cases. Methods are applied to estimate location-specific and overall relative risks of cardiovascular hospital admissions associated with simultaneous exposure to elevated levels of particulate matter and ozone in 51 US counties during the period 1999-2005.

Optimizing Models of the North Atlantic Spring Bloom Using Physical, Chemical and Bio-Optical Observations from a Lagrangian Float

The North Atlantic spring bloom is one of the main events that lead to carbon export to the deep ocean and drive oceanic uptake of CO(2) from the atmosphere. Here we use a suite of physical, bio-optical and chemical measurements made during the 2008 spring bloom to optimize and compare three different models of biological carbon export. The observations are from a Lagrangian float that operated south of Iceland from early April to late June, and were calibrated with ship-based measurements. The simplest model is representative of typical NPZD models used for the North Atlantic, while the most complex model explicitly includes diatoms and the formation of fast sinking diatom aggregates and cysts under silicate limitation. We carried out a variational optimization and error analysis for the biological parameters of all three models, and compared their ability to replicate the observations. The observations were sufficient to constrain most phytoplankton-related model parameters to accuracies of better than 15 %. However, the lack of zooplankton observations leads to large uncertainties in model parameters for grazing. The simulated vertical carbon flux at 100 m depth is similar between models and agrees well with available observations, but at 600 m the simulated flux is larger by a factor of 2.5 to 4.5 for the model with diatom aggregation. While none of the models can be formally rejected based on their misfit with the available observations, the model that includes export by diatom aggregation has a statistically significant better fit to the observations and more accurately represents the mechanisms and timing of carbon export based on observations not included in the optimization. Thus models that accurately simulate the upper 100 m do not necessarily accurately simulate export to deeper depths.

Grazing behaviour, physical activity and metabolic profile of two Holstein strains in an organic grazing system

The challenge for sustainable organic dairy farming is identification of cows that are well adapted to forage-based production systems. Therefore, the aim of this study was to compare the grazing behaviour, physical activity and metabolic profile of two different Holstein strains kept in an organic grazing system without concentrate supplementation. Twelve Swiss (HCH ; 566 kg body weight (BW) and 12 New Zealand Holstein-Friesian (HNZ ; 530 kg BW) cows in mid-lactation were kept in a rotational grazing system. After an adaptation period, the milk yield, nutrient intake, physical activity and grazing behaviour were recorded for each cow for 7 days. On three consecutive days, blood was sampled at 07:00, 12:00 and 17:00 h from each cow by jugular vein puncture. Data were analysed using linear mixed models. No differences were found in milk yield, but milk fat (3.69 vs. 4.05%, P = 0.05) and milk protein percentage (2.92 vs. 3.20%, P < 0.01) were lower in HCH than in HNZ cows. Herbage intake did not differ between strains, but organic matter digestibility was greater (P = 0.01) in HCH compared to HNZ cows. The HCH cows spent less (P = 0.04) time ruminating (439 vs. 469 min/day) and had a lower (P = 0.02) number of ruminating boli when compared to the HNZ cows. The time spent eating and physical activity did not differ between strains. Concentrations of IGF-1 and T3 were lower (P ≤ 0.05) in HCH than HNZ cows. In conclusion, HCH cows were not able to increase dry matter intake in order to express their full genetic potential for milk production when kept in an organic grazing system without concentrate supplementation. On the other hand, HNZ cows seem to compensate for the reduced nutrient availability better than HCH cows but could not use that advantage for increased production efficiency

The Devil’s Calculus: Mathematical Models of Civil War

In spite of the movement to turn political science into a real science, various mathematical methods that are now the staples of physics, biology, and even economics are thoroughly uncommon in political science, especially the study of civil war. This study seeks to apply such methods - specifically, ordinary differential equations (ODEs) - to model civil war based on what one might dub the capabilities school of thought, which roughly states that civil wars end only when one side’s ability to make war falls far enough to make peace truly attractive. I construct several different ODE-based models and then test them all to see which best predicts the instantaneous capabilities of both sides of the Sri Lankan civil war in the period from 1990 to 1994 given parameters and initial conditions. The model that the tests declare most accurate gives very accurate predictions of state military capabilities and reasonable short term predictions of cumulative deaths. Analysis of the model reveals the scale of the importance of rebel finances to the sustainability of insurgency, most notably that the number of troops required to put down the Tamil Tigers is reduced by nearly a full order of magnitude when Tiger foreign funding is stopped. The study thus demonstrates that accurate foresight may come of relatively simple dynamical models, and implies the great potential of advanced and currently unconventional non-statistical mathematical methods in political science.

The association between stress and physical fitness testing in the 2005 Department of Defense population survey

Objective. The purpose of this study was to examine the association of perceived stress and passing the fitness test in a cohort of Department of Defense active duty members. Reports of this association have been suggested in numerous articles. Methods. The 2005 DoD Survey of Health Related Behaviors Among Active Duty Military Personnel was used to examine the association between the participants’ perceived levels of stress from family and/or work related sources and the respondents’ last required fitness test taking into account potential confounder of the association. Measures of association were obtained from logistic regression models. Results. Participants who experienced “some” or “a lot” of stress either from work sources (OR 0.69, 95% CI: 0.58-0.87) or from personal/family sources (OR 0.70, 95% CI: 0.57-0.86) were less likely to pass the fitness test when compared to their counterparts who experienced “none” or “a little” stress. Additionally, those who reported “some” or “a lot” of stress either from work sources (OR 0.54, 95% CI: 0.41-0.70) or from personal/family sources (OR 0.54, 95% CI: 0.44-0.67) that interfered with their military duties were also less likely to pass the fitness test. The multivariate adjustment only slightly reduced the unadjusted association. Conclusions . An association exists between perceived stress levels and outcome of fitness testing. The higher the level of stress perceived, the less likely the person will be to pass the fitness test. Stress-related intervention might be useful to help the military members to achieve the level of fitness needed to perform their duties.^

Get ur 60: A social marketing campaign to promote and facilitate physical activity among Central Texas middle school students

If allowed to continue unabated, the obesity epidemic may lead to the first decline in life expectancy in the developed world (Olshansky et al., 2005). Similar to the relationship between smoking habits in youth and adulthood, obesogenic dietary and physical activity habits in childhood may persist into adulthood (Kelder et al., 2002). Teaching children how to establish healthy eating habits and activity levels, as well as providing them the necessary resources to internalize and maintain these behaviors, may be the key to curbing this epidemic.^ A school-based obesity prevention approach is advantageous for many reasons including exposure to large captive audiences, reduced costs of sustainability and long-term maintenance, and generalizability of models and results across multiple populations. The effectiveness of school-based programs has been researched over the past 20 years, with promising results.^ Social marketing is a program-planning process that “facilitates the acceptance, rejection, modification, abandonment, or maintenance of particular behaviors” (Grier & Bryant, 2005). Social marketing has been shown to be effective in a variety of public health applications including improving diet, increasing physical activity, and preventing substance abuse. It is hypothesized that social marketing could further enhance the effectiveness of the Coordinated Approach To Child Health (CATCH) Central Texas Middle School Project, a school-based obesity prevention program.^ The development, implementation, and initial evaluation of the get ur 60 campaign, to promote the Center for Disease Control and Prevention (CDC) recommended sixty minutes of daily activity, is described in this paper. Various components of the get ur 60 campaign were assessed to evaluate the effectiveness of the campaign during the first semester of implementation. At the end of the spring semester focus groups were held to collect student reactions to the first semester of the get ur 60 campaign.^ The initial results from the first semester of get ur 60 have demonstrated that the campaign as designed was feasible to implement, accepted at all intervention schools, and resulted in a measure of success. ^

Age models, sedimentology and geochemistry from sediment cores in Drake Passage throughflow

The Drake Passage (DP) is the major geographic constriction for the Antarctic Circumpolar Current (ACC) and exerts a strong control on the exchange of physical, chemical, and biological properties between the Atlantic, Pacific, and Indian Ocean basins. Resolving changes in the flow of circumpolar water masses through this gateway is, therefore, crucial for advancing our understanding of the Southern Ocean's role in global ocean and climate variability. Here, we reconstruct changes in DP throughflow dynamics over the past 65,000 y based on grain size and geochemical properties of sediment records from the southernmost continental margin of South America. Combined with published sediment records from the Scotia Sea, we argue for a considerable total reduction of DP transport and reveal an up to ~40% decrease in flow speed along the northernmost ACC pathway entering the DP during glacial times. Superimposed on this long-term decrease are high-amplitude, millennial-scale variations, which parallel Southern Ocean and Antarctic temperature patterns. The glacial intervals of strong weakening of the ACC entering the DP imply an enhanced export of northern ACC surface and intermediate waters into the South Pacific Gyre and reduced Pacific-Atlantic exchange through the DP ("cold water route"). We conclude that changes in DP throughflow play a critical role for the global meridional overturning circulation and interbasin exchange in the Southern Ocean, most likely regulated by variations in the westerly wind field and changes in Antarctic sea ice extent.

Reduced order adaptive models for systems of PDEs using POD

In this work we propose a method to accelerate time dependent numerical solvers of systems of PDEs that require a high cost in computational time and memory. The method is based on the combined use of such numerical solver with a proper orthogonal decomposition, from which we identify modes, a Galerkin projection (that provides a reduced system of equations) and the integration of the reduced system, studying the evolution of the modal amplitudes. We integrate the reduced model until our a priori error estimator indicates that our approximation in not accurate. At this point we use again our original numerical code in a short time interval to adapt the POD manifold and continue then with the integration of the reduced model. Application will be made to two model problems: the Ginzburg-Landau equation in transient chaos conditions and the two-dimensional pulsating cavity problem, which describes the motion of liquid in a box whose upper wall is moving back and forth in a quasi-periodic fashion. Finally, we will discuss a way of improving the performance of the method using experimental data or information from numerical simulations

Models for the prediction of handling damage in citrus and peaches grading lines, related to their physical properties.

Fruit damage during harvesting and handling is a standing problem, particularly for susceptible fruits like peaches and apricots. The resulting mechanical damage is a combination of fruit properties and damage inflicting effects due to procedures and to the equipment. Nine packing lines in the region of Murcia (SE Spain) have been tested with the aid of two different-size electronic fruits IS-100. Probabilities of impacts above three preset thresholds (50 g's, 100 g's and 150 g's) were calculated for each transfer point. Interaction fruit-packing line tests have been also performed in order to study the real incidence of packing lines on natural produce: apricots (1 variety), peaches (3 v.), lemons (1 v.) and oranges (3 v.). Bruises of handled and not handled samples of fruits were compared.

Higher levels of physical fitness are associated with a reduced risk of suffering sarcopenic obesity and better perceived health among elderly. The EXERNET multi-center study

Evaluar la asociación entre los niveles físicos de la aptitud, de calidad relacionada con la salud de la vida (CVRS) y la obesidad sarcopénica

Models and methods for the direct simulation of rough and micropatterned surfaces

Friction in hydrodynamic bearings are a major source of losses in car engines ([69]). The extreme loading conditions in those bearings lead to contact between the matching surfaces. In such conditions not only the overall geometry of the bearing is relevant, but also the small-scale topography of the surface determines the bearing performance. The possibility of shaping the surface of lubricated bearings down to the micrometer ([57]) opened the question of whether friction can be reduced by mean of micro-textures, with mixed results. This work focuses in the development of efficient numerical methods to solve thin film (lubrication) problems down to the roughness scale of measured surfaces. Due to the high velocities and the convergent-divergent geometries of hydrodynamic bearings, cavitation takes place. To treat cavitation in the lubrication problem the Elrod- Adams model is used, a mass-conserving model which has proven in careful numerical ([12]) and experimental ([119]) tests to be essential to obtain physically meaningful results. Another relevant aspect of the modeling is that the bearing inertial effects are considered, which is necessary to correctly simulate moving textures. As an application, the effects of micro-texturing the moving surface of the bearing were studied. Realistic values are assumed for the physical parameters defining the problems. Extensive fundamental studies were carried out in the hydrodynamic lubrication regime. Mesh-converged simulations considering the topography of real measured surfaces were also run, and the validity of the lubrication approximation was assessed for such rough surfaces.

The royal atlas of England and Wales, reduced from the ordnance survey; a complete series of topographical maps, physical and statistical charts, town plans, and index of 35,000 names ..

Mode of access: Internet.

Comparison of numerical and physical hydraulic models, Masonboro Inlet, North Carolina /

"June 1977."