Illinois submission for ... under Public law 99-660 "The State Comprehensive Mental Health Services Plan Act of 1986" and Public law 601-639 "Mental Health Amendments of 1990" for adults with serious mental illness.

Description based on: Sept. 30,1991.

Amending the Railroad retirement act of 1937 and the Railroad retirement tax act; report, together with supplemental and minority views, to accompany H.R. 13300.

Mode of access: Internet.

Medicines related dysphagia in primary care: The prevalence of and impact on community pharmacists

Dysphagia is a common and problematic symptom characterised by varying degrees of difficulty swallowing food, fluids and medicines of differing consistencies. International primary care based studies have identified that between 1 in 4 and 1 in 5 patients have some form of dysphagia, it can affect medicines taking behaviour and healthcare professionals are largely unaware of this1,2. Similar research has not been undertaken in the UK. Adherence related pharmacy based services in the UK provide an opportunity for community pharmacists to identify the problem and facilitate better medicines use. The aim of this pilot study was to estimate the level of patient reported dysphagia in older persons using community pharmacies in the UK, describe how it affects their medicine taking behaviour and identify whether advanced pharmacy services are related to improved awareness of this.

Using the factors that have a positive impact on the retention of low socioeconomic students to prepare accelerated enrolled nurses for the science units of a nursing degree : a practice report

At a campus in a low socioeconomic (SES) area, our University allows enrolled nurses entry into the second year of a Bachelor of Nursing, but attrition is high. Using the factors, described by Yorke and Thomas (2003) to have a positive impact on the attrition of low SES students, we developed strategies to prepare the enrolled nurses for the pharmacology and bioscience units of a nursing degree with the aim of reducing their attrition. As a strategy, the introduction of review lectures of anatomy, physiology and microbiology, was associated with significantly reduced attrition rates. The subsequent introduction of a formative website activity of some basic concepts in bioscience and pharmacology, and a workshop addressing study skills and online resources, were associated with a further reduction in attrition rates of enrolled nursing students in a Bachelor of Nursing.

Large-scale atmospheric dynamics of the wet winter 2009–2010 and its impact on hydrology in Portugal

The anomalously wet winter of 2010 had a very important impact on the Portuguese hydrological system. Owing to the detrimental effects of reduced precipitation in Portugal on the environmental and socio-economic systems, the 2010 winter was predominantly beneficial by reversing the accumulated precipitation deficits during the previous hydrological years. The recorded anomalously high precipitation amounts have contributed to an overall increase in river runoffs and dam recharges in the 4 major river basins. In synoptic terms, the winter 2010 was characterised by an anomalously strong westerly flow component over the North Atlantic that triggered high precipitation amounts. A dynamically coherent enhancement in the frequencies of mid-latitude cyclones close to Portugal, also accompanied by significant increases in the occurrence of cyclonic, south and south-westerly circulation weather types, are noteworthy. Furthermore, the prevalence of the strong negative phase of the North Atlantic Oscillation (NAO) also emphasises the main dynamical features of the 2010 winter. A comparison of the hydrological and atmospheric conditions between the 2010 winter and the previous 2 anomalously wet winters (1996 and 2001) was also carried out to isolate not only their similarities, but also their contrasting conditions, highlighting the limitations of estimating winter precipitation amounts in Portugal using solely the NAO phase as a predictor.

Impact of the timing and duration of weed control on the establishment of a rubber tree plantation

A produção da seringueira é reduzida pelas plantas daninhas que competem por recursos ambientais; portanto, a época e duração do controle de plantas daninhas influencia a interferência das plantas daninhas. Os objetivos deste estudo foram: avaliar o crescimento de plantas de seringueira (Hevea brasiliensis), determinar o período crítico para controle das plantas daninhas e avaliar a recuperação do crescimento das seringueiras que conviveram com plantas daninhas por diferentes períodos de tempo após o plantio. Dois grupos de tratamentos foram estabelecidos em condições de campo, no primeiro ano de investigação: um grupo conteve períodos crescentes de infestação de plantas daninhas, enquanto o outro conteve períodos crescentes de controle das plantas daninhas, também incluindo uma testemunha livre de plantas daninhas e uma testemunha com infestação total de plantas daninhas. No segundo ano da investigação, as plantas daninhas foram totalmente controladas. Urochloa decumbens foi a planta daninha dominante (mais de 90% de cobertura). O crescimento da cultura foi grandemente reduzido devido à interferência de plantas daninhas. A altura de plantas decresceu mais rapidamente que qualquer outra característica. Altura de planta, massa seca de folhas e área foliar decresceram em 99%, 97% e 96%, respectivamente, e foram as características mais reduzidas. A altura de plantas também se recuperou mais rapidamente que qualquer outra característica quando o período de controle das plantas daninhas foi entendido. Contudo, a massa seca do caule aumentou em 750%, fazendo desta a característica mais recuperada. O período crítico para o controle de plantas daninhas foi entre 4 e 9½ meses após o plantio, no primeiro ano; contudo, as seringueiras mostraram expressiva recuperação do crescimento quando as plantas daninhas foram controladas ao longo do segundo ano.

Assessment of marine litter in the Western Adriatic Sea and its impact on marine biota

Due to its environmental, safety, health and socio-economic impacts, marine litter has been recognized as a 21st century global challenge, so that it has been included in Descriptor 10 of the EU MSFD. For its morphological features and anthropogenic pressures, the Adriatic Sea is very sensitive to the accumulation of debris, but data are inconsistent and fragmented. This thesis, in the framework of DeFishGear project, intents to assess marine litter on beaches and on seafloor in the Western Adriatic sea, and test if debris ingestion by fish occurs. Three beaches were sampled during two surveys in 2015. Benthic litter monitoring was carried out in the FAO GSA17 during fall 2014, using a rapido trawl. Litter ingestion was investigated through gut contents analysis of 260 fish belonging to 8 commercial species collected in Western Gulf of Venice. Average litter density on beaches was 1.5 items/m2 during spring, and decreased to 0.8 items/m2 in summer. Litter composition was heterogeneous and varied among sites, even if no significant differences were found. Most of debris consisted of plastic sheets, fragments, polystyrene pieces, mussels nets and cottons bud sticks, showing that sources are many and include aquaculture, land-based activities and local users of beaches. Average density of benthic litter was 913 items/Km2 (82 Kg/Km2). Plastic dominated in terms of numbers and weight, and consisted mainly of bags, sheets and mussel nets. The highest density was found close to the coast, and sources driving the major differences in litter distribution were mussel farms and shipping lanes. Litter ingestion occurred in 47% of examined fish, mainly consisting of fibers. Among species, S. pilchardus swallowed almost all debris categories. Findinds may provide a baseline to set the necessary measures to manage and minimize marine litter in the Western Adriatic region and to protect aquatic life from plastic pollution, even accounting the possible implications on human health.

Impact of definitions of loss to follow-up (LTFU) in antiretroviral therapy program evaluation: variation in the definition can have an appreciable impact on estimated proportions of LTFU

OBJECTIVE To examine the impact of different definitions of loss to follow-up (LTFU) on estimates of program outcomes in cohort studies of patients on antiretroviral therapy (ART). STUDY DESIGN AND SETTING We examined the impact of different definitions of LTFU using data from the International Epidemiological Databases to Evaluate AIDS-Southern Africa. The reference approach, Definition A, was compared with five alternative scenarios that differed in eligibility for analysis and the date assigned to the LTFU outcome. Kaplan-Meier estimates of LTFU were calculated up to 2 years after starting ART. RESULTS Estimated cumulative LTFU were 14% and 22% at 12 and 24 months, respectively, using the reference approach. Differences in the proportion LTFU were reported in the alternative scenarios with 12-month estimates of LTFU varying by up to 39% compared with Definition A. Differences were largest when the date assigned to the LTFU outcome was 6 months after the date of last contact and when the site-specific definition of LTFU was used. CONCLUSION Variation in the definitions of LTFU within cohort analyses can have an appreciable impact on estimated proportions of LTFU over 2 years of follow-up. Use of a standardized definition of LTFU is needed to accurately measure program effectiveness and comparability between programs.

The formation of a subsurface anticyclonic eddy in the Peru-Chile Undercurrent and its impact on the near-coastal salinity, oxygen and nutrient distributions

The formation of a subsurface anticyclonic eddy in the Peru-Chile Undercurrent (PCUC) in January and February 2013 is investigated using a multi-platform four-dimensional observational approach. Research vessel, multiple glider and mooring-based measurements were conducted in the Peruvian upwelling regime near 12°30'S. The dataset consists of more than 10000 glider profiles and repeated vessel-based hydrography and velocity transects. It allows a detailed description of the eddy formation and its impact on the near-coastal salinity, oxygen and nutrient distributions. In early January, a strong PCUC with maximum poleward velocities of ca. 0.25 m/s at 100 to 200 m depth was observed. Starting on January 20 a subsurface anticyclonic eddy developed in the PCUC downstream of a topographic bend, suggesting flow separation as the eddy formation mechanism. The eddy core waters exhibited oxygen concentrations less than 1mol/kg, an elevated nitrogen-deficit of ca. 17µmol/l and potential vorticity close to zero, which seemed to originate from the bottom boundary layer of the continental slope. The eddy-induced across-shelf velocities resulted in an elevated exchange of water masses between the upper continental slope and the open ocean. Small scale salinity and oxygen structures were formed by along-isopycnal stirring and indications of eddy-driven oxygen ventilation of the upper oxygen minimum zone were observed. It is concluded that mesoscale stirring of solutes and the offshore transport of eddy core properties could provide an important coastal open-ocean exchange mechanism with potentially large implications for nutrient budgets and biogeochemical cycling in the oxygen minimum zone off Peru.

Politics of the 1945 Constitution:Democratization and Its Impact on Political Institutions in Indonesia

Introduction : Before 1998, no one could think about the amendment of the 1945 Constitution. The 1945 Constitution was a product of nationalist who had hard fought for independence from the Dutch colonization. This historical background made it the symbol of independence of the Indonesian nation. Thus, it has been considered as forbidden to touch contents of the 1945 Constitution whereas political leaders have legitimized their authoritarian rulership by utilizing a symbolic character of the Constitution. With the largest political turmoil since its independence, that is, a breakdown of authoritarian regime and democratic transformation in 1998-1999, however, a myth of the "sacred and inviolable" constitution has disappeared. A new theme has then aroused: how can the 1945 Constitution be adapted for a new democratic regime in Indonesia? 　　　The Indonesian modern state has applied the 1945 Constitution as the basic law since its independence in 1945, except for around 10 years in the 1950s. In the period of independence struggle, contrary to the constitutional provision that a kind of presidential system is employed, a cabinet responsible for the Central National Committee was installed. Politics under this institution was in practice a parliamentary system of government. After the Dutch transferred sovereignty to Indonesia in 1949, West European constitutionalism and party politics under a parliamentary system was fully adopted with the introduction of two new constitutions: the 1949 Constitution of Federal Republic of Indonesia and the 1950 Provisional Constitution of Republic of Indonesia. Since a return from the 1950 Constitution to the 1945 Constitution was decided with the Presidential Decree in 1959, the 1945 Constitution had supported two authoritarian regimes of Soekarno's "Guided Democracy" and Soeharto's "New Order" as a legal base. When the 32-year Soeharto's government fell down and democratization started in 1998, the 1945 Constitution was not replaced with a new one, as seen in many other democratizing countries, but successively reformed to adapt itself to a new democratic regime. In the result of four constitutional amendments in 1999-2002, political institutions in Indonesia are experiencing a transformation from an authoritative structure, in which the executive branch monopolized power along with incompetent legislative and judicial branches, to a modern democratic structure, in which the legislative branch can maintain predominance over the executive. However, as observed that President Abdurrahman Wahid, the first president ever elected democratically in Indonesian history, was impeached after one and a half years in office, democratic politics under a new political institution has never been stable. 　　　Under the 1945 Constitution, how did authoritarian regimes maintain stability? Why can a democratic regime not achieve its stability? What did the two constitutional amendments in the process of democratization change? In the first place, how did the political institutions stipulated by the 1945 Constitution come out? Through answering the above questions, this chapter intends to survey the historical continuity and change of political institutions in Indonesia along with the 1945 Constitutions and to analyze impact of regime transformation on political institutions. First, we examine political institutions stipulated by the original 1945 Constitution as well as historical and philosophical origins of the constitution. Second, we search constitutional foundations in the 1945 Constitution that made it possible for Soekarno and Soeharto to establish and maintain authoritarian regimes. Third, we examine contents of constitutional amendments in the process of democratization since 1998. Fourth, we analyze new political dynamics caused by constitutional changes, looking at the impeachment process of President Abdurrahman Wahid. Finally, we consider tasks faced by Indonesia that seeks to establish a stable democracy.

Reform momentum and its impact on Greek growth. Bruegel Policy Contribution 2015/12, July 2015

Greece has an imperfect track-record of structural reform implementation. However, the poor growth outcome of the Greek programmes is also a consequence of the timing and composition of reforms, which were not optimally geared towards a speedy transition to a new growth model based on the private sector. While the main responsibility for this lies with the Greek authorities, international institutions share the responsibility for the poor growth-enhancing effect of reforms. In the current context, further structural reform efforts should be mainly targeted at supporting Greece's speedy return to solid growth rates. This is not only because poverty and unemployment have reached very high levels, but also for political economy reasons: reforms must quickly be seen to be working in order to buttress the consensus in favour of reform. Further efforts should be made to improve Greece’s business environment and to liberalise product markets, in addition to shifting taxation away from labour and towards consumption. Reforms to improve the quality of institutions should continue and are very much needed in the Greek setting, while taking into account that their demanding implementation might use up administrative capacity and their impact on growth will only be seen over long time horizons.