Bottom-up review : analysis of DOD war game to test key assumptions : report to the Chairman and Ranking Minority Member, Committee on National Security, House of Representatives /

"B-272119"--P. 1.

Costs of managing urinary and faecal incontinence in a sub-acute care facility: A "bottom-up" approach

Aims: To measure accurately the direct costs of managing urinary and faecal incontinence in the sub-acute care setting. Materials and Methods: Prospective observational study was undertaken in two sub-acute care units in a metropolitan hospital. A consecutive series of 29 consecutive patients with urinary and/or faecal incontinence, who were in-patients in a geriatric rehabilitation or subacute neurologic unit underwent routine timed voiding protocol, as per usual care. Face-to-face bedside recordings of all incontinence care, with detailed cost analysis, were undertaken. Results: A total of 3,621 occasions of continence care were costed. The median time per 24 hr spent caring for incontinence per patient was 109 min (interquartile range 88-140). Isolated urinary incontinence episodes occurred in 28 patients (96.5%), mixed urinary/faecal incontinence episodes observed in 79.3%, and episodes of pure faecal incontinence were seen in 62%. The median costs of incontinence care in the sub-acute setting was $49AU per 24 hr, the major share ($41) spent on staff wages. The incontinence tasks of toileting assistance, pad changes, bed changes and catheter care were spread evenly across the three 8 hr shifts of duty. Conclusions: As our population demographics include an increasingly greater portion of the elderly, for whom long term institutional care is becoming relatively more scarce, provision of care in the sub-acute unit that may allow rehabilitation and return to home warrants scrutiny. This is the first study that delineates the costs of managing urinary and faecal incontinence in the sub-acute care setting. Such costs are substantial and place a heavy burden upon night-time carets. (C) 2004 Wiley-Liss, Inc.

Bottom-up risk regulation? How nanotechnology risk knowledge gaps challenge federal and state environmental agencies

Nanotechnologies have been called the "Next Industrial Revolution." At the same time, scientists are raising concerns about the potential health and environmental risks related to the nano-sized materials used in nanotechnologies. Analyses suggest that current U.S. federal regulatory structures are not likely to adequately address these risks in a proactive manner. Given these trends, the premise of this paper is that state and local-level agencies will likely deal with many "end-of-pipe" issues as nanomaterials enter environmental media without prior toxicity testing, federal standards, or emissions controls. In this paper we (1) briefly describe potential environmental risks and benefits related to emerging nanotechnologies; (2) outline the capacities of the Toxic Substances Control Act, the Clean Air Act, the Clean Water Act, and the Resources Conservation and Recovery Act to address potential nanotechnology risks, and how risk data gaps challenge these regulations; (3) outline some of the key data gaps that challenge state-level regulatory capacities to address nanotechnologies' potential risks, using Wisconsin as a case study; and (4) discuss advantages and disadvantages of state versus federal approaches to nanotechnology risk regulation. In summary, we suggest some ways government agencies can be better prepared to address nanotechnology risk knowledge gaps and risk management.

Top-down or bottom-up: the real choice for public services

This article considers two contrasting approaches to reforming public services in order to meet the needs of people living in poverty. The first approach is top-down, involves categorising individuals (as 'hard to help', 'at risk', etc) and invokes scientific backing for justification. The second approach is bottom-up, emancipatory, relates to people as individuals and treats people who have experience of poverty and social exclusion as experts. The article examines each approach through providing brief examples in the fields of unemployment and parenting policy - two fields that have been central to theories of 'cycles of deprivation'. It is suggested here that the two approaches differ in terms of their scale, type of user involvement and type of evidence that is used for their legitimation. While the article suggests that direct comparison between the two approaches is difficult, it highlights the prevalence of top-down approaches towards services for people living in poverty, despite increasing support for bottom-up approaches in other policy areas.

Bottom-up growth of fully transparent contact layers of indium tin oxide nanowires for light-emitting devices

Thin layers of indium tin oxide are widely used as transparent coatings and electrodes in solar energy cells, flat-panel displays, antireflection coatings, radiation protection and lithium-ion battery materials, because they have the characteristics of low resistivity, strong absorption at ultraviolet wavelengths, high transmission in the visible, high reflectivity in the far-infrared and strong attenuation in the microwave region. However, there is often a trade-off between electrical conductivity and transparency at visible wavelengths for indium tin oxide and other transparent conducting oxides. Here, we report the growth of layers of indium tin oxide nanowires that show optimum electronic and photonic properties and demonstrate their use as fully transparent top contacts in the visible to near-infrared region for light-emitting devices.

An overview of top-down vs. bottom-up models for informal settlement upgrading in South Africa

The paper explores informal settlement upgrading approaches in South Africa and presents a review of top-down vs. bottom-up models, using experience and lessons learned from the Durban metropolitan area. Reflections on past upgrading efforts suggest that top-down policies in South Africa have not been successful to date. By contrast, participatory techniques, such as planning activism, can be used to enhance community empowerment and a sense of local ownership. This paper reveals that although the notion of ‘bottom-up’, participatory methods for community improvement is often discussed in international development discourses, the tools, processes and new knowledge needed to ensure a successful upgrade are under-utilised. Participation and collaboration can mean various things for informal housing upgrading and often the involvement of local communities is limited to providing feedback in already agreed development decisions from local authorities and construction companies. The paper concludes by suggesting directions for ‘co-producing’ knowledge with communities through participatory, action-research methods and integrating these insights into upgrading mechanisms and policies for housing and infrastructure provision. The cumulative impacts emerging from these approaches could aggregate into local, regional, and national environmental, social and economic benefits able to successfully transform urban areas and ensure self-reliance for local populations.

Processi bottom-up per la rigenerazione di luoghi abbandonati. Una strategia per Villa Ghigi.

L’obiettivo del presente lavoro di tesi è quello di approfondire i processi di rigenerazione cosiddetti bottom-up o dal basso, poiché sono promossi da gruppi di cittadini, associazioni, cooperative o altre forme del terzo settore, che, esprimendo le proprie esigenze ed idee innovative, ottengono poi approvazione dall’amministrazione o dai proprietari dei beni. Si tratta di un fenomeno ancora poco presente in letteratura, poiché piuttosto recente e tuttora riscontrabile in maniera spontanea e disorganica. Per questo motivo una congrua parte della ricerca si è concentrata sull’analisi di casi studio italiani, per i quali sono state eseguite interviste ai protagonisti e sopralluoghi al fine di comprendere nel dettaglio il processo di riattivazione. A questi, si sono poi studiati alcuni esempi di realtà associative che mirano a mappare e a sistematizzare il fenomeno dell’abbandono architettonico. Sebbene le esperienze si siano dimostrate differenti tra loro e specifiche per il contesto e il territorio in cui sono collocate. si sono tuttavia individuate caratteristiche e dinamiche comuni che inducono a pensare a una tipologia di processo. Alla luce delle analisi dei casi studio, si è formulata una strategia possibile per un edificio che pur serbando valore storico e grandi potenzialità, si trova in stato di abbandono da più di quaranta anni: Villa Ghigi a Bologna. Si tratta di un’ex-villa padronale, all’interno di uno dei più importanti parchi pubblici bolognesi per la sua varietà vegetale e animale e per la sua posizione prossima al centro storico. Il progetto-processo che si propone si fonda su ipotesi realistiche e concrete di rigenerazione e si sviluppa secondo cinque fasi temporali differenti. Nell’iter si è infatti previsto l’alternarsi di momenti più astratti, incentrati sul networking e la definizione di prospettive, con tempi più fisici. dedicati all’intervento architettonico e alle trasformazioni concrete.

Aplicación y comparación de la metodología de diseño Top Down y Bottom Up

Este proyecto estudia y compara las metodologías Bottom Up y Top Down, utilizadas en el desarrollo de productos dentro de un departamento de manufactura en un ambiente colaborativo -- Se desarrolló un producto mediante ambas metodologías, posteriormente se analizó su incidencia en el comportamiento de indicadores de gestión, que miden el desempeño de una organización -- Se destacan también los beneficios del Top Down en la manufactura de grandes ensambles, tomando como ejemplo un torno

All Island All Active: An innovative top-down/bottom-up cross-border approach to increasing physical activity levels

National Institute of Health Sciences Research Bulletin: Volume 6, Issue 3 - June 2012

Top-down solar modulation of climate: evidence for centennial-scale change

During the descent into the recent ‘exceptionally’ low solar minimum, observations have revealed a larger change in solar UV emissions than seen at the same phase of previous solar cycles. This is particularly true at wavelengths responsible for stratospheric ozone production and heating. This implies that ‘top-down’ solar modulation could be a larger factor in long-term tropospheric change than previously believed, many climate models allowing only for the ‘bottom-up’ effect of the less-variable visible and infrared solar emissions. We present evidence for long-term drift in solar UV irradiance, which is not found in its commonly used proxies. In addition, we find that both stratospheric and tropospheric winds and temperatures show stronger regional variations with those solar indices that do show long-term trends. A top-down climate effect that shows long-term drift (and may also be out of phase with the bottom-up solar forcing) would change the spatial response patterns and would mean that climate-chemistry models that have sufficient resolution in the stratosphere would become very important for making accurate regional/seasonal climate predictions. Our results also provide a potential explanation of persistent palaeoclimate results showing solar influence on regional or local climate indicators.

Multitrophic effects of nutrient addition in upland grassland

Although the effects of nutrient enhancement on aquatic systems are well documented, the consequences of nutritional supplements on soil food webs are poorly understood, and results of past research examining bottom-up effects are often conflicting. In addition, many studies have failed to separate the effects of nutrient enrichment and the physical effects of adding organic matter. In this field study, we hypothesised that the addition of nitrogen to soil would result in a trophic cascade, through detritivores (Collembola) to predators (spiders), increasing invertebrate numbers and diversity. Nitrogen and lime were added to plots in an upland grassland in a randomised block design. Populations of Collembola and spiders were sampled by means of pitfall traps and identified to species. Seventeen species of Collembola were identified from the nitrogen plus lime (N + L) and control plots. Species assemblage, diversity, richness, evenness and total number were not affected by nutrient additions. However, there was an increase in the number of Isotomidae juveniles and Parisotoma anglicana trapped in the N + L plots. Of the 44 spider species identified, over 80% were Linyphiidae. An effect on species assemblage from the addition of N + L to the plots was observed on two of the four sampling dates (July 2002 and June 2003). The linyphiid, Oedothorax retusus, was the only species significantly affected by the treatments and was more likely to be trapped in the control plots. The increased number of juvenile Collembola, and change in community composition of spiders, were consequences of the bottom-up effect caused by nutrient inputs. However, despite efforts to eliminate the indirect effects of nutrient inputs, a reduction in soil moisture in the N + L plots cannot be eliminated as a cause of the invertebrate population changes observed. Even so, this experiment was not confounded by the physical effects of habitat structure reported in most previous studies. It provides evidence of moderate bottom-up influences of epigeic soil invertebrate food webs and distinguishes between nutrient addition and plant physical structure effects. It also emphasises the importance Of understanding the effects of soil management practices on soil biodiversity, which is under increasing pressure from land development and food production.

Community structure of mites (Arachnida: Acari) in six rubber tree clones

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Shedding light on the role of the prokaryotic assemblage in the biogeochemical cycles of the dark ocean

Se han eliminado las páginas en blanco