Optimizing Research on End-of-Life Care for Seniors:The Collective New Emerging Team on End of Life Care for Seniors University of Ottawa, Institute of Palliative Care

Background: End-of-life care for seniors is an important and neglected area of research. The University of Ottawa Institute of Palliative Care has expanded its research capacity by developing a Canadian Institutes of Health Research (CIHR) funded new emerging team on end-of-life care for seniors. This initiative brings together an interdisciplinary team of researchers from palliative care and geriatrics to develop a comprehensive program of research. Methods: 1) A variety of investigators from the fields of palliative care and geriatrics and disciplines of epidemiology, medicine, nursing, psychology and social work will collaborate on the development of a research agenda focussed on end-of-life care for seniors. 2) The conceptual model for the research program consists of 4 broad interrelated domains that are congruent with the CIHR themes of health services, clinical issues, population health and psychosocial, cultural, spiritual and ethical issues; this framework will guide the research program and all studies emanating from the program. 3) Research studies will focus on 5 areas of inquiry that are central to end-of-life care for seniors: palliative end-of-life care for rural seniors, care settings, burden, role of volunteers, and delirium. Results: This new team has the potential to obtain peer-reviewed funding, recruit and train a new generation of researchers, and build a network of concerned researchers. Conclusions: The new team should ultimately contribute to an improved quality of care for seniors who are approaching death.

Parameter studies of fibre laser micro-welding of AISI 316L using Taguchi method

This paper discusses the application of the Taguchi experimental design approach in optimizing the key process parameters for micro-welding of thin AISI 316L foil using the 100W CW fibre laser. A L16 Taguchi experiment was conducted to systematically understand how the power, scanning velocity, focus position, gas flow rate and type of shielding gas affect the bead dimensions. The welds produced in the L16 Taguchi experiment was mainly of austenite cellular-dendrite structure with an average grain size of 5µm. An exact penetration weld with the largest penetration to fusion width ratio was obtained. Among those process parameters, the interaction between power and scanning velocity presented the strongest effect to the penetration to fusion width ratio and the power was found to be the predominantly important factor that drives the interaction with other factors to appreciably affect the bead dimensions.

Parameter study on laser welding of nitinol wire by Taguchi method

A L27 Taguchi experiment was done to investigate the effect of laser power, welding time, laser mode (CW and two pulsed modes), focus position, and their possible interactions on the weld-bead aspect ratio of laser-welded NiTi wires by using a 100W fibre laser. The optimized parameter setting to produce the full penetrated weldment with minimum welding defects is successfully determined in the Taguchi experiment. The laser mode is found to be the most important parameter that directly controls the weld-bead aspect ratio. The focus position is the secondly important parameter for the laser welding of NiTi wires. Strong interaction between the power and focus position is found in the Taguchi experiment. The optimized weldment produced by the Taguchi experiment is mainly of columnar dendritic structure in the weld zone (WZ) with the size of 1-3µm, while the HAZ exhibits equiaxed grain structure with the size of 5-10µm. The Vickers micro-hardness test indicted that the WZ and HAZ in the weldment are softened to certain extends after fibre laser welding.

Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group.

BACKGROUND: Invasive fungal diseases are important causes of morbidity and mortality. Clarity and uniformity in defining these infections are important factors in improving the quality of clinical studies. A standard set of definitions strengthens the consistency and reproducibility of such studies. METHODS: After the introduction of the original European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group definitions, advances in diagnostic technology and the recognition of areas in need of improvement led to a revision of this document. The revision process started with a meeting of participants in 2003, to decide on the process and to draft the proposal. This was followed by several rounds of consultation until a final draft was approved in 2005. This was made available for 6 months to allow public comment, and then the manuscript was prepared and approved. RESULTS: The revised definitions retain the original classifications of "proven," "probable," and "possible" invasive fungal disease, but the definition of "probable" has been expanded, whereas the scope of the category "possible" has been diminished. The category of proven invasive fungal disease can apply to any patient, regardless of whether the patient is immunocompromised, whereas the probable and possible categories are proposed for immunocompromised patients only. CONCLUSIONS: These revised definitions of invasive fungal disease are intended to advance clinical and epidemiological research and may serve as a useful model for defining other infections in high-risk patients.

Pharmacogenomics of HIV Therapy: Summary of a Workshop Sponsored by the National Institute of Allergy and Infectious Diseases

Approximately 1 million people in the United States and over 30 million worldwide are living with human immunodeficiency virus type 1 (HIV-1). While mortality from untreated infection approaches 100%, survival improves markedly with use of contemporary antiretroviral therapies (ART). In the United States, 25 drugs are approved for treating HIV-1, and increasing numbers are available in resource-limited countries. Safe and effective ART is a cornerstone in the global struggle against the acquired immunodeficiency syndrome. Variable responses to ART are due at least in part to human genetic variants that affect drug metabolism, drug disposition, and off-site drug targets. Defining effects of human genetic variants on HIV treatment toxicity, efficacy, and pharmacokinetics has far-reaching implications. In 2010, the National Institute of Allergy and Infectious Diseases sponsored a workshop entitled, Pharmacogenomics A Path Towards Personalized HIV Care. This article summarizes workshop objectives, presentations, discussions, and recommendations derived from this meeting.

Proposed Improvement of the Iowa State Capitol Grounds, An Address before the Iowa Chapter American Institute of Architects at the State Historical Buiding, Des Moines, Iowa, October 22, 1913.

Concerning improvements to the State Capitol Grounds including placement of the Allison memorial and Soldiers and Sailor's momuments; removal of heating plant and relieving the state of coal, ashes, gas and smoke; provision of office space to the Adjutant General; an eventual executive mansion; provision of office buildings; and for a Supreme Court building where together with its library auxiliaries will have perpetual growth and constant accessbility; and propose restoration of natural scenic value of the capitol site.