929 resultados para year one


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Part of Iowa's Water Ambient monitoring Program, produced by the Iowa Department of Natural Resources.

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BACKGROUND: The English Improving Access to Psychological Therapies (IAPT) initiative aims to make evidence-based psychological therapies for depression and anxiety disorder more widely available in the National Health Service (NHS). 32 IAPT services based on a stepped care model were established in the first year of the programme. We report on the reliable recovery rates achieved by patients treated in the services and identify predictors of recovery at patient level, service level, and as a function of compliance with National Institute of Health and Care Excellence (NICE) Treatment Guidelines. METHOD: Data from 19,395 patients who were clinical cases at intake, attended at least two sessions, had at least two outcomes scores and had completed their treatment during the period were analysed. Outcome was assessed with the patient health questionnaire depression scale (PHQ-9) and the anxiety scale (GAD-7). RESULTS: Data completeness was high for a routine cohort study. Over 91% of treated patients had paired (pre-post) outcome scores. Overall, 40.3% of patients were reliably recovered at post-treatment, 63.7% showed reliable improvement and 6.6% showed reliable deterioration. Most patients received treatments that were recommended by NICE. When a treatment not recommended by NICE was provided, recovery rates were reduced. Service characteristics that predicted higher reliable recovery rates were: high average number of therapy sessions; higher step-up rates among individuals who started with low intensity treatment; larger services; and a larger proportion of experienced staff. CONCLUSIONS: Compliance with the IAPT clinical model is associated with enhanced rates of reliable recovery.

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This report summarizes the work done for the Vehicle Powertrain Modeling and Design Problem Proposal portion of the EcoCAR3 proposal as specified in the Request for Proposal from Argonne National Laboratory. The results of the modeling exercises presented in the proposal showed that: An average conventional vehicle powered by a combustion engine could not meet the energy consumption target when the engine was sized to meet the acceleration target, due the relatively low thermal efficiency of the spark ignition engine. A battery electric vehicle could not meet the required range target of 320 km while keeping the vehicle weight below the gross vehicle weight rating of 2000 kg. This was due to the low energy density of the batteries which necessitated a large, and heavy, battery pack to provide enough energy to meet the range target. A series hybrid electric vehicle has the potential to meet the acceleration and energy consumption parameters when the components are optimally sized. A parallel hybrid electric vehicle has less energy conversion losses than a series hybrid electric vehicle which results in greater overall efficiency, lower energy consumption, and less emissions. For EcoCAR3, Michigan Tech proposes to develop a plug-in parallel hybrid vehicle (PPHEV) powered by a small Diesel engine operating on B20 Bio-Diesel fuel. This architecture was chosen over other options due to its compact design, lower cost, and its ability to provide performance levels and energy efficiency that meet or exceed the design targets. While this powertrain configuration requires a more complex control system and strategy than others, the student engineering team at Michigan Tech has significant recent experience with this architecture and has confidence that it will perform well in the events planned for the EcoCAR3 competition.

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Both TBL and PBL attempt to maximally engage the learner and both are designed to encourage interactive teaching / learning. PBL is student centered. TBL, in contrast, is typically instructor centered. The PBL Executive Committee of the UTHSC-Houston Medical School, in an attempt to capture the pedagogical advantages of PBL and of TBL, implemented a unique PBL experience into the ICE/PBL course during the final block of PBL instruction in year 2. PBL cases provided the content knowledge for focused learning. The subsequent, related TBL exercises fostered integration / critical thinking about each of these cases. [See PDF for complete abstract]

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Economic conditions which had favoured Russia’s development suddenly changed in mid-2008. The Russian economy was hit, on the one hand, by a drastic slump in oil prices (which fell from nearly US$150 to US$50 between July 2008 and January 2009), and on the other by the outflow of investors (a net of US$130 billion of capital left Russia in the fourth quarter of 2008). Within several months, the financial crisis became an economic crisis affecting the entire economy. The financial reserves accumulated in times of prosperity (more than US$162 billion in the stabilisation funds and nearly US$598 billion in the currency and gold reserve) alleviated the negative impact of the crisis, although this failed to prevent the deep declines in macroeconomic indicators. Russia is one of the states most severely affected by the crisis. In the first half of 2009, its GDP fell by 10.4% compared to the same period in the previous year, while industrial production dropped by nearly 15%, and a decrease in investments of over 18% was reported. The poor economic performance has strongly affected the Russian budget, which reported a deficit for the first time in ten years in 2009. During the first year of the crisis (August 2008 – September 2009), Russia’s financial reserves were seriously reduced as a result of the government’s anti-crisis policy and interventions from the central bank: the reserve fund decreased by nearly 45% to US$76 billion, and the central bank’s reserves shrunk by nearly US$200 billion to US$409 billion. Meanwhile, however, the money in the National Welfare Fund, which had been intended almost entirely to subsidise the Pensions Fund between 2010 and 2015, rose almost three-fold (to US$90 billion). According to government forecasts, the money from the reserve fund is also supposed to be spent fully in 2010. The financial crisis has triggered a dynamic outflow of capital from the Russian market. So-called speculative capital was the first to demonstrate the lack of confidence in the Russian market. In the first half of 2009, the growth rate of long-term investments also decreased noticeably, although no spectacular withdrawal of direct investments from Russia has been observed. The economic crisis has also halted the foreign expansion of Russian private capital, while state-owned capital strengthened its position as an investor. Russia’s raw materials companies continue to be the main category of foreign investors; however, new technologies are gaining prominence as the second main direction of Russian investments.

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Mode of access: Internet.

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Cover title.

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We hypothesized that chronic oral administration of the phosphodiesterase-5 inhibitor sildenafil could improve the exercise capacity and pulmonary hemodynamics in patients with pulmonary arterial hypertension (PAH) on the basis of previous short-term studies. We tested this hypothesis in 14 subjects with PAH, including seven patients with the idiopathic form and seven patients with atrial septal defects, but no other congenital heart abnormalities. Patients were subjected to a 6-min walk test and dyspnea was graded according to the Borg scale. Pulmonary flow and pressures were measured by Doppler echocardiography. Patients were given sildenafil, 75 mg orally three times a day, and followed up for 1 year. Sildenafil therapy resulted in the following changes: increase in the 6-min walk distance from a median value of 387 m (range 0 to 484 m) to 462 m (range 408 to 588 m; P < 0.01), improvement of the Borg dyspnea score from 4.0 (median value) to 3.0 (P < 0.01), and increased pulmonary flow (velocity-time integral) from a median value of 0.12 (range 0.08 to 0.25) to 0.23 (range 0.11 to 0.40; P < 0.01) with no changes in pulmonary pressures. In one patient with pulmonary veno-occlusive disease diagnosed by a lung biopsy, sildenafil had a better effect on the pulmonary wedge pressure than inhaled nitric oxide (15 and 29 mmHg, respectively, acute test). He walked 112 m at baseline and 408 m at one year. One patient died at 11 months of treatment. No other relevant events occurred. Thus, chronic administration of sildenafil improves the physical capacity of PAH patients and may be beneficial in selected cases of veno-occlusive disease.

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A comparison was made between two different summer grazing systems at the McNay Research Farm. One system was the summer component of a year-round grazing system, involving the rotational stocking of smooth bromegrass-orchardgrass-birdsfoot trefoil pastures and winter stockpile pastures with cow-calf pairs co-grazing with stocker yearlings at .75 animal units per acre. That system was compared with a minimal land system involving the rotational stocking of smooth bromegrass-orchardgrass-birdsfoot trefoil summer pastures with cow-calf pairs grazing at .64 animal units per acre and hay removal from 25% of the pasture. Stocker yearlings or hay removal were used as management tools to remove excess forage and optimize forage quality. Hay was removed once from three fourths of the winter stockpiled pastures in 1996 (Yr. 1) and all the pasture in 1997 (Yr. 2). One hay removal occurred on one fourth of the allocated summer pastures in Year 1 and one half of the pastures in Year 2. In Year one, cow-calf pairs grazing in the year-round system utilized one fourth of the winter stockpile pastures due to a lack of forage on the summer pastures, whereas in Year 2 cowcalf pairs grazed winter stockpile pastures to remove forage as a second cutting of hay. Cow-calf pairs grazing with hay removal were supplemented with harvested hay for two weeks during the summer of Year 1 due to lack of grazable forage; in Year 2, no supplementation was needed. Grazing system did not affect cow body weight, condition score, or daily calf gain in either year. Growing animal production per acre was affected by grazing system, with the minimal land system having a higher production level in Year 1 and Year 2. The year-round system also produced more net winter forage than did the minimal land system in Year 1. Differences in forage yield and quality were only observed between winter stockpile forages of tall fescue-red clover and smooth bromegrass-red clover and summer pastures during the months of June, July, and August.

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Universidade Estadual de Campinas . Faculdade de Educação Física