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The rising number of older people living with disabilities and chronic diseases has increased home care needs. Studies and reviews exploring preventive approaches have proliferated, creating a need for a synthesis of evidence. We conducted a systematic review of systematic reviews to evaluate the effectiveness of preventive home visiting approaches for older people. Of the 5,973 citations identified in over 30 scientific and grey literature databases, 10 papers met all inclusion criteria. Systematic reviews were considered if they included controlled trials comparing interventions with and without professional home care. We found that interventions often included comprehensive geriatric assessments and follow-up visits. Results indicate that multidimensional preventive home visiting programs might have the potential to reduce mortality, in particular for younger subjects, and show a potential to improve functional autonomy, but these findings should be interpreted with caution due to the diversity of the interventions analysed.
Predictions of marine ice-sheet behaviour require models able to simulate grounding-line migration. We present results of an intercomparison experiment for plan-view marine ice-sheet models. Verification is effected by comparison with approximate analytical solutions for flux across the grounding line using simplified geometrical configurations (no lateral variations, no buttressing effects from lateral drag). Perturbation experiments specifying spatial variation in basal sliding parameters permitted the evolution of curved grounding lines, generating buttressing effects. The experiments showed regions of compression and extensional flow across the grounding line, thereby invalidating the boundary layer theory. Steady-state grounding-line positions were found to be dependent on the level of physical model approximation. Resolving grounding lines requires inclusion of membrane stresses, a sufficiently small grid size (<500 m), or subgrid interpolation of the grounding line. The latter still requires nominal grid sizes of <5 km. For larger grid spacings, appropriate parameterizations for ice flux may be imposed at the grounding line, but the short-time transient behaviour is then incorrect and different from models that do not incorporate grounding-line parameterizations. The numerical error associated with predicting grounding-line motion can be reduced significantly below the errors associated with parameter ignorance and uncertainties in future scenarios.
Snow and weather conditions typical of exceptional cycles of fresh-snow avalanches in the northern Alps are investigated using the numerical avalanche-hazard forecasting procedure of Météo-France. Sensitivity tests are performed on the events of February 1999 in the Chamonix France region, and resulting snowpack instability modeled at the massif scale is compared using adapted new indices and maps. Our results complete conclusions of earlier observation-based studies by providing new insights into the snow and weather conditions of February 1999. The large avalanches mainly resulted from large and very unstable fresh-snow accumulations. Moreover, the snowpack instability was increased locally by wind transport of light and fresh snow in February. The mechanical weaknesses resulting from the weather conditions prior to February were a key factor in explaining the unusual volumes of these avalanches. This study suggests that the operational numerical SAFRAN/Crocus/ MÉPRA (SCM) chain provides reliable forecasts of extreme new-snow avalanche situations at the massif scale, but that local-scale simulations are still needed to improve the efficiency of risk mitigation and civil protection policies.
Up to now, no case of spontaneous sex reversal has been described in the urodele amphibian Pleurodeles waltl reared at ambient temperature. However in offspring reared under laboratory conditions, males, females but also intersex individuals were obtained. The males, some females and the intersexes had the ZZ male genotype identified through a test performed with a sex-linked enzyme. The other females had the ZW female genotype. Using the animals of this particular strain, an offspring analysis was made on crosses between, respectively, ZZ males and ZW females, ZZ males and ZZ females, and ZZ intersexes and ZZ males or females. All these crosses gave ZZ males, ZZ females and ZZ intersexes. The spontaneous complete or partial sex reversal is inheritable, but the genetic mechanism of this inheritance has not yet been elucidated.
In the field of visual double stars, a long term follow-up is required, since their orbital periods may reach several centuries. Created in 1981 within the Société Astronomique de France (SAF) with the support of the late Paul Muller (1910-2000), the Commission des Etoiles Doubles provides the framework for the necessary collaboration between professional and amateur astronomers, through generations. The late Dr. Paul Baize (1901-1995) was a model for its members. Several professional astronomers became scientific advisors of the Commission and have guided many works made by amateurs.
The Working Group FITS (WG-FITS) is the international control authority for the Flexible Image Transport System (FITS) data format. The WG-FITS was formed in 1988 by a formal resolution of the IAU XX General Assembly in Baltimore (MD, USA), 1988, to maintain the existing FITS standards and to approve future extensions to FITS.
The business meeting began with a brief review of the current rules and procedures of the WG, which are documented on the WG web page. Four regional FITS committees have been established by the WG, covering North American, Europe, Japan, and Australian/New Zealand, to provide advice to the WG on pending proposals. While it is recognized that this committee structure might need to be revised to provide representation to other regions, the current system is working well, and there were no motions to make any changes at this time.
The carbon contents in carburized steels were investigated by electron
probe microanalysis (EPMA) for a range of carbon levels in the solid
solution less than 1 wt%. This article describes the difficulties
encountered with the classic analytical procedure using the k
ratio of X-ray intensities and the φ(ρz) model. Here, a
suitable calibration curve method is presented with emphasis on the
metallographic study of standard specimens and on the carbon
decontamination of samples.
To document the costs and the benefits (both in terms of costs averted and of injuries averted) of education sessions and replacement of phlebotomy devices to ensure that needle recapping did not take place.
The percentage of recapped needles and the rate of needlestick injuries were evaluated in 1990 and 1997, from a survey of transparent rigid containers in the wards and at the bedside and from a prospective register of all injuries in the workplace. Costs were computed from the viewpoint of the hospital. Positive costs were those of education and purchase of safer phlebotomy devices; negative costs were the prophylactic treatments and follow-up averted by the reduction in injuries.
A 1,050-bed tertiary-care university hospital in the Paris region.
Between the two periods, the proportion of needles seen in the containers that had been recapped was reduced from 10% to 2%. In 1990, 127 needlestick (12.7/100,000 needles) and 52 recapping injuries were reported versus 62 (6.4/100,000 needles) and 22 in 1996 and 1997. When the rates were related to the actual number of patients, the reduction was 76 injuries per year. The total cost of information and preventive measures was $325,927 per year. The cost-effectiveness was $4,000 per injury prevented.
Although preventive measures taken to ensure reduction of needlestick injuries appear to have been effective (75% reduction in recapping and 50% reduction in injuries), the cost of the safety program was high.
This economic assessment of the implementation of magnetic resonance imaging (MRI) in a French hospital examines data on the diagnostic resources used in neurology and neurosurgery before and after MRI was available. Given a similar patient population and case mix, there was no change in the resources used other than the addition of MRI. So far, MRI appears to be a complement to, and not a substitute for, other imaging techniques used in neuroradiology. The focus of this work is purely economic; its conclusions do not challenge the major scientific contributions of MRI.
Star forming regions are one of the active components of the interstellar medium and as such play an important role in the galactic “ecosystem”. When massive young stars are borned they have a strong impact on their environment through their radiation flux and stellar wind. We are then facing complicated interplays between gas in different states (ionized, atomic and molecular), dust particles and the young stars. The understanding of these interplays can only be done using multifrequency observations. Such an endaveour is already in progress (see Joncas et al. 1988 and Kömpe et al. 1989). We will describe here the young star forming region S187 (Sharpless 1959). This gas complex is nearby (≈1 kpc) thus permitting high spatial resolution with medium size instruments. It contains a faint optically visible HII region ionized by an unidentified BO or BO.5 star. The associated molecular cloud, discovered by Blair et al. (1975), contains a molecular outflow (Bally and Lada 1983) to which an H2O maser is associated (Henkel et al. 1986).
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