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Journal articles on the topic "Care cascade"
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Kedziora, David J., Romesh Abeysuriya, Cliff C. Kerr, George L. Chadderdon, Vlad-Ștefan Harbuz, Sarah Metzger, David P. Wilson, and Robyn M. Stuart. "The Cascade Analysis Tool: software to analyze and optimize care cascades." Gates Open Research 3 (June 7, 2019): 1488. http://dx.doi.org/10.12688/gatesopenres.13031.1.
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Introduction: Cascades, which track the progressive stages of engagement on the path towards a successful outcome, are increasingly being employed to quantitatively assess progress towards targets associated with health and development responses. Maximizing the proportion of people with successful outcomes within a budget-constrained context requires identifying and implementing interventions that are not only effective, but also cost-effective. Methods: We developed a software application called the Cascade Analysis Tool that implements advanced analysis and optimization methods for understanding cascades, combined with the flexibility to enable application across a wide range of areas in health and development. The tool allows users to design the cascade, collate and enter data, and then use the built-in analysis methods in order to answer key policy questions, such as: understanding where the biggest drop-offs along the cascade are; visualizing how the cascade varies by population; investigating the impact of introducing a new intervention or scaling up/down existing interventions; and estimating how available funding should be optimally allocated among available interventions in order to achieve a variety of different objectives selectable by the user (such as optimizing cascade outcomes in target years). The Cascade Analysis Tool is available via a user-friendly web-based application, and comes with a user guide, a library of pre-made examples, and training materials. Discussion: Whilst the Cascade Analysis Tool is still in the early stages of existence, it has already shown promise in preliminary applications, and we believe there is potential for it to help make sense of the increasing quantities of data on cascades.
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Kedziora, David J., Romesh Abeysuriya, Cliff C. Kerr, George L. Chadderdon, Vlad-Ștefan Harbuz, Sarah Metzger, David P. Wilson, and Robyn M. Stuart. "The Cascade Analysis Tool: software to analyze and optimize care cascades." Gates Open Research 3 (December 24, 2019): 1488. http://dx.doi.org/10.12688/gatesopenres.13031.2.
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Introduction: Cascades, which track the progressive stages of engagement on the path towards a successful outcome, are increasingly being employed to quantitatively assess progress towards targets associated with health and development responses. Maximizing the proportion of people with successful outcomes within a budget-constrained context requires identifying and implementing interventions that are not only effective, but also cost-effective. Methods: We developed a software application called the Cascade Analysis Tool that implements advanced analysis and optimization methods for understanding cascades, combined with the flexibility to enable application across a wide range of areas in health and development. The tool allows users to design the cascade, collate and enter data, and then use the built-in analysis methods in order to answer key policy questions, such as: understanding where the biggest drop-offs along the cascade are; visualizing how the cascade varies by population; investigating the impact of introducing a new intervention or scaling up/down existing interventions; and estimating how available funding should be optimally allocated among available interventions in order to achieve a variety of different objectives selectable by the user (such as optimizing cascade outcomes in target years). The Cascade Analysis Tool is available via a user-friendly web-based application, and comes with a user guide, a library of pre-made examples, and training materials. Discussion: Whilst the Cascade Analysis Tool is still in the early stages of existence, it has already shown promise in preliminary applications, and we believe there is potential for it to help make sense of the increasing quantities of data on cascades.
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Miller, William C., Catherine R. Lesko, and Kimberly A. Powers. "The HIV Care Cascade." Sexually Transmitted Diseases 41, no. 1 (January 2014): 41–42. http://dx.doi.org/10.1097/olq.0000000000000081.
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Sakhri, Noureddine. "Cascade of HIV Prevention, Care, and Treatment Services in Morocco in 2019." Iproceedings 8, no. 1 (February 2, 2022): e36373. http://dx.doi.org/10.2196/36373.
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Background The HIV care cascade is a way to show the proportion of people living with HIV (PLHIV) engaged at each stage of HIV care. Analyzing an HIV testing, care, and treatment cascade provides a framework for evaluating and improving service delivery. Objective The objective of this study is to analyze the continuums of HIV prevention, care, and treatment services at the national level in Morocco for the period 2015-2019. Methods This is a retrospective study concerning the reference centers for HIV care in Morocco carried out in 2019. Three types of cascades of HIV prevention and care were studied: a transversal cascade at the national level (2019), a longitudinal cascade for newly diagnosed PLHIV (between 2015 and 2017), and a cascade of prevention of mother-to-child transmission of HIV (PMTCT) among pregnant women (2016-2017). Results For the transversal cascade of the year 2019, the objectives of the three 90s were achieved except for the 1st 90 with a difference of 12%. For the longitudinal cascade after the start of treatment between 2015-2017, retention under treatment at 48 months was 83.3%, at 36 months was 83.8%, and at 24 months 91.0%. The 48-month loss to follow-up rate was 12.5%; 7.0% at 36 months; and 4.0% at 24 months. More than 90% of PLHIV started antiretrovirals within 3 months of diagnosis. The 2016-2017 PMTCT cascade conducted on 13 pregnant women according to available data indicated the absence of transmission of HIV from mothers to their children. Conclusions Our 2019 HIV cascade study demonstrated several successes. The achievement of the three 90s except for the first objective (of people who know their status), good retention of PLHIV in long-term treatment, and the success of PMTCT especially since Morocco aims to validate the elimination of mother-to-child transmission.
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Campbell, Jeffrey, Thomas Sandora, and Jessica Haberer. "1643. A scoping review of pediatric latent tuberculosis care cascades: Initial steps are lacking." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S811. http://dx.doi.org/10.1093/ofid/ofaa439.1823.
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Abstract Background Each year an estimated 1 million children develop and ~200,000 die from tuberculosis (TB). The WHO has named identification and treatment of latent tuberculosis infection (LTBI) one of the cornerstones of efforts to eliminate TB by 2030. Identification and treatment of pediatric LTBI requires completion of a complex care cascade. While attention has been given to LTBI care cascades in adults, to date there has been no attempt to map literature on the pediatric LTBI care cascade. Facilitators and barriers to retention in steps of the pediatric LTBI care cascade Methods We systematically searched PubMed, CINAHL, Cochrane and Embase databases for papers and abstracts describing screening, diagnosis, and treatment of pediatric LTBI. We categorized literature using seven step-offs in the pediatric LTBI care cascade, extrapolated from prior studies focused on adults: 1) intention to screen to initial test, 2) initial test to receipt of results, 3) receipt to referral for evaluation, 4) referral to completion of evaluation, 5) completion to treatment recommendation, 6) recommendation to treatment acceptance/initiation, and 7) initiation to treatment completion. Our aim was to assess factors that facilitated and inhibited completion of each cascade step, and to identify knowledge gaps in this literature. Results We identified 137 studies that met inclusion criteria. Most studies described multiple step-offs in the care cascade, although the focus of most (120/137 studies) was on initiation and completion of LTBI therapy (the final step in the care cascade). Several effective strategies to improve medication adherence were described, including selective use of nursing visits, directly observed therapy, shorter treatment regimens, and peer counseling. Reports of facilitators and barriers for retention in upstream step-offs in the cascade were scarce, revealing a lack of published evidence for how to retain children from pre-screening to treatment initiation (Table). Conclusion While existing literature describes LTBI treatment initiation and completion in children, our analysis reveals a lack of data guiding retention of children from LTBI screening through treatment initiation. This review highlights the need to further understand early steps of the care cascade, in order to help alleviate the burden of TB in children. Disclosures Jessica Haberer, MD, MS, Merck (Consultant)
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King, Shannon, Rebecca Heidkamp, Ashley Sheffel, Yvonne Yiru Xu, and Melinda Munos. "Effective Coverage for Nutrition: Operationalizing Effective Coverage Cascades for Nutrition Interventions Delivered to Pregnant Women and Children." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 853. http://dx.doi.org/10.1093/cdn/nzaa053_058.
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Abstract Objectives Many low and middle income country (LMIC) decision makers rely on data from multi-topic household surveys to identify the proportion of the population that has been reached with nutrition services, but these surveys do not always account for the quality of the services. Effective coverage cascades, commonly used in health systems research, capture measures of both coverage and quality to generate actionable information to improve nutrition programs, interventions, and policies. This study aims to describe the operationalization of effective coverage cascades for maternal and child nutrition interventions delivered through the health system using extant data in LMICs. Methods By linking household survey and health facility assessment data from seven LMICs, effective coverage cascades were developed for nutrition interventions delivered through antenatal care visits and sick-child visits. Facility readiness and provision of care index scores were defined for each intervention from clinical guidelines and an expert survey, then refined based on data availability. The facility readiness and provision of care scores were linked to individual care-seeking episodes from household survey data based on geographic domain and facility type. Finally, steps of the coverage cascade for each service in each country were estimated. Results National estimates of the effective coverage cascade for each set of nutrition interventions will be presented. Analysis is ongoing, however preliminary findings show gaps in service readiness such as lack of provider training and gaps in provision of care such as limited nutrition counseling. A substantial drop is seen from service contact to input-adjusted coverage to quality-adjusted coverage for both antenatal care and sick child care. Conclusions The cascade approach yielded summary measures that were useful for identifying high-level barriers to effective coverage; however, detailed measures within the cascade may be more useful for evidence-based decision making. Data availability on quality of care for nutrition interventions is scant, highlighting an opportunity to expand facility-based surveys to include nutrition interventions delivered through the health system. Funding Sources Bill & Melinda Gates Foundation through the DataDENT initiative and the Improving Measurement and Program Design grant.
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Yang, Zhangsheng, Milomir O. Simovic, Bin Liu, Matthew B. Burgess, Andrew P. Cap, Jurandir J. DalleLucca, and Yansong Li. "Indices of complement activation and coagulation changes in trauma patients." Trauma Surgery & Acute Care Open 7, no. 1 (September 2022): e000927. http://dx.doi.org/10.1136/tsaco-2022-000927.
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ObjectivesEarly complementopathy and coagulopathy are shown often after trauma. However, the prevalence of any interplay between complement cascade (ComC) and coagulation cascade (CoaC) after trauma remains unclear. This study intended to explore whether complement-coagulation crosstalk exists, which may provide a reliable guide to clinical implications in trauma patients.MethodsThis single-center cohort study of trauma patients enrolled 100 patients along with 20 healthy volunteers. Blood samples from patients were collected at admission, 45, 90, 135 minutes, and 18 hours after admission. Demographic characteristics were recorded, blood levels of ComC and CoaC factors, and inflammatory cytokines were measured by ELISA, clot-based assays, or luminex multiplex assay, and partial thromboplastin (PT) and partial thromboplastin time (PTT) were assessed using a Behring blood coagulation system.ResultsCompared with the healthy controls, plasma levels of complement factors (C5b-9 and Bb) and 11 tested inflammatory cytokines increased in moderately and severely injured patients as early as 45 minutes after admission and sustained higher levels up to 18 hours after admission. C5b-9 correlated positively to patients’ hospital stay. In parallel, the consumption of coagulation factors I, II, X, and XIII was shown throughout the first 18 hours after admission in moderately and severely injured patients, whereas PT, PTT, D-dimer, factor VII, and factor VIII values significantly increased from the admission to 135 minutes in moderately and severely injured patients. Along with an inverse correlation between plasma Bb, factors I and II, a positive correlation between C5b-9, Bb, D-dimer, PT, and PTT was evident.ConclusionsThis study demonstrates trauma-induced early activation of plasma cascades including ComC, CoaC, and fibrinolytic cascade, and their correlation between plasma cascades in severe trauma patients. Our study suggests that the simultaneous modulation of plasma cascades might benefit clinical outcomes for trauma patients.Level of evidenceProspective study, level III.
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Kohler, Philipp, Axel J. Schmidt, Matthias Cavassini, Hansjakob Furrer, Alexandra Calmy, Manuel Battegay, Enos Bernasconi, Bruno Ledergerber, and Pietro Vernazza. "The HIV care cascade in Switzerland." AIDS 29, no. 18 (November 2015): 2509–15. http://dx.doi.org/10.1097/qad.0000000000000878.
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Haber, Noah, Deenan Pillay, Kholoud Porter, and Till Bärnighausen. "Constructing the cascade of HIV care." Current Opinion in HIV and AIDS 11, no. 1 (January 2016): 102–8. http://dx.doi.org/10.1097/coh.0000000000000212.
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Hull, Mark W., Zunyou Wu, and Julio S. G. Montaner. "Optimizing the engagement of care cascade." Current Opinion in HIV and AIDS 7, no. 6 (November 2012): 579–86. http://dx.doi.org/10.1097/coh.0b013e3283590617.
Full textDissertations / Theses on the topic "Care cascade"
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Madzima, Rutendo. "Factors affecting men's movement through the HIV cascade in the public health services in Cape Town: Perspectives and experiences of health care providers." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/25353.
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The Human Immunodeficiency (HIV) epidemic in South Africa is disproportionately distributed by gender. Although women lead in the number of infections they are at an advantage when it comes to seeking and receiving care. Men's poor health seeking behaviour finds them seeking care late, testing at lower rates, defaulting from treatment and eventually having worse health outcomes. More men than women fail to enter and stay in the HIV cascade of care. The HIV cascade is a metaphor used to describe the steps that include HIV testing, initiation of antiretroviral therapy (ART), adherence, viral suppression and good health outcomes. As health care providers (HCPs) are the ones who interact directly with men in the health system their view of the factors that hinder men's movement through the HIV cascade are valuable to better understanding how men interact with the care system. In this research semi-structured interviews were held with eleven HCPs working with HIV positive patients (6 women, 5 men) across 2 health facilities and 1 non-governmental organisation (NGO) within the Klipfontein sub-district. Health care workers were found to share some of the more commonly held notions regarding the barriers men face in HIV care. However, their experiences offer some challenging ideas and the health systems appears to be realising the need to tailor HIV services to the needs of men. The experiences and perspectives of HCPs should be further explored and the findings used to influence health policies and clinical practice.
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Brouard, Cécile. "Cascade de prise en charge de l’hépatite C chronique en France métropolitaine." Thesis, Université Paris-Saclay (ComUE), 2019. http://www.theses.fr/2019SACLS473/document.
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Introduction : L’Organisation mondiale de la Santé a fixé un objectif d’élimination des hépatites C et B à l’horizon 2030, visant à ce que 90% des personnes ayant une infection chronique soient diagnostiquées et 80% soient traitées. La France s’est engagée à atteindre cet objectif pour l’hépatite C d’ici 2025. Ce travail a pour but d’estimer la cascade de prise en charge de l’hépatite C chronique en France métropolitaine : 1) en 2016, afin de disposer d’un premier point pour le suivi de l’élimination ; 2) en 2011, afin d’évaluer l’impact des antiviraux à action directe (AAD) sur la cascade.Méthodes : Les effectifs des populations suivantes ont été estimés pour 2016 (18-75 ans) et 2011 (18-80 ans) : 1) ayant une hépatite C chronique ; 2) ayant connaissance de leur infection ; 3) prises en charge pour leur infection au cours de l’année ; 4) en cours de traitement antiviral au cours de l’année. Les estimations 1) et 2) reposent : pour 2016, sur une enquête transversale, avec un volet biologique, réalisée auprès d’un échantillon aléatoire de la population générale métropolitaine ; pour 2011, sur des modélisations. Les estimations 3) et 4) ont été réalisées à partir du Système national des données de santé (SNDS), en : i) construisant, pour 3), un algorithme d’identification des personnes avec au moins un recours aux soins pour une hépatite C chronique dans l’année ; ii) prenant en compte l’ensemble des traitements antiviraux contre l’hépatite C pour 4).Résultats : Entre 2011 et 2016, le nombre de personnes ayant une hépatite C chronique a diminué de 31%, passant de 192 700 à 133 500. Le nombre de personnes ayant connaissance de leur infection est resté stable : 111 300 en 2011 et 107 600 en 2016. La proportion de personnes infectées ayant connaissance de leur infection est donc passée de 58% à 81%. Entre 2011 et 2016, le nombre de personnes identifiées comme prises en charge pour leur hépatite dans l’année est passé de 28 000 (15% des personnes infectées) à 34 300 (26% des personnes infectées). Parallèlement, le nombre de personnes en cours de traitement est passé de 12 900 (7% des personnes infectées) en 2011 à 16 100 en 2016 (12% des personnes infectées.Conclusion : Ce travail a permis, pour la première fois, d’estimer la cascade de prise en charge de l’hépatite C chronique en France métropolitaine, avant et après l’introduction des AAD. Il suggère un impact important de ceux-ci sur la cascade de soins. Pour autant, l’accès aux soins et au traitement des personnes infectées restait insuffisant en 2016, notamment au regard des objectifs d’éliminationIntroduction: The World Health Organization has targeted the elimination of hepatitis C and B by 2030, to ensure that 90% of people with chronic infection are diagnosed and 80% are treated. France has planned to achieve this goal for hepatitis C by 2025. This work aims to estimate the cascade of care for chronic hepatitis C in mainland France: 1) in 2016, in order to have a first point for monitoring the elimination; 2) in 2011 to assess the impact of direct-acting antivirals (DAAs) on HCV cascade of care.Methods: The numbers of the following populations were estimated for 2016 (18-75 years) and 2011 (18-80 years): 1) with chronic hepatitis C; 2) aware of their infection; 3) in care for chronic hepatitis C during the year; 4) undergoing antiviral treatment during the year. Estimates 1) and 2) were based on: for 2016, a cross-sectional survey, with a biological component, carried out on a random sample of the general metropolitan population; for 2011, on models. Estimates 3) and 4) were made from the National Health Insurance Information System (SNDS), by: i) constructing, for 3), an algorithm for identifying people in care for chronic hepatitis C in the year; ii) taking into account all antiviral treatments for 4).Results: Between 2011 and 2016, the number of people with chronic hepatitis C decreased by 31%, from 192,700 to 133,500. The number of people aware of their infection remained stable: 111,300 in 2011 and 107,600 in 2016. The proportion of chronically infected persons with knowledge of their infection has thus increased from 58% to 81%. Between 2011 and 2016, the number of people identified as being in care for their hepatitis in the year increased from 28,000 (15% of those infected) to 34,300 (26% of those infected). At the same time, the number of people being treated increased from 12,900 (7% of those infected) in 2011 to 16,100 in 2016 (12% of those infected).Conclusion: This work provides, for the first time, estimates of the cascade of care for chronic hepatitis C in mainland France, before and after the introduction of DAAs. It suggests a significant impact of DAAs on the cascade of care. However, access to care and treatment for infected people remained insufficient in 2016, especially with regard to elimination targets
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Pease, Christopher. "Latent Tuberculosis Infection in Iqaluit, Nunavut: An Analysis of the Cascade of Care and Cost-Effectiveness of a Novel Treatment Regimen." Thesis, Université d'Ottawa / University of Ottawa, 2020. http://hdl.handle.net/10393/40652.
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Background: The incidence of tuberculosis (TB) among Inuit is over 400 times that of Canadian-born non-indigenous people. To address this, more patients will need to complete preventative treatment. Methods: First, data were extracted retrospectively for all patients with a tuberculin skin test (TST) implanted in Iqaluit, Nunavut between January 2012 and March 2016 and used to identify sources of loss from the latent TB infection (LTBI) cascade of care. Associations between demographic and clinical factors and treatment non-initiation and treatment non-completion were identified using regression models. Second, using a slightly expanded version of the retrospective dataset plus other sources, a Markov model was utilized to assess the cost-effectiveness of a novel shortened regimen for LTBI (12 weeks of once weekly isoniazid and rifapentine (3HP)) compared to the current standard of care (9 months of isoniazid monotherapy (9H)). Results: Treatment non-initiation and non-completion were the largest sources of loss of TST positive patients from the cascade of care. LTBI testing via employment screening was associated with treatment non-initiation while older age was associated with both treatment noninitiation and non-completion. In cost-effectiveness analysis, 3HP was dominant over 9H: costs were lower ($835 vs $1229 per person) and health outcomes slightly improved (20.14 vs 20.13 QALYs gained per person treated), largely due to an improved treatment completion with 3HP. Conclusions: Interventions to increase LTBI treatment initiation and completion in Iqaluit are needed. This could include the use of 3HP instead of 9H for LTBI treatment which may improve treatment completion and result in cost savings and slightly improved health outcomes.
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Lehnus, Massimiliano. "Bio-BCA (Bio-Barcode Cascade Amplification) : development of a photosensitive, DNA-based exponential amplification platform technology for the detection of nucleic acid biomarkers." Thesis, University of Cambridge, 2018. https://www.repository.cam.ac.uk/handle/1810/277915.
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Wagner, Ryan G. "The Burden of Epilepsy : using population-based data to define the burden and model a cost-effective intervention for the treatment of epilepsy in rural South Africa." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-120163.
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Rationale Epilepsy is a common, chronic, neurological condition that disproportionately affects individuals living in low- and middle- income countries, including much of sub-Saharan Africa. Epilepsy is treatable, with the majority of individuals who take anti-epileptic drugs experiencing a reduction, or elimination, of seizures. Yet the number of individuals taking and adhering to medication in Africa is low and interventions aimed at improving treatment are lacking. Aims To define the epidemiology of convulsive epilepsy in rural South Africa in terms of incidence, mortality and disability-adjusted life years; to determine outpatient, out-of-pocket costs resulting from epilepsy treatment; to establish the level of adherence to anti-epileptic drugs amongst people with epilepsy; and, to determine whether the introduction of routine visits to people with epilepsy by community health workers is a cost-effective intervention for improving adherence to anti-epileptic drugs. Methods Nested within the Agincourt Health and Demographic Surveillance System, this work utilized a cohort of individuals diagnosed with convulsive epilepsy in 2008 to determine health care utilization and out-of-pocket costs due to care sought for epilepsy. Additionally, using blood samples from the cohort, anti-epileptic drug adherence was measured and, following the cohort, mortality rates were determined. Using these collected epidemiological parameters, disability-adjusted life years due to convulsive epilepsy were determined. Finally, combining the epidemiological and cost parameters, a community health worker intervention was modeled to determine its incremental cost-effectiveness ratio. Key Findings The burden of convulsive epilepsy is lower in rural South Africa than other parts of Africa, likely due to lower levels of known risk factors. Yet the burden, especially in terms of mortality, remains high, as does the treatment gap and health care utilization. Findings from the economic evaluation found the introduction of a community health worker to be highly cost-effective and would likely lower the burden of epilepsy in rural South Africa. Implications Epilepsy contributes to the burden of disease in rural South Africa, with high levels of mortality and a substantial treatment gap. The introduction of a community-health worker is likely to be one cost-effective, community based intervention that would lower the burden of epilepsy by improving adherence to anti-epileptic drugs. Implementing this intervention, based on these findings, is a justified and important next step.
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Baker, Nathaniel T. "Dynamique de la turbulence partiellement 2D / partiellement 3D : une étude expérimentale et théorique dans le cadre MHD à bas-Rm." Thesis, Université Grenoble Alpes (ComUE), 2017. http://www.theses.fr/2017GREAI005.
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L'objectif de cette thèse est de clarifier le rôle de la composante rotationnelle de la force de Lorentz dans sa capacité à imposer la topologie, et la dynamique des écoulements turbulents MHD à bas Rm, confinés par des parois rigides et électriquement isolantes. Le travail présenté ici se scinde en deux parties : D'une part une étude théorique effectuée dans un cadre faiblement inertiel, d'autre part une étude expérimentale d’écoulements turbulents pleinement développés. L’étude théorique porte sur un vortex isolé, stationnaire et axisymétrique, confiné entre deux parois rigides et électriquement isolantes, perpendiculaires à un champ magnétique uniforme. Grâce à un développement asymptotique des équations de Navier-Stokes, valable quel que soit le nombre de Hartmann, nous montrons que la dimensionnalité topologique de l’écoulement de base ne dépend que d'un seul paramètre. Ce paramètre en question compare en fait la distance sur laquelle la partie rotationnelle de la force de Lorentz est capable d'agir dans la direction du champ magnétique, avant d’être contrée par les effets visqueux. Cette étude met en lumière deux mécanismes inertiels capables d'engendrer une composante de la vitesse dans la direction du champ magnétique au premier ordre, en introduisant des recirculations dans le plan méridional : du pompage d'Ekman direct ou inverse. Un dispositif expérimental à également été construit durant ce projet, afin d’étudier la dynamique d’écoulements turbulents de métaux liquides soumis à des champs magnétiques intenses. La turbulence stationnaire engendrée par ce dispositif était forcée électriquement en imposant un courant continu à travers une matrice carrée et periodique d’électrodes d'injection. Grâce à ce dispositif, nous avons montré que les statistiques des fluctuations turbulentes étaient raisonnablement homogènes et axisymétriques, malgré un forçage inhomogène et anisotrope. Nous confirmons également, en comparant les densités d’énergie cinétique turbulentes mesurées le long des parois perpendiculaires au champ magnétique, que les processus physiques en jeu dans le domaine inertiel 3D de la turbulence MHD confinée à bas Rm sont bien la composante rotationnelle de la force de Lorentz d'une part, et les transferts inertiels d'autre part. Grâce à une étude statistique dans l'espace des échelles, nous montrons que la cinématique de la turbulence forcée dans notre expérience suit en fait une loi universelle qui ne dépend que de deux longueurs caractéristiques. Premièrement, l’échelle d'injection, dans la direction perpendiculaire au champ magnétique. Deuxièmement, le rayon d'action de la force de Lorentz avant d’être contrée par les effets inertiels, dans la direction parallèle au champ. Nous prouvons que le rapport entre cette dernière longueur caractéristique et la hauteur de l'enceinte expérimentale permet de différencier les structures turbulentes cinématiquement quasi-2D de celles qui sont cinématiquement 3D. En calculant directement le flux d’énergie cinétique turbulente perpendiculaire à travers les échelles horizontales, nous montrons que ce dernier est toujours dirigé vers les grandes échelles. Ce quel que soit la dimensionnalité des échelles en question. Autrement dit, une cascade inverse d’énergie perpendiculaire peut exister sans pour autant que les structures turbulentes associées soient quasi-2DThis thesis aims at clarifying the role of the solenoidal component of the Lorentz force in fixing the topological dimensionality, and the ensuing dynamics of low-Rm MHD turbulent flows confined between electrically insulating and no-slip Hartmann walls. The work presented here breaks down into two main parts: An analytical investigation carried out in the weakly inertial limit on the one hand, and an experimental study of fully developed turbulence on the other hand. The analytical investigation was performed on a single steady and axisymmetric electrically driven vortex confined between no-slip and electrically insulating walls perpendicular to a uniform magnetic field. Thanks to an asymptotic expansion valid for any Hartmann number, we showed that the topological dimensionality of the leading order is fully imposed by a single parameter, which compares the distance over which the Lorentz force is able to act in the direction of the magnetic field, before it is balanced out by viscous friction. This study highlights two inertial mechanisms capable of introducing a third velocity component in the direction of the field, by means of recirculations in the meridional plane: direct and/or inverse Ekman pumping. An experimental platform was designed and built from the ground up during this project, to investigate the dynamics of liquid metal turbulence subject to extreme magnetic fields. The turbulence sustained in our experiment was forced electrically by imposing a DC current through a square periodic array of electrodes. Thanks to this setup, we showed that the statistics of the turbulent fluctuations were homogeneous and axisymmetric to a satisfactory level, despite the forcing mechanism being inhomogeneous and anisotropic. By comparing the energy densities measured along the walls perpendicular to the magnetic field, we confirm that the physical processes at stake in the 3D inertial range of wall-bounded MHD turbulence at low-Rm are the solenoidal component of the Lorentz force on the one hand, and inertia on the other hand. Thanks to a statistical analysis in scale space, we show that their exists a universal law imposing the kinematics of turbulent structures in our experiment, which turns out to be fully described by only two lenghtscales. First, the forcing scale in the direction perpendicular to the magnetic field. Second, the range of action of the Lorentz force before it is balanced out by inertial transfers, in the direction parallel to the field. We prove that the ratio of this latter scale over the height of the channel in fact segregates kinematically quasi-2D from kinematically 3D turbulent structures. By computing the actual flux of perpendicular turbulent kinetic energy along perpendicular scales, we show that it always flows towards larger turbulent scales regardless of their topology. In other words, we show that the existence of an inverse cascade of perpendicular kinetic energy does not necessarily require perpendicular turbulent scales to be topologically quasi-2D in the inertial range
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Tristano, Elizabeth. "EFFECTS OF INVASIVE SPECIES INTRODUCTIONS ON NUTRIENT PATHWAYS IN AQUATIC FOOD WEBS." OpenSIUC, 2018. https://opensiuc.lib.siu.edu/dissertations/1566.
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Trophic interactions within aquatic ecosystems are complex, with many different pathways facilitating transfer of energy and nutrients among trophic levels and many different mechanisms that influence energy and nutrient transfer. This is illustrated in the “top down” and “bottom up” regulatory effects on aquatic food webs, through which primary producer biomass and, therefore, herbivore and carnivore densities, are influenced by both nutrient availability (bottom up) and densities of consumers at higher trophic levels (top down). In an aquatic food web, planktivore presence can directly alter zooplankton density via consumption, while indirectly shaping phytoplankton biomass via reduced herbivore abundance and the release of nutrients due to excretion, egestion, and decomposition. Novel species introduced into an established food web may have important consequences. An invasive species may impact an invaded food web through competition, predation, alteration of nutrient cycling, or, potentially, through facilitation of native species or other invasives. For example, an invasive planktivore may shift zooplankton density or community composition, thereby facilitating phytoplankton blooms. Such a planktivore may also compete with and, potentially, replace native species. Moreover, an invasive species that reaches high densities within its invaded range may serve as an important nutrient sink as it consumes a high biomass of native species or a nutrient source via excretion or decomposition. Two such invasive species with the capacity to dramatically alter native food web dynamics are bighead (Hypophthalmichthys nobilis) and silver carp (H. molitrix; collectively, bigheaded carp). Bigheaded carp are large-bodied, planktivorous fishes that were introduced into the United States in the 1970s and have since spread throughout much of the Mississippi River and its tributaries. These species currently threaten the Great Lakes, where they may constitute a threat to native planktivores such as gizzard shad (Dorosoma cepedianum) and commercially important species such as walleye (Sander vitreus), although there remains a great deal of uncertainty surrounding their potential ecosystem impacts. Consumption of both zooplankton and phytoplankton has been observed in bigheaded carp, although their impact on primary producer biomass is not well understood. Although field observations suggest that condition and abundance of native planktivores, including gizzard shad and bigmouth buffalo (Ictiobus cyprinellus), as well as zooplankton density, have declined following the bigheaded carp invasion, there is little direct, experimental evidence of bigheaded carp food web impacts. Therefore, I sought to examine the effects of bigheaded carp on native ecosystems through a series of mesocosm experiments at the Southern Illinois University pond facility. My primary objectives were to 1) observe potential competition between bigheaded carp and the native gizzard shad, 2) evaluate effects of bigheaded carp predation on zooplankton and phytoplankton communities, 3) assess impacts of bigheaded carp decomposition on nitrogen and phosphorus availability, and 4) measure the rate at which bigheaded carp excrete nitrogen and phosphorus. In order to elucidate the impacts of bigheaded carp on gizzard shad growth and survival, zooplankton and phytoplankton densities, and nitrogen and phosphorus availability in the pelagic and benthic pools and to determine whether gizzard shad experience a diet shift in response to bigheaded carp presence, I performed two mesocosm experiments with three treatments: gizzard shad only, gizzard shad, bigheaded carp, and fishless control (Chapter 1). I predicted that bigheaded carp would reduce zooplankton densities but that gizzard shad, which are both detritivorous and planktivorous, would be unaffected due to their ability to use detritus as an alternative food source. Additionally, both predator release via zooplankton consumption and increased nutrient availability from bigheaded carp excretion would stimulate phytoplankton. I found that gizzard shad survival was reduced by bigheaded carp presence but that surviving gizzard shad did not experience a decline in growth in the bigheaded carp plus gizzard shad treatments. This may have been due to the ability of gizzard shad to consume detritus, as foreguts of sampled gizzard shad in Experiment 2 contained mostly detritus. Moreover, phytoplankton density declined in the presence of silver carp in Experiment 2, suggesting silver carp herbivory. In addition, nitrogen and phosphorus availability in either the pelagic or benthic pools did not appear to be impacted by bigheaded carp presence. After demonstrating experimentally the overall negative impact of bigheaded planktivory on native food webs, I focused my remaining two chapters on the effects of silver carp on nutrient availability. In Chapter 2, I outline a decomposition experiment testing for potential changes in pelagic and benthic nitrogen and phosphorus availability and, in turn, phytoplankton, zooplankton, and macroinvertebrate densities in response to silver carp decomposition. Although silver carp die offs have been reported throughout the Midwest, little is known about the magnitude of those die offs and their consequences for the ecosystem. In this study, silver carp decomposition did not appear to alter nutrient availability or densities of phytoplankton or invertebrates. However, in comparison to northern streams in which salmon spawning and decomposition provide an important nutrient subsidy, the mesocosms used in this study have relatively higher background nutrient concentrations. Thus, silver carp decomposition, at least at the densities studied, may have little importance to in-stream nutrient availability. Lastly, because I am interested in how bigheaded carp, particularly silver carp, alter nutrient dynamics in invaded food webs, it is necessary to calculate silver carp nitrogen and phosphorus excretion rates, as well as body nitrogen and phosphorus content (Chapter 3). Nutrient stoichiometry theory predicts a balance between the relative consumption of nutrients by an organism and the extent to which the organism retains nutrients in its tissues or excretes them. Thus, it is a useful tool in determining how an invasive species may alter nutrient availability via consumption and excretion. In Chapter 3, I describe the body and excretion N:P ratios for silver carp, which exhibit a lower body N:P ratio than excretion N:P, suggesting that these organisms may serve as a sink for phosphorus. Moreover, silver carp body excretion N:P ratios were higher than those reported for gizzard shad, suggesting that, in regions where silver carp may replace gizzard shad or lower gizzard shad population density via competition (Chapter 1), silver carp may alter nutrient cycling processes in aquatic ecosystems by shifting the overall available N:P ratio. Bigheaded carp may pose a significant threat to invaded ecosystems through their potential to compete with native species, reduce plankton densities, and alter nutrient availability. However, although bigheaded carp are expanding in range and approaching the Great Lakes, the full extent of their ecosystem impacts remain uncertain. Through my work on bigheaded carp food web impacts, particularly the influence of silver carp on native species and nutrient cycling processes, I have found that bigheaded carp have the capacity to negatively impact invaded ecosystems overall by reducing zooplankton, phytoplankton, and forage fish densities. Moreover, as bigheaded carp in particular continue to reach high densities as they expand in range, their capacity to alter relative nitrogen and phosphorus availabilities must be monitored to understand the extent of their influence. Due to their ability to disrupt top down and bottom up processes in freshwater ecosystems, bigheaded carp constitute a critical environmental issue in the Great Lakes area and throughout the Midwest and, thus, it is imperative to continue to experimentally assess how bigheaded carp interact with native species to the detriment or benefit of U.S. freshwater communities.
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McGary, R. Shane. "The CAFE experiment : a joint seismic and MT investigation of the Cascadia subduction system." Thesis, Massachusetts Institute of Technology, 2013. http://hdl.handle.net/1721.1/79289.
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Thesis (Ph. D. in Geophysics)--Joint Program in Marine Geology and Geophysics (Massachusetts Institute of Technology, Dept. of Earth, Atmospheric, and Planetary Sciences; and the Woods Hole Oceanographic Institution), 2013.Page 176 blank. Cataloged from PDF version of thesis.
Includes bibliographical references.
In this thesis we present results from inversion of data using dense arrays of collocated seismic and magnetotelluric stations located in the Cascadia subduction zone region of central Washington. In the migrated seismic section, we clearly image the top of the slab and oceanic Moho, as well as a velocity increase corresponding to the eclogitization of the hydrated upper crust. A deeper velocity increase is interpreted as the eclogitization of metastable gabbros, assisted by fluids released from the dehydration of upper mantle chlorite. A low velocity feature interpreted as a fluid/melt phase is present above this transition. The serpentinized wedge and continental Moho are also imaged. The magnetotelluric image further constrains the fluid/melt features, showing a rising conductive feature that forms a column up to a conductor indicative of a magma chamber feeding Mt. Rainier. This feature also explains the disruption of the continental Moho found in the migrated image. Exploration of the assumption of smoothness implicit in the standard MT inversion provides tools that enable us to generate a more accurate MT model. This final MT model clearly demonstrates the link between slab derived fluids/melting and the Mt. Rainier magma chamber.
by R. Shane McGary.
Ph.D.in Geophysics
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Bernard, Franck. "Caractérisation des performances d'un télescope sous-marin à neutrinos pour la détection de cascades contenues dans le cadre du projet ANTARES." Phd thesis, Université de la Méditerranée - Aix-Marseille II, 2000. http://tel.archives-ouvertes.fr/tel-00001417.
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Les neutrinos cosmiques de haute energie (> 100 GeV) offrent l'opportunite d'ouvrir une nouvelle fenetre sur l'Univers et d'apporter des indications pour resoudre certaines enigmes de la Physique des Particules et de l'Astrophysique. Leur observation necessite la conception d'un nouveau type de detecteur. Nous avons caracterise les performances que l'on peut attendre d'un telescope sous-marin a neutrinos de premiere generation compose d'environ mille photomultiplicateurs, pour la detection de cascades contenues. Le seuil du detecteur se situe vers 200 GeV, le volume effectif atteint 8.10^6 m^3 au-dela de 100 TeV. L'ouverture angulaire vaut 4 pi sr, bien que le volume effectif soit plus faible d'environ 50% a la verticale descendante. La resolution spectrale est entre 10 et 15%, et la precision angulaire environ 2degres (sur l'energie et la direction du neutrino). Le taux de bruit de fond induit par les muons atmospheriques est inferieur a 1.8 fois celui du aux neutrinos atmospheriques. Son evaluation reste limitee par la statistique de simulation. Ces resultats soulignent qu'un telescope sous-marin a neutrinos possede de grandes potentialites de decouverte, non seulement de neutrinos muoniques, mais aussi de neutrinos electroniques, et devrait ouvrir une nouvelle ere de l'astronomie.
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Bernard, Franck. "Caractérisation des performances d'un téléscope sous-marin à neutrinos pour la détection de cascades contenues dans le cadre du projet ANTARES." Aix-Marseille 2, 2000. http://www.theses.fr/2000AIX22094.
Full textBooks on the topic "Care cascade"
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Hawes, Kristine A. Cascades of silence: The cafe leviticus poems. Simi Valley, CA: Alternate Way Press, 1996.
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Bruno Balbino Aires da Costa. "Mossoró não cabe num livro": Luís da Câmara Cascudo, o historiador da cidade. João Pessoa: Ideia, 2012.
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Tainted-Blood Tragedy in Canada: A Cascade of Governance Failures. Commoner's Publishing Society, Incorporated, 2016.
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The Cascade Analysis Tool for Continuum of Care Analytics: An Application in Diabetes Care in Ukraine. World Bank, Washington, DC, 2020. http://dx.doi.org/10.1596/33741.
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Taramusi, Isaac, Chenjerai Sisimayi, Clemens Benedikt, Nejma Cheikh, Nicole Fraser, Zara Shubber, Maria del Mar Quiroga, Mark Minnery, Rowan Martin-Hughes, and Sherrie Kelly. Improving the Allocative Efficiency of the HIV Response Across the Care Cascade in Zimbabwe. World Bank, Washington, DC, 2019. http://dx.doi.org/10.1596/33271.
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WHO Regional Office for the Western Pacific. Metrics for Monitoring the Cascade of HIV Testing, Care and Treatment Services in Asia and the Pacific. World Health Organization, 2020.
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Framework for Monitoring HIV/STI Services for Key Populations in Latin America and the Caribbean. Pan American Health Organization, 2021. http://dx.doi.org/10.37774/9789275121054.
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In Latin America and the Caribbean, between 50% and 65% of new HIV infections occur in key populations or their clients or sexual partners. Improving the availability and coverage of HIV/STI services for these populations requires the support of monitoring systems that are sustainable and adapt to the needs of the countries of the region. To respond to this need, the Pan American Health Organization, through an agreement with the Global Fund, has developed the Framework for Monitoring HIV/STI Services for Key Populations in Latin America and the Caribbean. It introduces a novel system in which the impact of HIV services on key populations is determined, not only by how HIV-positive people maintain an undetectable viral load but also by how HIV-negative people remain HIV-free. This document lists the essential HIV/STI services that, based on a combination prevention approach, should be offered to people from key populations. The monitoring framework establishes one or more indicators for each of the essential services together with the methodology for their measure. Likewise, a new HIV prevention cascade is introduced, which adds to the existing HIV care cascade. Countries are encouraged to disaggregate by key population group the HIV prevention and care cascades as well as the indicators. Finally, it is urgent to show the contribution of civil society organizations to the response to HIV infection and STIs to ensure their sustainability once external donors leave the region. To this end, the framework encourages breaking down the prevention and care cascades information by the service provider, to identify the contribution of health ministries, civil society organizations, and other actors.
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Morpurgo, Michael. Cascades - "Why the Whales Came" (Collins Cascades). HarperCollins Publishers, 1989.
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Singhi, Pratibha, Naveen Sankhyan, and Sunit Singhi. Acute Bacterial Meningitis. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0144.
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Bacterial meningitis is one of the severest infections in childhood. Neuronal damage in meningitis is largely due to the extensive inflammatory cascade induced by pathogenic bacteria. This chapter discusses the current understanding of the interaction of multitude of factors in the pathogenesis of bacterial meningitis. This includes the mechanisms involved in transcellular traversal of the bacteria, and induction and release of several inflammatory cytokines and chemokines. The management of a child with bacterial meningitis requires meticulous supportive care and timely, appropriate, and adequate antibiotic therapy. The chapter also reviews the current understanding of some important clinical aspects of care of a child with bacterial meningitis.
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Singhi, Pratibha, and Arushi G. Saini. Amoebic Infections of the Central Nervous System. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0165.
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Free-living amoebae are ubiquitous and can cause severe infections of the nervous system. The pathogenesis involves neuronal damage due to the activation of inflammatory cascade induced by the pathogenic amoebae, including both acute fulminant and chronic granulomatous inflammation. The diagnosis requires high clinical suspicion; eliciting history of contact with water or soil habitats of free-living amoebae is important. The chapter provides an overview of the different types of nervous system infections caused by the four genera of free-living amoebae, including their pathogenesis, rapid diagnostic tools, clinical features, and treatment strategies. Management includes timely, appropriate, and adequate antimicrobial therapy and supportive care.
Book chapters on the topic "Care cascade"
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Dess, Nancy K., and Richard W. Foltin. "The ethics cascade." In Laboratory animals in research and teaching: Ethics, care, and methods., 31–39. Washington: American Psychological Association, 2005. http://dx.doi.org/10.1037/10830-002.
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Lester, Lynette, Benson Njuguna, and Rajesh Vedanthan. "Team-Based Care Along the Cardiac Surgical Care Cascade." In Sustainable Development Goals Series, 143–53. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-83864-5_13.
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Thijs, L. G., and C. E. Hack. "Role of the Complement Cascade in Severe Sepsis." In Update in Intensive Care and Emergency Medicine, 78–98. Berlin, Heidelberg: Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-84827-8_6.
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Goldsmith, Wendi, Donald Gray, and John McCullah. "Project #9: Argo Cascades." In Bioengineering Case Studies, 55–59. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-7996-3_10.
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Faccioli, Pietro, and Carlos Lourenço. "Polarization in Cascade Decays." In Particle Polarization in High Energy Physics, 173–242. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-08876-6_6.
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AbstractThis chapter addresses the case of a vector particle produced indirectly from the decay or transformation of a particle having $$J = 0$$ ($$\chi_{c0} \to \mathrm{J}/\psi \, \gamma$$, $$\mathrm{B} \to \mathrm{J}/\psi \, \mathrm{K}$$, $$\mathrm{H} \to \mathrm{Z} \, \gamma$$, etc.), $$J = 1$$ or $$J = 2$$ ($$\chi_{c1,2} \to \mathrm{J}/\psi \, \gamma$$, $$\mathrm{Z} \to \mathrm{J}/\psi \, \gamma$$, etc.), describing the polarization frame definitions that can be adopted to represent the two-step process, and their respective advantages. We illustrate how several measurement and kinematic conditions can lead to very different observable polarizations of the vector particle, in the special but frequent case where the intermediate decay step remains unobserved and only the final dilepton angular distribution is measured. We also discuss how the peculiar observation, made at the LHC, of almost unpolarized “directly” produced J/$$\psi$$ mesons may be understood as the result of a two-step production mechanism.
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Tangi, Marco. "Dynamic Sediment Connectivity Modelling for Strategic River Basin Planning." In Special Topics in Information Technology, 27–37. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-15374-7_3.
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AbstractSediment connectivity is a distributed property of river systems that emerges from the connected transfer of sediment between multiple sources and sinks. Its disruption, brought by anthropic disturbances, can have severe and unforeseen consequences on both fluvial ecosystems and human livelihood. Modeling network-scale sediment connectivity provides a foundational understanding of river processes and their response to new pressures and can be used to forecast future system evolutions. In this chapter, we present the basin-scale, dynamic sediment connectivity model D-CASCADE (Dynamic CAtchment Sediment Connectivity And DElivery), which quantifies spatiotemporal patterns of sediment delivery in river networks. D-CASCADE considers multiple factors affecting transport, including heterogeneities in hydrology and sediment supply, different grain sizes, channel morphological evolution, and reservoir presence and management. The model is designed to be flexible, data parsimonious, and computationally efficient. We also present two applications of D-CASCADE in real-world case studies for historic geomorphic evolution reconstruction and future dam impacts forecasting. D-CASCADE is intended for integrated, basin-scale water management efforts, to perform multiple screening of various decision portfolios for hydromorphological impact assessments.
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Kumar, Kamal. "Scaffold Diversity Synthesis with Branching Cascades Strategy." In Concepts and Case Studies in Chemical Biology, 391–414. Weinheim, Germany: Wiley-VCH Verlag GmbH & Co. KGaA, 2014. http://dx.doi.org/10.1002/9783527687503.ch27.
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Chennaif, Mohammed, Mohamed Larbi Elhafyani, Hassan Zahboune, and Smail Zouggar. "Electric System Cascade Analysis for Optimal Sizing of an Autonomous Photovoltaic Water Pumping System." In Advances in Smart Technologies Applications and Case Studies, 282–90. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-53187-4_32.
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Miniat, Chelcy Ford, Jennifer M. Fraterrigo, Steven T. Brantley, Mac A. Callaham, Susan Cordell, Jeffrey S. Dukes, Christian P. Giardina, Shibu Jose, and Gary Lovett. "Impacts of Invasive Species on Forest and Grassland Ecosystem Processes in the United States." In Invasive Species in Forests and Rangelands of the United States, 41–55. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-45367-1_3.
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AbstractIn this chapter, we describe current understanding of and identify research gaps on how invasive species directly, and indirectly, affect ecosystem processes. Specifically, we focus on how invasive species can alter the terrestrial carbon, nitrogen, and hydrologic cycles and how changes to these terrestrial cycles cascade to affect water quantity and quality. While invasive species may alter other ecosystem processes, we focus on these due to their importance to policy, to the public, and to their likely interaction with climate change effects. For example, carbon sequestration and surface water supply originating from forests and grasslands (Caldwell et al. 2014) are important policy and public concerns, and drought frequency and intensity will likely increase with climate change (Vose et al. 2016a). Our goal is to draw generalizations rather than provide details on invasive species effects on a case-by-case basis. We do, however, provide case studies for illustration and draw linkages with other chapters that provide detailed coverage to disturbance regimes (Chap. 10.1007/978-3-030-45367-1_5) and types and mechanisms of ecological impact caused by invasive insects (Chap. 10.1007/978-3-030-45367-1_2).
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Audia, Camilla, Emma Visman, Gino Fox, Emmah Mwangi, Mary Kilavi, Mark Arango, Sonja Ayeb-Karlsson, and Dominic Kniveton. "Decision-Making Heuristics for Managing Climate-Related Risks: Introducing Equity to the FREE Framework." In Climate Risk in Africa, 57–76. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-61160-6_4.
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AbstractManaging climate-related risks is clouded in differing levels of uncertainty that are magnified when trying to understand their potential impacts on socio-ecological systems. The ‘cascade of uncertainty’ is particularly apparent in Africa where socio-ecological data are sparse, and the development and validation of impact models are at varying stages. In this context, using heuristics may serve as an effective way for policy makers to incorporate climate change knowledge into decision-making. Previous scholarship has identified the principles of Flexibility, Robustness and Economic low/no regrets in decision-making under uncertainty. In this chapter, we first make the case for adding Equity to these heuristics, where equity involves ensuring that reducing the climate change risk for one cohort of society does not result in its increase for another. Second, we describe how these principles have been applied under two DFID/NERC funded projects: ForPAc and AMMA-2050 through the use of Participatory Impact Pathways Analysis tools.
Conference papers on the topic "Care cascade"
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Yamada, N., L. Brosseau, G. Ramchandran, and J. Vincent. "287. Workplace Comparison of Personal Cascade Impactors for Inhalable Aerosol Exposures." In AIHce 1996 - Health Care Industries Papers. AIHA, 1999. http://dx.doi.org/10.3320/1.2764958.
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King, Helen, Heather Richardson, and Caroline Nicholson. "P-14 The cascade project: promoting age-attuned palliative care." In A New World – Changing the landscape in end of life care, Hospice UK National Conference, 3–5 November 2021, Liverpool. British Medical Journal Publishing Group, 2021. http://dx.doi.org/10.1136/spcare-2021-hospice.35.
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Geiser, Markus, Jessica L. Klocke, Markus Mangold, Pitt Allmendinger, Andreas Hugi, Pierre Jouy, Balint Horvath, Jérôme Faist, and Tilman Kottke. "Single-shot microsecond-resolved spectroscopy of the bacteriorhodopsin photocycle with quantum cascade laser frequency combs (Conference Presentation)." In Biophotonics: Photonic Solutions for Better Health Care, edited by Jürgen Popp, Valery V. Tuchin, and Francesco S. Pavone. SPIE, 2018. http://dx.doi.org/10.1117/12.2306831.
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Ashton, Savanah, and Sipporah Enuaraq. "P586 Ikajurniq: an inuit cascade of care framework for sexually transmitted and blood borne infections." In Abstracts for the STI & HIV World Congress (Joint Meeting of the 23rd ISSTDR and 20th IUSTI), July 14–17, 2019, Vancouver, Canada. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/sextrans-2019-sti.657.
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Bones, Ana Amélia, Karla Viana, Silvio Cazella, and Airton Stein. "P181 Epidemiological information on HIV in the management of the cascade of care in health services." In Abstracts for the STI & HIV World Congress (Joint Meeting of the 23rd ISSTDR and 20th IUSTI), July 14–17, 2019, Vancouver, Canada. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/sextrans-2019-sti.336.
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Arnone, A. A., and S. S. Stecco. "Inviscid Cascade Flow Calculations Using a Multigrid Method." In ASME 1989 International Gas Turbine and Aeroengine Congress and Exposition. American Society of Mechanical Engineers, 1989. http://dx.doi.org/10.1115/89-gt-22.
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An accurate reliable and efficient computer code for inviscid cascade flow calculations has been developed and applied on sheared H-type grids. The integration in time is based on Jameson’s explicit Runge-Kutta scheme. Numerical efficiency is obtained through local time stepping, implicit residual smoothing and a full multigrid strategy. An additional wedge is added to blades with rounded trailing edges and care is taken to correctly capture the shock system when the outlet flow is supersonic. Comparison with experiments shows that the method can be applied to turbomachinery, yielding good blade-to-blade predictions.
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Suzuki, Kensuke, Shigetsugu Takano, Hideyuki Yoshitomi, Shingo Kagawa, Hiroaki Shimizu, Masayuki Otsuka, Katunori Furukawa, et al. "Abstract B29: The elucidation for functional roles of Metadherin in metastatic cascade of pancreatic cancer." In Abstracts: AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; May 12-15, 2016; Orlando, FL. American Association for Cancer Research, 2016. http://dx.doi.org/10.1158/1538-7445.panca16-b29.
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Kroch, Abigail. "S09.1 The relationship between demographics, health needs and the HIV care cascade outcomes: from infection to viral suppression." In Abstracts for the STI & HIV World Congress (Joint Meeting of the 23rd ISSTDR and 20th IUSTI), July 14–17, 2019, Vancouver, Canada. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/sextrans-2019-sti.45.
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Farr, Katherine, Talemwa Nalugwa, Priya Shete, Adithya Cattamanchi, Mariam Nantale, Christopher Ojok, Denis Oyuku, et al. "Late Breaking Abstract - The tuberculosis diagnostic evaluation cascade of care at microscopy centers linked to Xpert MTB/RIF hubs in Uganda." In ERS International Congress 2017 abstracts. European Respiratory Society, 2017. http://dx.doi.org/10.1183/1393003.congress-2017.oa1943.
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Domingues, Carmen Silvia, Mariza Tancredi, Valdir Pinto, Carla Luppi, Solange Gomes, Rosa Alencar, Maria Clara Gianna, and Artur Kalichman. "P745 The pregnancy syphilis cascade of care: “95–95–95” goals for reducing of congenital syphilis in the state of sao paulo, brazil." In Abstracts for the STI & HIV World Congress (Joint Meeting of the 23rd ISSTDR and 20th IUSTI), July 14–17, 2019, Vancouver, Canada. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/sextrans-2019-sti.804.
Full textReports on the topic "Care cascade"
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Forrester, Donald, Sophie Wood, Charlotte Waits, Rebecca Jones, Dan Bristow, and Emma Taylor-Collins. Children's social services and care rates in Wales: A survey of the sector. Wales Centre for Public Policy - Cardiff University, March 2022. http://dx.doi.org/10.54454/20220311.
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Wales has seen a rise in both the number and rate of children looked after. The rate is now higher than any time since the 1980s. In addition, Wales has consistently had more children looked after per 10,000 of the population than the rest of the UK. This trend is a cause for concern; particularly the impact on the outcomes of children who are taken into care in terms of educational attainment, health, unemployment, homelessness, and criminal justice. Moreover, the Covid-19 pandemic is expected to have worsened the situation. To understand better the factors influencing care rates, the Welsh Government commissioned the Wales Centre for Public Policy and the Centre for Children’s Social Care Research and Development (CASCADE) at Cardiff University to undertake a survey with the children’s social care (CSC) workforce.
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Hajarizadeh, Behzad, Jennifer MacLachlan, Benjamin Cowie, and Gregory J. Dore. Population-level interventions to improve the health outcomes of people living with hepatitis B: an Evidence Check brokered by the Sax Institute for the NSW Ministry of Health, 2022. The Sax Institute, August 2022. http://dx.doi.org/10.57022/pxwj3682.
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Background An estimated 292 million people are living with chronic hepatitis B virus (HBV) infection globally, including 223,000 people in Australia. HBV diagnosis and linkage of people living with HBV to clinical care is suboptimal in Australia, with 27% of people living with HBV undiagnosed and 77% not receiving regular HBV clinical care. This systematic review aimed to characterize population-level interventions implemented to enhance all components of HBV care cascade and analyse the effectiveness of interventions. Review questions Question 1: What population-level interventions, programs or policy approaches have been shown to be effective in reducing the incidence of hepatitis B; and that may not yet be fully rolled out or evaluated in Australia demonstrate early effectiveness, or promise, in reducing the incidence of hepatitis B? Question 2: What population-level interventions and/or programs are effective at reducing disease burden for people in the community with hepatitis B? Methods Four bibliographic databases and 21 grey literature sources were searched. Studies were eligible for inclusion if the study population included people with or at risk of chronic HBV, and the study conducted a population-level interventions to decrease HBV incidence or disease burden or to enhance any components of HBV care cascade (i.e., diagnosis, linkage to care, treatment initiation, adherence to clinical care), or HBV vaccination coverage. Studies published in the past 10 years (since January 2012), with or without comparison groups were eligible for inclusion. Studies conducting an HBV screening intervention were eligible if they reported proportion of people participating in screening, proportion of newly diagnosed HBV (participant was unaware of their HBV status), proportion of people received HBV vaccination following screening, or proportion of participants diagnosed with chronic HBV infection who were linked to HBV clinical care. Studies were excluded if study population was less than 20 participants, intervention included a pharmaceutical intervention or a hospital-based intervention, or study was implemented in limited clinical services. The records were initially screened by title and abstract. The full texts of potentially eligible records were reviewed, and eligible studies were selected for inclusion. For each study included in analysis, the study outcome and corresponding 95% confidence intervals (95%CIs) were calculated. For studies including a comparison group, odds ratio (OR) and corresponding 95%CIs were calculated. Random effect meta-analysis models were used to calculate the pooled study outcome estimates. Stratified analyses were conducted by study setting, study population, and intervention-specific characteristics. Key findings A total of 61 studies were included in the analysis. A large majority of studies (study n=48, 79%) included single-arm studies with no concurrent control, with seven (12%) randomised controlled trials, and six (10%) non-randomised controlled studies. A total of 109 interventions were evaluated in 61 included studies. On-site or outreach HBV screening and linkage to HBV clinical care coordination were the most frequent interventions, conducted in 27 and 26 studies, respectively. Question 1 We found no studies reporting HBV incidence as the study outcome. One study conducted in remote area demonstrated that an intervention including education of pregnant women and training village health volunteers enhanced coverage of HBV birth dose vaccination (93% post-intervention, vs. 81% pre-intervention), but no data of HBV incidence among infants were reported. Question 2 Study outcomes most relevant to the HBV burden for people in the community with HBV included, HBV diagnosis, linkage to HBV care, and HBV vaccination coverage. Among randomised controlled trials aimed at enhancing HBV screening, a meta-analysis was conducted including three studies which implemented an intervention including community face-to-face education focused on HBV and/or liver cancer among migrants from high HBV prevalence areas. This analysis demonstrated a significantly higher HBV testing uptake in intervention groups with the likelihood of HBV testing 3.6 times higher among those participating in education programs compared to the control groups (OR: 3.62, 95% CI 2.72, 4.88). In another analysis, including 25 studies evaluating an intervention to enhance HBV screening, a pooled estimate of 66% of participants received HBV testing following the study intervention (95%CI: 58-75%), with high heterogeneity across studies (range: 17-98%; I-square: 99.9%). A stratified analysis by HBV screening strategy demonstrated that in the studies providing participants with on-site HBV testing, the proportion receiving HBV testing (80%, 95%CI: 72-87%) was significantly higher compared to the studies referring participants to an external site for HBV testing (54%, 95%CI: 37-71%). In the studies implementing an intervention to enhance linkage of people diagnosed with HBV infection to clinical care, the interventions included different components and varied across studies. The most common component was post-test counselling followed by assistance with scheduling clinical appointments, conducted in 52% and 38% of the studies, respectively. In meta-analysis, a pooled estimate of 73% of people with HBV infection were linked to HBV clinical care (95%CI: 64-81%), with high heterogeneity across studies (range: 28-100%; I-square: 99.2%). A stratified analysis by study population demonstrated that in the studies among general population in high prevalence countries, 94% of people (95%CI: 88-100%) who received the study intervention were linked to care, significantly higher than 72% (95%CI: 61-83%) in studies among migrants from high prevalence area living in a country with low prevalence. In 19 studies, HBV vaccination uptake was assessed after an intervention, among which one study assessed birth dose vaccination among infants, one study assessed vaccination in elementary school children and 17 studies assessed vaccination in adults. Among studies assessing adult vaccination, a pooled estimate of 38% (95%CI: 21-56%) of people initiated vaccination, with high heterogeneity across studies (range: 0.5-93%; I square: 99.9%). A stratified analysis by HBV vaccination strategy demonstrated that in the studies providing on-site vaccination, the uptake was 78% (95%CI: 62-94%), significantly higher compared to 27% (95%CI: 13-42%) in studies referring participants to an external site for vaccination. Conclusion This systematic review identified a wide variety of interventions, mostly multi-component interventions, to enhance HBV screening, linkage to HBV clinical care, and HBV vaccination coverage. High heterogeneity was observed in effectiveness of interventions in all three domains of screening, linkage to care, and vaccination. Strategies identified to boost the effectiveness of interventions included providing on-site HBV testing and vaccination (versus referral for testing and vaccination) and including community education focussed on HBV or liver cancer in an HBV screening program. Further studies are needed to evaluate the effectiveness of more novel interventions (e.g., point of care testing) and interventions specifically including Indigenous populations, people who inject drugs, men who have sex with men, and people incarcerated.
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Mironenko, M. V., M. Yu Spasennykh, and V. B. Polyakov. The cascade of reservoirs of the ``Mayak`` Plant: Case history and the first version of a computer simulator. Office of Scientific and Technical Information (OSTI), July 1994. http://dx.doi.org/10.2172/10114733.
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Hessburg, Paul F., Bradley G. Smith, and R. Brion Salter. Using estimates of natural variation to detect ecologically important change in forest spatial patterns: a case study, Cascade Range, eastern Washington. Portland, OR: U.S. Department of Agriculture, Forest Service, Pacific Northwest Research Station, 1999. http://dx.doi.org/10.2737/pnw-rp-514.
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Schorung, Matthieu. A Geographical Contribution on Interurban Passenger Rail Transportation in the United States. Mineta Transportation Institute, February 2022. http://dx.doi.org/10.31979/mti.2022.2212.
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Why does the rail infrastructure of the United States lag behind those of many other developed countries? Where is U.S. high-speed rail? This research approaches this in a dilemma by exploring Amtrak’s traditional rail services and high-speed rail projects in the nation to understand the workings of public rail transportation policies, what they contain, and how they are developed and pursued by the different stakeholders. This research utilizes case studies and a multiscale approach to analyze the territorialization of intercity rail transportation policies. The analysis demonstrates the emergence of a bottom-up approach to projects, notably apparent in the California HSR project and in the modernization of the Cascades corridor. Furthermore, this research concluded that, first, the development of uniform arguments and recommendations to encourage new rail policies emphasizes structuring effects and economic role of high-speed rail, congestion reduction, modal shift. Second, a tangible though uneven pro-rail position exists among public actors at all levels. Stakeholders prioritize improving and modernizing existing corridors for the launch of higher-speed services, and then on hybrid networks that combine different types of infrastructures. Although there are no publicly backed projects for new lines exclusively dedicated to high-speed rail, most of the high-speed corridors are in fact “higher-speed” corridors, some of which are intended to become high-speed at some time in the future.
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Liu, Zhanjiang John, Rex Dunham, and Boaz Moav. Developmental and Evaluation of Advanced Expression Vectors with Both Enhanced Integration and Stable Expression for Transgenic Farmed Fish. United States Department of Agriculture, December 2001. http://dx.doi.org/10.32747/2001.7585196.bard.
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The objectives of the project were to develop expression vectors using the Sleeping Beauty transposon technology and the genetic border elements to provide both enhanced integration rate and stable transgene expression, and to evaluate the application of such vectors in farmed fish such as catfish and carp. The panel recommended adding the objective of evaluating the endogenous transposable elements, particularly in catfish, in order to evaluate the applicability of the expression vectors while reduc1ng efforts in real production of transgenic fish considering the focus of the project was to develop the vector and evaluation of its applicability, not producing transgenic fish. Efficient production of transgenic farmed fish is hindered by two major problems: mosaicism due to delayed integration after single-cell stage, and silencing of transgene expression. In this project, we proposed to combat these problems by coupling the Sleeping Beauty transposon technology that can enhance integration rate and the border elements that can insulate transgene from position effect. Our major objective was to develop a new generation of expression vector that contains both of these elements. We have developed expression vectors containing both the Sleeping Beauty transposon signals, inverted repeats and direct repeats (IR and DR, respectively), and the border elements, scs and scs'. Growth hormone minigene has been cloned into this vector for applications of such vectors in growth enhancement. Luc reporter gene has been also cloned into this vector cascades for relative easy evaluation of transgene expression. Transgenic fish have been produced using these expression vectors in both catfish (US) and carp (Israel). Much effort was also devoted to evaluation of the endogenous transposable elements in catfish as recommended by the BARD grant panel. Multiple families of Tcl-like transposons were identified from catfish. Surprisingly, many Tc I-related transcripts were identified. Among these transcripts, both the sense and antisense transcripts were present. Some of the transcripts may be useful for development of novel transposase-based technology for aquaculture applications in the future. This project has both scientific and aquaculture implications. First, to develop expression vectors containing both IR/DR and scs/scs' repeated elements have been reported being extremely technically difficult due to excision of the repeated sequences by the E. coli host during cloning processes. We have successfully constructed this advanced vector that contained very complex cascades for both gene integration and gene regulation. We have produced transgenic fish using such vectors. This advanced expression vector should be useful for production of transgenic fish. By simply replacing the growth hormone gene, any gene of interest can be readily inserted in this vector. Thus this vector should provide technological possibility for early integration and stable expression of any economically important genes in aquaculture. We have also evaluated the applications of the Sleeping Beauty-based vectors in terms of the impact of gene size and found that the size of trans gene drastically affects transposition. The system will be only useful for transferring genes smaller than 5.6 kb. We have also identified novel transposase-related transcripts that may be useful for the development of novel transposase-based technologies for general scientific research and for aquaculture applications.
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Case Study on Development of Hydropower Risks and Impact Mitigation Guidelines and Recommendations (Volume 3, 1st Interim Report). Vientiane, Lao PDR: Mekong River Commission Secretariat, December 2015. http://dx.doi.org/10.52107/mrc.ajg81o.
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