EXAMINING QUALITY INDICATOR RATES FOR OLDER HOME CARE CLIENTS WITH DUAL SENSORY IMPAIRMENT (DSI) AND EXPLORING THE HETEROGENEITY WITHIN DSI.

Older adults with impairments in both hearing and vision, called dual sensory impairment (DSI), are at an increased risk of negative health outcomes such as impaired communication and difficulties with mobility. It is unknown whether DSI is associated with potential quality of care issues. This study used a set of home care quality indicators (HCQIs) to examine potential quality issues in older clients (65+) with DSI. Further, it looked to explore how HCQI rates differed based on the geographic region of care and whether the client’s level of hearing and vision impairment was related to certain HCQIs. The HCQIs were generated from data collected using the Resident Assessment Instrument for Home Care and capture undesirable outcomes (e.g., falls, cognitive decline). Higher rates indicate a greater frequency of experiencing the issue. In this sample (n=352,656), the average age was 82.8 years (sd=7.9), the majority were female (63.2%), and 20.5% experienced DSI. Compared to those without DSI, clients with DSI had higher rates across 20 of the 22 HCQIs. The HCQI rates differed by geographic region, with specific regions consistently performing worse than others. Finally, the level of hearing and vision impairment was related to certain HCQIs more than others, for example hearing impairment appeared to be more related to the quality indicator measuring communication difficulty. Overall, the hope is that this information can help to identify some of the potential issues around quality and in turn, assist in continually improving the services being provided to these clients

Foraging as an evidence accumulation process

A canonical foraging task is the patch-leaving problem, in which a forager must decide to leave a current resource in search for another. Theoretical work has derived optimal strategies for when to leave a patch, and experiments have tested for conditions where animals do or do not follow an optimal strategy. Nevertheless, models of patch-leaving decisions do not consider the imperfect and noisy sampling process through which an animal gathers information, and how this process is constrained by neurobiological mechanisms. In this theoretical study, we formulate an evidence accumulation model of patch-leaving decisions where the animal averages over noisy measurements to estimate the state of the current patch and the overall environment. Evidence accumulation models belong to the class of drift diffusion processes and have been used to model decision making in different contexts. We solve the model for conditions where foraging decisions are optimal and equivalent to the marginal value theorem, and perform simulations to analyze deviations from optimal when these conditions are not met. By adjusting the drift rate and decision threshold, the model can represent different strategies, for example an increment-decrement or counting strategy. These strategies yield identical decisions in the limiting case but differ in how patch residence times adapt when the foraging environment is uncertain. To account for sub-optimal decisions, we introduce an energy-dependent utility function that predicts longer than optimal patch residence times when food is plentiful. Our model provides a quantitative connection between ecological models of foraging behavior and evidence accumulation models of decision making. Moreover, it provides a theoretical framework for potential experiments which seek to identify neural circuits underlying patch leaving decisions

Comparative Deregulation of Far Eastern Telecommunications Markets: Economic Incentives and International Competitive Strategies

The deregulation of telecommunications has taken a major step with the WTO agreements in February of this year. Namely, each of the major Far Eastern countries has agreed to open their market in some form of planned entry. These markets will allow for the introduction of competition of local and international services now currently restricted to the local PTT as well as allowing the entry of new services in what are generally closed markets. This paper analyzes the implications of changes in several key Far Eastern countries and discusses how this will impact the U.S. economy and the overall policy implications that this will focus on

Shedding Light on the Symmetries of Dark Matter

I consider symmetries which could explain observed properties of dark matter, namely, its stability on Gyr time scales or its relic density and discuss how such symmetries can be discovered through the study of the propagation and polarization of light in its transit through dark matter.Comment: 6 pages, Invited talk at the 4th International Symposium on Symmetries in Subatomic Physics (SSP 2009), June 2-5, 2009, Taipei, Taiwa

A Revised Historical Light Curve of Eta Carinae and the Timing of Close Periastron Encounters

The historical light curve of the 19th century "Great Eruption" of etaCar provides a striking record of violent instabilies encountered by the most massive stars. We report and analyze newly uncovered historical estimates of the visual brightness of etaCar during its eruption, and we correct some mistakes in the original record. The revised light curve looks substantially different from previous accounts: it shows two brief eruptions in 1838 and 1843 that resemble modern supernova impostors, while the final brightening in December 1844 marks the time when etaCar reached its peak brightness. We consider the timing of brightening events as they pertain to the putative binary system in etaCar: (1) The brief 1838 and 1843 events peaked within weeks of periastron if the pre-1845 orbital period is shorter than at present due to the mass loss of the eruption. Each event lasted only 100 days. (2) The main brightening at the end of 1844 has no conceivable association with periastron, beginning more than 1.5yr afterward. It lasted 10yr, with no obvious influence of periastron encounters during that time. (3) The 1890 eruption began to brighten at periastron, but took over 1yr to reach maximum and remained there for almost 10yr. A second periastron passage midway through the 1890 eruption had no effect. While evidence for a link between periastron encounters and the two brief precursor events is compelling, the differences between the three cases above make it difficult to explain all three phenomena with the same mechanism.Comment: 11 pages, 4 figures. submitted to MNRAS on october 12. updated reference

Global inventory of nitrogen oxide emissions constrained by space-based observations of NO2 columns

sions (37.7 Tg N yr #1 ) agrees closely with the GEIAbased a priori (36.4) and with the EDGAR 3.0 bottom-up inventory (36.6), but there are significant regional differences. A posteriori NO x emissions are higher by 50 -- 100% in the Po Valley, Tehran, and Riyadh urban areas, and by 25 -- 35% in Japan and South Africa. Biomass burning emissions from India, central Africa, and Brazil are lower by up to 50%; soil NO x emissions are appreciably higher in the western United States, the Sahel, and southern Europe

Boundary layer charge dynamics in ionic liquid-ionic polymer transducers

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98705/1/JApplPhys_109_014909.pd

Identification of Stage‐Specific Genes Associated With Lupus Nephritis and Response to Remission Induction in (NZB × NZW)F1 and NZM2410 Mice

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108024/1/art38679.pd