Alternatives to standard hemodialysis

Survival of patients on hemodialysis remains poor, but the benefits of increasing urea clearance have probably been maximized within our current treatment schedules. Long dialysis sessions (8 hr) produce impressive outcomes, with mortality 53% to 55% lower than conventional schedules. Even increasing from 4 to 5 hr may improve survival. Increased frequency of dialysis (6 times weekly) produces impressive reductions in left ventricular mass and could conceivably be implemented in‐center. Preliminary data suggest a 61% reduction in mortality with increased frequency. Nightly dialysis combines longer sessions with increased frequency and has produced remarkable clinical gains in blood pressure, left ventricular mass, serum phosphate, and sleep apnea. However, the data are mainly from case series and impact on mortality remains unknown. Expansion of home hemodialysis would be necessary for this modality to grow. Convective therapies remove middle molecules more effectively, and observational data suggest hemodiafiltration has the potential to improve mortality by 35% to 36%. Hemodiafiltration has the advantage of being relatively easy to implement. The uremic milieu is complex and further investigation of the underlying pathophysiology is needed to inform future dialysis interventions. The survival data above are from observational studies, and hence benefits are likely to be exaggerated. Randomized trials of dialysis interventions are desperately needed. They remain difficult to perform, because of the complexity of both the patient population and the interventions, and because of limited available funding.     

Systems that Should Have Failed: Critical Infrastructure Protection in an Institutionally Fragmented Environment

Recent years have witnessed major governmental initiatives regarding critical infrastructure protection (CIP). During that same time, critical infrastructures (CIs) have undergone massive institutional restructuring under the headings of privatization, deregulation and liberalization. Little research has gone into understanding the interactions between these two developments. In this article, we outline the consequences of institutional restructuring for the changing ways in which CIs ensure the reliability and security of their networks and services. Neither Normal Accident Theory nor High‐Reliability Theory can account for reliability under these conditions. We then investigate the implications of these findings for CIP.     

Assessment of Highway Bridge Upgrading by Dynamic Testing and Finite-Element Model Updating

The Land Transport Authority of Singapore has a continuing program of highway bridge upgrading for refurbishing and strengthening bridges to allow for increasing vehicle traffic and increasing axle loads. One subject of this program has been a short-span bridge taking a busy main road across a coastal inlet near a major port facility. Experiment-based structural assessments of the bridge were conducted before and after upgrading works including strengthening. Each assessment exercise comprised three separate components: (1) a strain and acceleration monitoring exercise lasting approximately one month; (2) a full-scale dynamic test carried out in a single day without closing the bridge; and (3) a finite-element model updating exercise to identify structural parameters and mechanisms. This paper presents the dynamic testing and the modal analysis used to identify the vibration properties and the quantification of the effectiveness of the upgrading through the subsequent model updating. Before and after upgrade, similar sets of vibration modes were identified, resembling those of an orthotropic plate with relatively weak transverse bending stiffness. Conversion of bearings from nominal simple supports to nominal full fixity was shown via model updating to be the principal cause of natural frequency increases of up to 50%. The utility of the combined experimental and analytical process in direct identification of structural properties has been proven, and the procedure can be applied to other structures and their capacity assessments.     

Interstate forensic psychology consultations: A call for reform and proposal of a model rule.

Forensic psychology has made important gains in professional recognition and stature in the courts, resulting in increasing demands for mobility of expertise. Current regulations regarding the interjurisdictional temporary forensic practice of psychology, however, are characterized by variability of regulations, ambiguity and inaccessibility, and continuing total barriers. A uniform, well-reasoned policy is needed. A conceptual basis for such a policy is provided by a discussion of licensing rationales and the application of these to forensic practice. Uniformity, public and professional protection, and practicability are identified as fundamental regulatory criteria. A Model Rule Regarding the Temporary Forensic Practice of Psychology is proposed for adoption by state licensing boards on a nationwide basis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validity of Three Measures of Communication for Predicting Relationship Adjustment and Stability Among a Sample of Young Couples.

The goal of this study was to examine whether data from 3 different measures of communication (i.e., self-report, quasi-observational, and observational) can predict relationship adjustment and stability 1 year later when used conjointly in a sample of 62 young couples. The 3 measures of communication were the Communication Skills Test-Revised (CST-R), the Communication Box (CB), and the Demand/Withdraw Pattern Questionnaire (DWPQ). Through hierarchical multiple regression analyses, results revealed that the CST-R and the DWPQ predict both genders' relationship adjustment 1 year later when used conjointly. Logistic regression analyses revealed that none of the measures of communication significantly predicted relationship stability. In conclusion, the combination of the CST-R and the DWPQ appears to be useful for longitudinally predicting relationship adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Surfactant behavior and its influence on the viscosity of associative thickeners solutions, thickened latex dispersions, and waterborne latex coatings

Surfactants, varying in their chemical composition and hydrophobic behavior, are used in the formulation of a waterborne coating. These differences influence their aggregation in micellar structures, their interaction with associative thickeners, and in particular, the synergies present in their competitive adsorptions on the disperse phases in a waterborne coating. Adsorption of HEUR thickeners on latexes and the ability of surfactants to displace them from those surfaces is an important variable in the dispersion’s viscosity. With large particle latexes, viscosity increases arise primarily from the network built through the interaction of HEURs with surfactants in the aqueous phase. Fluorescence is used to verify the mechanism by which surfactants enhance associative thickener viscosities. That is best achieved with nonionic surfactants, because of their synergies with large hydrophobe HEURs at low concentration. With decreasing latex particle size the adsorbed species is an important contributor to the dispersion’s viscosity through its contribution to the latex’s effective volume fraction increase and when the size of the adsorbed HEUR is matched to the separation distances of the latex at 0.25 volume fraction. Achieving controlled shear-thinning behavior in small particle size latex paints with the economic constraints on the amount of HEUR required to obtain 90 KU viscosities are discussed. Presented at the 80th Annual Meeting of the Federation of Societies for Coatings Technology, October 30–November 1, 2002, in New Orleans, LA. Polymer and Coatings Dept., Fargo, ND 58103.     

Does anticipation training affect drivers' risk taking?

Skill and risk taking are argued to be independent and to require different remedial programs. However, it is possible to contend that skill-based training could be associated with an increase, a decrease, or no change in risk-taking behavior. In 3 experiments, the authors examined the influence of a skill-based training program (hazard perception) on the risk-taking behavior of car drivers (using video-based driving simulations). Experiment 1 demonstrated a decrease in risk taking for novice drivers. In Experiment 2, the authors examined the possibilities that the skills training might operate through either a nonspecific reduction in risk taking or a specific improvement in hazard perception. Evidence supported the latter. These findings were replicated in a more ecological context in Experiment 3, which compared advanced and nonadvanced police drivers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

THE OPTIMUM SPEED OF VISUAL INSPECTION USING A RANDOM SEARCH STRATEGY

Choosing a standard speed for visual inspection is difficult using standard work measurement techniques. This paper uses a different approach, taking a model of human functioning in inspection and deriving an optimum speed of working so as to balance the cost of time against the cost of errors. Random search is used as the model and both self-paced and externally-paced conditions are derived for multiple fault types. Optimization using a Golden Section search is used to provide optimum inspection speed.     

The visual control of reaching and grasping: Binocular disparity and motion parallax.

The primary visual sources of depth and size information are binocular cues and motion parallax. Here, the authors determine the efficacy of these cues to control prehension by presenting them in isolation from other visual cues. When only binocular cues were available, reaches showed normal scaling of the transport and grasp components with object distance and size. However, when only motion parallax was available, only the transpont component scaled reliably. No additional increase in scaling was found when both cues were available simultaneously. Therefore, although equivalent information is available from binocular and motion parallax information, the latter may be of relatively limited use for the control of the grasp. Binocular disparity appears selectively important for the control of the grasp. (PsycINFO Database Record (c) 2010 APA, all rights reserved)