ObjectiveTo estimate the joint effect of a multifaceted access intervention on primary care physician (PCP) productivity in a large, integrated prepaid group practice.Data...Full Text Available
The Joint Commission on Accreditation of Hospitals (JCAH) has continuously emphasized improvement in the quality of care provided in hospitals as the central purpose of the accreditation process. In...Full Text Available
The health politics and policy communities are still struggling with the question of "what went wrong" in the 1993-94 health care reform effort. Here I identify which Americans were politically active and inactive during the health care reform debate to explore the role political participation may have had in determining the outcome of the debate. Using data from a national and California random-sample telephone surveys, and controlling for other demographic attributes, I found that those who engaged in political activity specifically related to health care reform were disproportionately more likely to be self-identified conservatives, less likely to favor an employer mandate plan, more likely to be fifty to sixty-four years old, more likely to be men, and more likely to have greater interest in and knowledge of the health care issue. Even in California, where a single-payer ...
The objective of the project was to develop a welded tubular joint database to assess the fatigue design curves (X and X{prime}) in the American Petroleum Institute design code (API RP2A). Changes in the curve-fitting method and screening criteria (primarily the exclusion of the very thin tubular joints) produced results different from those reported previously. The current results show that the X and X{prime} curves are too conservative and that a new curve should be adopted. The Department of Energy T{prime} curve was found to be consistent with the screened tubular joint air data and is recommended for use in API RP2A. The weldment size effect exponent (n) of 0.25 in the current version of API RP2A was found to be too small, and a higher value of 0.30 consistent with the Department of Energy recommendations is recommended. The fatigue test results for tubular joints tested in air ...
In the last 40 years, significant advances have been made in the understanding of the neurophysiologic processes involved in the experience of trauma and pain. This knowledge, together with the rapid growth and understanding in the behavioral health sciences, has expanded to include a much better appreciation of how these fields are converging and contribute to a process called neuroplasticity. These basic mechanisms common to all patients have important implications for clinical outcome and for improving clinical practice. This article is written for clinicians who manage patients with sacroiliac joint dysfunction, a specific type of nonspecific low back pain.
...as agro forestry subject matter specialist, eastern supervisor, conservation and GIS officer with the Ministry of Agriculture and WWF-Korup national park project, respectively, in south west Cameroon . Peter holds joint Honours BSc in Forestry & Soil Science (WALES-UK) and MSc Resource Management (Edinburgh-UK)....
Purpose - The purpose of this paper is to explain some tax management complications for onshore and offshore hedge funds posed by US FIN 48, Uncertain Tax Positions, and to emphasize the hedge fund manager's responsibility for careful tax planning and compliance. Design/methodology/approach - The paper discusses a hedge fund's objective to deliver tax-efficient results to investors, explains the background of FIN 48, and illustrates five types of situations in which conservative auditors following FIN 48 may raise "red flags." Findings - With the advent of FIN 48's standards careful tax planning and compliance are more important than ever for a hedge fund. Significant complications may arise from unwise, tardy, or missed tax elections; filing an IRS Form 8275, Disclosure Statement, stating...
Objective: To assess the efficacy, prospects and future of conservative management of beta thalassemia major patients in a developing country. Design: Patients registered at IHBTS were studied over a period of three years. They consented to being managed on moderate transfusion regimen, aiming to maintain a pre-transfusion haemoglobin(Hgb) level of 9.0 plus minus 1.0 g per dL. We studied their transfusion requirements, status for transfusion transmitted infections (TTls), serum ferritin levels and complications developing as a result of iron overload. Subjects: Initially all registered patients were included in this study. Sporadic patients as well as dropouts occurring due to any reason, (patients concurrently seeking treatment at other centres as well, or complying poorly to advised chelation therapy) were excluded from the study. The data presented here conforms to a cohort of 60 regular patients who adhered best to our selection criteria. Main Outcome Measures: ...
In 15 patients (16 hip joints) we found the clinical and radiological signs of BMOS. On T1-weighted MRI images areas of low signal intensity could be observed in the head, neck and the intertrochanteric region of the femur in various extensions. These areas showed a significant increase in signal intensity on the T2-weighted images. Because pain was resistant to conservative therapy all these patients were treated by core decompression of the femoral head in a prospective study. Bone cores were evaluated histologically using undecalcified sections and quantitative microradiography. The existence of intramedullary oedema in exactly the regions exhibiting the MRI pattern of bone marrow oedema was verified histologically; however, bone and marrow changes similar to those of early avascular necrosis (AVN) were also visible. (orig.)
This is the second revision of the ETDE/INIS Joint Thesaurus, including all updates up to September 2006. It contains 21 147 valid descriptors and 9 114 forbidden terms. The Joint Thesaurus contains the controlled terminology for indexing all information within the subject scopes of the International Nuclear Information System (INIS) and the Energy Technology Data Exchange (ETDE). The terminology is intended for use in subject descriptions for input or retrieval of information in these systems. The thesaurus is a terminological control device used in translating from the natural language of documents, indexers or users into a more constrained system language It is also a controlled and dynamic vocabulary of semantically and generically related terms which covers a specific domain of knowledge. The basic terminology in this thesaurus goes back to the 1969 edition of the EURATOM Thesaurus. The structure subsequently given to that terminology was ...
Sodium monofluoroacetate (1080) is a vertebrate pesticide widely used for possum control in New Zealand. Fluoroacetate is also a toxic component of poisonous plants found in Australia, South Africa, South America, and India. Because of its importance and effectiveness in pest control and the highly toxic nature of this compound, its acute sub-lethal and target organ toxicity have been extensively studied. In relation to its use as a pesticide its environmental fate, persistence, non-target impacts and general toxicology have been and continue to be extensively studied. Toxic baits must be prepared and used with extreme care, otherwise humans, livestock, and non-target wildlife will be put at risk. The high risk of secondary poisoning of dogs is a cause for concern. 1080 acts by interfering with cellular energy production. Possums die from heart failure, usually within 6-18 h of eating baits. Long-term exposure to sub-lethal doses can have harmful effects and strict ...
This is the 1st revision of the INIS/ETDE Joint Thesaurus. It contains 20 953 valid descriptors and 8 600 forbidden terms. It was last updated in December 2003. The Joint Thesaurus contains the controlled terminology for indexing all information within the subject scope of both INIS (International Nuclear Information System) and ETDE (Energy Technology Data Exchange) information systems. The terminology is intended for use in subject description for input or retrieval of information in those systems. The thesaurus is a terminological control device used in translating from the natural language of documents, indexers or users into a more constrained system language It is also a controlled and dynamic vocabulary of semantically and generically related terms which covers a specific domain of knowledge. The domain of knowledge covered by this Thesaurus includes physics (in particular, plasma physics, atomic and molecular physics, and especially ...
ObjectiveTo evaluate the primary care communications initiative, which introduced NHSnet to primary care in Scotland.DesignSemi-structured telephone...Full Text Available
PurposeDescription and analysis of the effects and side-effects of integrated mental health care in the Netherlands.Context of caseDue...Full Text Available
This paper describes how a computerized MIS is used to assist HMO management to conduct utilization and quality of care review activities in a prepaid medical care network. The HMO is a ‘network’...Full Text Available
BackgroundExisting studies concerning the health care use of homeless people describe higher utilisation rates for hospital-based care and emergency care, and lower rates for primary...Full Text Available
BackgroundWe examined whether older adults who had continuity of care with a primary care physician (PCP) had lower mortality.MethodsSecondary analyses...Full Text Available
The International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO) was launched in the year 2000, based on a resolution by the IAEA General Conference (GC(44)/RES/21). INPRO intends to help to ensure that nuclear energy is available in the 21st century in a sustainable manner, and seeks to bring together all interested Member States, both technology holders and technology users, to consider, jointly, actions to achieve desired innovations. INPRO is taking care of the specific needs of developing countries. This IAEA publication is part of Phase 1 of INPRO. It intends to provide an overview on history, present situation and future perspectives of nuclear fuel cycle technologies. While this overview focuses on technical issues, nevertheless, the aspects of economics, environment, and safety and proliferation resistance are important background issues for this study. After a brief description about the INPRO project and an evaluation ...
... CJCSI 3141.01C, Responsibilities for the Management and ... of a multivolume set of CJCS unclassified and ... (1) CJCSM 3122.01A, Joint Operation ...
... directed the transformation of designated Service operational headquarters into effective and scalable Joint Task Force headquarters capable of ...
We exhibit static solutions of multi-flavour QCD in two dimensions that have the quantum numbers of baryons and mesons, constructed out of quark and anti-quark solitons. In isolation the latter solitons have infinite energy, corresponding to the presence of a string carrying the non-singlet colour flux off to spatial infinity. When $N_c$ solitons of this type are combined, a static, finite-energy, colour singlet solution is formed, corresponding to a baryon. Similarly, static meson solutions are formed out of a soliton and an anti-soliton of different flavours. The stability of the mesons against annihilation is ensured by flavour conservation. The static solutions exist only when the fundamental fields of the bosonized Lagrangian belong to $U(N_c{\\times}N_f)$ rather than to $SU(N_c) \\times U(N_f)$. Discussion of flavour symmetry breaking requires a careful treatment of the normal ordering ambiguity. Our results can be viewed as a derivation ...
The purpose of the Utility Applications Program is to provide information and assistance to interested utilities on central station energy storage systems. Compressed air and underground pumped hydroelectric energy storage are the primary technical focus. Smaller utilities are the primary targets of this program, as they may not have resources to track and utilize new energy conservation developments. The program, initiated during this year-long period, consists of a series of tasks integrating and supporting energy storage implementation. Program management and technical coordination activities monitor the wide range of research ongoing both under government support and in industry and provide a locus for dissemination of results. Recently completed DOE demonstration studies provide the central data base and the DOE CAES and UPH Technology Program activities provide another major resource. In addition a UPH preliminary feasibility study in coorination with Central ...
The performance of more than 3,000 offshore platforms in the Gulf of Mexico was observed during the passage of Hurricane Andrew in August 1992. This event provided an opportunity to test the procedures used for platform analysis and design. A global bias was inferred for overall platform capacity and loads in the Andrew Joint Industry Project (JIP) Phase 1. It was predicted that the pile foundations of several platforms should have failed, but did not. These results indicated that the biases specific to foundation failure modes may be higher than those of jacket failure modes. The biases in predictions of foundation failure modes were therefore investigated further in this study. The work included capacity analysis and calibration of predictions with the observed behavior for 3 jacket platforms and 3 caissons using Bayesian updating. Bias factors for two foundation failure modes, lateral shear and overturning, were determined for each structure. Foundation capacity ...
Throughout the DOE complex there are numerous facilities that handle hazardous and radioactive waste solutions. Due to the hazardous constituents of the mixed waste, secondary containment of tank systems and their ancillary piping, in accordance with Resource Conservation and Recovery Act, is a concern for such existing facilities. The Idaho Division of Environmental Quality was petitioned in 1990 for an Equivalent Device determination regarding secondary containment of waste lines embedded in interior concrete walls. The petition was granted; however, it expires in 1996. To address the secondary containment issue, additional studies were undertaken. One study verified the hypothesis that an interior wall pipe leak would follow the path of least resistance through the naturally occurring void found below a rigidly supported pipe and pass into an adjacent room where detection could occur, before any significant deterioration of the concrete takes place. Other tests ...
Keywords: energy, management, conservation, program, fiscal, year, 2005, annual, ...S Environmental Protection Agency Energy Management and Conservation Program ...ENVIRONMENTAL P ROTECTION AGENCY Energy Management and Conservation Program Fiscal Year 2005 Annual Report
Jet Propulsion Laboratory. California Institute of Technology. Pasadena, California. Energy and Water Conservation. Steve Rigdon. Facilities Energy Manager ...
Purpose: To evaluate MR imaging of the hip in patients with a clinically suspected impacted fracture of the femoral neck in cases where conventional plain films show negative or equivocal findings. Material and Methods: Twenty-seven such patients were prospectively examined by MR imaging with a 1.0 T unit, within 24 hours of admittance to hospital. A coronal T1-weighted turbo spin-echo sequence (n=27), and a coronal STIR sequence (n=25) or a coronal T2-weighted turbo spin-echo fast saturation sequence (n=2) were used. The evaluations were made by 2 radiologists with experience in musculoskeletal radiology. Results: There were 6 patients with a petrochanteric fracture, 2 without and 4 with slight displacement. Five patients had an impacted fracture of the femoral neck, and 3 had a fracture of the superior pubic bone. Of 2 patients with advanced arthrosis, i had an impacted femoral neck fracture and the other a nondisplaced intertrochanteric fracture. There was 1 patient who had ...
A geothermal heat pump-assisted heating system is introduced into Changchun City and a survey is conducted to determine if the system may be popularized in this extremely cold region located in the northeastern part of China. In concrete terms, the hot water that circulates through the office building of Changchun Ground Heat Development Co., Ltd., is switched to hot water prepared by a geothermal heat pump. The test continued from December 2000 to March 2001. It is then concluded that heating by geothermal heat pumps will be fully serviceable to Changchun City. Implemented are (1) the shift from the coal fired boiler system to a geothermal heat pump system comprising 16 subterranean heat exchangers for the heating of the office building which is approximately 1000 m{sup 2} large, (2) long-term monitoring of the operating conditions, (3) measurement of subterranean heat exchanger thermal conductivity and subterranean temperature, and (4) the study of pipe shapes for improved thermal ...
This paper describes the unique challenges involved in achieving compliance with the Resource Conservation and Recovery Act (Public Law 94-580) Land Disposal Restrictions (LDR) treatment standards for four types of mixed wastes generated throughout the U.S. Department of Energy (DOE) complex: (1) radioactively contaminated lead acid batteries; (2) radioactively contaminated cadmium-, mercury-, and silver-containing batteries; (3) mercury-bearing mixed wastes; and (4) radioactive lead solids. For each of these mixed waste types, the paper identifies the strategy pursued by DOE's Office of Pollution Prevention and Resource Conservation Policy and Guidance (EH-43) in coordination with other DOE elements and the U.S. Environmental Protection Agency (EPA) to meet the compliance challenge. Specifically, a regulatory interpretation was obtained from EPA agreeing that the LDR treatment standard for wastes in the D008 'Radioactive Lead Solids' ...
The Northwest Foster Care Alumni Study examined the relation between experiences in foster care and depression among young adults who spent at least a year in foster care as adolescents. Results indicate that preparation for leaving foster care, nurturing supports from the foster family, school stability, access to tutoring, access to therapeutic service and support, and a shorter and more stable placement history were associated with a lower probability of depression in young adulthood. Results provide evidence that suggest ways to improve practice to decrease rates of depression among alumni of care. (Contains 2 tables.)
Purpose - The article discusses how care programmes and integrated care pathways can be linked, finding ways to improve healthcare process professional and logistical quality from a supply chain and a network point-of-view. Design/methodology/approach - The authors argue that owing to cost containment goals and increasing healthcare demand, healthcare services systems are challenged to improve service quality, whilst at the same time finding ways to improve delivery processes. It explores if the combination of two instruments, care programmes and integrated care pathways, can meet both goals. This combination is illustrated by an example from the Institute of Mental Health Care Eindhoven en de Kempen. Findings - Analysis suggests that care programmes can be combined with integrated care pa...
An assessment of the joint shear strength of exterior concrete beam-column joints reinforced internally with Glass Fibre Reinforced Polymer (GFRP) reinforcements under monotonically increasing load on beams keeping constant load on columns is carried out in this study. Totally eighteen numbers of specimens are cast and tested for different parametric conditions like beam longitudinal reinforcement ratio, concrete strength, column reinforcement ratio, joint aspect ratio and influence of the joint stirrups at the joint. Also finite element analysis is performed to simulate the behaviour of the beam-column joints under various parametric conditions. Based on this study, a modified design equation is proposed for assessing the joint shear strength of the GFRP reinforced beam-column specimens b...
Aims:To Study the religious and ideological views and practice of Palliative Care physician towards Euthanasia.Materials and Methods:An...Full Text Available
Paediatric palliative care is a holistic approach aimed at addressing the complex issues related to the care of children and families facing chronic life limiting illnesses. The needs of children are...Full Text Available
BackgroundDepression is a common illness, often treated in primary care. Many studies have reported undertreatment with antidepressants in primary care. Recently, some studies also...Full Text Available
BackgroundLittle is known about differences in professional care seeking based on marital status. The few existing studies show more professional care seeking among the divorced...Full Text Available
"Correctional Health Care: Implications for Public Health Policy" is the first in a series of articles that examines the special health care needs of persons who are incarcerated in America's correctional...Full Text Available
BackgroundUntil now only limited research has been done on the prevalence of chronic pain in primary care. The aim of this investigation was to study the health care utilisation...Full Text Available
Six patient assessment systems that have explicit decision rules for replicating team judgments on level of care patient placement were selected for analysis. The six were selected because of their...Full Text Available
BackgroundThe Emergency Care Summary (ECS) was introduced in 2006 to allow aspects of the general practitioner (GP; family doctor, equivalent to primary care physician) medical record...Full Text Available
BackgroundSensory information from mechanoreceptors in the skin, muscles, tendons, and joint structures plays an important role in joint stability. A joint injury can lead to disruption...Full Text Available
Hyaluronan (HA) is important for joint cavitation, lubrication, volume regulation and synovial fluid drainage but little is known about the regulation of joint HA synthesis/secretion in vivo....Full Text Available
This monograph explores an alternative way of providing a JSOTF headquarters to the Joint Force Commander. Beginning with a history of joint SOF doctrine, the monograph outlines the evolution of special operations command and control and the subsequent ne...
Special Operations Forces (SOF) within a Joint Task Force are controlled by a Joint Special Operations Task Force (JSOTF). Presently, JSOTF headquarters are formed around the core of the Theater Special Operations Command (TSOC), a service SOF headquarter...
Conceptual documents like Joint Vision 2010 (JV 2010), the Concept for Future Joint Operations (CFJO), and the Revolution in Military Affairs (RMA) postulate that advances in technology and information superiority will revolutionize the way military force...
OBJECTIVETo examine psychometric properties of the Confidence in Diabetes Self-Care (CIDS) scale, a newly developed instrument assessing diabetes-specific self-efficacy...Full Text Available
AbstractObjective: This study examined the effectiveness of a telephone-based referral-care management (TBR-CM) intervention on psychiatric health...Full Text Available
This article is a story of networking of palliative care at the corporate level. This gives an insight that if you have will and dedication then you can imagine and make it true that networking can...Full Text Available
... Harbor Township Vineland Voorhees Pediatric Partner Hospitals AtlantiCare Regional Medical Center- City Campus, Atlantic City AtlantiCare Regional Medical Center - ...
OBJECTIVETo evaluate trends in costs of ambulatory care related to female pelvic floor disorders (PFD) in the United States.STUDY DESIGNFull Text Available
OBJECTIVE AND DESIGNThis study used qualitative and quantitative methods to examine the reasons primary care physicians and nurses offered for their inability to initiate guideline-concordant...Full Text Available
Information superiority provides the Joint force a competitive ... Information Grid (GIG) as it matures and fills the needs of the Joint Task Force ... representatives from The Army Secretariat, Headquarters Department of Army ...
Title: FY 2004 Energy Management and Conservation Program Annual Report ...Energy Management and Conservation Program ...Environmental Protection Agency Office of Administration and Resources Management 1200 Pennsylvania Avenue, NW (3101A)
When performing trenchless pipe renovation work - whichever process you use - the success of the job depends on the careful removal of all scale, sediments and rust from the innerwall surfaces. The VACUJET process - in which the pipe is cleaned with water at pressures of up to 2 500 bar using a technique jointly developed by Preussag Rohrsanierung GmbH and Fabex GmbH - meets all requirements. The equipment includes a mobile waste water treatment unit which is small enough to fit on a standard trailer. Despite its compact dimensions this plant is so effective that it can treat all the waste water generated during the high pressure cleaning jobs so that it is suitable for reuse in the cleaning process or for release into the sewerage system. (orig.) [Deutsch] Bei der grabenlosen Rohrsanierung, ganz gleich nach welchem Verfahren saniert wird, ist die sorgfaeltige Entfernung von alten Beschichtungen, Ablagerungen und Rost eine wesentliche ...
The design of a 345-kV prefabricated capacitive-graded joint for oil-filled cables and the manufacture and testing of prototype joints are described. Tests on prototype No. 4 demonstrated the adequacy of the printed circuit design. It was not possible to consistently obtain high-quality capacitive sheets and substantial effort is required to remedy this problem. Advantages of these prefabricated joints are summarized, and specific recommendations are made for further development of the concept.
The Joint Convention on the Safety of Spent Fuel management and on the Safety of Radioactive Waste Management is the first legal instrument to directly address the safety of spent fuel and radioactive waste management on a global scale. The Joint Convention entered into force in 2001. This paper describes its process and its main achievements to date. The perspectives to establish of a Global Waste Safety Regime based on the Joint Convention are also discussed. (authors)
This paper reports on a flexible dimensionaly flush joint for 500kV aluminum-sheathed oil-filled cables capable of being assembled, pulled an installed in a similar manner to cables at site which has been developed. This joint is intended for use at intermediate points on long bridges or tunnels where local assembly and installation of conventional joints would be difficult. In developing the joint various novel and original techniques have been employed, including the flexible flush jointing of segmental conductors, the flexible jointing of paper insulation by a combination of wrapping-back and stepping methods, plus on-site aluminum sheath corrugating and sealing methods.
During the second half of 1993, the groundwater at the F-Area Seepage Basins (FASB) was monitored in compliance with Module 3, Section C, of South Carolina Hazardous Waste Permit SC1-890-008-989, effective November 2, 1992. The monitoring well network is composed of 87 FSB wells screened in the three hydrostratigraphic units that make up the uppermost aquifer beneath the FASB. A detailed description of the uppermost aquifer is included in the Resource Conservation and Recovery Act Part B post-closure care permit application for the F-Area Hazardous Waste Management Facility submitted to the South Carolina Department of Health and Environmental Control (SCDHEC) in December 1990. Beginning in the first quarter of 1993, the standard for comparison became the SCDHEC Groundwater Protection Standard (GWPS) specified in the approved F-Area Seepage Basins Part B permit. Currently and historically, gross alpha, nitrate, nonvolatile beta, and tritium are ...
This conference provided a forum for more than 500 delegates from industry, government universities and research centres to share their professional knowledge on research and development that affects all sectors of geotechnical engineering, applied geology and hydrogeology. Accomplishments in the geoenvironmental field were also highlighted. The geotechnical sessions were entitled: pile foundations and load testing; excavations and special foundation issues; reinforced soil and soil-structure interactions; advances in modelling, constitutive issues; advances in modelling, consolidation and other applications; advances in modelling, discrete elements and slope stability; embankments and dams; landfills and barriers; fundamental soil mechanics; soil mechanics and ground movement; GIS and remote sensing; landslides and slopes; cone penetration tests and liquefaction assessment; rock mechanics; engineering geology; geoenvironmental sustainability; oilsand and petroleum geomechanics; and, ...
The effect of aging on the microstructure and tensile properties of a type 316LN stainless steel/Alloy 800 joint, welded with 16-8-2 stainless steel consumable, has been studied to characterize and evaluate the joint for long-term elevated temperature service. The joint was subjected to accelerated againg heat treatments at 873 K up to 5000 h to simulate long-term service exposures. Analysis of the results from this investigation shows that this joint has adequate stability of microstructure and tensile properties even after prolonged exposure at elevated temperatures. (orig.)
The hierarchy of integrable nonlinear equations associated with the quadratic bundle is considered. The expressions for the solution of linearization of these equations and their conservation law in the terms of solutions of corresponding Lax pairs are found. It is shown for the first member of the hierarchy that the conservation law is connected with the solution of linearized equation due to the Noether's theorem. The local hierarchy and three nonlocal ones of the infinitesimal symmetries and conservation laws explicitly expressed through the variables of the nonlinear equations are derived. (author)
This experimental study investigates the effectiveness of crossed inclined bars (X-bars) as joint shear reinforcement in exterior reinforced concrete beam-column connections under cyclic deformations. Test results of 20 joint subassemblages with various reinforcement ratios and arrangements including X-bars in the joint area are presented. The X-type, non-conventional reinforcement is examined as the only joint reinforcement and in combination with common stirrups or vertical bars. The experimental results reported herein include full loading cycle curves, energy dissipation values and a categorization of the observed damage modes. Based on the comparisons between the overall hysteretic responses of the tested specimens, it is deduced that joints with X-bars exhibited enhanced cyclic perfo...
An effective rehabilitation strategy is proposed to enhance the strength and stiffness of the beam-column joint in this study. An analytical model is proposed to predict the column shear of the joints strengthened with carbon fiber reinforced polymer (CFRP). Three full scale interior beam-column joints, including two specimens strengthened with CFRP and one prototype specimen, are tested in this study. The specimens are designed to represent the pre-seismic code design construction in which there is no transverse reinforcement. A new optical non-contact technique, digital image correlation (DIC), which can measure the full strain field of specimen, is used to measure and observe the full strain field of the joint. The experimental results show that the beam-column joints strengthened with ...
The critical part of the trimetallic transition joint (type 304 stainless steel/Alloy 800/2.25 Cr-1 Mo steel), the Alloy 800/2.25 Cr-1 Mo steel joint welded with Inconel 182, was subjected to thermal cycling between room temperature and 873 K. The thermal cycling test procedure used produces accelerated failures in transition joints similar to those observed in steam generators of operating power plants. On thermal cycling, precipitation at the weld/ferritic steel interface decreased on post-weld heat treatment. This precipitation increased with increased prior ageing and applied stress. The results of these tests indicated a considerable improvement in performance of the trimetallic transition joint compared to the direct (bimetallic) transition joint. (orig.).
The study examines the question of whether or not civilian marketing practices and principles can be applied in the military care setting. Using the NRMC Great Lakes as a basis, the answer is yes--consumers of military medical care are ready to be the rec...
The paper describes the possibilities of using data warehousing and OLAP technologies in public health care in general and then our own experience with these technologies gained during the implementation...Full Text Available
BackgroundMost studies on children with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) have been undertaken in tertiary care and little is known about their management...Full Text Available
By analyzing the data of 459 patients who completed the Supportive Care Needs Survey (SCNS), the prevalence, medical and non-medical predictors of unmet needs were investigated. Breast cancer patients...Full Text Available
BackgroundInternationally, there is increasing use of telephone consultations, particularly for triaging requests for acute care. However, little is known about how this mode of...Full Text Available
BackgroundWith a growing number of genetic tests becoming available to the health and consumer markets, genetic health care providers in Canada are faced with the challenge of developing...Full Text Available
Objectives To evaluate the extent to which intensive care units participating in the initial Keystone ICU project sustained reductions in rates of catheter related bloodstream infections.Design...Full Text Available
Goals of workThe goal of this study was to evaluate, at a population level, the association between specialized palliative care services (SPCS) and short- and long-term caregiver...Full Text Available
Fresh blood has many potential advantages over older blood, but there is no evidence that these properties translate into clinical benefit for intensive care patients. The observational multicenter...Full Text Available
Digital information flow within the intensive care unit (ICU) continues to grow, with advances in technology and computational biology. Recent developments in the integration and archiving of these...Full Text Available
BackgroundNew Zealand's Primary Health Care Strategy (NZPHCS) was introduced in 2002. Its features are substantial increases in government funding delivered as capitation payments,...Full Text Available
Psychology as both a science and a profession has been closely identified with other disciplines in the broad field of health since the turn of the present century. Recent advances in health care have...Full Text Available
OBJECTIVES:To investigate the prevalence of potential drug interactions at the intensive care unit of a university hospital in Brazil and to analyze their clinical significance.METHODS:This...Full Text Available
The objective of this study was to evaluate the effect of pregabalin in painful cervical or lumbosacral radiculopathy treated in Primary Care settings under routine clinical practice. An observational,...Full Text Available
ObjectiveTo identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients.Full Text Available
The outcome of patients admitted to intensive care units is known to be influenced by such factors as age, previous health status, severity of disease, and diagnosis. To estimate the outcome of such...Full Text Available
ObjectiveTo report the outcome of children with life-threatening asthma (LTA) admitted to a university Pediatric Intensive Care Unit (PICU).MethodsRetrospective...Full Text Available
Background Little is known about how migrants adapt to first-world public health systems. In Norway, patients are assigned a registered general practitioner (RGP) to provide basic care...Full Text Available
This article explores the effects of reimbursement and utilization control policies on utilization patterns and spending for physician and hospital outpatient services under state Medicaid programs....Full Text Available
OBJECTIVE. This study was conducted to determine whether an index for measuring quality of care for psychiatric emergencies is reliable and valid. DATA SOURCES/STUDY SETTING. The study used primary...Full Text Available
OBJECTIVE: To examine primary care physicians' management of rheumatoid arthritis, ascertain the determinants of management and compare management with that recommended by a current practice panel....Full Text Available
This paper summarizes the findings for the African Region of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. We present an overview...Full Text Available
BackgroundIntegration of medical care across clinicians and settings could enhance the quality of care for patients. To date, there is limited data on the levels of integration in...Full Text Available
IntroductionThe aim of the study was to assess and classify incidents of electromagnetic interference (EMI) by second-generation and third-generation mobile phones on critical care...Full Text Available
Electronic personal health records (ePHRs) can potentially maximize access and coordination of health information and improve patient/clinician collaboration, patient self-management, and health outcomes....Full Text Available
BackgroundThe Government has invested £7 million (approx. $11.5 million) to connect all Primary Care Practices in Scotland to the National Health Service...Full Text Available
PURPOSE This study was designed to evaluate the impact of electronic medical record (EMR) implementation on quality of diabetes care.METHODS We conducted a 5-year longitudinal...Full Text Available
Objectives:Despite its impact on health policy, the relationship between geographical proximity and health care seeking has received scant attention in the medical literature. This...Full Text Available
OBJECTIVE--To review findings from studies of the influence of desktop computers on primary care consultations. DESIGN--Systematic review of world reports from 1984 to 1994. SETTING--The computerised...Full Text Available
Emergency Departments (ED) are fast-paced, information-intensive environments where patient care team members must address their information needs quickly and accurately. We conducted a qualitative...Full Text Available
The method of linear analogue self-assessment (LASA) was used to quantify the views concerning day care which were held by patients attending a geriatric day hospital. The results suggest that day hospitals...Full Text Available
ObjectivesTo assess Croatian community pharmacists' patient care competencies using the General Level Framework (GLF).MethodsThe competencies of...Full Text Available
PURPOSE We wanted to assess computer capabilities in a primary care practice-based research network and to understand how receptive the practices were to new ideas for automation of practice...Full Text Available
Quality research, requiring large numbers of participants, in the intensive care unit (ICU) population requires multicentre collaboration. Although logistically challenging, this methodology reduces...Full Text Available
BACKGROUND. Diabetes can be effectively treated and monitored in general practice. Postgraduate medical education at a local level is required to support this strategic shift of medical care from hospital...Full Text Available
Despite an accumulating body of literature addressing racial/ethnic disparities in children’s health and health care, there have been few published studies of interventions that have...Full Text Available
Will the aging of Canada's population bankrupt the health care system? In this issue (see pages 1555 to 1560) Dr. Marie Demers reports that the increase in physician service costs for elderly people...Full Text Available
PURPOSE The Wells rule is widely used for clinical assessment of patients with suspected deep vein thrombosis (DVT), especially in the secondary care setting. Recently a new clinical decision...Full Text Available
The overarching goal of medical training is to nurture the growth of knowledgeable, caring and insightful clinicians guided by the ideals of medical professionalism. Recent definitions of professional...Full Text Available
BackgroundThe Canadian Emergency Department Triage and Acuity Scale (CTAS) is a well recognized and validated triage system that prioritizes patient care by severity of illness....Full Text Available
Patients do considerable information work. Technologies that help patients manage health information so they can play active roles in their health-care, such as personal health records, provide...Full Text Available
Very few areas of medical science have experienced more rapid development of new and beneficial treatment approaches during the past two decades than the disciplines required for total care of patients...Full Text Available
This article compared conceptual and empirical strengths of alternative methods for estimating racial disparities using non-linear models of health care access. Three methods were presented...Full Text Available
OBJECTIVE: To increase cost-efficiency while maintaining the standard of medical care, an accelerated surgical stay program for patients having breast surgery was instituted. SUMMARY BACKGROUND DATA:...Full Text Available
...dates of the implementation of the standard unique health identifier for health care providers. 162.404 Section 162.404 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA...
In recent years conservation of electric power has become an integral part of utility planning. The 1980 Pacific Northwest Electric Power Planning and Conservation Act (Northwest Power Act) requires that the region consider conservation potential in planning acquisitions of resources to meet load growth. The Bonneville Power Administration (BPA) developed its first estimates of conservation potential in 1982. Since that time BPA has updated its conservation supply analyses as a part of its Resource Program and other planning efforts. Major updates were published in 1985 and in January 1990. This 1992 document presents updated supply curves, which are estimates of the savings potential over time (cumulative savings) at different cost levels of energy conservation measures (ECMs). ECMs are devices, pieces of equipment, or actions that increase the efficiency of ...
When completed, Lawrence Livermore National Laboratory's (LLNL) National Ignition Facility (NIF) will be the world's largest laser with experimental capabilities applicable to stockpile stewardship, energy research, science and astrophysics. As construction of the conventional facilities nears completion, operations supporting the installation of specialized laser equipment have come online. Playing a critical role in the precision cleaning of mechanical parts from the NIF beamline are three pieces of aqueous cleaning equipment. Housed in the Optics Assembly Building (OAB), adjacent to NIF's laser bay, are the large mechanical parts gross cleaner (LMPGC), the large mechanical parts precision cleaner (LMPPC), and the small mechanical parts gross and precision cleaner (SMPGPC). These aqueous units, designed and built by Sonic Systems, Inc., of Newtown, Pennsylvania, not only accommodate parts that vary greatly in size, weight, geometry, surface finish and ...
Objectives To test the hypotheses that, compared with conventional outpatient consultations, joint teleconsultation (virtual outreach) would incur no increased costs to the NHS, reduce...Full Text Available
AIM: To evaluate the effects of percutaneous ozone injection via the posterior-lateral route and inner margin of the facet joint in the treatment of large lumbar disc herniation.METHODS:...Full Text Available
Exact anatomic knowledge about the location of the gonads and the application of corresponding measures of radiation protection are the preconditions for an efficient reduction of the danger of a possible genetic damage as a result of radiation exposition during X-ray examination of the hip joint of newborns. (VJ).
The purpose of the Joint Task Force Headquarters Master Training Guide (JTF HQ MTG) is to provide a descriptive, performance-oriented training guide to assist leaders in training their units. It also serves as a guide for the JTF Headquarters in actual op...
We studied multi-joint coordination during tasks of transporting real and imaginary objects with two arms. One of the arms was unexpectedly arrested in one third of trials performed. In the...Full Text Available
Objective:To assess the efficacy of facet joint infiltrations for pain relief in 44 selected patients with chronic nonradicular low back pain (LBP).Materials...Full Text Available
Examination of a painful hip is fairly concise and reliable at detecting the presence of a hip joint problem. Hip joint disorders often go undetected, leading to the development of secondary disorders....Full Text Available
This joint statement was developed by the CMA and the Canadian Pharmaceutical Association, a national association of pharmacists, and includes the goal of drug therapy, strategies for collaboration...Full Text Available
The structure of a demountable vacuum joint designed for operation from -120 to +120 deg C is developed and tested. Requirements of especially low gas release from the materials used have been fulfilled; the same concerns low sealing efforts, repeated action and keeping tightness under loads, indium being used as a sealant. Experimental studies of demountable vacuum joints, dia 100,125,140,160,180 and 200 mm, with an indium sealant permit to make the following conclusions: 1. The joints are sealed at sealing specific efforts of 0.4 kg/mm (without considering atmospheric pressure). 2. The joints retain tightness at opening and closing a cover five times and under +-120 deg C. 3. To ensure repeated operation of the joint with continued stable sealing effort, one should make sure the sealed surfaces coincide at repeated sealing. 4. When operating demountable vaccum ...
...COMCAM forces document Air Force and air component activities...supported unified command or joint task force commander, through the...Force COMCAM forces in a joint environment. If an...share of Unified Command headquarters COMCAM and visual...
... Title : Mental Health and Resilience: Soldiers' Perceptions about Psychotherapy, Medications, and Barriers to Care in the United States Military. ...
Japan Atomic Energy Research Institute (JAERI) and the High Energy Accelerator Research Organization (KEK) are promoting the joint project integrating both the Neutron Science Project (NSP) of JAERI and the Japan Hadron Facility Project (JHF) of KEK for comprehensive studies on basic science and technology using high-intensity proton accelerator. This document describes the joint project prepared by the Joint Project Team of JAERI and KEK to construct accelerators and research facilities necessary both for the NSP and the JHF at the site of JAERI Tokai Establishment. It was originally written in English and translated into Japanese with some corrections. (author)
... The pharmacologist/toxicologist and the statistician will jointly determine if a statistical review is needed and when the review should be done. ...
... from theory to practice will be significantly reduced while intrinsically revolutionizing the approach to engineering network security architectures. ...
runs are necessary, provision shall be made for expansion joints, motion of the units, or similar compensation to ensure that no excessive strains are ...
... to integrate and synchronize SC efforts and capabilities, as noted in the SC Roadmap, the joint community needs to publish SC policy and expand ...
The rapid global loss of natural habitats and biodiversity, and limited resources, place a premium on maximizing the expected benefits of conservation actions. The scarcity of information on the fine-grained...Full Text Available
Synaptic vesicle endocytosis is critical to maintain synaptic communication during intense stimulation. Here we describe Tweek, a conserved protein that is required for synaptic vesicle recycling....Full Text Available
BackgroundIn a world limited by data availability and limited funds for conservation, scientists and practitioners must use indicator groups to define spatial conservation priorities....Full Text Available
We report herein a case of thoraco diaphragmatico biliary fistula in a 24-year-old male who was managed conservatively with antibiotics and tube thoracostomy and had complete radiological clearance.
Background and AimsCrassula hunua and C. ruamahanga have been taxonomically controversial. Here their distinctiveness is assessed so that their taxonomic and conservation...Full Text Available
The paper presents a comprehensive analysis of the energy conservation policy conducted in the Central and Eastern European countries - its development from the start of reforms and up to the present. The problems of rational energy consumption are shown to be closely connected with the concrete conditions of the transition from the economy based on the command principles to the market economy. The author indicates the main areas of application for energy conservation activities. He also describes the models for determination of energy intensity in different branches of energy economy, and organisational structure of the measures to be taken foe energy conservation. (author)
Energy conservation presents major opportunities to industry, both to improve its energy efficiency (hence its competitiveness and profitability) and to supply services and equipment. There are vast markets, both in the United Kingdom and overseas, but there are also barriers. There is reluctance on one hand to make new investment on the scale required. On the other hand, the problems of meeting a fragmented new demand are complicated by the fragmentation of the conservation supply industry. This calls for a new coherent, and innovative approach by both the conservation supply industry and the financial institutions. 3 tables.
The use of pre-dehumidified air having widely established itself as a safe and economical conservation method during the stoppage of steam turbines, it was obvious that this method would be applied also to steam boilers and ancillary aggregates. Experience with the conservation of condensers, prheaters and the water/steam-side of steam boilers in large-scale power stations is reported on. By the example of projects with topical interest, the problems and possibilities of boiler conservation on the firing side are illustrated. The contribution is to stimulate further discussions. (orig.).
Abstract An increase in chronic disease prevalence is contributing to health care cost growth and decreased quality of life in industrialized nations worldwide. Inadequate management of chronic diseases is a leading cause of hospitalizations and, thus, avoidable expenditures. In this study, we evaluated the impact of nurse-delivered care calls, the primary intervention of a proactive chronic care management (CCM) program, in a population aged 65 and older in Germany. In this analysis, hospital admission rates were evaluated among program enrollees who were diagnosed with diabetes, heart failure, coronary heart disease, or chronic obstructive pulmonary disease. The Intervention group comprised those members who participated in care calls (n?=?13,486), whereas the Comparison group included e...
The Sultanate of Oman has a relatively young national health care system that could demonstrate its high performance at an international level. Emergency medicine as a specialty has developed rapidly in the country over the last decade. This has involved the parallel development of local emergency residency training, prehospital emergency care, and emergency nursing programs. This article reviews the progress of emergency care practice in this country from a general primary care system toward becoming an established specialty in hospital, prehospital, and private emergency care settings. It also describes aspects of undergraduate, postgraduate, and continuous emergency medicine education in the country. Further, a glimpse into academic emergency medicine and emergency nursing is provided. ...
We propose a dynamical model for business cycle based on an optimal DI model. In the model there exists a conserved quantity, which corresponds to the total energy in a dynamical system. We found that the business cycle with the period 6 or 7 years is nicely reproduced, since the model predicts a periodic motion in the conservative system.
Authors obtained T1-weighted MRI images of the femoral head after fracture of the femoral neck and classified the signals into four patterns to investigate the sequential changes of the femoral head. The T1-weighted MRI images obtained initially after femoral neck fracture showed a normal pattern in 10 of the 15 hip joints studied. MRI images obtained subsequently still showed the normal signal pattern in eight of the 10 hip joints which had shown the normal pattern in the first MRI, while two of the 10 joints subsequently showed a band pattern. The joint with the homogeneous pattern in the first MRI subsequently showed a band pattern. Of the three joints with an inhomogeneous pattern in the first MRI, two joints showed a subsequent band pattern, and the other a normal pattern. The joints which showed a band pattern continued to show a ...
As an engineered barrier system in the geological disposal of high-level waste, multibarrier system is considered. Multibarrier system consists of the vitrified waste, the overpack and the buffer. Bentonite is one of the potential material as the buffer because of its low water permeability, self-sealing properties, radionuclides adsorption and retardation properties, thermal conductivity, chemical buffering properties, overpack supporting properties, stress buffering properties, etc. As the construction technology of the buffer, the block installation method and in-situ compaction method, etc, are being investigated. The block installation method is to emplace the buffer blocks manufactured in advance at the ground facility, and construction processes of the block installation method at the underground will be simplified compared with the in-situ compaction method. However, the block joints of buffer might be a mechanical weak portion or might be a preferential ...
In the paper the role of conservation laws in evolutionary processes, which proceed in material systems (in material media) and lead to generation of physical fields, is shown using skew-symmetric differential forms. In present paper the skew-symmetric differential forms on deforming (nondifferentiable) manifolds were used in addition to exterior forms, which have differentiable manifolds as a basis. Such skew-symmetric forms (which were named evolutionary ones since they possess evolutionary properties), as well as the closed exterior forms, describe the conservation laws. But in contrast to exterior forms, which describe conservation laws for physical fields, the evolutionary forms correspond to conservation laws for material systems. The evolutionary forms possess an unique peculiarity, namely, the closed exterior forms are obtained from these forms. It is just this that enables one to describe the ...
Measurements of human joint motion frequently involve the use of opto-electronic and other motion analysis systems where some type of makers are used to establish joint motion within a global reference coordinate frame. Typically, this global reference coordinate frame is chosen to be most convenient for the person carrying out the experiment in which the joint motion is measured, and Euler angles are chosen as the measure of joint motion. Results, however, may be quite arbitrary and therefore rendered meaningless if the reference frame is not properly chosen with respect to the physical joint axis. In order to make a proper choice of coordinate axes in the reference frame, one must take into consideration both the location and the orientation of die physical joint axis relative to the reference frame`s axes. In nature, joint axes can exist ...
AbstractOBJECTIVETo provide an overview of the 2009 edition of the Rourke Baby Record (RBR), which incorporates recent research in the literature relating to preventive health care for children aged 0 to 5 years.QUALITY OF EVIDENCERecommendations are identified as supported by good, fair, or consensus evidence, according to the classification of the Canadian Task Force on Preventive Health Care.MAIN MESSAGENew information and recommendations are given for growth monitoring, nutrition, developmental surveillance, physical examination maneuvers, immunization schedules, and advice for parents. Anticipatory guidance updates relate to injury prevention, infant swaddling, literacy facilitation, nonparental child care, parenting skills programs, serum lead levels, over-the-counter cough and cold medications, pacifiers, antipyretics, insect repellents, and dental care and oral health. The 2009 RBR is available ...
One of the most challenging problems in Opportunistic Spectrum Access (OSA) is to design channel sensing-based protocol in multi secondary users (SUs) network. Quality of Service (QoS) requirements for SUs have significant implications on this protocol design. In this paper, we propose a new method to find joint policies for SUs which not only guarantees QoS requirements but also maximizes network throughput. We use Decentralized Partially Observable Markov Decision Process (Dec-POMDP) to formulate interactions between SUs. Meanwhile, a tractable approach for Dec-POMDP is utilized to extract sub-optimum joint policies for large horizons. Among these policies, the joint policy which guarantees QoS requirements is selected as the joint sensing strategy for SUs. To show the efficiency of the proposed method, we consider two SUs trying to access two-channel primary users (PUs) network modeled by discrete ...
The objectives of this paper are to: quickly outline the extent of the care gap in osteoporosis; define T-2 (knowledge) translation and its relationship to quality improvement; discuss the barriers to best practice in osteoporosis care after a fracture; convey the importance of rigor in design and evaluation of translational interventions by drawing upon examples from the broader literature; describe in some detail a series of post-fracture intervention trials conducted in Alberta, Canada; and make some conclusions specifically about osteoporosis interventions and more generally about T-2 translational research.
The mixed structure of a nuclear reactor building is composed of SC-columns, S-beams, S-joints and PCa-panels. Following the last report (Part 7)[1], the main test results of the mixed structure, that is, the deformation mode, strain distribution and shear strength, are described. The S-joints using ultrahigh strength materials had no buckling nor shear slipping. The proposed mixed structure resisted the external horizontal forces under integrated uniformity among SC-columns, S-joints and PCa-panels. It could be confirmed that the mixed structure can be established. (author)
Twenty-seven patients with symptoms or clinical findings suggesting joint or bone disorders of the anterior chest wall (ACW) were evaluated by spiral CT with 3-dimensional (3-D) and multiplanar reconstructions. Preceding conventional ACW tomography was performed in 10 patients. ACW joint and bone changes were visualized more adequately by coronal 2-D reconstructions based on spiral CT than by conventional tomography. In addition, nonossified costal cartilages and soft tissue lesions were demonstrated. 3-D reconstructions sometimes added information, especially in patients with fracture and dislocation. (orig.).
Studied are the mechanical properties of welded joints and heat affected zones of the Kh8N10T steel and OT4 and VT1-2 titanium alloys on welding in Ar+deltaF_6 and Ar+CCl_2F_2 mixtures contributed to a decrease of porosity. Tensile and impact tests of welded joints have revealed that additions of sulfur hexafluoride into argon causes a decrease of impact strength in titanium alloy when the tensile strength does not depend on the composition of a halogen-containing atmosphere. Freon (CCl_2F_2) additions decrease only slightly the impact strength of the investigated alloys.
Magnetic resonance (MR) imaging and histopathology were used to diagnose an articular process synovial myxoma in a dog. On MR images, the tumor was characterized by distortion of the left L1-L2 articular process, widening of the articular process joint, and the presence of a mass contiguous with the synovium of the articular process that displaced the spinal cord. The tumor was T2-hyperintense, T1-hypointense, relative to muscle, and had mild contrast enhancement. The MR features of articular process synovial myxoma may be distinct from other diseases of the articular process joint.
In the context of safety assessment of radioactive waste repositories, complex radionuclide transport models covering key safety-relevant processes play a major role. In recent Swiss safety assessments, such as Kristallin-I, an important drawback was the limitation in geosphere modelling capability to account for geosphere heterogeneities. In marked contrast to this limitation in modelling capabilities, great effort has been put into investigating the heterogeneity of the geosphere as it impacts on hydrology. Structural geological methods have been used to look at the geometry of the flow paths on a small scale and the diffusion and sorption properties of different rock materials have been investigated. This huge amount of information could however be only partially applied in geosphere transport modelling. To make use of these investigations the 'PICNIC project' was established as a joint cooperation of PSI/Nagra and QuantiSci to provide a new ...
... Ashton WS, Puntel RA, Wiswell TE. A rapid and readily available repair of the peripherally inserted central catheter in the nursery. NEONATAL INTENSIVE CARE 11 ...
Patients rely on their primary care physician to manage multiple, often chronic medical conditions that require prescription medications. Balancing the risk to benefit of treatments can be challenging...Full Text Available
During an outbreak of Flavobacterium meningosepticum septicaemia in a neonatal intensive care unit 9 infants were treated with intravenous trimethoprim sulphamethoxazole. Bacteriological cure was achieved...Full Text Available
A questionnaire on the development of specialist clinics was distributed to the members of the Association of British Neurologists and completed by 104 members (85 consultants). Half of the respondents...Full Text Available
ERDMANN A.L., DE ANDRADE S.R., FERREIRA DE MELLO A.L., KLOCK P., DO NASCIMENTO K.C., SANTOS KOERICH M. & STEIN BACKES D. (2011) Practices for caring in nursing: Brazilian research groups. International Nursing Review58, 379-385 Background:- The present study considers the production of knowledge and the interactions in the environment of research and their relationships in the system of caring in nursing and health. Aim:- To elaborate a theoretical model of the organization of the practices used for caring, based on the experiences made by the research groups of administration and management in nursing, in Brazil. Methods:- The study is based on grounded theory. Twelve leaders of research groups, working as professors in public universities in the south and the south-east of Brazil, distri...
ObjectiveTo investigate the prevalence of complicating and concurrent morbidities in older diabetic patients and to evaluate to what extent their occurrence affects the burden of...Full Text Available
Sepsis has continuously been a leading cause of neonatal morbidity and mortality despite current advances in chemotherapy and patient intensive care facilities. Neonates are at high risk for...Full Text Available
BackgroundAs long-term nursing home care is likely to increase with the aging of the population, identifying chronic medical conditions is of particular interest. Although need factors...Full Text Available
A Health Care Establishment (HCE) is an establishment where medical services are rendered. The above services are provided by the health care personnel. The infrastructure of a HCE may include Information Technology (IT) equipment that stores and processes HC information. Previously, IT equipment consisted solely of stand-alone systems, whereas in recent years, the trend has been towards computer networks and distributed systems in HCEs. The spread of distributed information technology in HCEs have necessitated the implementation of Security in HCISs, to assure confidentiality, integrity and availability of HCE information. This paper discusses the issues of Security and Network Security in Health Care Information Systems (HCISs). It also suggests a method in establishing Network Security Guidelines and describes Principles for the provision of Network Security in HCEs. PMID:10163736
... 82 Ibid, 200. 83 Ibid, 200. 84 Ibid, 201. 43 Page 49. care to hunt down and execute all that claimed to be from the house of David. They considered ...
A Health Care Establishment (HCE) is an establishment where medical services are rendered. These services are provided by the health care personnel. The infrastructure of a HCE may include Information Technology (IT) equipment that stores and processes HC information. The spread of distributed information technology in HCEs have necessitated the implementation of Network Security in Health Care Information System (HCISs), to assure confidentiality, integrity and availability of HC information being transmitted across HC networks. This paper presents a road map in implementing Network Security guidelines for the provision of Network Security in HCEs, work carried out within the Secure Environment for Information Systems in Medicine (SEISMED) project under the Advanced Informatics in Medicine (AIM) programme. PMID:8591295
... dressing changes and site care, mid-line placement, placement of peripherally inserted central catheters, heparin locks, and patient education. ...
PurposeHealth information technology (HIT) and physician career satisfaction are associated with higher-quality medical care. However, the link between HIT and physician...Full Text Available
The economics of medical computer networks are presented in context with the patient care and administrative goals of medical networks. Design alternatives and network topologies are discussed with...Full Text Available
Caring for a child with a potentially fatal medical condition is a challenge for parents or caregivers. The ability to measure parental self-efficacy in pediatric palliative care may be an important component of targeting supportive services that address individual needs of families. Therefore, the goal was to develop a Pediatric Palliative Care Parental Self-Efficacy Measure (PCPEM). First, a list of questions were generated that asked parents their level of confidence in carrying out tasks involved in caring for a child with a potentially fatal medical condition in 6 palliative care domains: 1) medical discussion/decisions; 2) symptom management/medication; 3) daily activities; 4) feelings/concerns; 5) spirituality; and 6) end-of-life care. The PCPEM was narrowed to 58 questions after expert reviews. Then, 16 caregivers of children receiving palliative ...
Summary Objective To evaluate the cost-effectiveness of an educational outreach intervention to improve primary respiratory care by South African nurses. Methods Cost-effectiveness analysis alongside a pragmatic cluster randomised controlled trial, with individual patient data. The intervention, the Practical Approach to Lung Health in South Africa (PALSA), comprised educational outreach based on syndromic clinical practice guidelines for tuberculosis, asthma, chronic obstructive pulmonary disease, pneumonia and other respiratory diseases. The study included 1999 patients aged 15 or over with cough or difficult breathing, attending 40 primary care clinics staffed by nurses in the Free State province. They were interviewed at first presentation, and 1856 (93%) were interviewed 3 months late...
BackgroundAlthough advances in rehydration therapy have made cholera a treatable disease with low case-fatality in settings with appropriate medical care, cholera continues...Full Text Available
In contrast to the increasing availability of information pertaining to the care of children with chronic kidney disease (CKD) from large-scale observational and interventional studies, epidemiological...Full Text Available
Brief admission of the new diabetic child and of a parent to an enlightened hospital for stabilisation, preliminary education, and familiarisation with hospital and community staff is well worth while....Full Text Available
Background Increasing numbers of cancer patients are using the Internet, but little is known about their attitudes toward online health care.Full Text Available
of injuries, disabilities, and deaths; and 3. Encourage professionals from a wide spectrum of disciplines such as engineering, bioengineering, medicine, health care, public...
This bibliography of nonserial publications consists of 610 annotations. It is intended as a guide to the development of a collection for librarians and for health professionals in research and education....Full Text Available
OBJECTIVE: To evaluate the effectiveness of a program to improve hypertension control practices in primary care. DESIGN: Retrospective quasi-experimental study. SETTING: Three hospital-based family...Full Text Available
Subcommittee of the Joint Committee on Atomic Energy of the United States, Outer Space Propulsion by Nuclear Energy, hearings, 85th Cong., 2d sess., 22, ...
Microscopy and chemotaxonomy from HPLC analysis of phytoplankton pigments initiated in 2003 suggest that Noctiluca miliaris blooms are becoming more intense ...
... Headquarters Element, Defense Logistics Agency, Support Detachment 3 ... Joint Task Force, Team 6 ... 19th Special Forces Group, Support Element 1 ...
... 7th Joint Task Force Augmentation Team Schwetzingen ... Headquarters 85th Division Training Support, Detach 2 ... 20th Special Forces Company A ...
... WHS- Washington Headquarters Service. ... US Military (ie, Army, Navy, Air Force) service publications ... Strike Group to Fight in the Joint Task Force. ...
ObjectivesTo determine what biodiversity data is held by record centres for the South Downs Lifescapes pilot area and the format in which it is stored.
... WHS- Washington Headquarters Service. ... ie, Army, Navy, Air Force) service publications ... The Case of the Rapid Deployment Joint Task Force. ...
This paper summarizes the main features of four current REDD proposals: Compensated Reduction, Papua New Guinea et al; Joint Research Center; and Brazil. ... ...
of Earth Science data and information management capabilities. Dale Schulz/400 . For your exceptional achievement in leading the joint LaRC/GSFC team in ...
... WHS- Washington Headquarters Service ... but also with respect to other Joint, National and ... unit of action (UA) combat team or task force is organized ...
... Joint Meritorious Award to DLA," Dimnsions Vol. ... recently the Defense Finance Accounting Services (DFAS ... gmbAt Service SUoDort Field Manual. ...
... In this manner, a JBI-enabled COI would have the full suite of JBI information management capabilities, but would still be based on and have full ...
... Joint Staff and other US Military (ie, Army, Navy, Air ... The major products of this work are significant advances in ... Keywords: Dogs; Laboratory animals ...
OBJECTIVE: To evaluate the interobserver agreement of ultrasonographic assessment of finger and toe joints in patients with rheumatoid arthritis (RA) by 2 investigators with different medical backgrounds. METHODS: Ultrasonography and clinical examination were performed on 150 small joints of 30 patients with active RA. A General Electric LOGIQ 500 ultrasound unit with a 7-13-MHz linear array transducer was used. In each patient, 5 preselected small joints (second and third metacarpophalangeal, second proximal interphalangeal, first and second metatarsophalangeal) were examined independently on the same day by 2 ultrasound investigators (an experienced musculoskeletal radiologist and a rheumatologist with limited ultrasound training). Joint effusion, synovial thickening, bone erosions, and power Doppler signal were evaluated in accordance with an introduced 4-grade semiquantitative scoring system, on ...
... Experts ( Appendix 5 ), and the NMFS-Sea Grant Joint Graduate Fellowship Program ( Appendix 6) . The Task Force consisted of one representative from NMFS Headquarters and 1-2 rep...
Jan 14, 2004 ... presented to the nation at NASA Headquarters, Washington, D.C., ...... Board/Air Force Scientific Advisory Board Joint Task Force on ...
Feb 6, 2003 ... Director, Plans and Programs, Headquarters Air Force Materiel Command, .... Commander of the Joint Task Force Southwest Asia at Prince ...
... (l0)6o). 316. Statf,'ent. In Hearings before the Subcommittee on Research, Do'v,-Iopment, and Radiation of the Joint Committee on Atomic Energy. ...
...QUALIFICATION AND CERTIFICATION OF LOCOMOTIVE ENGINEERS Implementation of the Certification...operations and certifies locomotive engineers from a different railroad...designated supervisor of locomotive engineers or a certified train...
joint task force (JTF), division (OIV) and regimental combat team (RCT) with ..... Headquarters, Department of the Army. (HQOA), (2010). Field Manual 2-0 ...
Motivated by the numerical investigations of Laval, Dubrulle & Nazarenko (1999), we develop a quasilinear theory of the 2D Euler equation and derive an integro-differential equation for the evolution of the coarse-grained vorticity. This equation respects all the invariance properties of the Euler equation and conserves angular momentum in a circular domain and linear impulse in a channel (as well as in an infinite domain). The explicit energy is not rigorously conserved as it is partly transfered into fine-grained fluctuations but the total energy is conserved. We prove a H-theorem for the Fermi-Dirac entropy and make the connection with statistical theories of 2D turbulence.
Energy conservation and local energy deposition are investigated in the context of coupled-particle (i.e., neutrons, gamma rays, and charged particles) transport analysis. For charged particles, the concept of group splitting the 1 = 0 transfer matrix to ensure both particle and energy conservation is introduced. Although these procedures are more complex than those found in the usual neutron or coupled-neutron gamma-ray problem, they yield a consistent approach for the calculation of local energy deposition.
Energy conservation and local energy deposition are investigated in the context of coupled-particle (i.e., neutrons, gamma rays, and charged particles) transport analysis. For charged particles, the concept of group splitting the 1 = 0 transfer matrix to ensure both particle and energy conservation is introduced. Although these procedures are more complex than those found in the usual neutron or coupled-neutron gamma-ray problem, they yield a consistent approach for the calculation of local energy deposition.
Autophagy is an evolutionarily conserved, catabolic process that involves the entrapment of cytoplasmic components within characteristic vesicles for their delivery to and degradation within lysosomes....Full Text Available
SummaryMammalian iron homeostasis is regulated by the interaction of the liver-produced peptide hepcidin and its receptor, the iron transporter ferroportin. Hepcidin binds to...Full Text Available
A Consultants' Meeting on 'The assessment of soil conservation technologies for sustainable agricultural production' was held in Vienna at the IAEA Headquarters from May 28-30, 2001. The consultants' presentations reviewed recent advances in the use of fallout radionuclides to measure soil erosion as well as approaches and technologies applied for soil conservation worldwide. Also, activities and experiences of FAO and UNEP in the field of land degradation, soil conservation and related issues were presented. Based on the information provided by the Scientific Secretary, a full project proposal was prepared during the second part of the Consultants' Meeting. The consultants also provided recommendations on the formulation and implementation of a future CRP on the subject.
The Sirtuins are a family of orthologues of yeast Sir2 found in a wide range of organisms from bacteria to man. They display a high degree of conservation between species, in both sequence and function,...Full Text Available
Autophagy is an evolutionarily conserved catabolic process that involves the invagination and degradation of cytoplasmic components through an autophagosomelysosome track. Autophagy functions...Full Text Available
Aesthetic dentistry continues to evolve through innovations in bonding agents, restorative materials, and conservative preparation techniques. The use of direct composite restoration in posterior teeth...Full Text Available
... River at Ango Ango (about 4 km from Matadi (probably upstream)), and the second at Chaundron de ... proposal were to be adopted the site at Matadi would be lost. No conservation measures in ...
... River at Ango Ango (4 km south of Matadi (upstream)), and the second on a small tributary ... proposal were to be adopted the site at Matadi would be lost. No conservation measures in place ...
strives to reduce our "environmental footprint" in the following areas: EPA Facilities Energy Conservation Requirements | Goals and Strategies | Results | Reports Green Power...
Guidelines for the viability primer component of the version 3 workbook. The Viability page in the current version of the Excel spreadsheet for conservation ... ...
Lifespan can be extended by reduction of dietary intake. This practice is referred to as dietary restriction (DR), and extension of lifespan by DR is evolutionarily conserved in taxonomically diverse...Full Text Available
A survey was conducted to determine the sources of buildings energy conservation case studies and educational aids available in Canada. In total 785 consultants, educational institutions, building developers, manufacturers and government agencies were contacted. The results of this survey provide an indication of those agencies in Canada most actively involved with energy conservation in buildings, a listing of those agencies in Canada having case study information and/or educational aids materials available related to energy conservation in buildings, and a broad description of the subject area of the case studies and educational aids listed. The results of this study are intended to provide a source listing of energy conservation case studies and educational aids to the Buildings Energy Technology Transfer Program lead agencies and others conducting similar studies in the buildings sectors for use as ...
Diethyl phthalate (DEP) and di-n-butyl phthalate (DnBP) are used extensively in personal care products, including fragrances (DEP) and nail polish (DnBP). Between May 2003 and...Full Text Available
Implementing a successful local area network for a publications work-group isn't as simple as the scarcity of information on the subject would suggest. Making a network work for your requires careful planning, developing and acquiring network expertise, transforming your group's patterns of working together, and carefully managing the human and technological resources.
Implementing a successful local area network for a publications work-group isn`t as simple as the scarcity of information on the subject would suggest. Making a network work for your requires careful planning, developing and acquiring network expertise, transforming your group`s patterns of working together, and carefully managing the human and technological resources.
BackgroundInformal payments for health care are common in most former communist countries. This paper explores the demand side of these payments in Albania. By using data from the...Full Text Available
Comprehensive geriatric care should receive nation-wide attention in order to realize its objectives. An analysis of patient problems at the Geriatirc Clinic, Tygerberg Hospital and Goodwood Aftercare Hospital is presented. The training of personnel, with full motivation of the community, to render health services to the aged is discussed. PMID:7368010
BackgroundEffectiveness of services for patients diagnosed with severe mental illness (SMI) may improve when treatment plans are needs based. A regional Cumulative Needs for Care...Full Text Available
A joint experimental and theoretical analyses based on the grounds of DFT anharmonic potential and the use of a variational method allow us to revisit and assign the gas phase spectra of vinylarsine in the mid-IR area until 6300cm-1. Several weak and very weak bands corresponding to overtones and combinations are newly observed and assigned in complement to the fundamental bands.
Resistance exercise has been widely reported to have positive rehabilitation effects for patients with neuromuscular and orthopaedic conditions. This paper presents an optimal design of magneto-rheological fluid dampers for variable resistance exercise devices. Adaptive controls for regulating the resistive force or torque of the device as well as the joint motion are presented. The device provides both isometric and isokinetic strength training for various human joints.
Through a comprehensive and aggressive research program Consolidated Edison Company of New York, Inc. (Con Edison) has designed, developed, and installed several new products to address the environmental impact of dielectric fluid from pipe-type cable systems. These include: On Line Leak Detection, Leak Location, Retractable Flow Direction Indicator, Full Stop Joints, and Transition Joints. This paper describes the application of the aforementioned products on the Con Edison underground transmission system.
In recent years there has been a renewed interest in the treatment of quantum mechanics in terms of joint distribution functions, i.e. functions of momentum and position coordinates p and q. The author considers j.d.f. in the sense of classical probability theory of a stochastic variable. The j.d.f. is then interpreted as the probability that the variables p and q have certain values, the variables being considered as a property possessed by the object system. This formalism is used to provide a unified description of bradyons and tachyons. (Auth.).
According to the present invention, a joined product is at least two ceramic parts, specifically bi-element carbide parts with a bond joint therebetween, wherein the bond joint has a metal silicon phase. The bi-element carbide refers to compounds of MC, M.sub.2 C, M.sub.4 C and combinations thereof, where M is a first element and C is carbon. The metal silicon phase may be a metal silicon carbide ternary phase, or a metal silicide.
To evaluate injury patterns of facet joints and associated soft tissue injuries in patients with acute traumatic cervical facet joint injuries. From among patients with cervical spine trauma, 27 with facet joint injuries, as seen on CT and MRI, were chosen for this study. CT scans were analyzed with regard to the location of facet joint injury, the presence or absence of facet dislocation or fracture, and other associated fractures. MR images were analyzed with regard to ligament injury, intervertebral disc injury, intervertebral disc herniation, and spinal cord injury. The most common location of facet joint injury was C6-7 level(n=10), followed by C5-6(n=8). Among these 27 patients with facet joint injuries, 12(44%) had bilateral injuries and 15(56%) unilateral injuries. Facet fractures were present in 17 cases(63%) and the fracture of inferior facet was more ...
A report is presented of a hearing conducted before the Joint Committee on Atomic Energy on August 27, 1976, to discuss the legal implications for reactor licensing resulting from court challenges to procedures for assessing the environmental impact of radioactive waste disposal. (DG)
Material related to routine as well as sensitive aspects of parent/day care center relationships is presented in this training module, one of a series providing staff development information for programs operated for dependents of military personnel. The module offers a brief discussion of ways caregivers can help parents feel at ease about leaving their children in child care and presents a set of multiple-choice skill-building exercises for effectively working with parents. Exercises focus on various topics, including how parents can be approached when their child may have a health problem, when child abuse or neglect is suspected, and when parental cooperation is needed to stop a child's undesirable or disruptive behavior. Exercises are also devoted to the questions of whether or not caregivers should act as advisors to parents or tell parents about their child's behavior at the center. Concluding exercises indicate how caregivers can ...
Recently, weight reduction of vehicles has been of great interest, and consequently, the use of low-density materials in the automotive industry is increasing every year. Materials should not be substituted such a way that material of component parts is simply changed because there is a problem in achieving stiffness and strength. To achieve these requirements, the automobile should be redesigned totally. Aluminum spaceframe is rapidly being adopted as a body structure for accommodating lightness, stiffness and strength requirement. In aluminum spaceframe manufacturing, it is often required to join aluminum tube. But there are few suitable methods for joining aluminum tube, so that much interest has been focused on testing suitable joining methods. Joining by electromagnetic forming(EMF) can be useful method in joining aluminum tube, which offers some advantages compared with the conventional joining method. In this paper, joining by EMF was investigated as a pre-study for applying an ...
Transition joints in power plants between ferritic steels and austenitic stainless steels suffer from a mismatch in coefficients of thermal expansion (CTE) and the migration of carbon during service from the ferritic to the austenitic steel. To overcome these, nickel-based consumables are commonly used. The use of a trimetallic combination with an insert piece of intermediate CTE provides for a more effective lowering of thermal stresses. The current work envisages a trimetallic joint involving modified 9Cr-1Mo steel and 316LN austenitic stainless steel as the base materials and Alloy 800 as the intermediate piece. Of the two joints involved, this paper describes the choice of welding consumables for the joint between Alloy 800 and 316LN. Four consumables were examined: 316, 16-8-2, Inconel 82 and Inconel 182. The comparative evaluation was based on hot cracking tests and estimation of mechanical ...
To investigate the effect of external loads arising from differential thermal expansion between a substrate and a surface-mount component during thermomechanical cycling, specimens with a nickel surface-mount component on a copper substrate were prepared. Specimens consisted of two 100 #mu#m thick 1 mm"2 solder joints about 9 mm apart, with two designs. In one specimen (denoted 'dual-shear'), the as-fabricated joints were not stressed due to differential contraction during solidification and cool down. In the other specimen (denoted 'component'), a continuous copper substrate between the joints caused the nickel component to be put in compression during cool down, which imposed shear on the joints. To impose differential thermal shear strains, the 'dual-shear' specimen was clamped to a copper block to cause a significant reversal in sign of the shear imposed on the solder joint ...
A new formulation of the theory of tachyons is developed using the same two postulates as in special relativity. Use is made of a 'switching principle' to show how tachyons automatically obey the laws of conservation of energy, momentum and electric charge. Tachyonic mechanics is further developed by a consideration of tachyonic rods and clocks. There follows a discussion of the conservation of electric charge and the apparent visual appearance of a tachyonic cube. 19 refs., 9 figs.
The Waste Acceptance Preliminary Specifications (WAPS) require that the DWPF estimate the inventory of long-lived radionuclides present in the waste glass, and report the values in the Waste Form Qualification Report. In this report, conservative (biased high) estimates of the radionuclide inventory of glass produced from waste currently in the Tank Farm are provided. In most cases, these calculated values compare favorably with actual data. In those cases where the agreement is not good, the values reported here are conservative.
...Project objectives to restore/create network of secure lapwing breeding sites to provide conservation management advice to planners, developers and land managers to raise awareness of lapwing conservation issues in the local areaKey dates so far First pair of lapwing breeding at Parc Bryn Bach, mitigation site for loss of a nearby large lapwing breeding colony, in May 2008Work planned or underway Continued working with developers and landowners to ...
It is shown that a simple algorithm which exactly segregates between adiabatic and non-adiabatic electrons in particle-in-cell simulations of drift modes yields excellent conservation properties (e.g. particle number, energy) compared to the conventional df scheme. The removal of the free streaming term in the evolution of the marker weight is shown to be responsible for the improved linear and nonlinear properties of the simulated plasma.
Hepatitis C virus (HCV) nonstructural protein 5B (NS5B), the viral RNA-dependent RNA polymerase (RdRp), is a tail-anchored protein with a highly conserved C-terminal transmembrane domain (TMD) that...Full Text Available
By revisiting previous definitions, we show that one can define an energy current operator that satisfies the continuity equation for a general Hamiltonian in one dimension. This expression is useful for studying electronic, phononic and photonic energy flow in linear systems and in hybrid structures. The definition allows us to deduce the necessary conditions that result in current conservation for general-statistics systems. The discrete form of the Fourier's law of heat conduction naturally emerges in the present definition.
The Demand 80/81 forecasts cover each sector of the economy and are conditional upon alternative assumptions concerning national economic growth, energy prices, other prices, and conservation policy. The forecasts also include forms of energy other than electricity to provide a comprehensive energy picture. Although the forecasts proceed through time in one-year increments, their primary focus is on the period from 1985 to 2000. The forecasts are based on twelve sets of alternative assumptions, or scenarios. A forecast of economic growth and nonenergy variables is used to drive the model to 12 different conditional forecasts. These represent four sets of price assumptions and three sets of non-price conservation assumptions. The price assumptions are: high, baseline, low and constant 1976, which - because of the inverse relationship between prices and consumption - represent low consumption, baseline consumption, high consumption, and extra ...
In the Arabian Gulf region in general, and in Saudi Arabia in particular, demand for water in the agricultural, domestic, and industrial sectors has increased dramatically as a result of rapid development, and improved standard of living, and diversification of economic activity in agriculture and industry. This article presents an overview of supply and demand situations prevailing in the Arabian Gulf region and discusses various conventional and unconventional alternatives for meeting the growing demand for water. It also describes conservation measures and their socioeconomic effects.
Three book reviews and five essays address the problems of governing coastal regions. The books reviewed and the articles covered the institutions and programs involved in resource management, the balance of local and state interests in coastal conservation and developments, a consensus on coastal planning issues, and a growing trend in state-local collaborative planning. Four of the articles pertain to California, and one focuses on programs in Maine, Rhode Island, and Washington. 135 references. (DCK)
Mitsubishi Research Institute has analyzed the energy demand of a typical Japanese city, Yokohama, as well as the distribution of fossil-energy flow, and the final consumption by sectors. It has evaluated the effectiveness of various energy conservation measures, (e.g., cogeneration, electric cars, insulation,...) in countering the global warming trend. This study defines a viable methodology which may be utilized, in the future, in examining the effectiveness of environmental policies. (TEC). 1 tab., 4 figs.
Studies have shown that Canada's national parks are vulnerable to the impacts of climate change. A wide range of biophysical climate change impacts could affect the integrity of conservation lands in each region of Canada. This report examines the potential impact of climate change on landscape alterations and vegetation distribution in Canada's wide network of conservation lands. It also presents several ways to integrate climate change into existing conservation policy and adaptation strategies. Canada's conservation lands include provincial parks, migratory bird sanctuaries, national wildlife areas and wildlife protected areas. This is the first study to examine biome changes by applying an equilibrium Global Vegetation Model (GVM) to Canada's network of national park systems. Some of the policy and planning challenges posed by changes in landscape level vegetation ...
This document presents the results of a review of publicly available information on energy use in health care facilities. The information contained in this document and in the sources cited herein provides the background and context for efforts to reduce energy use and costs in health care. Recognizing the breadth and diversity of relevant information, the author acknowledges that the report is likely not comprehensive. It is intended only to present a broad picture of what is currently known about health care energy use. This review was conducted as part of a 'High Performance Health Care Buildings' research study funded by the California Energy Commission. The study was motivated by the recognition that health care facilities collectively account for a substantial fraction of total commercial building energy use, due in large part to the very high energy ...
On June 2, 1992, Landers` earthquake struck the Solar Electric Generating System II, located in Daggett, California. The 30 megawatt power station, operated by the Daggett Leasing Corporation (DLC), suffered substantial damage due to structural failures in the solar farm. These failures consisted of the separation of sliding joints supporting a distribution of parabolic glass mirrors. At separation, the mirrors fell to the ground and broke. It was the desire of the DLC and the Solar Thermal Design Assistance Center (STDAC) of Sandia National Laboratories (SNL) and to redesign these joints so that, in the event of future quakes, costly breakage will be avoided. To accomplish this task, drawings of collector components were developed by the STDAC, from which a detailed finite element computer model of a solar collector was produced. This nonlinear dynamic model, which consisted of over 8,560 degrees of freedom, underwent model reduction to form a ...
Under the current design philosophy, reactor structures are to be designed to withstand large inelastic deformation caused by strong and severe ground motion. The design of the main structural elements and their connections are to be such that they always fail in ductile mode. This will ensure large energy absorption capacity of the structures under seismic excitation and avoid sudden and brittle failure of the structure. Over the years, a number of experimental investigations have been carried out on RC beam- column joints to study their behaviour and strength. However, these studies mostly pertain to small scale joints of moment resisting frame of residential buildings and commercial complexes. Information on full scale joints existing in NPP structures are scanty. Therefore, experimental programme was planned in the laboratory to construct identical large sized joints with the same reinforcement ...
Objectives This paper examines the determinants of the insureds decision to use their health insurance card when seeking outpatient and inpatient health care in Vietnam. Methods Uses Vietnams latest Household Living Standard Survey data and random-intercept logistic regression to assess the influence of the observed individual, household and commune/ward factors on the insureds decision to access health insurance benefits while controlling for the unobserved commune/ward-specific factors. Results Compared to the compulsory enrollees, the voluntary enrollees and the beneficiaries of the Health Care Fund for the Poor are less likely to use their card when seeking inpatient care. An individuals likelihood of accessing insurance benefits varies inversely with income and the level of education,...
Given the concern over the potential for health risks associated with certain ingredients (e.g., phthalates) in personal care products, usage patterns of 30 types of personal care products (e.g., shampoo, sunscreen, fragrance, etc.) were collected in 604 California households through a telephone interview. Preferences in selecting products, e.g., scented or unscented, aerosol, and brand loyalty, were also investigated. Participants were recruited in three age groups, children (mostly preschoolers), their parents, and adults age 55 or older. Use frequencies of various product types varied by sex, age group, race, education, and climatic region. Product use by parent and child from the same household were correlated. Use frequencies of products in the same class (e.g., skincare) were moderat...
Participants in the conference selected to attend two different working group sessions. The working groups discussed different perspectives of system-based approaches to osteoporosis and fracture care. The group on postfracture case management recommended that nurse case managers be used to improve communication among patients, orthopaedic surgeons, and those providing ongoing clinical care. The hospital working group discussed the impact of and barriers to improved postfracture management in the hospital setting. The health systems group emphasized the difference between a closed system in which long-term benefits of interventions were more likely to be appreciated than in fee for service systems. The health information technology group discussed the advantages and challenges of electroni...
Opinion statement Because a minority of patients with D-transposition of the great arteries are diagnosed in utero by ultrasound, most present after delivery with cyanosis. In the absence of apparent lung disease, cyanotic neonates suspected of having a cardiac lesion should be immediately transferred to an intensive care unit at a pediatric tertiary care center for monitoring, resuscitation, and to define the cardiac anatomy and physiology. A prostaglandin E-1 infusion is usually initiated to maintain ductal patency and promote intra-cardiac mixing. In the past, balloon atrial septostomy (BAS) was routinely performed to enlarge the atrial septal defect and improve intra-cardiac mixing while the infants awaited surgery. Recent literature has reported an increase risk of stroke in neonates ...
Objectives Vietnamese patients? views on healthcare are changing as surgical interventions become more commonplace, but their views on perioperative care have remained largely unstudied during this period of rapid change. This study assesses Vietnamese patients? impression of anesthesia safety and postoperative pain in relation to clinical outcomes with the aim of improving patient-centered perioperative care. Methods The study cohort consisted of 180 hospitalized patients who were followed for 24?h following abdominal surgery. The assessments of these patients on the use of anesthesia and postoperative pain were measured by means of a 5-point Likert scale survey. Perioperative events were recorded on standardized forms by medical staff. The relationship between relevant factors affecting ...
To determine the proportion of rheumatoid arthritis (RA) patients receiving preventive health care according to US Preventive Services Task Force recommendations compared with a community-based population sample, with emphasis on dyslipidemia testing, given the increased risk of cardiovascular disease (CVD) in RA patients. Patients with RA (ICD-9 code 714.0 at ?2 office visits with a rheumatologist) and a primary care physician (PCP) at the Geisinger Health System (GHS) were identified through electronic health records. The records were searched back from 3/31/08 for the length of time required to satisfy each outcome measure. Percentages were compared with population testing rates using the Pearson Chi-square test. Eight hundred and thirty-one RA patients were compared to 169,476 subjects...
Objective. Preterm neonates are susceptible to infection due to a combination of sub-optimal immunity and increased exposure to invasive organisms. Invasive fungal infections are associated with significant morbidity and mortality among preterm infants cared for in the neonatal intensive care unit (NICU). Mannose-binding lectin (MBL) is a component of the innate immune system, which may be especially important in the neonatal setting. The objective of this study was to investigate the presence of any association between MBL gene polymorphism and nosocomial invasive fungal infection in preterm neonates. Methods. Codon 54 (B allele) polymorphism in exon 1 of the MBL gene was investigated in 31 patients diagnosed as nosocomial invasive fungal infection and 30 control preterm neonates. Results...
Despite the many advances in scientific research over the last several decades, cutting edge technologies and therapeutics often take many years to find their way into widespread use. The dissemination and uptake of best practices into clinical care is sometimes a neglected component of research that is essential to improve the population?s health. Type 2 translational research, sometimes called ?Proof in Practice Research,? seeks to maximize the yield of what has been learned from the bench and from carefully controlled clinical trials and to extend those benefits to a larger population. One aspect of type 2 translational research, sometimes called evidence implementation or implementation science, applies what has been learned about clinical medicine to achieve best practices across prov...
Reliable exposure information for cosmetic and other personal care products and ingredients is needed in order to conduct safety assessments. Essential information includes both the amount of product applied, and the frequency of use. To obtain current data, studies to assess consumer use practices were undertaken. Six widely used personal care product types were included in the studies. Five of the products were cosmetics (spray perfume, hairspray, liquid foundation, shampoo, body wash) and one product was a cosmetic/over-the-counter drug product (solid antiperspirant). Three hundred and sixty women, ages 19-65 years, who regularly use the products of interest, were recruited at 10 different geographical locations within the US. The number of recruits was chosen to ensure a minimum of thr...
AbstractBACKGROUND: Disparities in treatment and mortality for colorectal cancer (CRC) may reflect differences in access to specialized care or other characteristics of the area where an individual lives. METHODS: Surveillance, Epidemiology and End Results Program-Medicare data for seniors diagnosed with CRC were linked to area measures of the sociodemographic characteristics and the capacity of surgeons, medical oncologists, and radiation oncologists. Outcomes included receipt of stage-appropriate CRC care and mortality. RESULTS: After adjustment, blacks and Hispanics were less likely than whites to undergo surgery (odds ratio [OR] 0.57, 95% confidence interval (CI) 0.52-0.63 and OR 0.82, 95% CI 0.70-0.95, respectively). Individuals who lived in areas with the highest tertile of surgeon c...
The objective of this study was to evaluate the association between the number of blood cultures collected and the appropriateness of care for suspected bacteremic community-acquired urinary tract infection (UTI) in the elderly. We retrospectively evaluated the medical records of 129 patients with UTI >65?years old admitted to a large community-based training hospital in Japan from 1 January 2006 to 31 December 2009. We assessed the association between the number of blood cultures collected and the appropriateness of care received, as well as other factors. Two-thirds of the patients were women, and patients >85?years old accounted for 45.0% of the cases. Most of the organisms isolated from the urine and blood were Escherichia coli (65.4?67.0%). More than two blood cultures were collected ...
Background ?Guidelines for safe and effective management and use of point of care testing? have been recently launched in Ireland. Aims To survey point of care testing (POCT) services in the Republic of Ireland. Methods A questionnaire covering accreditation status, existence of POCT committees, quality management systems, and staff resources was distributed by the Irish External Quality Assessment Scheme (IEQAS). Results Of those that returned completed questionnaires, 56% had assigned specific POCT responsibilities to designated staff. Most support was for blood gases and glucose analysis. Compared with other published studies, Irish laboratories gave similar support for blood gases, less for glucose and much less for urinalysis. Conclusions This survey demonstrated poor IT support for P...
Magnetic resonance imaging has proven an invaluable method in the diagnosis of joint diseases associated with osteonecrotic, inflammatory, traumatic and degenerative processes. At the clinical level, it has an important role in decisions about the method of treatment and evaluations of the therapeutic success. When the merits of MRT are balanced against those of conventional radiography including tomography and CT, which both ensure better spatial resolution in the visualisation of cortical and spongy bone structures, it becomes quite evident that MRT must not be regarded as an alternative method of imaging but as one that can be used additionally to obtain the most information for the diagnosis of arthropathy. The question as to whether new pulse sequences (snap shots) or invasive techniques like intra-articular injection of paramagnetic substances (MR arthrography) are likely to become routine procedures in the detection of joint diseases ...
Magnetic pulse welding is a solid state impact welding process, similar to explosive welding, which produces metallurgical bond by oblique high-speed impact between two metal bodies. This violent impact removes the metal surface oxide layers and then joins the two atomic level clean metal surfaces together by the incidental compression pressure. The impact velocity is at 200?400?m/s and the being welded metal surface undergoes severe plastic deformation with strain rate in the order of 106?107?s?1. The ultrafine-grained structure was observed on the welded interface. This article studied two types of similar material lap joint interfaces and the base metals were aluminum alloy 6061 and copper alloy 110. Nano-indentation testing shows that the welded interfaces have significantly greater ha...
In this paper, for an acceleration of utilization of magnesium alloy which is being interested in recent years, friction welding of AZ31 magnesium alloy was carried out, and the joint performance was discussed in relation to the deformation heat input in the upset stage and upset loss as a evaluation factor. Where, the deformation heat input in the upset stage is mechanical work represented by the product of upset speed and axial pressure. As a result, it was made clear that the friction welding of AZ31 magnesium alloy was easy in the atmosphere, and good welded joints without a non- adhesion area at the weld interface could de obtained. Moreover, the evaluation factors discussed were possible to evaluate to joint performance. (orig.)
Glass fiber-reinforced polymer (GFRP) reinforcing bars were used recently as main reinforcement for concrete structures. The noncorrodible GFRP material exhibits linear-elastic stress-strain characteristics up to failure with relatively low modulus of elasticity compared to steel. This raises concerns on GFRP performance in structures where energy dissipation, through plastic behavior, is required. The objective of this research project is to assess the seismic behavior of concrete beam-column joints reinforced with GFRP bars and stirrups. Two full-scale exterior T-shaped beam-column joint prototypes are constructed and tested under simulated seismic load conditions. One prototype is totally reinforced with GFRP bars and stirrups, while the other one is reinforced with steel. The experimen...
The VNC2 and VNC5 steel tests on endurance were carried out in order to determine the capacity for work of large welded samples and to investigate the methods of welding. The samples made by the arc welding demonstrated the most high endurance at low frequencies of loading during the test of welded joints made of the VNC2 steel. The application of the VNC2 steel interlayers together with intermediate heat treatment allows one to increase the static and fatigue strength of welded joints at corresponding decrease of the construction weight during welding of the VNC5 steel as well as its combination with the VNC2 steels. The gas protection deterioration during steel welding leads to considerable diversity of values of endurance.
During sporting events, injured athletes often return to competition after icing because of the reduction in pain. Although some controversy exists, several studies suggest that cryotherapy causes a decrease in muscle activity, which may lead to a higher risk of injury upon return to play. The purpose of this study was to investigate the effect of a 20-min knee joint cryotherapy application on the electromyographic activity of leg muscles during a single-leg drop jump in twenty healthy subjects, randomly assigned to an experimental and a control group. After the pre-tests, a crushed-ice bag was applied to the knee joint of the experimental group subjects for 20min, while the control group subjects rested for 20min. All subjects were retested immediately after this period and retested again...
Considering beryllium as plasma facing armour this paper presents recent results obtained in Russia. A special process of joining beryllium to a Cu-alloy material structure is described and recent results of thermal cycling tests of such joints are presented. Summarizing the results, the authors show that a Cu-alloy heat sink structure armoured with beryllium can survive high heat fluxes ({>=}10 MW/m{sup 2}) during 1000 heating/cooling cycles without serious damage to the armour material and its joint. The principal feasibility of thermal cycling of beryllium grades and their joints directly in the core of a nuclear reactor is demonstrated and the main results of this test are presented. The paper also describes the thermal cycling of different beryllium grades having cracks initiated by previously applied high heat loads simulating plasma disruptions. (orig.)
The progression of hip dysplasia was investigated in 116 military working dogs. Serial pelvic radiographs were graded for degree of dysplasia and degenerative joint disease (DJD). Norberg angles, angles of inclination, and joint space widths were measured. There was a significant correlation between the Norberg angle and the degree of dysplasia (p less than 0.0001). Angles of inclination and joint space width measurements did not demonstrate a correlation to canine hip dysplasia. Dysplastic dogs had a significant estimated risk for development of DJD compared to normal dogs (p less than 0.0001; odds ratio of 70.2). Dogs with normal hip conformation at 24 months of age or older did not develop moderate nor severe DJD. PMID:8875357
In Pakistan, the agricultural sector is the largest water user with 95%, leaving only marginal quantities for households and industry. On one hand, agriculture is a very important sector in Pakistan's economic development, contributing about 23 % to the national GDP -but industry contributes slightly more using only about 2 % of the available water resources. As Pakistan faces a growing problem of water shortage, significant achievements in water conservation have to be materialized, predominantly on the agricultural sector. There is scope for a higher degree of efficiency in water use, as water losses, namely in irrigation, are still rather high. There is another good reason for water conservation in agriculture: Over-irrigation results in rising water tables and increased soil salinity, which has reduced Pakistan's agricultural output during the last 2 decades by nearly 25%. Water conservation measures can be divided into ...
BackgroundHow socio-demographic factors influence women's autonomy in decision making on health care including purchasing goods and visiting family and relatives are very poorly...Full Text Available
A public health emergency such as an influenza pandemic will lead to shortages of mechanical ventilators, critical care beds, and other potentially life saving treatments. This will raise difficult...Full Text Available
... be able to watch the many intricate steps Dr. Richard Alexander must accomplish to remove the cancer. ... door to informed medical care. Now let's join Dr. Richard Alexander at the University of Maryland Medical ...
Patient decision support systems have a promising role in the delivery of health care. However, the best approach for further development of these systems is a matter of speculation. To help chart a...Full Text Available
BackgroundStrategies to accurately identify the occurrence of specific health care events in administrative data is central to many quality improvement and research efforts. Many...Full Text Available
Patients who fail to attend initial appointments reduce clinic efficiency. To maximize attendance by newly referred outpatients, we introduced a mandatory group orientation clinic for all new patients...Full Text Available
Objective To establish current practice in the use of Read codes for diabetes.Design Cross sectional study.Setting 17 practices in the Battersea...Full Text Available
Personal Health Records (PHRs) are increasingly recognized as a strategy to improve patient-provider communication, availability of health information, and quality of care, by making the delivery of...Full Text Available
Albeit the considerable progress that has been made both in our understanding of the pathophysiology of acute renal failure (ARF) and in its treatment (continuous renal replacement therapies), the morbidity...Full Text Available
Femur fractures typically affect elderly patients with multiple co-morbidities. Pain control can be difficult, requiring intensive nursing and physician care as elderly patients may manifest cardiovascular...Full Text Available
Over 30 months 9292 consecutive patients admitted to nine coronary care units with suspected myocardial infarction were considered for admission to a randomised double blind study comparing the effect...Full Text Available
OBJECTIVE: The objective was to define and characterize the costs associated with trauma care at a level I trauma center. Once the costs were identified, attending physician-led teams were designed...Full Text Available
BackgroundThere has been substantial research on psychosocial and health care determinants of health disparities in the United States (US) but less on the role of modifiable risk...Full Text Available
BackgroundDespite having the largest population in Africa, Nigeria has no accurate population based data to plan and evaluate eye care services. A national survey was undertaken...Full Text Available
Patient-centered interdisciplinary health care for children with chronic medical disorders represents an evolution from the traditional “stop and go” treatment for acute illnesses. This...Full Text Available
This Mini-Computer-Assisted Nursing Management System allows nursing to control staffing costs and more effectively relate staffing to patient care requirements. Nursing resources are prospectively...Full Text Available
BackgroundPatients’ general tendency to adhere to health care provider-recommended treatments is associated with a number of health outcomes, but whether it influences pain...Full Text Available
BackgroundThe link between maternal factors and birth outcomes is well established. Substantial changes in society and medical care over time have influenced women's reproductive...Full Text Available
Although the demand for use of information technology within the healthcare industry is intensifying, relatively little has been written about guidelines to optimize IT investments. A technology architecture...Full Text Available
Abstract The Read Thesaurus (Version 3 of the Read Codes) is a controlled medical vocabulary produced during the Clinical Terms Projects with the involvement of over 2,000 health care...Full Text Available
BackgroundAdolescents have been identified as a high-risk group for poor adherence to and defaulting from combination antiretroviral therapy (cART) care. However, data on outcomes...Full Text Available
Skin cancers in skin of color often present atypically or with advanced stage in comparison to Caucasian patients. Health care providers must maintain a high index of suspicion when examining...Full Text Available
Dental caries continues to be a common chronic disease among various population groups. Patient care can be improved with detection at the earliest stage. However, current techniques do not...Full Text Available
BackgroundSeverely disabling chronic pain in the adult population is strongly associated with a range of negative health consequences for individuals and high health care costs,...Full Text Available
ObjectiveTo implement a role-reversal exercise to increase first-year pharmacy students' awareness of communication barriers in the health care setting, especially for deaf and hard-of-hearing...Full Text Available
Percutaneous tracheostomy is a routine procedure in intensive care units. In cases of very low position of the larynx, cervical spine deformation, morbid obesity, or neck tumor, performance of the classic...Full Text Available
BackgroundInternet education is increasingly provided to health professionals, but little is known about the most effective strategies for delivering the content. The purpose of...Full Text Available
ObjectiveTo test whether a disclosure intervention improves subjective health and reduces medical consumption and sick leave in somatising patients in general practice.DesignNon-blind...Full Text Available
Background In May 2000, AstraZeneca launched a Web service for asthma patients and health-care providers called LinkMedica, which includes an asthma diary for...Full Text Available
Continuing Medical Education (CME) is a requirement among practicing physicians to promote continuous enhancement of clinical knowledge to reflect new developments in medical care. Previous research...Full Text Available
ObjectiveThe authors present an Electronic Healthcare Record (EHR) server, designed and developed as a proof of concept of the revised prEN13606:2005 European standard concerning...Full Text Available
The current obesity pandemic is expected to result in considerable downstream morbidity, mortality and incremental costs to health care systems around the world. The major metabolic complications of...Full Text Available
BackgroundMefloquine has historically been considered safe and well-tolerated for long-term malaria chemoprophylaxis, but its prescribing requires careful attention to rule out contraindications...Full Text Available
ObjectiveComputerized physician order entry with clinical decision support has been shown to improve medication safety in adult inpatients, but few data are available regarding its...Full Text Available
ObjectivesPericardial tamponade after cardiac surgery is difficult to diagnose, thereby rendering timing of rethoracotomy hard. We aimed at identifying factors predicting the outcome...Full Text Available
This program focused on practice-level service change as a means of improving patient care and developing leadership skills of 19 general practitioners (GPs) and aimed to: promote and support change...Full Text Available
AimsTo describe nurse burnout, job dissatisfaction, and quality of care in Japanese hospitals, and to determine how these outcomes are associated with work environment...Full Text Available
In terms of managing thrombotic disorders, genotype-based individualized patient care emerged as early as 1994 when the association of factor V Leiden (G1691A), and later, prothrombin (G20210A),...Full Text Available
BACKGROUND:Reports indicate that characteristics of older adults with chronic pain may be different than those of younger persons.OBJECTIVE:To study...Full Text Available
An outbreak with a multiresistant Klebsiella pneumoniae (MRKP) strain among seven patients admitted to the adult intensive care unit (ICU) of a regional teaching hospital in The Netherlands...Full Text Available
BackgroundOral cancer is as prevalent as cervical and testicular cancer in the United Kingdom. Nursing staff provide the oral health care for the patient population in hospital....Full Text Available
BackgroundNorway, and particularly Oslo, has the highest reported incidence of hip fractures in the world. It is increasingly common to care for older hip fracture patients in orthogeriatric...Full Text Available
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...research and publications and some who are accredited by the British Association of Sport and Exercise Sciences (BASES), which enables them to work with high performance athletes . We care about your progress and welfare. As our recent QAA review noted \\
Out of nearly 900 women in a research study of human immunodeficiency virus infection in pregnancy, 8 were subsequently found not to be infected. Misdiagnoses could have resulted from (a) laboratory...Full Text Available
Laparoscopic colon surgery for select cancers is slowly evolving as the standard of care but minimally invasive approaches for rectal cancer have been viewed with significant skepticism. This procedure...Full Text Available
We report on the presentation and management of a patient with herniation of the rectum following a coccygectomy. We used an abdominal approach and careful pelvic dissection to define the defect in...Full Text Available
The needs of hospitalized geriatric patients differ from the needs of hospitalized younger adults. In an attempt to improve systems of care for the older adult, the Centers for Medicare and Medicaid...Full Text Available
... the nest with young when the female left (male meadow voles were in the nest with young too infrequently ... prairie voles, whereas the number of checks that male meadow voles were in the nest increased s...
PurposeTo assess the prevalence and the dosimetric and clinical predictors of mandibular osteoradionecrosis (ORN) in patients with head and neck (HN) cancer who underwent...Full Text Available
Background and ObjectiveCervical cancer is one of the leading causes of morbidity and mortality amongst the gynecological cancers worldwide, especially in developing countries. It...Full Text Available
ObjectiveTo investigate possible differences in operative delivery rate among low-risk women, randomised to an alongside midwifery-led unit or to standard obstetric units within...Full Text Available
ObjectivesIn 2003, the Omani Ministry of Health Child Health Care Program initiated a national Birth Defects (BD) Register. This paper reviews the magnitude and risk factors of birth...Full Text Available
BackgroundThe prevalence of tobacco use among individuals with mental illness remains a serious public health concern. Tobacco control has received little attention in community...Full Text Available
The Clinical Summary is a Web-based application for accessing the clinical database at the Massachusetts General Hospital. The application has been developed to give physicians in our health care community...Full Text Available
Policies and regulations in the current health care environment have impacted the manner in which patient data - especially protected health information (PHI) - are handled in the clinical and...Full Text Available
ObjectiveMany hospitals utilize antimicrobial management teams (AMTs) to improve patient care. However, most function with minimal computer support. We evaluated the effectiveness...Full Text Available
PURPOSE We wanted to assess the impact of an electronic health record–based diabetes clinical decision support system on control of hemoglobin A1c (glycated hemoglobin),...Full Text Available
We previously demonstrated the ability to create engineered arteries by carefully controlling the mechanical environment of intact arteries perfused ex vivo, yielding engineered arteries...Full Text Available
Giardiasis is recognized as a worldwide public health problem. Seroprevalence data from both the developing and developed world show high rates of carriage in populations at risk for fecal-oral transmission,...Full Text Available
BackgroundSarcoma encompasses an uncommon group of cancer and the data is insufficient from Pakistan. We report our four years experience of Sarcoma of soft tissues and bones.MethodsThis...Full Text Available
BackgroundMany interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services...Full Text Available
ObjectiveWhile essential for patient care, information related to medication is often written as free text in clinical records and, therefore, difficult to use in computerized systems....Full Text Available
ObjectiveThe study aimed to examine the effect of household and community characteristics on financial catastrophe and impoverishment due to health payment in Western and Central...Full Text Available
Background:The minimum hemoglobin cutoff for blood donation in India is 12.5 gm% for both male and female donors and the minimum donation interval is 3 months. Donation...Full Text Available
Ever-changing audio technology requires that National Library Service NLS always be aware of developments and prepare carefully for any systematic changes that may be desired or required. Usefulness, cost effectiveness, thoughtful stewardship, and educate...
Total health care expenditure in 2006 was $2.1 trillion. This figure is estimated to double within the next few years as the cost of treating diabetes and other chronic conditions continues to rise....Full Text Available
It is usually very complex to design an Integrated Information System in a hospital that includes both in-patient and out-patient medical care data. The difficulty appears because each department...Full Text Available
PurposeTo develop a generic instrument for measuring short-term health status in the recovery period among patients undergoing abdominal and pelvic surgery.Full Text Available
BackgroundChina has had no effective and systematic information system to provide guidance for strengthening PHC (Primary Health Care) or account to citizens on progress. We report...Full Text Available
BACKGROUND AND AIMS:In view of increasing therapeutic efficacy, the delivery of hepatitis C virus (HCV) antiviral treatment is expected to increase. Yet practical experience reveals...Full Text Available
BackgroundLung volume reduction surgery is effective at improving lung function, quality of life, and mortality in carefully selected individuals with advanced emphysema. Recently,...Full Text Available
BackgroundEffective prevention of excessive alcohol use has the potential to reduce the public burden of disease considerably. We investigated the cost-effectiveness of Screening...Full Text Available
BackgroundMany health care professionals use spinal palpatory exams as a primary and well-accepted part of the evaluation of spinal pathology. However, few studies have explored...Full Text Available
The purpose of the meeting reported here was to develop a set of national evidence-based standards for assessing and managing patients with potentially resectable rectal cancer. This report represents...Full Text Available
ObjectivesTo see whether there are age variations in the relationships between having a close companion friend at church, health, and outpatient physician visits.Full Text Available
You receive an annuity if eligible -- requires 18 months service for FERS; and 60 ... You may use up to 104 hours of your accrued sick leave to care for sick family ...
Social support is a critical, yet underutilized resource when undergoing cancer care. Underutilization occurs in two conditions: (a) when patients fail to seek out information, material assistance,...Full Text Available
... yourself to call 911 until you have performed CPR for about 2 minutes. 3. Carefully place the ... more breaths. The chest should rise. 9. Continue CPR (30 chest compressions followed by 2 breaths, then ...
... and retrieve an AED until you have performed CPR for about 2 minutes. 3. Carefully place the ... more breaths. The chest should rise. 9. Continue CPR (30 chest compressions followed by 2 breaths, then ...
home when you are sick helps everyone you care about Questions & Answers Flu Vaccine: Q&A Vaccine Dosage & Administration Vaccine Supply for 2011-12 Season Vaccine Supply and...
home when you are sick helps everyone you care about Questions & Answers Flu Vaccine: Q&A Vaccine Dosage & Administration Vaccine Supply for 2011-12 Season Vaccine Supply and...
home when you are sick helps everyone you care about Questions & Answers Flu Vaccine: Q&A Vaccine Dosage & Administration Vaccine Supply for 2011-12 Season Vaccine Supply and...
Drownings in Recreational Water Settings - United States, 2001-2002 While immediate CPR can save someone's life, often medical care in the hospital cannot prevent serious...
Low bone mineral density (BMD) is prevalent in human immunodeficiency virus (HIV)–infected subjects. Initiation of antiretroviral therapy is associated with a 2%–6% decrease...Full Text Available
The aim of the overview is to give a perspective of global biobank development is given in a view of positioning biobanking as a key resource for healthcare to identify new potential markers that can...Full Text Available
The devastating earthquake in Sichuan, China on 12 May 2008 left thousands of survivors requiring medical care and intensive rehabilitation. In view of this great demand, the Chinese Speaking Orthopaedic...Full Text Available
Abstract This paper focuses on the basic principles of information technology (IT) organization within health sciences centers. The paper considers the placement of the leader of the...Full Text Available
IntroductionTransfusion is a common treatment in pediatric intensive care units (PICUs). Studies in adults suggest that prolonged storage of red blood cell units is associated with...Full Text Available
BACKGROUND:The value of other health care professionals is increasingly being recognized to compensate for the shortage of physicians in Canada. Chronic cough is one of the most...Full Text Available
BackgroundComputer-based health-risk assessments are electronic surveys which can be completed by patients privately, for example during their waiting time...Full Text Available
Validation of body-mass relationships requires a careful statistical analysis of data of normal weight individuals. BMI (ratio between body mass and square of body height) and BSI values (ratio between...Full Text Available
Careful measurements do not confirm an anomalous anisotropy in the angular distribution of fission fragments from the fast neutron fission of Americium 242. The energy range covered was 1.60-3.15 MeV. (AIP)
Information needs that arise when clinicians use clinical information systems often go unresolved, forcing clinicians to defer decisions or make them with incomplete knowledge. My research characterizes...Full Text Available
ContextWhile opioids are increasingly used for chronic non-cancer pain (CNCP), we know little about opioid dosing patterns among individuals with CNCP in usual care...Full Text Available
Alton Ochsner was a giant of American surgery. His career encompassed patient care, teaching, and research as symbolized on the original seal of the Ochsner Clinic. His ideas were innovative and groundbreaking...Full Text Available
This study describes instructions for after-hours care offered by family physicians' offices when patients telephone the practice. Randomly selected (n=1,680) Ontario family physicians and general practitioners...Full Text Available
Acute kidney injury (AKI) is a common clinical problem with significant clinical and economic consequences. A number of studies point to a rising incidence of AKI in the hospital and in the intensive...Full Text Available
Platelet reactivity plays a pivotal role in the pathogenesis of ischemic adverse events during and after acute coronary syndromes (ACS), and percutaneous coronary intervention (PCI). Glycoprotein (GP)...Full Text Available
BackgroundErrors have been the concern of providers and consumers of health care services. However, consumers' perception of medical errors in developing countries is rarely explored....Full Text Available
BackgroundIntrapartum fetal hypoxia remains an important cause of death and permanent handicap and in a significant proportion of cases there is evidence of suboptimal care related...Full Text Available
BackgroundParents of chronically ill children are at risk for a lower Health Related Quality of Life (HRQoL). Insight in the dynamics of factors influencing parental HRQoL is necessary...Full Text Available
BackgroundTraffic injuries can cause physical, psychological, and economical impairment, and affected individuals may also experience shortcomings in their post-accident care and...Full Text Available
Recent health care policies and regulations have impacted the manner in which patient data – especially protected health information (PHI) – are handled in both the clinical...Full Text Available
...2010-10-01 false Special rules relating to group health plans. 146.145 Section 146.145 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE GROUP HEALTH...
...discrimination against participants and beneficiaries based on a health factor. 146.121 Section 146.121 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE GROUP HEALTH...
This remodeled form of Einstein's relativity theories retains and incorporates only experimentally proven principles. It is based on a generalized law for spinning and rotational motions, which is in fact the conservation law of momentum vector direction, and can be successfully used for the precision computation of planetary and lunar orbits. The most fundamental principles of the remodeled relativity theory are the conservation laws of energy and momentum. Based on experience of relativity experiments, we adopted the principles that energy level is the underlying cause for relativistic effects, and that mass is expressed by the relativistic energy equation from Einstein. From space age ephemeris generation experience and following nature's way to conserve energy and momentum, we found reason to replace the concept of "relativity of all frames" with that of "nature's preferred frame", which helped us to escape Einstein's ...
Clin. Otolaryngol. 2009, 34, 438-446. Objective: To determine whether economic costs associated with a conservative management strategy for unilateral acoustic neuroma offer an economic advantage over active management options. Design: Cost and sensitivity analysis on a prospective cohort. Setting: Single centre study within a tertiary referral centre in Toronto, Canada. Participants: 72 patients (32 males, 40 females) aged 36 to 78 years with unilateral acoustic neuroma were assigned initially to a conservative management strategy. Entry criteria were small tumour size (less than 15mm in the cerebellopontine angle), patient preference and/or significant co-morbidity. Interventions: MRI scanning was performed every 6 months for the first year, annually subsequently and then every 2-3 years...
Of the many energy-conservation options available to the design engineer, a system-management approach is recommended as one that will effect maximum benefits to the owner. Systems management includes energy-conscious consideration of design criteria, design details, installation, testing and balancing, and operation. It requires the informed participation of the design engineer, contractor, testing and balancing (TAB) engineer, and owner/operator. Within limits, almost every component of HVAC systems offers an opportunity to conserve energy. Many of these impact energy determinants such as system static pressure, system total air flow, or the quantity of outside air. A few design considerations for energy conservation in a simple system and the impact that the TAB work has on these are illustrated. Particular attention is devoted to the energy impact of systems management, makeup air, and system static pressure.
An energy saving dc-dc converter circuit is disclosed having two energy efficient means which operate in tandem, an energy conserving means and a voltage doubling means. These energy efficient means are applied in combination with elements commonly found in dc-dc converter circuits, namely an ac voltage generator, a transformer for stepping up the generated ac voltage, and means for storing the converted dc voltage. The energy conserving means is connected to the dc voltage storage means. It comprises a resettable inhibit circuit which cuts off the provision of dc voltage for conversion for a predetermined interval when the output of the converter exceeds a predetermined level. The voltage doubling means is reponsive to outputs of the inhibit circuit of the energy conserving means and the ac voltage generator. It provides a phase inverted waveform of the generated ac voltage on one of two leads to the ac voltage step-up ...
There are two fundamental reasons or motivations for energy conservation: (1) economics; and (2) consideration of energy - its sources and availability. Economics speaks for itself and needs little explanation: a project is undertaken, the cost is recovered in a given period of time (we hope) and our company realizes cost savings thereafter. We study and propose a project; we estimate the payback. If approved, we implement the project. Then, we eagerly watch for its effectiveness - for the proposed payback. The second consideration in regard to energy conservation might - in the foreseeable future - become by far the most important - that of availability. Very knowledgeable persons have stated that this - in reality - is the most serious problem facing our nation today. Readily available, reasonably priced energy has given to the US the high form of living experienced today. An interruption in this flow could catapult our nation in an awesome ...
Evolutionary conservation of DNA sequences provides a tool for the identification of functional elements in genomes. We have created a database of evolutionary conserved regions (ECRs) in vertebrate genomes entitled ECRbase that is constructed from a collection of pairwise vertebrate genome alignments produced by the ECR Browser database. ECRbase features a database of syntenic blocks that recapitulate the evolution of rearrangements in vertebrates and a collection of promoters in all vertebrate genomes presented in the database. The database also contains a collection of annotated transcription factor binding sites (TFBS) in all ECRs and promoter elements. ECRbase currently includes human, rhesus macaque, dog, opossum, rat, mouse, chicken, frog, zebrafish, and two pufferfish genomes. It is freely accessible at http://ECRbase.dcode.org.
Abstract The baobab tree, with more than 300 uses and commercial value in EU and United States, has been identified as one of the most important trees to be conserved and domesticated in Africa. A decline in baobab populations because of changes in climate could have a negative effect on African livelihoods. Therefore, it is important to study the potential future distribution of this species and determine strategies for conservation. We used Maxent, 480 geo-referenced records, present and future climatic and soil layers. Different general circulation models and scenarios were selected. Models were simulated for (i) All records, (ii) East Africa and (iii) West Africa species records. For each combination, the proportion of the present habitat that might remain suitable in the future was de...
The manual enhances and simplifies the work of those architects and engineers whose practice includes the analysis and modification of existing buildings to reduce both fuel consumption and operating costs. A review of the principles of energy use and conservation is given. The manual also provides a step-by-step methodology for assessing and improving the year-round energy performance of buildings, as well as a series of forms, charts, and nomographs designed to serve as day-to-day tools in the energy professional's toolbox. After a cost-benefit analysis is prepared for each conservation opportunity, the owner will be able to implement decisions based on projected energy savings and calculate investment costs, operational changes, and payback periods. Each of these considerations is accorded a detailed treatment.
To date few reports have provided direct comparison of psychosocial vulnerability and resources among youth with victimization and perpetration histories. Within a racially diverse, high-risk...Full Text Available
... Headquarters 5th Brugade 78th Division (Ts) ... 2nd Battalion 20th Special Forces Company B ... 29th Corps Personnel Serves Hq Joint Task Force Aug ...
... NE Mall Room B-607, EPA Headquarters, 401 M ... formally adopted and initiated a joint strategy for ... CLI kick-off Partner and Task Force meeting. ...
Isokinetic training and assessment of the knee joint has been the mainstay of rehabilitation, especially in patients with anterior cruciate ligament deficiency. Besides the original shin pad used, the...Full Text Available
The Space Task Group in its study of future directions in space, with ..... almost $6 billion and a peak civil service and contractor work force of 420000 people. ..... space organizations permitting assumptions of primary or joint responsibility for ...
Washington, DC -07/24/09 Photo: Secretary Clinton and Iraqi Prime Minister al-Maliki at HCC Bilateral; Washington, DC -07/24/09 Photo: Secretary Clinton at Joint Press...
Haemophilia, the commonest hereditary bleeding disorder, arises because of the absence of, decrease in, or deficient functioning of plasma coagulation factor VIII or factor IX. With rare exceptions,...Full Text Available
The corrosion behaviour of friction stir welded (FSW) joints of AA 5083 has been compared to that of MIG welded joints. Pitting and stress corrosion cracking (SCC) resistance in 3.5% NaCl + 0.3 g/l H{sub 2}O{sub 2} and in EXCO (4 M KCl + 0.5 M KNO{sub 3} + 0.1 M HNO{sub 3}) solutions has been determined at 25 C. SCC susceptibility was evaluated by slow strain rate tests (SSRT), at a strain rate of 1 x 10{sup -6}s{sup -1}. Welds obtained by FSW technique showed a higher corrosion resistance in EXCO solution and a lower pitting tendency than the base alloy. Electrochemical measurements (corrosion potential measurements, polarization curves recording) evidenced that FSW weld was cathodic to base alloy. FSW joints were not susceptible to SCC in both test solutions, whereas MIG joints cracked in both solutions. (orig.)
This report is designed to cover the overall Operation Castle radiological safety matters from the viewpoint of those issues of direct concern to Headquarters, Joint Task Force Seven. It was written for the express purpose of assisting in the development ...
This report is designed to cover the overall Operation Castle radiological safety matters from the viewpoint of those issues of direct concern to Headquarters, Joint Task Force Seven. It was written for the express purpose of assisting in the development ...
A study of the joint evolution of the normal- and neutron-star components of massive binaries opens with a classification scheme and the analytic expressions to be applied in Paper II for computer simulation of the observable properties of such systems.
Metallic O-ring or Helicoflex seals can prevent relaxation and provide greater resilience than composite seals, helping to keep joints leaktight. Their characteristics and applications in the nuclear industry are outlined. (Author).
... We also toured a Trident submarine at Kings Bay, Ga. "During the weekend at the Joint Interagency Task Force Headquarters in Key West, Fla., we ...
... The high resolution imagery , collected over Rio de Janeiro, Brazil, included a mixture of large commercial buildings and private houses, as well as the airport and some community parks. 10/08/11 Read more Top EU R&D companies expect a 5% ...
The article reviews the Rothschild First Interim Report on the future of the British Coal Industry and British Coal Corporation. The report incorporates work undertaken by the Joint Working Groups set up with British Coal. The article points out various errors in the report and criticizes its conclusions.
We describe two cases of septic arthritis occurring in association with lower urinary tract infection in elderly men. In both cases the organism isolated from both the joint and the urine was Staphylococcus...Full Text Available
In view of the situation that aging of boiler components proceeds and some `Type IV` cracking incidents are reported recently, the development of an accurate remaining life evaluation method for boiler weldment parts is an important subject for the utilities. In this study, simulated materials with coarse and fine grain microstructures in a weldment heat affected zone were produced, and their high temperature strength properties were evaluated. The strength property of the weld joint was also discussed based on the experimental and analytical results. It was found that the creep rupture strength of the fine grain material was as low as 1/2 of the base metal and as 1/5 of the coarse grain material, and the weld joint ruptured at the fine grain region in a shorter period than the base metal as the applied stress level decreased. Many grainboundary creep cavities were also observed in the fine grain region. A creep deformation analysis by FEM ...
Tendon reconstruction using grafts often results in adhesions that limit joint flexion. These adhesions are precipitated by inflammation, fibrosis, and paucity of tendon differentiation signals...Full Text Available
Officers receive service-specific education and undergo experiences within their components that provide the expert knowledge that enables them to operate in their respective military departments. Given the Department of Defense (DoD) emphasis on service ...
Static task intensity–endurance time (ET) relationships (e.g. Rohmert's curve) were first reported decades ago. However, a comprehensive meta-analysis to compare experimentally-observed...Full Text Available
Prophylactic knee braces are designed to prevent and reduce the severity of ligamentous injuries to the knee. Conflicting evidence is reported concerning their efficacy. The purpose of this study was...Full Text Available
The goal of this study was to evaluate topics used to troubleshoot circuit boards with known or suspected thermally intermittent components. Failure modes for thermally intermittent components are typically mechanical defects, such as cracks in solder paths or joints, or broken b...
Seventy seven patients with soft tissue shoulder lesions including adhesive capsulitis and disorders of the rotator cuff and acromioclavicular joint were admitted to a trial comparing two different...Full Text Available
This study investigates the doctrinal guidance available to a corps headquarters if required to serve as ajoint task force headquarters and simultaneously be required to warfight the corps. The study contends that a corps being required to simultaneously ...
...undertake missions and tasks (on either a...Secretary of Defense to task the DoD Components...the Chairman of the Joint Chiefs of Staff any commitment of military forces assigned to the Unified... (9) Military forces employed in MSCA...approval from higher headquarters, local military...
(General Stafford) was selected as chair for the Task Force based on his expertise .... a large foreign customer base that includes joint working agreements with Russia, the .... NASA Headquarters management advocates the Jorge Scientific ...