Aims:To Study the religious and ideological views and practice of PalliativeCare physician towards Euthanasia.Materials and Methods:An...Full Text Available
This article is a story of networking of palliativecare 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
Paediatric palliativecare 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
Goals of workThe goal of this study was to evaluate, at a population level, the association between specialized palliativecare services (SPCS) and short- and long-term caregiver...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
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
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
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 palliativecare may be an important component of targeting supportive services that address individual needs of families. Therefore, the goal was to develop a Pediatric PalliativeCare 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 palliativecare 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 ...
OBJECTIVE--To review findings from studies of the influence of desktop computers on primary careconsultations. DESIGN--Systematic review of world reports from 1984 to 1994. SETTING--The computerised...Full Text Available
The purpose of this study was to evaluate the safety and efficacy of TACE with microspheres preloaded with doxorubicin in unresectable intrahepatic cholangiocarcinoma (UCH). Twenty patients with UCH were observed; 9 refused, preferring other palliativecare or chemotherapy, and 11 agreed to be treated with one or more cycles of DC beads loaded with doxorubicin (100-150 mg) in a TACE procedure between February 2006 and September 2007. A total of 29 individual TACE procedures were performed. Follow-up imaging was performed on all patients before, immediately after, and 4 weeks after each TACE procedure to evaluate the response and need for further treatment. Each patient received i.v hydration, antibiotics, and medications against nausea and pain before TACE. Survival rate was calculated using Kaplan-Meier survival curve. A response rate of 100% followed RECIST criteria was observed. Eight of eleven patients are alive, with a median survival of ...
A 67-year-old man presented with gastrointestinal bleeding resulting from a fistula between the aortic stump and the fourth part of the duodenum 14 months after an axillobifemoral bypass, graft excision, and aortic stump closure for aortic graft infection. The patient initially refused any attempt at definitive surgical treatment so coil embolization of the aortic stump was performed via a brachial approach. Coil embolization may be a useful adjunct in the management of such difficult problems. This approach may buy time and allow careful planning of a definitive treatment or may serve as a palliative procedure in inoperable patients. PMID:15947052
Oral mucositis associated with head and neck radiotherapy can substantially hinder completion of cancer therapy. Alleviation of this often severe stomatitis can provide enhanced patient comfort and facilitate appropriate care. A double-blind format was used in a pilot project to measure, against a control rinse, the effectiveness of an oral rinse consisting of hydrocortisone, nystatin, tetracycline, and diphenhydramine in controlling radiation-related mucositis. A combination of clinical evaluation and patient responses to a questionnaire was used to judge the results of the topical medications. Patients using the experimental medication developed less mucositis than did patients in the control group.
Since many years, people take care of hazardous consequences of a non controlled economic growth and the sustainable development concept gains on one. This situation leads to consequences in the building industry and in the energy policy: buildings insulation in consideration, demand of consultants. In this framework, the partnership between Gaz De France and CICF has to be built. (A.L.B.)
The utilization of health care services in children and adolescents with chronic benign pain was studied in a Dutch population sample of 254 chronic pain sufferers aged 0-18 years. Children and adolescents who had reported chronic pain (continuous or recurrent pain >3 months) in our previous prevalence study were asked to keep a 3-week diary on their pain and to fill out questionnaires on background factors, health care use and the impact of pain. Parent ratings were used for children aged 0-11 years, self-report was used in adolescents (12-18 years). In a 3-month period, in 53.4% of the cases medication was used for pain, and general practitioners and specialists were consulted for pain in 31.1% and 13.9% of subjects, respectively. Physiotherapists, psychologists and alternative health providers were visited by 11.5, 2.8, and 4.0%, respectively. In the preceding year, 6.4% had been hospitalized due to pain. The most ...
Offers an updated version of French and Raven's bases of social power model and describes Raven's power/interaction model of interpersonal influence. Applies elements of both models to school consultation practices. Explores social power and influence occurring during school consultation. Describes a research agenda for further exploration of social power within consultation. (RJM)
Consultant and advanced practice are relatively new concepts in radiography. There is evidence to show that as the career progression framework is being adopted the numbers of consultant and advanced practitioners in radiography are growing with the latter growing at a faster rate. The article considers the concept of advanced and consultant practice and the education requirements to support development. Preparation for an advanced practice role begins at the practitioner stage. Masters' level programmes are available to support the development of advanced practice. Education needs to be flexible as new advanced practice roles emerge. It is necessary to take practitioners beyond a defined modality to include leadership and people skills. These are essential for those aspiring to become consultants. Consultants require a high level of clinical knowledge for expert practice ...
BackgroundA key feature of a good general practice consultation is that it is patient-centred. A number of verbal and non-verbal behaviours have been identified as important to establish...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.
A ten week old girl who had previously undergone a palliative procedure for the hypoplastic left heart syndrome had unrelieved aortic coarctation that did not respond to standard balloon dilatation....Full Text Available
Incidence of esophageal cancer (EC) is rising more rapidly in the Western world than that of any other cancer. Despite advances in therapy, more than 50% of patients have incurable disease at the time...Full Text Available
AIM: To evaluate the efficacy of self expandable metallic stents (SEMS) in patients with malignant esophageal obstruction and fistulas.METHODS: SEMS were implanted in the presence of fluoroscopic...Full Text Available
The heterogeneity of metastatic breast cancer mandates the need to select therapies taking into account tumor and patient characteristics. Chemotherapy is indicated in the palliative setting especially...Full Text Available
Different cases exist in various countries regarding the institutional status, the organization and the technical resources of the Nuclear Regulatory Authority (NRA): there are NRAs having extended internal technical capability and others relying mostly on external technical support. Considering the research and development activities and the very broad range of technical matters on which the regulatory and licensing activity are based, the NRA can not rely only on internal resources, and generally there is the need of technical and scientific support together with enhanced international cooperation. The international cooperation and networking among NRAs, and their Technical Support Organizations (TSO), represents a fundamental way to maintain competence, capability and knowledge. Within the EU member states this is becoming more and more an institutional duty. In providing technical support for regulatory activity, the experience shows, from one side, the importance to have TSO with ...
In the case of a serious accident and as a precautionary measure, several protection actions can be implemented by the prefect during the emergency phase. In France the levels of intervention are given by a ministerial decree of the 13. october 2003, resuming recommendations of the International Atomic Energy Agency. The selected values are: an efficient dose of 10 mSv for the stake under cover and in the listening: the concerned persons have to put under cover in a building, any openings carefully closed and stay in the listening of the orders of the prefect; an efficient dose of 50 mSv for evacuation; an efficient dose to the thyroid of 100 mSv for the taking of stable iodine tablets. In order to help the authorities to choose between the keeping of populations at their place or immediate evacuation the decision criteria are: if the forecasted efficient dose of the first month is under 1 mSv, the populations stay in place; if the forecasted efficient dose is ...
In the case of a serious accident and as a precautionary measure, several protection actions can be implemented by the prefect during the emergency phase. In France the levels of intervention are given by a ministerial decree of the 13. october 2003, resuming recommendations of the International Atomic Energy Agency. The selected values are: an efficient dose of 10 mSv for the stake under cover and in the listening: the concerned persons have to put under cover in a building, any openings carefully closed and stay in the listening of the orders of the prefect; an efficient dose of 50 mSv for evacuation; an efficient dose to the thyroid of 100 mSv for the taking of stable iodine tablets. In order to help the authorities to choose between the keeping of populations at their place or immediate evacuation the decision criteria are: if the forecasted efficient dose of the first month is under 1 mSv, the populations stay in place; if the forecasted efficient dose is ...
As part of the work scope set in the French law on high level long lived waste R&D passed in 1991, CEA is conducting a research program to establish the scientific basis and assess the feasibility of long term storage as an option for the safe management of nuclear waste for periods as long as centuries. This goal is a significant departure from the current industrial practice where storage facilities are usually built to last only a few decades. From a technical viewpoint such an extension in time seems feasible provided care and maintenance is exercised. Considering such long periods of time, the risk for Society of loosing oversight and control of such a facility is real, which triggers the question of whether and how long term storage safety can be actually achieved. Therefore CEA commissioned a study (1) in which MUTADIS Consultants (2) and CEPN (3) were both involved. The case study looks into several past and actual human ...
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
BackgroundSoft tissue foreign bodies are a common cause of orthopedic consultation in emergency departments. It is difficult to confirm their existence because conventional radiology...Full Text Available
Phytoremediation, a technology using plants to remediate or stabilize contaminants in soil, groundwater, or sediments, has recently received a great deal of attention from regulators, consultants, responsible parties, and stakeholders. phytoremediation ha...
Objective: To explore the interventional method to treat biliary recurrent jaundice after T tube drainage in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods: 7 biliary metallic stents were placed in 7 patients with recurrent jaundice after T-tube drainage in cholangiocarcinoma cases. Results: Stent placement was once successful in all 7 cases with successful rate of 100%. For all cases, TBIL, ALT, GTP and AKP values 7 days postoperatively were significantly lower than that of preoperation together with subsidence of jaundice satisfactorily for 100% after the treatment. Conclusions: Percutaneous placement of biliary metallic stents was effective economic, minimal invasive and safe for palliation of biliary recurrent jaundice after T tube drainage in cholangiocarcinoma-induced obstructive jaundice
Background The Norwood procedure consists of three palliative operations, performed in neonates with hypoplastic left heart syndrome. Especially the first stage (Norwood I) is associated with the highest mortality rates in paediatric cardiac surgery (up to 25%). During surgery, the aorta is reconstructed and a systemic-to-pulmonary shunt is applied. Originally the modified Blalock-Taussig shunt was used, but recently the right-ventricle-to-pulmonary-artery shunt is increasingly being employed. We reviewed the results of our operative strategy, where an individualised choice of shunt is made. Furthermore, attempts to reduce interstage mortality (between Norwood I and II) were assessed. Methods All neonates who underwent Norwood stage I palliation from August 2004 until November 2010 were in...
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...
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
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
... 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
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
Over a 7-year period transient hyperthyroidism was diagnosed in 35 patients seen in a consulting practice in a community hospital. The patients were followed up for an average of 15 months. Initially...Full Text Available
BackgroundTo determine male outpatient attenders' sexual behaviours, expectations and experience of talking about their sexuality and sexual health needs with a doctor.MethodsA...Full Text Available
The report presents detailed technical information concerning application of flue gas desulfurization (FGD) systems to industrial boilers. The information was obtained by a survey of plant personnel, control system vendors, regulatory agencies, and consulting engineering firms. T...
The use of digital wound images would allow remote consultation between patients, physicians, or other caregivers over the Internet. To evaluate the efficacy and validity of digital images for assessment...Full Text Available
BackgroundAcute low back pain is a very common symptom and reason for many medical consultations. In some unusual circumstances it could be linked to a rare aetiology.Case...Full Text Available
The aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample...Full Text Available
... Areas of Consultation: All Areas About DECC Bioenergy Carbon capture & storage Carbon Reduction Commitment Climate Change Agreements CRC energy efficiency scheme Development, consents and planning reform Electricity Electricity network Emissions Emissions trading Energy markets Energy network Energy security Feed-in Tariffs Fuel poverty Funding and support Gas Governance Green Deal Hydroelectricity International climate change International energy Legislation Low-carbon Microgeneration News Nuclear Oil Renewable energy Saving energy and CO2 Site Wide Footer Smart ...
As a condition of accession into the European Union (EU), Lithuania is committed to the closure and decommissioning of Ignalina NPP comprising two RBMK-1500 reactor units (Fig. 1). It was agreed in a special protocol to the Accession Treaty that, in return for adequate EU financial assistance, Unit 1 would be closed before 2005 and Unit 2 by the end of 2009. The first unit was duly shut down on December 31, 2004. Lithuania, which has borders with Russia (Kaliningrad territory), Poland, Latvia and Belarus, spent fifty years as part of the Soviet Union and was deeply integrated into its economy and electrical infrastructure. At the break-up of the USSR, Lithuania inherited electricity generating capacity designed to supply the north-west region including ownership of Ignalina NPP located in the north-east of the country. Ignalina NPP Unit 1 was commissioned in 1983, Unit 2 in 1987; the planned lifespan of each unit was 30 years. Construction of a third unit was started but never ...
To compare clinical effectiveness of Viabil-covered stents versus uncovered metallic Wallstents, for palliation of malignant jaundice due to extrahepatic cholangiocarcinoma, 60 patients were enrolled in a prospective and randomized study. In half of the patients a bare Wallstent was used, and in the other half a Viabil biliary stent. Patients were followed up until death. Primary patency, survival, complication rates, and mean cost were calculated in both groups. Stent dysfunction occurred in 9 (30%) patients in the bare stent group after a mean period of 133.1 days and in 4 (13.3%) patients in the covered stent group after a mean of 179.5 days. The incidence of stent dysfunction was significantly lower in the covered stent group (P = 0.046). Tumor ingrowth occurred exclusively in the bare stent group (P = 0.007). Median survival was 180.5 days for the Wallstent and 243.5 days for the Viabil group (P = 0.039). Complications and mean cost were similar in the two ...
The incidence of hepatocellular carcinoma (HCC) is increasing in developed countries and the general status of HCC patients is now by far better than a few years ago, allowing physicians to propose some different treatments of these patients. Among these treatments, intra-arterial injection of 131-iodine-labelled Lipiodol could be used in palliative, curative or adjuvant settings. After a brief summary of the modalities of this treatment, requiring the collaboration of Gastro-enterologists, Oncologists, Radiologists and Nuclear Medicine physicians, the different possibilities of therapeutic uses of this new approach are described and an outlook of these developments is proposed. (author)
Carcinoma en cuirasse of the breast, which invades the skin via lymphatics and may encase the entire thorax and abdomen, is poorly controlled by surgery, chemotherapy, or conventional irradiation. Palliation of patients with breast carcinoma en cuirasse is a difficult clinical problem which must be effectively managed over extended periods due to the indolent nature of this disease. The management of three cases is reported, and the new technique of rotational subtotal skin electron-beam therapy (SSEBT) is presented. (author).
Self-expanding metallic stent insertion has been widely applied for the palliative treatment of malignant esophageal strictures. Although it is known as an easy, safe, and effective procedure, complications are well known and include things such as stent migration and esophageal stent occlusion caused by tumor in growth. However, metallic stent fractures have been rarely reported in the esophagus, especially for nitinol stents. We report a case of a stent fracture associated with migration in a patient with a malignant esophageal stricture near the gastroesophageal junction. It is highly probable that the stent fracture was due to chemical erosion of the stent caused by gastric juice
The aim of this retrospective study was to determine the safety and efficacy of chemoembolization (TACE) as palliative treatment for patients with unresectable intrahepatic cholangiocarcinoma (CCA) and to compare the results with those in the literature. Fifteen patients with histology-proven CCA (5 men, 10 women) had received palliative treatment with TACE over a 6-year period. The treatment protocol comprised repeated TACE at a minimum of 8-week intervals. TACE was performed with a mixture of 10 ml Lipiodol and 10 mg mitomycin C injected into the tumor-supplying vessels. Follow-up investigations after 8-10 weeks comprised contrast-enhanced multislice spiral CT and laboratory control. Statistical evaluation included survival analysis using the Kaplan-Meier method. During the investigation period 58 TACEs (3.9 #+-# 3.8; 1-15) were performed in 15 patients. Mean tumor size was 10.8 #+-# 4.6 cm (range, 2.0-18.0 cm). Unifocal tumor disease was ...
To evaluate repeated hepatic intraarterial chemotherapy (HIC) as a palliative treatment option for unresectable cholangiocarcinoma and liver metastases of various origins that were progressive under systemic chemotherapy. Between 2002 and 2006, 55 patients were treated in 4-week intervals (mean five sessions). Combined gemcitabine/mitomycin was administered intraarterially within 1 h. Tumor response was evaluated after the third session according to RECIST. Treated tumor entities were colorectal carcinoma (CRC) (n = 12), breast cancer (BC) (n = 12), cholangiocarcinoma (CCC) (n = 10), pancreatic (n = 4), ovarian (n = 3), gastric, cervical, papillary (each n = 2), prostate, esophageal carcinoma, leiomyosarcoma (each n = 1), cancer of unknown primacy (CUP) (n = 5). All patients tolerated the treatment well without any major side effects or complications. In total, there were 1 complete response (CR), 19 partial responses (PR), 19 stable (SD) and 16 progressive ...
To evaluate the feasibility and clinical effectiveness of using a polyurethane-covered expandable nitinol stent in the palliative treatment of malignant duodenal obstruction. Under fluoroscopic guidance, a polyurethane-covered expandable nitinol stent was placed in 12 consecutive patients with malignant duodenal obstructions. All presented with severe nausea and recurrent vomiting. The underlying causes of obstruction were duodenal carcinoma (n=4), pancreatic carcinoma (n=4), gall bladder carcinoma (n=2), distal CBD carcinoma (n=1), and uterine cervical carcinoma (n=1). The sites of obstruction were part I (n=1), part II (n=8), and III (n=3). Due to pre-existing jaundice, eight patients with part II obstructions underwent biliary decompression prior to stent placement. An introducer sheath with a 6-mm outer diameter and stents 16 mm in diameter were employed, and to place the stent, and after-loading technique was used. Stent placement was technically successful in ...
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
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
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
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
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
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...
As its indigenous gas supplies decline, the UK will need to import more gas. In November 2006, the Department of Trade and Industry issued a consultation on revising the consent regime for offshore gas storage and offshore liquefied natural gas unloading. A total of 27 responses had been received by the closing date of 16 February 2007 from a variety of interest parties including developers and their representative organisations, consultants, environmental organisations, maritime organisations, heritage organisations and other public bodies. This report presents the Government's response to the views expressed by these respondents. The majority of respondents supported the Government's proposals to put in place new legislation to permit offshore gas storage activities. Many believed new legislation was necessary to provide the legal certainty necessary ro encourage offshore development and investment in such developments. ...
... Title : Mental Health and Resilience: Soldiers' Perceptions about Psychotherapy, Medications, and Barriers to Care in the United States Military. ...
Problems relating to electromagnetic compatibility and power quality were discussed, combined with a discussion of the role that consulting engineers can play in resolving them. The need for the consulting engineer to be aware of design specifications of equipment was considered essential. Similarly, the interrelationship between installations using variable speed drives, halogenous lighting systems, capacitor banks, high-voltage power lines, power transformers, etc., and the need for familiarity with the operating characteristics of different types of power systems were stressed as key ingredients to success in ascertaining events and causes of equipment failure or power system problems on the network. The main sources of disturbances, impact of voltage variations, the importance of controlling voltage imbalance, and system protection were summarized. 4 figs.
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. ...
The key to the future for electric utilities will not be found in legislation or regulation. Title VII of the Energy Policy Act of 1992 will prove to be just as ineffectual in improving the industry's position as was the Public Utility Regulatory Policies Act of 1978. These legislative palliatives, which produced so much commotion and so many reams of heated commentary, are largely irrelevant to a successful future for electric utilities. The key will be found in economics, not in law, and the future will lie in completing Thomas A. Edison's century-old vision for the industry, half of which the industry has heretofore ignored. The industry must embrace the complete vision and evolve from electric utilities into [open quotes]end-use energy utilities.[close quotes
The incidence of hilar cholangiocarcinoma is very rare worldwide. Radical resection is the only prognostic factor for long survival in patients with hilar cholangiocarcinoma. Postoperative radiation therapy can improve local control and survival rates for patients with palliative resection, but it remains controversial in patients with radical resection. Biliary drainage can effectively release bile duct obstruction for the majority of patients with locally advanced disease, and may even prolong survival when combined with radiation therapy. Radiation therapy includes extrernal beam therapy alone, external beam therapy with intraluminal brachytheapy and new radiation technique, such as three dimentional conformal therapy and intensity modulated radiation therapy. The propective randomized clinical study is needed for further investigation in the role of combined modality therapy especially for hilar cholangiocarcinoma. (authors)
Objective To report the clinical response to image-guided percutaneous cryotherapy (IPC) for the palliative management of localized metastases in patients with gynecologic malignancies. Methods Institutional review board approval and patient consent were obtained. Gynecologic oncology patients were identified from our institution's cryotherapy database from August 2003 to August 2007. Cryotherapy was performed with 2.4?mm diameter probes (Endocare, Irvine, CA) with ultrasound or computerized tomography (CT) guidance under conscious sedation and local anesthesia. Follow-up was conducted by imaging studies and clinical encounters, using Response Evaluation Criteria in Solid Tumors (RECIST criteria). Results Twenty-eight ablation sessions were performed for 41 metastatic foci in 15 patients w...
The paper discusses a number of recent studies investigating into the energy conservation and environmental impacts of electric heating systems (off-peak storage systems). In future, i.e. in and after 1993, off-peak storage systems will be evaluated through comparative analyses of oil-fired heating systems, pollutant emission analyses, the eventual success of pollution abatement measures designed for power plant emissions to keep within the legal limiting values, and the possible abandonment of pollution abatement measures abroad. Opposing the electric heating studies submitted by the electric power industry the author refutes their favourable results referring to the palliative selection of inadequate or vague parameters. Assuming average power plant pollutant emissions of 180 mg/standard/sup 3/ the nitrogen oxide emissions of oil-fired heating systems (134.1 kg/Tj) are found to be below those of off-peak storage systems (242.5 kg/Tj).
A 21-year-old woman developed midesophageal stricture two weeks after ingestion of aluminium phosphide (AlP) tablets. Aluminium phosphide is a lethal protoplasmic toxin and is also the most common cause of suicidal poisoning in northern India. Upper gastrointestinal endoscopy (UGIE) showed a tight esophageal stricture 29?cm from the incisors with a circumferential ulcer. Dilatation up to 17?mm was done using Savary-Gilliard dilators. She had repeated dilatations three times at nearly two-week intervals. In view of the resistant stricture, a silicone Polyflex stent was placed across the stricture and removed after 3?months; there was no recurrence of stricture even after three months of follow-up. Patients with recurrent esophageal stricture and those with fistula may benefit from silicone ...
The Coordinated Research Project is a topical collection of research agreements and contracts. The research contracts are awarded with financial support of about 10-20% of the total contract cost. Among the activities of the project is the organization of consultant group meetings and workshops involving several international experts and representatives of users and developers of border radiation monitoring equipment. The project also supports in coordinating the development of equipment and techniques for up-to-date border monitoring and in establishing of a process for providing nuclear forensics support to member states
This book presents the current knowledge about the effects of electromagnetic fields on living matter. The three-part format covers dielectric permittivity and electrical conductivity of biological materials; effects of direct current and low frequency fields; and effects of radio frequency (including microwave) fields. The parts are designed to be consulted independently or in sequence, depending upon the needs of the reader. Useful appendixes on measurement units and safety standards are also included.
I travelled to San Jose, Costa Rica on July 8, 1990 to evaluate all of the completed elements of the ongoing feasibility study for the San Lorenzo River hydroelectric project. The feasibility study is being supported by ORNL under the Renewable Energy Applications and Training Project. The project is being studied for implementation by CONELECTRICAS, a consortium of rural electric cooperatives and the study itself is being conducted by BEL Engineering, a Costa Rican consulting firm under contract to CONELECTRICAS, USAID/PIC and NRECA.
We wanted to determine the technical and clinical efficacy of using a PTFE-covered self-expandable nitinol stent for the palliative treatment of malignant biliary obstruction. Thirty-seven patients with common bile duct strictures caused by malignant disease were treated by placing a total of 37 nitinol PTFE stents. These stents were covered with PTFE with the exception of the last 5 mm at each end; the stent had an unconstrained diameter of 10 mm and a total length of 50 80 mm. The patient survival rate and stent patency rate were calculated by performing Kaplan-Meier survival analysis. The bilirubin, serum amylase and lipase levels before and after stent placement were measured and then compared using a Wilcoxon signed-rank test. The average follow-up duration was 27.9 weeks (range: 2 81 weeks). Placement was successful in all cases. Seventy-six percent of the patients (28/37) experienced adequate palliative drainage for the remainder of ...
We wanted to determine the technical and clinical efficacy of placing a self-expandable PTFE-covered nitinol stent for the management of inoperable malignant biliary obstruction. Thirty six patients with inoperable malignant biliary obstructions were treated by placement of self-expandable PTFE-covered nitinol stents (S and G Biotech Corporation, Seongnam, Korea). Clinical evaluation was done with assessment of the serum bilirubin and alkaline phosphatase levels, which were measured before and after stent placement within 1 week, at 1 month and at 3 months. The patient survival rate and stent patency rate were calculated with performing Kaplan-Meier survival analysis. Successful stent placement was achieved in all the patients without procedure-related complication. Pancreatitis as an early complication occurred in two cases. The serum bilirubin and alkaline phosphatase levels were significantly decreased after the procedure. During the follow-up, recurrent obstructive jaundice ...
Inferior vena cava (IVC) obstruction is a well-described clinical entity. Most IVC obstructions from malignant neoplasms are a direct result of tumor compression [Oviedo J, Cerda S. Vascular invasion by hepatocellular carcinoma. Arch Pathol Lab Med 2001;125: 454-5; Furui S, Sawada S, et al. Gianturco stent placement in malignant caval obstruction: analysis of factors for predicting the outcome. Radiology 1995;195:147-52; Fletcher WS, Lakin PC, et al. Results of treatment of inferior vena cava syndrome with expandable metallic stents. Arch Surg 1998;133:935-8]. The symptoms of IVC obstruction include progressive ascites, scrotal edema and lower body edema. These constellations of symptoms are described as IVC syndrome and are devastating to a patient with end-stage cancer. We describe a palliative therapy utilizing Luminexx nitinol self-expanding stents to treat intracaval hepatoma thrombus obstructing the IVC. The procedure is rapidly performed, technically ...
We wanted to evaluate the long-term results of a dual expandable nitinol stent for the palliative treatment of malignant gastroduodenal strictures. The dual stent consists of two stents; an outer partially nylon covered stent and an inner bare nitinol stent. The outer stent was placed into the stricture and this was followed by coaxial placement of the inner bare stent. Using fluoroscopic guidance, dual expandable stents were placed in 86 patients with inoperable malignant gastroduodenal strictures. The technical and clinical success, the complication, survival and the stent patency were evaluated during the follow-up period. Stent placement was technically successful in 83 of the 86 patients. After stent placement, 74 of the 85 patients showed improvement of their symptoms. During the mean follow-up period of 133 days, 24 patients (28%) developed recurrent symptoms due to incomplete expansion (n=1), stent migration (n=4), food impaction (n=2), granulation tissue ...
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 ...
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 proposal was on the November ...
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.
... 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
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
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
This presentation outlined the corporate history of the Ohmega Group, a small company from Gaspe, Quebec which offers consulting services to the automation and telecommunication sector. It was created in 1982 and has been involved with the wind power industry since 1996. The main services provided by Ohmega Group include electrical and mechanical construction and maintenance services. This paper also reviewed the benefits of using Supervisory Control and Data Acquisition (SCADA) systems in the wind power industry to monitor, control and collect data from wind turbines. The Ohmega Group has provided consulting services to Cartier Wind Energy Inc., a company that was awarded several wind turbine projects by Hydro-Quebec Distribution. The Ohmega Group applied the SCADA system at the Baie des Sables, Anse a Valleau and Carleton wind turbine arrays. The typical architecture of SCADA systems on a wind farm was presented along with ...
Since the 1970s, Danish electricity supply has been dependent on imported coal. This has lead to greater reliability of supply, as could be seen during the Gulf War when Danish electricity prices remained stable in contrast to conditions in other countries. The disadvantage is the air pollution caused by coal combustion. This is regulated, it is stated, by several international laws and agreements, and these are named here. The nature of this form of pollution is explained in relation to actual Danish power plants and their efforts to reduce emissions of sulphur dioxide and nitrogen oxides. Carbon dioxide, which is a greenhouse gas, is also emitted. Danish environmental policy concentrates on these problems. The efforts of the electric power companies to reduce air pollution are detailed, both nationally and internationally, and their positive consequences are described. Desulphurization and denitrification costs are claimed to be 4.6 Danish oere and 1.9 Danish oere per year per kWh ...
The aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample of children and adolescents aged between 0 and 18 years of age was drawn from the records of ten general practices. According to their responses to a pain questionnaire, subjects were assigned to the chronic benign pain group (n = 95) if they had pain of more than three months' duration, or to the control group (n = 105) if they had pain of less than three months' duration or no pain at all. All the subjects had an average GP consultation rate of 2.6 contacts per year. No significant age and sex differences were found. Chronic benign pain in childhood and adolescence is not related to increased use of healthcare services, suggesting that somatisation does not play a major role in children with chronic benign pain. PMID:12030664
Development of renewable energy systems for remote communities is gaining interest among government, utilities, NGOs and the communities themselves as a means of improving lifestyles of community members and showcasing renewable energy systems. The Huu-ay-aht First Nation, whose traditional territory is located on the west side of Vancouver Island in British Columbia, is a community which has energy related problems and energy related opportunities. The objective of this study is to assess possible energy options for the Huu-ay-aht First Nation traditional territory. Current and future energy services within the territory were used as the starting point for developing energy system options. Extensive consultation with community members was instrumental in clearly defining the objectives of the study and understanding the territory's energy demand. The energy demand assessment included an estimation of the electric, heating and transportation loads in the community, ...
The Conawapa-Winnipeg Power Transmission Complex includes five interrelated transmission and conversion facilities. This booklet describes work done on the upgrade of the southern receiver system, one component of the complex. The southern receiver system is composed of a network of high voltage transmission lines and station facilities. The booklet includes a description of the upgrade, the project setting, short and long-term effects and impact management, and the next steps to be taken in the process, including the regulatory process and public consultation.
The results of the examination of 23 children with Ewing's sarcoma of the rib were analyzed: panoramic chest X-rays in 4 projections, spot radiographs of the robs, superexposed pictures, laterograms, urography, angiography, computerized tomography, and scanning of the skeleton. Causes of diagnostic errors made at the first consultation by a physician, were identified. Peculiarities of X-ray signs of tumors of this site in children were studied. Diagnostic difficulties in tumors complicated by pleurisy and in tumors of small sizes with extrapleural growth were shown. Inclusions in the extraoseous tumor component were noted in 8.7% of the cases.
...Publications Consultations Application forms Vacancies Contact us About us Air Climate change Flooding Live flood warnings Flood map How to use it About the ...map View the map FAQs Contact us & Feedback Flooding: who does what? Flood warning - what we do Floodline Warnings Direct Flood ...risk Being prepared FAQs Floodline kids Flooding publications External links Business & Flood Risk Seminar Contact us Land Planning Radioactive substances Waste Water ... You are here: Home Page Flooding Flood map View the map View the map: terms and conditions Important information about ...
The Remote Teaching Assistant (RTA) software currently under development at UC Davis allows students and Teaching Assistants (TA`s) to interact through multimedia communication via the Internet. To resolve the problem of TA unavailability and limited knowledge, an Expert Teaching Assistant (ETA) module is being developed. When TA`s are not on-line, students in need of help consult ETA. The focus of this research is the development and integration of ETA with RTA, the establishment of an architecture suitable for use with education (the domain) in any sub-domain (course), and the creation of a mechanism usable by non-technical personnel to maintain knowledge bases.
During 2009, the Hilton M. Briggs Library, South Dakota State University, went live with MetaLib, a federated search engine from Ex Libris. This paper presents the implementation process, addresses resource accessibility issues, and suggests a number of resources that can be consulted about these issues. Readers can apply similar strategies to projects involving federated search systems, as many implementation projects involve the same basic considerations presented here. The author did not find any studies specifically focused on configurations of MetaLib resources, so this content should be singularly useful.
... Biogas: The green gas? | EurActiv Biogas has become an attractive alternative source of energy in Europe as the renewable fuel ...Graduate Programme Research Analyst Junior Consultant Training Coordinator Post an EU job Biogas: The green gas? Published: 09 April 2010 |...Updated: 06 July 2010 Biogas has become an attractive alternative source of energy in Europe as the renewable fuel serves several policy priorities, ranging from ... Policy Summary Biogas is a renewable energy source that can be used for heating or electricity production. If compressed, it can ...
The Asejire dam at Ibadan, Nigeria was constructed in the late sixties for the purpose of providing water for the city of Ibadan (presently about 4,5 million inhabitants). It is located on the Oshun river approximately fifteen miles from the city. In 1982 cracks were observed on the wing walls and although these continued to develop, no attempt was made at that time to investigate their causes and no repair was carried out. In 1989 the SGI ENGINEERING Group of Geneva, Switzerland was appointed as the consultant for the complete refurbishment of the Asejire water scheme. The consortium Degremont-Poat-Clemessy was awarded the contract for the project. The African Development Bank and the Nigerian Government have provided the loan to finance the project.
This proceedings volume contains contributions by about 70 authors on market trends, funding, marketing, boundary conditions and sales promotion of thermal solar energy and photovoltaic systems. The contributions reflect the diversity of authors, e.g. consultants, advocates and agents of solar technology producers and financial organisations. Central issues were markets in and outside Europe, quality assurance, interdepartmental cooperations, and marketing strategies of the solar industry. The proceedings volume also contains the conference schedule and self-descriptions of the authors' institutions. (orig.)
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
Background and purpose: A diagnosis of malignancy and its treatment is a very stressful time for patients and their families. This study was conducted to determine the impact of more intensive written information on patients' anxiety levels. The secondary aim was to determine the impact of this information on patients' satisfaction levels. Materials and methods: This prospective randomized trial consisted of patients with a pathological diagnosis of cancer having radical radiotherapy (RT). Patients were randomized to receive the more intensive information (including written information and a telephone call from the research nurse) or not to receive the more intensive information at the time of their initial consultation with the radiation oncologist. Study questionnaires measuring anxiety (STAI form) were completed prior to their first consultation (baseline) at the time of simulation (pre-RT) and at the completion of radiotherapy. A second ...
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 ...
Objective: To explore the interventional treatment for biliary re-stenosis after metallic stents placement in patients due to cholangiocarcinoma and evaluate its therapeutic effect. Methods: Percutaneous metallic stents placement or combined with continuously infusion arterial chemotherapeutic and chemotherapeutic embolization were performed in 12 patients with biliary re-stenosis using 12 metallic stents. Results: Once stent placement was 100% successful in all 12 cases, TBIL, ALT, GTP and AKP values 7 days postoperatively were significantly lower than that in preoperation. Jaundice was reduced satisfactorily in 12 patients. 3 patients were undergone continuously arterial chemotherapeutics infusion and chemotherapeutic embolization 4 weeks after stents placement. Conclusions: Percutaneous replacement of biliary metallic stents was effective and safe for palliation of malignant biliary re-stenosis and would be much better when combined with continuously arterial ...
The mortality in undrained abdominal abscesses is high with a mortality rate ranging between 45 and 100%. The outcome in abdominal abscesses, however, has improved due to advances in image guided percutaneous interventional techniques. The main indications for the catheter drainage include treatment or palliation of sepsis associated with an infected fluid collection, and alleviation of the symptoms that may be caused by fluid collections by virtue of their size, like pancreatic pseudocele or lymphocele. The single liver abscesses may be drained with ultrasound guidance only, whereas the multiple abscesses usually require computed tomography (CT) guidance and placement of multiple catheters. The pancreatic abscesses are generally drained routinely and urgently. Non-infected pancreatic pseudocysts may be simply observed unless they are symptomatic or cause problems such as pain or obstruction of the biliary or the gastrointestinal tract. Percutaneous routes that ...
The Zollinger-Ellison syndrome (ZES) is taken as an example of the diagnostic and therapeutic strategy in gastro-entero-pancreatic endocrine tumours, given the standard characteristics of this procedure, whatever the nature of the primitive tumour. Management of ZES includes: anatomical localization of gastrinoma and of possible metastases, in 60 % of cases this step conditioning therapeutic indications and chances of cure; search of a type 1-multiple endocrine neoplasia (MEN A), in 25 % of cases; therapeutic indications: ablative surgery with curative intent in case of gastrinoma and of resectable liver metastases, palliative treatment otherwise: anti-secretory drugs, somatostatin analogues, chemotherapy and interferon {alpha}; long-term follow-up of patients with resected tumour. At each step, somatostatin receptor scintigraphy with indium 111-pentetreotide does play a pivotal role. (author). 110 refs.
MRI provides a non-invasive diagnostic tool complementing echocardiography on one hand, and showing advantages over echocardiography, on the other hand, especially after corrective procedures. The multiple different MRI sequences need to be adapted to examinations of children and patients with congenital heart disease (CHD), and can be used to detect morphologic changes, blood-flow in the heart and thoracic vessels and diastolic or systolic function of myocardium. Several factors determine the success of the examination of a complex congenital heart disease or a postoperative situs. Pediatric radiologists and radiologists experienced in congenital heart diseases have to work in close cooperation. Echocardiography should be performed before MRI. The results of prior examinations and the clinical history of the patients, including possible palliative or reconstructive operations, must be available before MRI to guide the planning of the examination. With a systematic ...
Rapid corrosion of PWR steam generator carbon steel support structures and consequential denting of steam generator tubes led to considerable investigation of the mechanism of corrosion and for palliatives. The basic mechanism is now fairly well understood. Chloride present in the boiler feedwater from condenser leakage is concentrated in the support plate crevice as a result of the superheat present. This leads to the formation of a low pH acid ferrous chloride environment either through the hydrolysis of a weak base chloride such as MgCl_2 or the combined action of a neutral chloride with an oxidizing agent. Rapid attack of the carbon steel ensues with the Fe_3O_4 corrosion product forming at the metal/oxide interface. This oxide has a volume approximately twice that of the steel consumed and thus eventually fills the crevice between the tube and the support plate. Oxide growth continues leading to compression of the Alloy 600 primary tube and to distortion and ...
To evaluate the efficacy of newly designed covered and non-covered coated colorectal stents for colonic decompression. Twenty-six patients, (15 palliative cases and 11 preoperative) underwent treatment for the relief of colorectal obstruction using metallic stents positioned under fluoroscopic guidance. In 24 of the 26, primary colorectal carcinoma was diagnosed, and in the remaining two, recurrent colorectal carcinoma. Twenty-one patients were randomly selected to receive either a type A or type B stent; for the remaining five, type C was used. Type A, an uncovered nitinol wire stent, was lightly coated to ensure structural integrity. Type B (flare type) and C (shoulder type) stents were polyurethane covered and their diameter was 24 and 26mm, respectively. The rates of technical success, clinical success, and complications were analyzed using the chi-square test, and to analyse the mean period of patency, the Kaplan-Meier method was used. Thirty of 31 attempted ...
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 ...
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...
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
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
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
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...
...named Chair at Epworth Hospital Professor Nilmini Wickramasinghe has been named Chair, Health Information Management , at Epworth HealthCare. Related links School of Business ...the College of Business at RMIT University has been named Epworth Chair, Health Information Management , by Epworth HealthCare. Professor Wickramasinghe has more than ... Professor Wickramasinghersquo;s appointment as Epworth Chair, Health Information Management , will help to further strengthen this clinical academic alliance, with RMIT now ...
Aim.- To describe the clinical aspects of implantable cardioverter defibrillators care in Sweden with focus on organisation, the role and education of nurses, patient information and education and areas in need of improvement. Background.- Implantable cardioverter defibrillators implantations have developed rapidly in recent years and are now an established arrhythmia treatment. The expanding indication for implantable cardioverter defibrillators implantation demands new competencies and resources in the implantable cardioverter defibrillators team members. Methods.- Participants were recruited among physicians and nurses in all of the hospitals implanting implantable cardioverter defibrillators (n-=-16). Data were collected by a questionnaire. Additionally, all written educational materia...
For the performance assessment of radioactive and hazardous waste disposal sites, risk assessments are usually performed for the long term, i.e., over an interval in space and time for which one can predict movement and behavior of toxic agents in the environment. This approach is based on at least three implicit assumptions: One, that the engineering layout will take care of the immediate endangerment of potential receptors; two, that one has carefully evaluated just how far out in space and time the models can be extrapolated, and three, that one can evaluate potential health effects for very low exposures. A few of these aspects will be discussed here in the framework of the scientific method.
During the last ten years, the U.S. Nuclear Regulatory Commission and the U.S. nuclear utilities have been developing methods and requirements for risk-informed applications making use of probabilistic risk assessments (PRA) of nuclear power plants. Early in this process, it became clear that the existing PRAs were done with different objectives and methodologies by different analysts. For uniformity and consistency in future risk-informed applications, industry consensus standards on probabilistic risk assessments were deemed to be essential. Currently, the following standards have been published or under preparation: - ASME RA-S-2002: 'Standard for Probabilistic Risk Assessment for Nuclear Power Plant Applications', Addendum C, March 2005. - ANSI/ANS-58.21-2003 'External-Events PRA Methodology' March 2003. - ANS-58.22 'Low Power and Shutdown PRA Standard'. - ANS-58.23 'Fire PRA Methodology Standard'. - ANS Level 2 and Level 3 PRA Standards. The ASME Standard specifies the ...
ICU telemedicine uses audiovisual conferencing technology to provide critical care from a remote location. Research is needed to best define the optimal use of ICU telemedicine, but efforts are hindered by methodological challenges and the lack of an organized delivery approach. We convened an interdisciplinary working group to develop a research agenda in ICU telemedicine, addressing both methodological and knowledge gaps in the field. To best inform clinical decision-making and health policy, future research should be organized around a conceptual framework that enables consistent descriptions of both the study setting and the telemedicine intervention. The framework should include standardized methods for assessing the preimplementation ICU environment and describing the telemedicine program. This framework will facilitate comparisons across studies and improve generalizability by permitting context-specific interpretation. Research based on this framework ...
PURPOSE We wanted to examine how coordinated care is implemented in primary care practices to address patients' health behavior change needs. METHODS Site visit notes, documents, interviews, and online implementation diaries were collected from July 2005 to September 2007 from practice-based research networks (PBRNs) participating in Prescription for Health: Promoting Healthy Behaviors in Primary Care Research Networks (P4H). An iterative group process was used to conduct a cross-case comparative analysis of 9 interventions. Published patient outcomes reports from P4H interventions were referenced to provide information on intervention effectiveness. RESULTS In-practice health risk assessment (HRA) and brief counseling, coupled with referral and outreach to a valued and known counseling resource, emerged as the best way to consistently coordinate and encourage follow-through for health behavior counseling. Findings from ...
Advanced developments in computer technologies offer exciting opportunities for new distribution tools and applications in various fields of physics. The convenient and reliable exchange of data is clearly an important component of such applications. Therefore, in 2003, the A+M Data Unit initiated within the collaborative efforts of the DCN (Data Centre Network) a new standard for atomic, molecular and particle surface interaction data exchange (AM'PSI) based on XML (eXtensible Markup Language). A working group composed of staff from the IAEA, NIST, ORNL and Observatoire Paris-Meudon meets biannually to discuss progress made on the XML schema, and to foresee new developments and actions to be taken to promote this standard for AM/PSI data exchange. (author)
The long-term health consequences of war service remain unclear, despite burgeoning scientific interest. A longitudinal cohort study of a random sample of Australian Vietnam veterans was designed to assess veterans' postwar physical and mental health 36 years after the war (2005-2006) and to examine its relation to Army service, combat, and post-traumatic stress disorder (PTSD) assessed 14 years previously (1990-1993). Prevalences in veterans (n = 450) were compared with those in the Australian general population. Veterans' Army service and data from the first assessments were evaluated using multivariate logistic regression prediction modeling. Veterans' general health and some health risk factors were poorer and medical consultation rates were higher than Australian population expectatio...
This report summarizes a public workshop that was held on April 27, 1999, in Rockville, Maryland. The workshop was conducted as part of the US Nuclear Regulatory Commission's (NRC) efforts to further develop its understanding of the risks associated with low power and shutdown operations at US nuclear power plants. A sufficient understanding of such risks is required to support decision-making for risk-informed regulation, in particular Regulatory Guide 1.174, and the development of a consensus standard. During the workshop the NRC staff discussed and requested feedback from the public (including representatives of the nuclear industry, state governments, consultants, private industry, and the media) on the risk associated with low-power and shutdown operations.
This book, an updated version of the 1985 edition, contains thirteen chapters, beginning with a preface which provides the objective of the book. The primary objective is to offer a comprehensive survey of the biological, hydrological, mathematical, and biochemical aspects of stream, lake, estuary, and ocean pollution analysis. The book also contains ten appendices of useful tables and nomographs of pertinent data. This book provides a very good summary and review of stream, lake, estuary, and ocean pollution. This book is recommended for environmental engineering students, environmental consulting engineers, and regulatory personnel. It provides an excellent summary of the field of stream and lake analysis and modeling. Every chapter includes a significant number of questions and pertinent references.
The Low Power and Shutdown (LPSD) PRA (Probabilistic Risk Assessment) Standard (ANS-58.22) is currently being drafted by a Writing Group under the auspices of the Risk Informed Standards Committee of the American Nuclear Society (ANS). The Writing Group includes representatives from nuclear utilities, US Nuclear Regulatory Commission (NRC), national laboratories, universities, and consultants with substantial experience producing LPSD PRAs. This draft standard is scheduled to be released for public comment in the second quarter of 2004, with publication by the end of 2004. The LPSD PRA Standard is based on a mature technology that shares many requirements with full power PRAs. It will provide specific methods and criteria whereby PRAs of appropriate quality and scope can be used in the conduct of plant decision-making and other activities, including addressing NRC requirements. This paper presents the current status of this standard.
Results that contradict known physics, data manipulated, lack of vigilance by co-authors, failures in the system for scientific publication... Last September a US Committee of Enquiry unveiled one of the most serious frauds in the history of physics. Over a two year period, a young researcher at Bell Laboratories had published a large number of articles with exciting results for solid state physics, but which, alas, were fraudulent! Obviously a fraud of this magnitude is exceptional. However, it did serve to focus attention on the problem of integrity and honesty in research practices. This subject, crucial to the well-being and credibility of scientific research, will be the central theme of the lecture given by Nicholas Steneck, Professor of History at the University of Michigan. A leading expert on this issue, on which he has published extensively, he is a consultant to the Office of Research Integrity in the US, and has been closely involved in public ...
This report discusses the topic geothermal resource assessment and its importance to laymen and investors for finding geothermal resources for direct-use applications. These are applications where the heat from lower-temperature geothermal fluids, 120 to 200/sup 0/F, are used directly rather than for generating electricity. The temperatures required for various applications are listed and the various types of geothermal resources are described. Sources of existing resource data are indicated, and the types and suitability of tests to develop more data are described. Potential development problems are indicated and guidance is given on how to decrease technical and financial risk and how to use technical consultants effectively. The objectives of this report are to provide: (1) an introduction low-temperature geothermal resource assessment; (2) experience from a series of recent direct-use projects; and (3) references to additional information.
Papers and presentations were made by all participating countries and provided a wide range of perspectives on the use of the ASSET methodology. Generally, the views expressed were positive, however, there were comments on areas were the service could be improved or enhanced. The workshop was divided into three task groups to analyze the self-assessments conducted at Krsko NPP, Slovenia; Dukovany NPP, Czech Republic; and Balakovo NPP, Russian Federation. In addition, they were asked to comment on the recommendations on the ASSET service made by the Consultants' Meeting of 26-30 August 1996 on ''Performance of the IAEA programme on Operational Safety Services''. A presentation was made by Mr. B. Thomas to remind delegates of the ASSET methodologies, and Mr. V. Sivokon demonstrated the latest developments of computer software available for assisting in the plant Self-Assessment process. Refs, figs, tabs.
The radiographic features of Ewing's sarcoma of the bones of the hands and feet are reviewed utilizing cases obtained from the Mayo Clinic patient files and the consultation files of Drs. D.C. Dahlin and K.K. Unni. This series consists of a total of 43 cases of pathologically proven Ewing's sarcoma involving the small bones of the hands and feet. The classic radiographic features of Ewing's sarcoma in the long bones, including lytic, permeative destruction, aggressive periosteal reaction, cortical violation, and a soft tissue mass, are also seen in the bones of the hands and feet, with similar frequency. These classic features are most commonly present in lesions affecting the short tubular bones. Lesions affecting the tarsal bones more often demonstrate atypical radiographic features. These atypical radiographic appearances may play a role in the reported delay in diagnosis of Ewing's sarcoma within the tarsal bones. (orig.)
The purpose of this paper is to relate some of the commonly encountered problems with operational procedures in the nuclear industry and offer practical suggestions for their elimination. The paper is based on recent consultant experience in assisting industry clients with human performance related design and assessment initiatives. Operational procedures are a key part of an integrated system design. Procedures provide the specified instructions for actions people are to undertake in operating a facility to achieve production and safety goals. While organizations continue to make substantial investments in procedure development and maintenance, problems with procedures continue to occur, as evidenced through operating inefficiencies, errors, and events. The paper reviews the role procedures play in facility operations, comments on current development and maintenance practices, discusses the extent of human performance related problems attributed to procedure ...
The OSHA's chemical occupational exposure standard for laboratories is an outgrowth of the previously issued Hazard Communication Standard. The standard relieves laboratories from complying with general industry standards but does not require compliance with specific guidelines. The heart of the standard is the creation of a Chemical Hygiene Plan (CHP) in every laboratory. The CHP addresses major issues such as safety equipment and procedures, work practices and training, the designation of a chemical hygiene officer, and the provision of medical consultation and examination for affected employees. This new standard, in effect as of 31 January, 1991, presents yet another regulatory challenge to laboratory managers but also will ensure a safer work environment for laboratory workers.
This paper summarizes the long and meaningful relationship between the University of Lowell (UL) and Yankee Atomic Electric Company (YAEC) in the area of nuclear thermal hydraulics. The UL has actively interacted with YAEC for many years. Many UL graduates from the nuclear program as well as health physics and other disciplines are employed by YAEC. Furthermore, many students have worked for YAEC on a part-time basis through summer employment or the coop program. Several graduate students have completed their thesis work under the joint direction of UL and YAEC personnel, and some faculty members have had consulting and research contracts with the company. At the same time, YAEC employees have taken advantage of the graduate program offered by UL and have earned advanced degrees. Some YAEC personnel have taught courses at UL and have served on the industrial advisory committees.
This paper focuses upon the workings of the electricity pool of England and Wales. Created as a generators` pool, with the twin objectives of preserving order-of-merit dispatch and setting marginal-cost pricing signals, it is now evident that the system may not provide an efficient market-clearing mechanism from the consumers` perspective. Thus, over the five years since its inception, there have been repeated calls to incorporate more explicitly demand-side pricing signals into the process. A number of official reviews and various consultants have looked at the issue and there have been trial periods of active demand-side bidding. This paper reviews that experience to date.
While substantial research has examined the control of information systems (IS) projects, most studies in this area have only examined how one controller manages a single group of controllees. However, many IS projects, especially enterprise systems projects (often initiated by an organization's corporate headquarters, and involving business unit users and consultants), have multiple stakeholders. The corporate headquarters (the project's principal controller) must simultaneously ensure that the various stakeholders are aligned with the project's goals despite their diverse motivations, and that the stakeholders collaborate with each other to achieve project success. Behavior control theory argues that the controller enacts a control portfolio of formal and informal controls. However, the ...
This paper seeks to challenge the traditional way in which we assess the value of green buildings in terms of their environmental friendliness, energy efficiency and whole life cost. In the UK, quantity surveyors (or cost consultants) have a perception that more energy efficient and environmentally friendly buildings cost between 5% and 15% more to build from the outset. This common assumption is not backed up by recent research and should be questioned. Construction professionals need to be informed of the whole life cost and environmental impact of buildings so that they can encourage key stakeholders to make more sustainable choices. These emerging issues together with practical tools are considered with case studies from recent projects. (Author)
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 resource materials. 17 tabs.
Over the past decades the Mekong River basin has experienced several droughts, the most recent of which occurred in the hydrological year 2004/2005. Impacts extended across agriculture, forestry, water resources, supply, industry, transport and the environment. In early 2006, the Mekong River Commission Secretariat initiated close consultations with the MRC member states Cambodia, Lao PDR, Thailand and Vietnam, aiming at the formulation of a common Drought Management Programme, which would enhance the existing drought management capacity and ensure effective support. This paper draws attention to the programme formulation process. It shows how national capacity needs were assessed and synthesized into a basin-wide capacity development programme. The paper concludes that in the context of i...
The United States Department of Energy (DOE) at the Morgantown Energy Technology Center (METC) contracted with P.S. Lowell and Co. Inc. (Lowell and Co.) and Jay S. Dweck, Consultant, Inc., (JSD) to enhance the capability of ASPEN in simulating coal gasification and oil shale processing plants. Of particular concern was the capability to predict the distribution of environmentally significant components among the various aqueous and organic liquids and gas streams within or leaving the process. The project was divided into major task areas. The first was to develop and implement the calculational routines necessary for predicting aqueous electrolyte chemical reactions. Part of this effort also was to select a species list and collect and/or regress data for the necessary parameters. The second task was to develop and implement a multi-phase flash capability (including precipitated solids) and unit operations models for a venturi and a solid/liquid separator. 19 ...
Twenty-eight measurement while drilling tools are listed in this year's MWD Comparison Tables. Updated data on tools listed last year and data on five new tools provide a convenient guide for choosing MWD systems. Future MWD technologies include sonic tools and tools that make measurements ahead of the bit. For the seventh year, Petroleum Engineer International presents the Measurement While Drilling (MWD) Tables comparing a variety of available tools from many different vendors. The 1994 Tables include two additional companies and five new MWD tools not found in last year's Tables. However, the tables should serve only as a reference source. System specifications can change rapidly as tools are refined and new technologies develop. Operators and contractors should consult designated MWD marketing representatives before making a final tool selection.
In the past years I have been dealing with the following aspects of waste planning: a) waste reduction (regarding particularly home composting); b) transformation and reorganisation of waste collection systems; c) experimental introduction of a new way to pay for waste collection and treatment services, from ''tax'' to ''tariff''. In these years, I have been a consultant for municipalities in the planning of these three points. In the city (Venice) and in the Region I come from (''Veneto'') there are some of the most important Italian experiences about them. (orig).
This seminar on the subject of ``electrical smog`` welcomed participants from Bavarian environmental consultancy agencies, rural and urban district authorities, ministries, consume-consultancy agencies and public health authorities. Leading scientists from research and authorities gave papers on the sources, exposure and effects/actions of electromagnetic fields and present the current state of knowledge about the hazards and risk of this radiation for human health. The proceedings in hand provide the papers given on the following topics: electromagnetic fields - and introduction to relevant issues; low-frequency fields - sources and exposure; high-frequency fields - sources and exposure; biological actions and effects of low-frequency fields; biological actions and effects of high-frequency fields; low-frequency fields - helath risk assessment; high-frequency fields - health risk assessment. (Uhe) [Deutsch] Das Seminar zum Thema Elektrosmog ...
Aim: To determine whether experience improves the consistency of visual search behaviour in fracture identification in plain radiographs, and the effect of specialization. Material and methods: Twenty-five observers consisting of consultant radiologists, consultant orthopaedic surgeons, orthopaedic specialist registrars, orthopaedic senior house officers, and accident and emergency senior house officers examined 33 skeletal radiographs (shoulder, hand, and knee). Eye movement data were collected using a Tobii 1750 eye tracker with levels of diagnostic confidence collected simultaneously. Kullback-Leibler (KL) divergence and Gaussian mixture model fitting of fixation distance-to-fracture were used to calculate the consistency and the relationship between discovery and reflective visual search phases among different observer groups. Results: Total time spent studying the radiograph was not significantly different between the groups. However, the ...
This is the second quarterly technical report for the RP-5 Renewable Energy Project. The report summarizes the work progress, effort and activities that took place during the period of October 1, 2002 to December 31, 2002. The report has been prepared in accordance with the Department of Energy (DOE) Guidelines. This technical report covers all meetings and discussions that were conducted in order to follow up on potential renewable energy technologies that were identified in the previous report; the technologies were analyzed for their feasibility, suitability and cost effectiveness for this project. This report covers the one-day conceptual design kickoff meeting that took place on November 4, 2002. The meeting was held to discuss the practicality and implementation of potential innovative technologies. Following the kickoff meeting, Inland Empire Utilities Agency (IEUA) and CH2M Hill, the Public Interest Energy Research (PIER) Consultant, held a meeting on ...
One of the challenges facing Clean Development Mechanism (CDM) projects today is their limited ability to secure financing for the underlying greenhouse gas emission reduction activities, particularly in the least developed countries. Among the key reasons for this is the fact that most financial intermediaries in the CDM host countries have limited or no knowledge of the CDM Modalities and Procedures. Moreover, approaches, tools and skills for CDM project appraisal are lacking or are asymmetrical to the skills in comparable institutions in developed countries. Consequently, developing country financial institutions are unable to properly evaluate the risks and rewards associated with investing or lending to developers undertaking CDM projects, and therefore have, by-and-large, refrained from financing these projects. In addition, some potential project proponents lack experience in structuring arrangements for financing a project. This Guidebook - commissioned by the UNEP Risoe Centre ...
We wanted to evaluate the usefulness of a new type of a complex expandable nitinol stent that was designed to reduce the stent's propensity to migration during the treatment of malignant gastroduodenal obstructions. Two types of expandable nitinol stent were constructed by weaving a single thread of 0.2mm nitinol wire in a tubular configuration: an uncovered stent 18mm in diameter and a covered stent 16mm in diameter. Both ends of the covered stent were fabricated by coaxially inserting the covered stent into the tubular uncovered stent and then attaching the two stents together with using nylon monofilament. Under fluoroscopic guidance, the stent was placed in 29 consecutive patients (20 men and 9 women, mean age: 65 years) who were suffering with malignant gastric outlet obstruction (n=20), duodenal obstruction (n=6) or combined obstruction (n=3). Clinical improvement was assessed by comparing the food intake capacity before and after the procedure. The complications were ...
Total skin electron beam therapy (TSEB) was used in the treatment of 33 patients with lymphoma and 13 patients with leukemia involving extensive segments of the skin surface. Twenty-two of 23 had lesions as a primary manifestation of lymphoma (primary cutaneous lymphoma-PCL) and 11 developed cutaneous lesions following disseminated nodal lymphoma (secondary cutaneous lymphoma-SCL). A once weekly fractionation scheme was employed to irradiate the entire skin surface with 3.5 to 4 MeV electron beam from a 6 MeV linear accelerator. During each weekly session, 400 rad were delivered to the entire skin and a complete course consisted of 4-6 consecutive weekly sessions. The majority of patients have been previously treated elsewhere for various periods and all patients have been at risk for a median of 12 months, range from 12-117 months following TSEB. Striking predominance of the diffuse pattern (76%) was demonstrated in both the PCL and SCL. There was extracutaneous involvement in 63% ...
To investigate the problems of the Hanaro stent (Solco Intermed, Seoul, Korea) when used in the palliative treatment of patients with inoperable malignant biliary obstruction. Between January 2000 and May 2001, the treatment of 46 patients with malignant biliary obstruction involved percutaneous placement of the Hanaro stent. Five patients encountered problems during removal of the stent's introduction system. The causes of obstruction were pancreatic carcinoma (n=2), cholangiocarcinoma (n=2), and gastric carcinoma with biliary invasion (n=1). In one patient, percutaneous transhepatic cholangiography and stent insertion were performed as a one-step procedure, while the others underwent conventional percutaneous transhepatic biliary drainage for at least two days prior to stent insertion. A self-expandable Hanaro stent, 8-10 mm in deameter and 50-100 mm in lengh, and made from a strand of nitinol wire, was used in all cases. Among the five patients who ...
This paper reports the characteristics and local management of 826 acute wounds identified during an audit across all health care providers serving the population of Bradford, UK. Of the wounds encountered 303 were traumatic wounds and 237 primary closures with smaller numbers of other acute wound types. Of the 303 traumatic wounds 174 occurred in women (57.4%). Men predominated in the under 45s (65M:26F), this being largely accounted for by hand and finger trauma (n=62) particularly in patients of working age (M32:F12). Women predominated in the over 65s (50M:130F), this being largely accounted for by lower limb traumatic wounds (M24:F91), the majority of these being in patients 65 and over (M14:F82). In this sub-group of 96 patients 25 had wounds of 6 weeks or longer duration, only 3 had...
We analyzed the effects of the Colorado Medicaid Capitation Program on the duration and services of over 21,000 outpatient mental health episodes for young children. The study spanned a three year period before and after capitation was implemented, and compared episodes of outpatient care for children from 14 capitated Community Mental Health Centers (CMHCs) with those from three CMHCs that remained fee-for-service. Proportional hazards regressions revealed that capitation resulted in an increase in outpatient episode duration, over and above similar effects for the comparison fee-for-service episodes. The hypothesis that there were longer capitated episodes for children who were hospitalized was not supported. Children with behavioral and anxiety disorders had longer capitated episodes. Service intensity decreased over time in the managed care sites. Changes in case mix may have had an impact on changes in episode duration and service ...
The aims of the study were to develop and test the psychometric properties of the Thai Family Health Routines (TFHR) scale, a 70-item self-report questionnaire used to measure the health of Thai families through their routine behaviors in daily life. Development of the TFHR was based on the structural domains of Denham's Family Health Model. The TFHR scale was initially composed of 85 items and tested on 1,040 families living in the central region of Thailand. The confirmatory factor analysis, with an acceptable factor structure model, yielded 70 items aligned with six factors: self-care, safety and prevention, mental health behavior, family care, family caregiving, and illness care routines. The preliminary psychometric properties demonstrated that the TFHR scale had satisfactory internal consistency, criterion validity, and construct validity. The test results suggested that the TFHR scale has potential benefits for ...
National efforts to improve the quality and safety of health care present challenges for medical education and training. Today's doctors need to be skilled communicators who know how to identify, prevent and manage adverse events and near misses, how to use evidence and information, how to work safely in a team, how to practise ethically, and how to be workplace teachers and learners. These competencies (knowledge, skills and attitudes) are set out in the National Patient Safety Education Framework (NPSF) of the Australian Council for Safety and Quality in Health Care. The NPSF is designed to help medical schools, vocational colleges, health organisations and private practitioners develop curricula to enable health professionals to work safely. The NPSF describes what doctors (depending on their level of knowledge and experience) can do to demonstrate competencies in a range of quality and safety activities. Medical schools, vocational ...
Following the February 2011 earthquake in Christchurch, New Zealand (NZ), the authors participated in counselling local residents, and debriefing and supervising support teams. Indications were that risk for mental health disorders, including Post-Traumatic Stress Disorder (PTSD), may be elevated in residents, and that this risk may continue for some time. Patients may be de-prioritising their mental health issues when these become normalised throughout the city's population. The authors recommend that primary care patients are assessed using a brief, comprehensive tool (for example, the Case-finding and Help Assessment Tool) that targets many health and behavioural issues identified as increasing in the city following the earthquake. Anxiety and mood disorder symptoms may indicate assessment is appropriate to reduce harm arising from increased risk for PTSD. Concern also is raised for primary health care providers who may have experienced the ...
The urine test strip is the most common test used to detect ketones in veterinary patients, but it can underestimate the degree of ketonuria and hence, ketonemia. Additionally, adequate urine samples for analysis may be difficult to obtain from dehydrated animals. The standard method used to detect and monitor ketonemia in human medicine is measurement of serum or whole blood beta-hydroxybutyrate (?HOB). A point-of-care (POC) analyzer has been validated for this purpose in humans. This study compared the accuracy of the POC device to an enzymatic reaction laboratory method for measurement of ?HOB in dogs. Although the POC sensor tended to overestimate ?HOB concentrations, there was good correlation (R(2) = 0.96) and good agreement between the 2 methods with a bias +/- precision of 0.0860 +/- 0.3410 mmol/L ?HOB. The POC ?HOB sensor can be useful for assessing ketonemia in dogs. PMID:21119867
This paper contributes to an understanding of pharmacogenomics-in-the-making by foregrounding a regulatory setting in which these technologies must be situated: decision-making about pharmaceutical reimbursement. Health care assessment organizations have been introduced in many countries to systematically address the issue of health care coverage. Using the example of Sweden, the process of deciding reimbursement status is shown to hinge on the creation of stable and clinically feasible categories of patients, diseases and drug responses. Through a series of analogous examples concerning conventional pharmaceuticals, it is argued that current mechanisms for categorizing reimbursable drugs could be upset when pharmacogenomic advances provide a means of making patients more specific objects ...
Purpose Skilled placement of peripherally inserted central catheters (PICC) has a profound impact on patient well-being and costs of care. The use of ultrasound-guided methods and prescribed training for cannulation skills are evidence-based practice recommendations. The purpose of this study was to compare two methods of PICC instruction on the acquisition of applied skills. Methods Residents were randomly assigned to one of two groups (N?=?16/16) of this blind-rater study and were trained to perform ultrasound-guided PICC cannulation using either simulation or apprenticeship methods. All residents were assessed placing a PICC in applied clinical patient care. Results Residents who completed simulation training had significantly better transfer of skills to applied clinical practice than ...
Summary This third paper, in a three-part CE series on the preventions of infection in patients with chronic kidney disease, focuses on surveillance and auditing of healthcare-associated infections within the renal care environment. The last decade has seen an increased awareness of the threat to patient safety from healthcare-associated infection (HCAI) and the emergence of multi-drug resistance organisms. Effective HCAI prevention strategies include adequate governance structures, access to expert advice, adherence to standard and transmission-based precautions, minimising the use of invasive medical devices, and surveillance. Surveillance data can be collected using outcome (e.g. infection) and/or process (e.g. hand hygiene compliance audit) measures. Establishing a surveillance program...
Background/Purpose: Peripherally inserted central venous catheters (PICCs) are commonly used for neonatal vascular access. The aim of this study was to look at PICC line complication rates and possible predictors of PICC infection in a neonatal intensive care unit. Method: This was a prospective study of 226 neonates who had PICCs on our neonatal intensive care unit between January 2006 and June 2009. Complete data was available on 218 neonates who had 294 PICC lines. Criteria for catheter-related sepsis was positive blood cultures (peripheral/central) and/or a positive catheter tip culture after removal in the presence of a clinical suspicion of line sepsis. Results: Of 218 neonates, 132 (169 lines) were medical, and 86 (125 lines) were surgical. Our PICC line infection rate was 17 infect...
Around the world there is a small industry of non-governmental organisations that provide health care in niche areas that cannot be met by national health care provision. One topic is facial deformity that can have a dramatic effect on quality of life. In this study we investigate the morbidity and outcome of a British surgical team working for a 2-week period in Ethiopia. Thirty-five patients who presented with facial deformities had 47 operations during a 2-week period. Data were recorded for a minimum of 3 weeks postoperatively. Operative techniques were classified as simple or complex. Postoperative complications were assessed and classified as major, intermediate, and minor. In addition, the character of each complication was recorded and the cause elucidated. After 3 weeks the clinic...
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...
Abstract Background: This study involves a multicentre surveillance of tigecycline and tetracycline activity against Gram-negative and Gram-positive bacteria from primary care centres (PCCs), general hospital wards (GHWs) and intensive care units (ICUs) in Denmark (n == 9), Finland (n == 10), Norway (n == 7) and Sweden (n == 19). Methods: The hospitals were each asked to test 30 consecutive Gram-positive and 30 Gram-negative clinical isolates. Supportive information accompanying each isolate included the study centre, ward level (PCC, GHW, or ICU), patient identification and source of the isolate. Minimum inhibitory concentrations (MICs) for tetracycline and tigecycline were determined with the Etest. Results: The isolates collected comprised 1610 Gram-negative and 1767 Gram-positive clini...
Geographic information system (GIS) technology is now being used by wind energy developers who are required to consider and accommodate a wide variety of environmental and social considerations. This poster presentation discussed some of the new features available in current GIS technologies. High resolution imagery from satellites is being used to verify the accuracy of collected spatial data, as well as to investigate potential locations for meteorological towers, turbine sites, and roads. Slopes are easily calculated using GIS software tools, and digital elevation data can be used with high resolution aerial photography to determine routes for new roads and to establish available sites for crane pads. The GIS tools allow developers to consider protected ecological areas, wetlands and forests, and gives them the ability to better report project development considerations at public consultations. Wind resource grid outputs can also be projected using GIS software. ...
Mining operations took place at the Sullivan Mine, located at Sullivan, Abitibi, Quebec between 1930 and 1967 and generated large quantities of tailings. These tailings now represent a waste rock pile in the shape of a delta on the shore of De Montigny Lake. The area covers approximately 50 hectares. When the waste rock pile was first established, several terrestrial and aquatic ecosystems were lost forever. In addition, the very nature of the tailings, combined to the action of the wind and lake, further slow the natural site regeneration. The Ministere des Ressources naturelles du Quebec (Quebec Natural Resources Department) asked Les Consultants en Environnement Argus to prepare a site remediation plan to stimulate the natural regeneration of the ecosystems. It would enable the local fauna to resume its occupation of the territory, while ensuring its proper integration in the environment. The authors described in detail the proposed plan that addresses all the ...
The purpose of this new industrial chair is to ensure the continuation and development of new research activities in the field of environment protection as it relates to the good management of mine tailings. The mining industry plays a vital role in the economy of a number of regions in both Quebec and Canada and also causes environmental problems due to the generation of liquid, solid, and gaseous wastes. Mine tailings can cause acid mine drainage. This acid mine drainage (AMD) can have detrimental effects on the ecosystems adjoining tailings or waste rock piles. We must remain aware that some of the remedial measures instituted to contain AMD might cause problems due to their possible instability. Despite the fact that instability is a rare occurrence, it can have disastrous effects on the environment as demonstrated in Spain, Guyana, and the Philippines during the last few years. The creation of this chair in environment and tailings management will allow the consolidation of ...
The use of renewable energy offers a range of exceptional benefits, including: a decrease in external energy dependence; a boost to local and regional component manufacturing industries; promotion of regional engineering and consultancy services specialising in the use of renewable energy; increased R and D, decrease in impact of electricity production and transformation; increase in the level of services for the rural population; creation of employment, etc. To achieve these benefits, a series of actions are required, among which the following are particularly important: creation of a suitable climate for performing R and D; training of technicians in design, production and maintenance of equipment; motivation for establishing a new market; proper financing; fostering of appropriate technologies; practical demonstration of results, etc. This article reviews the progress made in the Autonomous Community of Galicia in terms of the introduction of renewable energy ...
Today, the analysis of renewable energy places the emphasis on the technological and economic attributes with social and environmental impact assessment providing for a rather static, narrow frame of analysis. The participation and response of social actors and other stakeholders is usually of a traditional type, with consultation documents and public meetings, collection of complaints and suggestion schemes. This often encourages parochialism and an over-concentration on relatively trivial issues. It is, therefore, imperative to establish a new participatory planning platform to incorporate the wider socio-economic aspects of renewable energy systems and to provide for an operational analytical decomposition of them. In this work the issue of decomposition analysis is clarified, and a new agenda for the societal and technological decomposition analysis of renewable energy systems is developed. A case study is disclosed to present the relevance of the established ...
In response to the consultation from the National Council on Radiation Protection and Measurements (NCRP) to the International Commission on Radiological Protection (ICRP) committee 2, retention and excretion of 239Pu deposited at wound site were calculated by coupling together the proposed NCRP wound model and the current ICRP systemic model of Pu. The physicochemical forms considered were the soluble form categorized into 'Strong Retention', and the colloidal, particulate and fragmentary forms. The results are summarized as follows. If in soluble form, immediate medical intervention is needed to prevent uptake of radionuclides to body tissues, and prompt wound monitoring is essential for an accurate estimation of the initially deposited radioactivity. If in particulate form, a multi-component exponential equation leads to an overestimation of the absorption rate to blood because of significant lymph node drainage. The committed doses in the organs for direct ...
Organic farming (or ecological agriculture) is of growing importance in the agricultural sector worldwide. In the Nordic countries, 1-10% of the arable land was in organic production in 1999. Organic farming can be seen as an approach to agriculture where the aim is to create integrated, humane, environmentally and economically sustainable agricultural production systems. Principles like nutrient recycling, prevention rather than treatment and the precautionary principle are included in aims and standards. Animal welfare is another hallmark of organic livestock production but despite this, several studies have indicated severe health problems e.g. in organic poultry production in Denmark. Also the quality of animal food products in relation to human health, particularly the risk of zoonotic infections, has been debated. For these reasons there is a need for improvement of production methods and animal health status. Vets play an important role in this development through work in ...
The purpose of the study was to optimise the technique employed for AP shoulder and lateral cervical spine examinations following an investigation into image quality, based on clinical assessment, and effective dose, calculated from patient entrance surface dose measurements. A study was therefore conducted in an attempt to determine whether the increased radiation dose to the patient following the introduction of an anti-scatter grid was justified by the level of improvement in image quality. The study, involving 100 patients, was able to demonstrate that the increase in radiation dose to the patient when using an anti-scatter grid for AP shoulder examinations is not justified by the improved image quality. A poor level of inter-rater reliability between the consultants scoring the lateral cervical spine images prevented a firm conclusion from being reached. The fact that all images were of diagnostic quality, however, suggested that the use of the anti-scatter ...
The purpose of the study was to optimise the technique employed for AP shoulder and lateral cervical spine examinations following an investigation into image quality, based on clinical assessment, and effective dose, calculated from patient entrance surface dose measurements. A study was therefore conducted in an attempt to determine whether the increased radiation dose to the patient following the introduction of an anti-scatter grid was justified by the level of improvement in image quality. The study, involving 100 patients, was able to demonstrate that the increase in radiation dose to the patient when using an anti-scatter grid for AP shoulder examinations is not justified by the improved image quality. A poor level of inter-rater reliability between the consultants scoring the lateral cervical spine images prevented a firm conclusion from being reached. The fact that all images were of diagnostic quality, however, suggested that the use of the anti-scatter ...
Nova Corporation and its related businesses are involved in natural gas production, gas pipelines, consulting services, and upgrading of natural gas into chemicals and plastics. Nova owns Alberta Gas Transmission Division, the primary gas transportation system in Alberta, with 11,400 miles of pipeline and total deliveries in 1992 of 3.4 trillion ft"3. Nova also owns 50% of Foothills Pipe Lines Ltd., one of Canada's largest carriers of exported gas, and 50% of TQM Pipeline Partnership, which transports natural gas in Quebec. Nova conducts its chemicals business through Novacor Chemicals Ltd., which has plants in Alberta, Ontario, Quebec, and the USA. Novacor's major petrochemicals are methanol, ethylene, propylene, and styrene and its major plastics are polystyrene, polypropylene, and polyethylene. Nova's gas-producing branch Novalta Resources produced 26 billion ft"3 of natural gas in 1992 and has proven reserves of 334 billion ft"3. Nova's net income in 1992 was ...
This report presented some quick facts about oil and gas pipelines in Turkey and presented opportunities for trade. The key players and customers in the oil and gas sector were described along with an export check list. Turkey is looking into becoming an energy bridge between oil and gas producing countries in the Middle East, Central Asia and Europe. The oil and gas sectors are dominated by the Turkish Petroleum Corporation, a public enterprise dealing with exploration and production, and the State Pipeline Corporation which deals with energy transmission. They are also the key buyers of oil and gas equipment in Turkey. There are several pipelines connecting countries bordering the Caspian Sea. Opportunities exist in the areas of engineering consulting as well as contracting services for oil and gas pipeline transmission and distribution. Other opportunities lie in the area of pipeline construction, rehabilitation, materials, equipment, installation, and ...
Comprised of seven persons with extensive experience in the issues of nuclear waste, the Independent Review Committee (IRC) provides independent and objective review of Defense Transuranic Waste Program (DTWP) activities managed by the Joint Integration Office (JIO), formerly the Defense Transuranic Waste Lead Organization (TLO). The Committee is ensured a broad, interdisciplinary perspective since its membership includes representatives from the fields of nuclear engineering, nuclear waste transportation, industrial quality control, systems and environmental engineering and state and local government. The scope of IRC activities includes overall review of specific TLO plans, projects and activities, and technical review of particular research and development projects. The Committee makes specific suggestions and recommendations based upon expertise in the field of TRU Waste Management. The IRC operates as a consulting group, under an independent charter providing ...
Industrial facilities offer a wide variety of design challenges to engineers, including the mechanical engineers who design the HVAC, the process, exhaust, and other required mechanical systems; the mechanical contractors who install and maintain the systems (and who also may do design work); and the owners` engineers who are responsible for the day-to-day operation of their facilities. Along with the responsibility to see that all systems function as intended is the responsibility to ensure that all worker health concerns are addressed. These include heat stress avoidance and the proper control of harmful substances. The services of industrial hygienists may be required to ensure this. These may be independent consultants or the staff members of mechanical design firms. In addition, it is not unusual for major corporations that own manufacturing plants to have staff industrial hygienists. The accompanying sidebar presents a checklist of items to be considered when ...
In accordance with the Department of Energy`s National Environmental Policy Act implementing procedures in Volume 10 of the Code of Federal Regulations, Section 1021,312, the Environmental Restoration and Waste Management Programmatic Environmental Impact Statement Implementation Plan has two primary purposes: to provide guidance for the preparation of the Programmatic Environmental Impact Statement and to record the issues resulting from the scoping and the extended public participation process. The Implementation Plan identifies and discusses the following: background of Environmental Restoration and Waste Management activities, the purpose of the Programmatic Environmental Impact Statement, and the relationship of the Programmatic Environmental Impact Statement to other Departmental initiatives (Chapter 1); need and purposes for action (Chapter 2); scoping process and results of the public participation program in defining the scope of the Programmatic Environmental Impact ...
The Fifteenmile Basin Habitat Improvement Project is an ongoing multi-agency effort to improve habitat in the Fifteenmile drainage and increase production of the depressed wild, winter steelhead run. Cooperating agencies include the Oregon Department of Fish and Wildlife, USDA Forest Service. USDA Soil Conservation Service and Bonneville Power Administration. in consultation with the Confederated Tribes of Warm Springs. The Oregon Department of Fish and Wildlife is administering project work on state and private lands and the U.S.D.A. Forest Service is administering project work on National Forest land. Project work on the Forest has been sub-divided into four components; (1) Ramsey Creek, (2) Eightmile Creek, (3) Fifteenmile Creek, and (4) Fivemile Creek. Forest Service activities in the Fifteenmile basin during 1988 involved habitat improvement work on Ramsey Creek, continuation of physical and biological monitoring, collection of spawning survey information, and ...
The conservation of energy through the use of the optimum economic thickness of insulation has clear benefits for industry in the U.S. Potential energy savings have been estimated to be the equivalent of 250 million of barrels of oil per year over the next decade. As is the case with any capital expenditure, the dollars spent for insulation must be expected to provide the plant owner with a certain return on his investment. This manual provides data and guidelines for estimating dollar costs and insulation life which enable the user to specify the least-cost insulation thickness based on minimum life cycle cost and required percentage return on investment. A large degree of design flexibility is provided for, so that specific economic and design criteria may be taken into account. A number of useful working aids are provided, including sample problems, forms and worksheets, and nomographs which may be used to simplify calculations. Insulation designers, manufacturers, installers and ...
The Atomic Energy Control Board (AECB), Canada's nuclear regulatory authority, is preparing new regulations based on ICRP-60. The proposed regulations have some features which are different from ICRP-60, e.g., the limit for pregnant workers was set at a higher level than that proposed in ICRP-60. The AECB, through its consultative process, received many responses from female staff in nuclear medicine. The concern was that it would be very difficult to prove compliance with such low doses, particularly for internal doses. There was an additional concern that hospital administrators would respond to the reduction of the current pregnant worker limit from 10 mSv to the ICRP-60 recommended value of 2 mSv by discriminating against hiring women. A new proposal for the dose limit for pregnant workers has been made which will limit the dose to the mother by means of a combining formula that will take both external and internal doses into account. (author).
The objective of this task was to obtain powder property data on candidate glass former materials, sufficient to guide conceptual design and estimate the cost of glass former handling facilities as requested under Part B1 of BNFL Technical and Development Support. Twenty-nine glass forming materials were selected and obtained from vendors for the characterization of their physical properties, durability in caustic solution, and powder flow characteristics. A glass former was selected based on the characterization for each of the ten oxide classes required for Envelope A, B, and C mixtures. Three blends (A, B, and C) were prepared based on formulations provided by Vitreous State Laboratory and evaluated with the same methods employed for the glass formers. The properties obtained are presented in a series of attached Tables. It was determined that five of the ten glass formers, (kyanite, iron oxide, titania, zircon, and zinc oxide) have the potential to cause some level of solids f low ...
The report contains an overall frame for transformation of knowledge and experience from risk analysis to emergency education. An accident model has been developed to describe the emergency situation. A key concept of this model is uncontrolled flow of energy (UFOE), essential elements are the state, location and movement of the energy (and mass). A UFOE can be considered as the driving force of an accident, e.g., an explosion, a fire, a release of heavy gases. As long as the energy is confined, i.e. the location and movement of the energy are under control, the situation is safe, but loss of confinement will create a hazardous situation that may develop into an accident. A domain model has been developed for representing accident and emergency scenarios occurring in society. The domain model uses three main categories: status, context and objectives. A domain is a group of activities with allied goals and elements and ten specific domains have been investigated: process plant, ...
Acceptance testing of mammographic imaging systems technical is the first approach in order to guarantee that mammograms will be achieved with the minimum radiation dose compatible with an image quality suitable for diagnose purposes. The aim of this study is to assess the practical applicability of different protocols in acceptance test of digital mammographic systems. This study has been carried out on the results of the acceptance tests of five flat panel digital mammographic systems. Parameters established in the systems technical specifications and those evaluated in the consulted protocols were tested. Due to the fact that the legislation in our country does not demand to consider a specific protocol, the results obtained were also compared considering different existing protocols. Results show discrepancies between manufacturers limiting values and those established in the protocols. Some parameters, such as the automatic exposure control compensation and ...
Objectives1. To identify with older people the problems which they encounter in finding their way about public building/spaces.~%~2. To produce ideas, in consultation with older people, for an information/navigation aid that might facilitate their use and enjoyment of public buildings/spaces, notably hospitals, large shops, railway stations, airports.~%~3. To develop an emulation model of the information/navigation aid~%~4. To monitor use of the model by older people~%~5. To identify further research~%~6. [continued...]DescriptionThe growth in the number of older people offers scope for the development of customised information/navigation aids to help them to find their way around complex public spaces. New technology however is unlikely to be taken up by older people unless it is acceptable to them. The research will involve engineers in designing, testing and modifying a model of such an aid in conjunction with a sample of older people.~%~Older people, in ...
Because of past military operations, lack of upkeep and looting there are now enormous radioactive waste problems in Iraq. These waste problems include destroyed nuclear facilities, uncharacterized radioactive wastes, liquid radioactive waste in underground tanks, wastes related to the production of yellow cake, sealed radioactive sources, activated metals and contaminated metals that must be constantly guarded. Iraq currently lacks the trained personnel, regulatory and physical infrastructure to safely and securely manage these facilities and wastes. In 2005 the International Atomic Energy Agency (IAEA) agreed to organize an international cooperative program to assist Iraq with these issues. Soon after, the Iraq Nuclear Facility Dismantlement and Disposal Program (the NDs Program) was initiated by the U.S. Department of State (DOS) to support the IAEA and assist the Government of Iraq (GOI) in eliminating the threats from poorly controlled radioactive materials. The Iraq NDs Program ...
As waste disposal methods and long-term precautionary care of the environment are closely related, disposal of non-avoidable and intractable residual products is to be viewed primarily from a safety angle. Also, thermal processes airm mainly at treatment, not utilization. 'Safety' in this context addresses both the environmental compatibility of the products and the process itself. In other words, only mature techniques (i.e., safe, proven ones) are employed. (orig.)
Atopic eczema is a chronic skin condition affecting between 5% and 20% of children aged up to 11 years at one time or other. Research suggests that prevalence is increasing and various environmental...Full Text Available
BackgroundMany emergency ambulance calls are for older people who have fallen. As half of them are left at home, a community-based response may often be more appropriate than hospital...Full Text Available
In the past decade, a new technique has been developed for measuring tensile stresses in solids. This ultrasonic technique has been used thus far primarily for measuring fastener tension. The precision of measurement is routinely to 2-3% and, with special care, to approx. 1%. The method is insensitive to the frictional losses which plague tensioning by torque wrench. Though the approach is relatively new, it promises a wide range of applicability.
On the basis of legally provided area dose measurements and time records of fluoroscopic examinations during the operation, radiation doses to medical personnel and patients are evaluated. Adequate radiation protection measures and a careful behaviour in the operating room keep the radiation exposure to the personnel below the maximum permissible exposure. Taking into account the continuous personnel radiation monitoring and medical supervision, radiation hazards in the operating room can be considered low.
... 03/08/2011 Professor named Chair at Epworth Hospital Professor Nilmini Wickramasinghe from the College of Business at RMIT University has been named Epworth Chair, Health Information Management , by Epworth HealthCare. 26/07/2011 Study investigates drug-free relief for tension headaches As Australia marks its first National Pain Week ...
Military working dogs are rapidly becoming integral to military operations. While they bring many valuable capabilities to the battlefield, it is important that Special Operations leaders consider canine team capabilities and requirements when planning missions. Careful logistical and operational planning can optimize the health, performance, and readiness of the working dog while protecting the safety and well-being of the team members working with them. We also offer recommendations for medical treatment of dog bites. PMID:19813342
A filter for extracting solids and liquids from gaseous combustion exhausts comprises a textile filter element formed of polyacrylonitrile fibers oxidized by careful heat treatment and comprising approximately 61% carbon after treatment. The filter may be woven, knitted or formed as a batting of randomly-oriented fibers. Abrasion resistant coatings and lubricants for the fibers are disclosed. The filter material is especially useful as a filter bag.
To optimize the emergency care of patients with multiple injuries, a special emergency room with integrated radiological equipment has been developed. It consists of a linear array of a computed tomography system, a mobile C-arm with an integrated scattered radiation grid for conventional films and a C-arm fluorographic system. The intent is to avoid delay caused by transport and repositioning of the patient. It enables all necessary diagnostic procedures to be performed within a minimal amount of time. (orig./MG).
The "1"3"1I-labelled monoclonal antibodies 791T/36 and 79IT/36 Fab fragments have been evaluated in the imaging of patients with colorectal cancer, with benign colorectal tumours, and with malignant tumours of other parts of the gastrointestinal tract. The results of clinical imaging have been carefully correlated with clinical findings and direct measurement of the preferential uptake of antibody by the tumours. (UK).
In the 21st century, eighty years after William Baer presented his groundbreaking work treating bone and soft tissue infections with live maggots, thousands of therapists around the globe have rediscovered...Full Text Available
BackgroundIntermittent preventive treatment of malaria during pregnancy (IPTp) is a key intervention in the national strategy for malaria control in Tanzania. SP, the current drug...Full Text Available
The author furnishes a review of incidents of major damage to high-output steam turbines. At the same time, he thereby underlines the call for an improvement in the exchange of experience on such damage and its causes at international level. Only the careful observance of past damage experience - including that of foreign manufacturers and operators - complete and modern monitoring equipment and the painstaking evaluation of all data furnished by such equipment can keep the risk of new technical development within economically tolerable limits. (orig.).
Decision-making is strongly based on modelling in two of our water supply projects concerning artificial ground water. The model used is a 2-dimensional flow and transport model using the element method. Due to sharp variations in Finnish soils, the modelling process is based on careful and detailed evaluation of basic hydrogeological data before and during model calibration.
BackgroundGeneralized anxiety disorder (GAD) is the most frequent anxiety disorder in primary care patients. It is known that painful physical symptoms (PPS) are associated with...Full Text Available
BackgroundThe frequency of transfer of genes encoding resistance to antimicrobial agents was determined by conjugation in ESBL-producing and/or fluoroquinolone or aminoglycoside...Full Text Available
CTX-M-type extended-spectrum β-lactamases (ESBLs) have become increasingly common worldwide, with the notable exception of the United States, where TEM- and SHV-type ESBLs have appeared to predominate....Full Text Available
BackgroundResistance to third generation cephalosporins due to acquisition and expression of extended spectrum β-lactamase (ESBL) enzymes among Gram-negative bacteria is...Full Text Available
The implementation of information technology will continue to have important effects on the practice of emergency medicine. Patient registration and tracking systems, telemedicine electronic order entry systems, and the advent of electronic health records are some examples of applications that influence patient care in emergency departments. We review the literature regarding information technology advances in emergency medicine and outline the important role that emergency physicians play in developing and implementing a national health information technology strategy. PMID:16712540
The objectives of this project to interface the site-specific real-time radiological dose assessment system FADAS(Following Accident Dose Assessment System) to CARE. In this study, the results of the field tracer experiments conducted on the Younggwang site have been analysed. And the experimental procedure on Ulchin site has been introduced. The environmental characteristics on Ulchin and Wolsung has been investigated.
A team of physicians, pharmacists, and informatics professionals developed a CDSS added to a commercial electronic medical record system to provide prescribers with patient-specific maximum dosing recommendations...Full Text Available
Niger is the second poorest country in the world but it has natural resources underground in the form of uranium ores deposits. This uranium is currently mined by two companies incorporated under Nigerian law: Somair and Cominak, operated by the principal shareholder Areva (through its subsidiary Cogema). After a presentation of Somair and Cominak key figures, this document details the working conditions and radiological protection, the environmentally friendly operations, the production traceability, the local economic development, the strengthening of the health care system and the development of the infrastructure. (A.L.B.)
A laser spectrometer for the ethylenediaminetetra-acetic acid (EDTA) titration of magnesium or calcium ions that is designed around a handheld laser pointer as the source and a photoresistor as the detector is developed. Findings show that the use of the spectrometer reduces the degree of uncertainty and error in one part of the EDTA titrations, however overall standard deviations depend on the skill of the student and their willingness to be careful and precise.
In the treatment of prostatic cancer using a newly proposed intermittent multiportal therapy (DIMT), acute reactions, change in tumor marker levels, and complications more than 6 months after treatment were evaluated. From June 1989 to September 1990, 26 patients with prostatic cancer (stage A2, 3 patients; B, 9; C, 2; D, 10; recurrence, 2) were treated. Fifteen patients were followed up for more than one year, with a mean period of 11.6 months. The treatment schedule is 52.5 Gy in 16 fractions in 4 weeks for radical treatment, and 30.0 Gy in 8 fractions in 2 weeks for palliative treatment. The 360 degree rotation about the patient was divided into 16 fractions, and 2 opposing fractions were used in one day as parallel opposed portals to treat the target volume. The fractions were serially treated one per day, so that 8 treatment days produced a total dose of distribution similar to that for conventional conformational therapy. The size of the irradiation field ...
Aim: Compounds such "9"9"mTc-MDP and "9"9"mTc-HEDP are used regularly in bone scintigraphy for metastasis detection. The therapeutics properties of beta emitter radionuclides like "1"5"3Sm, "1"6"6Ho and "1"7"7Lu has been widely reported in literature being "1"7"7Lu the less developed for medical applications. With the purpose of study different radiopharmaceuticals alternatives, for metastasis bone palliation, we have evaluated, on a comparative basis, the labeling of "1"5"3Sm-MDP, "1"5"3Sm-HEDP, "1"6"6Ho-MDP, "1"6"6Ho-HEDP, "1"7"7Lu-MDP and "1"7"7Lu-HEDP from the exhibited radionuclidic purity and biological distribution point of view. Material and Methods: The radionuclides were produced at La Reina Research Reactor, Chilean Nuclear Energy Commission. The radionuclidic purity was determined by gamma-Ray spectrometry. The labeling was accomplished with MDP (Plenum) and HEDP synthesized in-house. The in-vitro affinity of labeled compounds to the mineral bone matrix ...
Objective: To evaluate the effect of PTBD in treating malignant biliary obstruction caused by hilar cholangiocarcinoma. Methods: We retrospectively analyzed the data of 103 patients(M:62,F:41)with malignant obstructive jaundice caused by hilar cholangiocarcinoma. After taking percutaneous transhepatic cholangiography, metallic stent or plastic external catheter or external-internal catheter for drainage was deployed and then followed up was undertaken with clinical and radiographic evaluation and laboratory. examination. Results: All patients went though PTBD successfully (100%). According to Bismuth classification, all 103 cases consisted of I type(N=30), II type (N=30), III type (N=26) and IV type (N=17). Thirty-nine cases were placed with 47 stents and 64 eases with drainage tubes. 4 cases installed two stems for bilateral drainage, 2 cases installed two stents because of long segmental strictures with stent in stent, 1 case was placed with three stents, and 3 cases installed stent ...
Purpose: To determine the value of MRI in the postoperativ evaluation of a singular ventricle compared to echocardiography and cardiac catheterization. Materials and methods: Thirty-one patients (range: 6 months to 30 years) with a functional single ventricle following palliative corrective operations. Five patients had a Blalock-Taussig-Shunt, 8 patients a Glenn-Anastomosis and 18 a cavopulmonary shunt (6 with classic Fontan-Circulation, 12 with modified cavopulmonary anastomosis). The results in terms of postoperative morphologic changes were compared to percutaneous echocardiography (31/31) and cardiac catheterization (6/31). Results: Echocardiography, which was performed on all patients, could not visualize the entire length of the tunnel, the Glenn-Anastomosis or the central pulmonary arteries in 70% of the patients due to an inadequate acoustic window. MRI was able to show the entire tunnel in 11/12 patients and the central pulmonary arteries in 30/31 ...
The family of natriuretic peptides consists of the atria natriuretic peptide (ANP), the cerebral natriuretic peptide (BNP), the type C natriuretic peptide (CNP) and the peptide isolated from the dendroaspis snakes' poison (DNP), whose presence in humans has not been confirmed. The physiological function of ANP is in the control of arterial blood pressure by regulation of systemic vascular resistance of blood vessels. BNP is produced as one of the factors in the acute response to inflammatory tissue damage, mainly in coronary vessels. Increased serum concentrations of natriuretic peptides have been found in stress situations, such as trauma or major surgery, systemic hypotension, and in intrinsic myocardial dysfunction. High concentrations of natriuretic peptides were observed in severe sepsis, septic shock and in multiple organ failure, probably due to increased secretion by mediators of the inflammatory process.The highest concentrations of ANP and BNP were found in lethal conditions. ...
Data fusion techniques are based on the premise that two or more carefully designed NDE tests are potentially capable of offering additional information concerning the test object relative to what can be garnered from a single test. However, information from a heterogeneous set of transducers cannot be fused unless the data is mapped onto a common `format'. The eddy current method cannot, for example, provide time-of-flight information that can be combined from estimates derived from ultrasonic tests. This paper presents a simple solution to address the problem by employing the so-called Q-transform to relate diffusive fields, such as those generated by eddy current probes, and propagating wave fields generated by ultrasonic NDT sensors. The paper illustrates how the distance between a defect and a source can be extracted from eddy current data generated using carefully selected excitation signals. Numerical results and comparisons with ...
SummaryA laboratory-based surveillance study was conducted from January 2007 to May 2010 in San Martino Tertiary Referral Hospital in Genoa, Italy in which the molecular epidemiology of multidrug-resistant Acinetobacter baumannii was investigated in the five intensive care units (ICUs). A total of 53 A. baumannii strains were isolated from patients admitted to ICUs (69.8%) and to other epidemiologically linked hospital wards (30.2%) and were genotyped by repetitive extragenic palindromic polymerase chain reaction (REP-PCR), multilocus sequence typing (MLST) and adeB sequence typing. REP-PCR fingerprinting analysis, MLST and adeB typing results were well correlated and allowed us to classify strains causing epidemic events into three major epidemic clones: A (REP-I/ST4, adeB-STII genotype) ...
This study aimed to reveal that severe disturbance of attachment relationship with primary care-giver can affect functional and anatomical brain development by measuring cerebral perfusion on "9"9"mTc-ECD brain SPECT and correlative MRI. We included 18 children aged 31 to 76 months who met the diagnostic criteria of RAD as defined in DSM-IV and ICD-10 and SSP and CARS. "9"9"mTc-ECD SPECT was performed using CERASPECT. MRI was performed in all patients. SPECT data were visually assessed. 15 of 18 children had abnormal perfusion on SPECT, revealing decreased perfusion of Lt.thalamus (7/15) and Rt.thalamus (3/15), and bilateral thalami (5/15). Perfusion of basal ganglia was decreased in 8 children. Decreased perfusion of Lt. parietal area was seen in 2. Whereas, all patients had normal MR findings. Perfusion abnormalities involving thalamus, BG in most children with RAD were found in this study. These results suggest that brain development of infant could be impeded ...
An attempt was made to minimize the channeling tail by implantation along a random equivalent direction following a careful alignment of the target. In order to analytically determine the random equivalent directions, critical angles for channeling were mapped on a stereogram. Boron ions with energies of 17 and 45 keV are implanted along specified directions determined from the map. The depth distribution of the dopant is profiled by SIMS and the effects of water orientation upon the channeling tail are noted. Industrial common use of a 7/sup 0/ tilt is not optimum. However, implantation with the wafer tilted at 5.5 +/- 0.5/sup 0/ from the surface normal and rotated at 7.0 +/- 0.5/sup 0/ from a (100) plane shows the least channel-tail compared to implantation along other directions. Rapid thermal annealing (RTA) is a promising annealing method for shallow junction formation. Transient enhanced diffusion of implanted boron is observed. Two different mechanisms for ...
An attempt was made to minimize the channeling tail by implantation along a random equivalent direction following a careful alignment of the target. In order to analytically determine the random equivalent directions, critical angles for channeling were mapped on a stereogram. Boron ions with energies of 17 and 45 keV are implanted along specified directions determined from the map. The depth distribution of the dopant is profiled by SIMS and the effects of water orientation upon the channeling tail are noted. Industrial common use of a 7"0 tilt is not optimum. However, implantation with the wafer tilted at 5.5 +/- 0.5"0 from the surface normal and rotated at 7.0 +/- 0.5"0 from a (100) plane shows the least channel-tail compared to implantation along other directions. Rapid thermal annealing (RTA) is a promising annealing method for shallow junction formation. Transient enhanced diffusion of implanted boron is observed. Two different mechanisms for the boron ...
Clinical-HINTS (Health Intelligence System) is a horizontally integrated decision support system (DSS) designed to meet the requirements for intelligent real-time clinical information management in critical care medical environments and to lay the foundation for the development of the next generation of intelligent medical instrumentation. The system presented was developed to refine and complement the information yielded by clinical laboratory investigations, thereby benefiting the management of the intensive care unit (ICU) patient. More specifically, Clinical-HINTS was developed to provide computer-based assistance with the acquisition, organisation and display, storage and retrieval, communication and generation of real-time patient-specific clinical information in an ICU. Clinical-HINTS is an object-oriented system developed in C+2 to run under Microsoft Windows as an embryo intelligent agent. Current generic reasoning skills include ...
The Belgian Malinois dog was introduced into the Department of Defense Military Working Dog Program in 1984. All dogs are purchased in Europe and have adapted well to the rigorous training requirements of the program. Most veterinary problems seen in this breed are related to kennel confinement and include traumatic dental disease, tail lesions, a variety of dermatologic conditions, and an inability to gain weight. Epilepsy is a breed problem and has been seen in this population, as has gastric dilatation/volvulus. Both elbow and hip dysplasia exist in the Malinois breed. PMID:1900116
We summarize our lattice QCD study of the form factor at zero recoil in the decay {bar B} {yields} D*{ell}{bar {nu}}. After careful consideration of all sources of systematic uncertainty, we find, h{sub A{sub 1}}(1) = 0.913{sub -17-30}{sup +24+17}, where the first uncertainty is from statistics and fitting while the second combined uncertainty is from all other systematic effects.
In recent years the feedstock base of the coking plants in the South has been significantly degraded: the charges contain an increased quantity of gas coal and coal from coalfields in the East are being included. Certain plants in the Ukraine receive coal from the Kuznetsk, Pechora and Karaganda coalfields. Addition of these coal types in the charges of plants in the South is expected to continue in the future. Their efficient utilization requires careful investigation of the new charges in order to determine the optimal composition and to produce blast furnace coke meeting modern specifications.
We numerically demonstrate selective near-field localization determined by the polarization state of a single emitter coupled to plasmonic nano-cluster. Seven gold nanospheres are carefully arranged such that up to ten polarization states of the single emitter, including linear, circular, and elliptical polarizations, can be distinguished via the distinct field localization in four gaps. The ability to transform polarization state into field spatial localization may find application for single emitter polarization analysis.
Power System Stabilizers (PSS) have broad application throughout the world. PSS application requires careful tuning which is usually accomplished in the field with the generator and power system in an abnormal condition. Recently developed equipment which combines fast Fourier transform capability with digital computer technique provides a means of PSS tuning which is faster and more accurate than was previously obtainable. This paper describes a PSS tuning test conducted using the new technique. The advantages will be apparent to the reader. The described test is very poignant as evidenced by two unexpected occurrences of instability.
The role of natural enemies in the regulation of populations is one of the major questions facing population ecologists. Simplification have led to two theoretical ways of incorporating the role of natural enemies in single ecological models: diffusion models and patch-type models. The predictions of the models are different because of the way variability is incorporated. Three equations are presented for diffusion models and one for patch models. Since the two types of models apply at different combinations of spatial and temporal scales, the right model(s) to choose for a particular study requires careful assessment. A continuing dialogue between experimentalists and theoreticians will lead to a better understanding of natural systems such as those that occur in biological control.
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.
Fifty patients scheduled to undergo IVF received a standard anesthetic of fentanyl and propofol for induction, followed by propofol infusion, with Bispectral index values and modified Ramsey sedation scores recorded at 5-minute intervals for the duration of anesthesia care. Moderate sedation was found only transiently during the first 5-10 minutes of the oocyte retrieval, but thereafter the level of sedation increased, with deep sedation and general anesthesia measured in all patients as determined by both the Bispectral index scores and lack of response to painful stimulation.
Periosteal Ewing's sarcoma is an uncommon, but well documented origin of this malignant condition with radiography signs, different from intramedullary growing tumours. Imaging modalities like CT or MRI supply proof of macroscopically intact endosteal cortical surface and free medullary cavity in long bones affected by this periosteal type of malignancy. Definite confirmation is valid after a careful microscopic investigation of the resected specimen. The prognosis of this type of Ewing's sarcoma may be favourable than that of the central type. Early diagnosis and therapy are thus essential. A clinical survey of six observations is given. (orig.).
Nonlinear distortion added by the loudspeaker in a hearing aid lowers the signal-to-noise ratio and may degrade the hearing aid user's ability to understand speech. The balancedarmature- type loudspeakers, predominantly used in hearing aids, are inherently nonlinear devices, as any displacement of the loudspeaker diaphragm inevitably changes the magnetic and electrical characteristics of the loudspeaker. A numerical time-domain model capable of describing these nonlinearities is presented. By simulation it is demonstrated how the output distortion could potentially be reduced significantly through careful design of the mechanical properties of the armature.
Cross-sectional imaging has revolutionised the radiological diagnosis of pleural collections. Not only can the precise location and volume of a pleural effusion be established, but also features specific for the aetiology of the effusion can be demonstrated. Increasingly, radiologists are called upon to perform image-guided biopsies, aspirations and small bore chest drain placement, all of which have been shown to be safe and efficacious. Pneumothoraces occurring due to acute trauma and in an intensive care setting can also benefit from radiological input, both in terms of diagnosis and image-guided treatment. (orig.)
Kaluza-Klein higher derivative induced gravity is studied for its application in the inflationary universe. The stability of an inflationary solution in a $D+4$-dimensional anisotropic space is analyzed carefully. We show that there is two nontrivial constraints derived from the static assumptions on the $D$-dimensional scale factor $d$ and scalar field $\\psi$. We find that a physical inflationary solution is consistent with the above constraints. In addition, a compact formula for the non-redundant $4+D$ dimensional Friedmann equation is also derived for convenience. Possible implications are also discussed in this paper.
Most of the essays gathered in this volume were first presented at a conference, Justice and the Human Genome, in Chicago in early November, 1991. The goal of the, conference was to consider questions of justice as they are and will be raised by the Human Genome Project. To achieve its goal of identifying and elucidating the challenges of justice inherent in genomic research and its social applications the conference drew together in one forum members from academia, medicine, and industry with interests divergent as rate-setting for insurance, the care of newborns, and the history of ethics. The essays in this volume address a number of theoretical and practical concerns relative to the meaning of genomic research.
Measurements of the humeral cortical thickness demonstrate that generalised osteoporosis in female Bantu commences in the fifth decade and gradually increases until, in the ninth decade, all subjects are osteoporotic. The combined cortical thickness (CCT) of the humerus in young adults is very similar to that found previously in a white London population and the loss of cortex with age is very similar. It is concluded that the known low incidence of femoral neck fracture in Bantu is not due to a lower incidence of generalised osteoporosis but to environmental factors. The chief environmental factor postulated is the greater amount of physical work performed by the Bantu. A more careful mode of walking is suggested as a subsidiary cause. (orig.).
Hope is an essential dimension of life. Hope, according to Marcel?s thinking, is the act by which the temptation to despair is actively overcome. Hope comes alive when confronting life?s trials, darkness, illness and separation. Marcel differentiates ?I hope? from ?I hope that?. Hope as a central construct for nursing has been analysed, defined, and studied by the nursing theorist Jean Watson in her Theory of Human Caring, and Kaye Herth with her strategies (Herth Hope Index). These strategies are based on Marcel?s existential notion that human beings have an endless possibility of improving their own being.
The objectives of the project were to develop operational techniques for promoting contaminant hideout return from tube support crevices and to identify the effect of chemical inhibitor application on corrodent transport. The implementation of routine procedures for promoting the return of sequestered corrodents could retard the progression of denting or other corrosion processes and improve steam generator availability. Tests also quantified the effect of inhibitor application on crevice hideout and hideout return processes, with the intention of developing a better understanding of the inhibition mechanism. By carefully monitoring the hideout and hideout return inventories, the program also has provided the opportunity to study steam generator concentration processes in general.
Objective: Results of reliability and agreement studies are intended to provide information about the amount of error inherent in any diagnosis, score, or measurement. The level of reliability and agreement among users of scales, instruments, or classifications is widely unknown. Therefore, there is a need for rigorously conducted interrater and intrarater reliability and agreement studies. Information about sample selection, study design, and statistical analysis is often incomplete. Because of inadequate reporting, interpretation and synthesis of study results are often difficult. Widely accepted criteria, standards, or guidelines for reporting reliability and agreement in the health care and medical field are lacking. The objective was to develop guidelines for reporting reliability and...
This article examines the interplay between globalising and localising forces occurring in a child welfare reform project in South Korea. Focusing especially on care and education services for children and families provided by the Korean 'Dream Start' programme, which provides comprehensive health, parental involvement and welfare services to low-income children and their families, I discuss its involvement in the process of 'glocalisation'. Drawing on Foucaultian ideas, I conducted a critical discourse analysis of the policy documents of Dream Start. The article concludes by discussing local resistance to the creation of a cosmopolitan child and the dual qualities of inclusion/exclusion inscribed in the Dream Start project.
A zinc/air battery is claimed whose performance is improved by omitting separating elements such as diaphragms etc. The cathode and anode spaces are separated by a collector with holes big enough to permit the electrons to pass freely while restraining the anode material. Further, the active material consists of a spherical care of inert material with a zinc coating. Under the zinc coating, the spherical particles have another thin coating of an electropositive material, e.g. nickel. The cell also contains means for circulating the anode suspension.
The paper presents an integrated approach to the problem of electron temperature diagnostics of the plasma in a reversed field pinch. Three different methods, sampling different portions of the electron distribution function, are adopted, namely Thomson scattering, soft X-ray spectroscopy by pulse-height analysis and filtered soft X-ray intensity ratio. A careful analysis of the different sources of systematic errors is performed and a novel statistical approach is adopted to mutually validate the three independent measurements. A satisfactory agreement is obtained over a large range of experimental conditions, indicating that in the plasma core the energy distribution function is well represented by a maxwellian. (author)
The electromagnetic properties of a prototype gravitational wave detector, based on two coupled superconducting microwave cavities, were tested. The radio-frequency (rf) detection system was carefully analysed. With the use of piezoelectric crystals small harmonic displacements of the cavity walls were induced and the parametric conversion of the electromagnetic field inside the cavities explored. Experimental results of bandwidth and sensitivity of the parametric converter versus stored energy and voltage applied to the piezoelectric crystal are reported. A rf control loop, developed to stabilize phase changes on signal paths, gave a 125 dBc rejection of the drive mode on a time scale of 1 h.
Optimization is a powerful paradigm for expressing and solving problems in a wide range of areas, and has been successfully applied to many vision problems. Discrete optimization techniques are especially interesting since, by carefully exploiting problem structure, they often provide nontrivial guarantees concerning solution quality. In this paper, we review dynamic programming and graph algorithms, and discuss representative examples of how these discrete optimization techniques have been applied to some classical vision problems. We focus on the low-level vision problem of stereo, the mid-level problem of interactive object segmentation, and the high-level problem of model-based recognition. PMID:20660950
Delayed cerebral necroses after irradiation are to be divided into hemispheric and midline lesions, as they differ from each other in several aspects. Apart from the symptoms, they are differing in the duration of latency, in the course and prognosis, and also with regard to morphology. Though there is no doubt that radiation tolerance of cerebral midline structures is relatively limited, on biological grounds, evidence of a difference between the tolerated doses could not be given from the existent inhomogeneous radiation data, with the help of the NSD-concept. Radiation planning for the region of the head, nevertheless, carefully should avoid in every case to involve the structures of the cerebral midline.
The main purpose of this paper is to stress the importance of CT depiction of the mandibular incisive canal. This anatomical structure contains a major neurovascular bundle and is thus very important in the planning of mandibular implants in the canine-incisive area. The importance of careful assessment of the mandibular canal course before implantology is now widely recognized. The same holds true for the canine-incisive region in the jaw, to detect the incisive canal if present and prevent any complications from its accidental damage. CT with a dedicated software showed the incisive canal in a large number of patients, which calls for precise reporting of its presence, course, and relationships with teeth.
This book constitutes the thoroughly refereed post proceedings of the international workshop Computer Vision Approaches to Medical Image Analysis, CVAMIA 2006, held in Graz, Austria in May 2006 as a satellite event of the 9th European Conference on Computer Vision, EECV 2006. The 10 revised full papers and 11 revised poster papers presented together with 1 invited talk were carefully reviewed and selected from 38 submissions. The papers are organized in topical sections on clinical applications, image registration, image segmentation and analysis, and the poster session. (orig.)
As an application of ART2 neural networks, computer aided monitoring of pump efficiency is successfully examined for an industrial waste-liquid treatment process with measured data of valve openness and liquid flow rates. By running the neural networks in parallel, we confirm that accuracy to detect system changes is good, and the adjustment of classifier parameters is relatively easy. Investigating the resulting classes carefully, frequency of each class is correlated with pump efficiency. The relative amount of variables are also related to the classes. (author)
In recent years, several groups, including the physician assistant, health information management, ophthalmic medical technician/technologist, and athletic training review committees, have left the Commission on Accreditation of Allied Health Education Programs (CAAHEP) system to form their own, profession-specific accrediting bodies. Their motivation was typically a desire for greater professional visibility and autonomy. Combined, these professions represented one third of the CAAHEP's programs. This article reviews the history of allied health and examines current attempts to bring cohesion and identity to this increasingly fractured segment of the U.S. health care system. PMID:18444439
Close coupled expressions for phenomenological cross sections which describe transport properties of atom--diatom mixtures are obtained in the total-J coupling scheme and are related to the bracket integrals of kinetic theory. Coupled states and infinite order sudden expressions for the generalized phenomenological cross sections using initial, final, and average l-labeling are also given. Particular care is taken to use a phase convention for the CS and IOS approximations which is consistent with the Arthurs--Dalgarno formalism and which gives the correct behavior of degeneracy averaged differential cross sections.
Excessive irradiation due to unexpected leakage was found on a patient receiving electron beam therapy. The cause of this leakage was analyzed and the amount of leakage was measured for different electron beam energies. The highest leakage occurred with a 6 x 6 cm cone using a 12 MeV electron beam. The leakage dose measured along the side of the cone could be as great as 40%. Until the cones are modified or redesigned, it is advised that all patient setups be carefully reviewed to assure that no significant patient areas are in the side scatter region.
...Advances in Chronic Kidney Disease-The purpose of Advances Chronic Kidney Disease is to provide in-depth, scholarly review articles about the care and mana ... Advances in Chronic Kidney Disease - Elsevier Home Products User Resources About Us Support & Contact Elsevier Websites Advanced Product ...Search Browse Journals Advances in Chronic Kidney Disease Advances in Chronic Kidney Disease Additional Information Related Publications Editorial Board Journal Online e- Alert Readers ...year: 6 Tips Title This is my tip content Visit Advances in Chronic Kidney Disease Online! The purpose of Advances Chronic Kidney Disease is ...
The present research has been made to develop and review critically the functional requirements of the specific safety systems of CANDU such as SDS-1, SDS2, ECCS, and containment. Based on R documents for this, a systematic study was made to develop the domestic regulation statements. Also, the conventional laws are carefully reviewed to see the compatibility to CANDU. Also, the safety assessment method for CANDU was studied by reviewing C documents and recommendation of IAEA. Through the present works, the vague policy in the CANDU safety regulation is cleaning up in a systematic form and a new frame to measure the objective risk of nuclear power plants was developed.
The present research has been made to develop and review critically the functional requirements of the specific safety systems of CANDU such as SOS-1, SOS-2, ECCS and containment. Based on R documents for this, a systematic study was made to develop the domestic regulation statements. Also, the conventional laws are carefully reviewed to see the compatibility to CANDU. Also, the safety assessment method for CANDU was studied by reviewing C documents and recommendation of IAEA. Through the present works, the vague policy in the CANDU safety regulation is cleaning up in a systematic form and a new frame to measure the objective risk of nuclear power plants was developed.
In this work, the right management procedure for hydraulic power oil will be discussed and suggested. A thermal power plant turbine should respond to the change of load status. However, to satisfy the frequency of alternating current, the revolution per minute should be kept constant. Therefore, by controlling the flow rate of the steam to the turbine, the governor satisfies the load variation without alternating the revolution per minutes of the turbine. To protect the governor, the hydraulic power unit should be managed carefully by controlling the quality and the flow rate of the oil.
There is increasing pressure to operate laboratory facilities in environmentally and financially sustainable ways. A key factor in achieving this goal is careful consideration of how energy is used by the buildings' ventilation system, both for conditioning air supplied to the laboratories and the energy used moving air through the building. Traditionally, laboratory energy use is treated as an engineering concern within the scope of the building's overall design and operation. However, this approach limits the involvement of key stakeholders in many important decisions and can lead to unexpected safety concerns for the laboratory's users. We believe that a broad view of the parties affected by a laboratory building's operations is necessary to avoid having the various stakeholders working...
Recent rapid growth in mobile computing technologies enables telemedicine applications to operate on mobile devices. Our focus is on the design of an integrated electrocardiogram (ECG) beat detector on a Personal Digital Assistant (PDA) platform for the health screening process. The ECG beat detector module will be supported by the PDA version of Personal Health Information Management System (PHIMS) and Facilitated Accurate Referral Management System (FARMS) through wireless network infrastructure as a home-based mobile cardiac monitoring solution. PMID:17282192
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 ...
MRI provides a non-invasive diagnostic tool complementing echocardiography on one hand, and showing advantages over echocardiography, on the other hand, especially after corrective procedures. The multiple different MRI sequences need to be adapted to examinations of children and patients with congenital heart disease (CHD), and can be used to detect morphologic changes, blood-flow in the heart and thoracic vessels and diastolic or systolic function of myocardium. Several factors determine the success of the examination of a complex congenital heart disease or a postoperative situs. Pediatric radiologists and radiologists experienced in congenital heart diseases have to work in close cooperation. Echocardiography should be performed before MRI. The results of prior examinations and the clinical history of the patients, including possible palliative or reconstructive operations, must be available before MRI to guide the planning of the examination. With a systematic ...
The windmill industry in Denmark is currently confronted with making a choice between competing technologies so that the role of the stimulus of state subsidies for research has lately increased in importance. The Ministry of Energy, it is claimed, must be aware of this as possibilities for making use of research results are dictated by the market and competition. The industry is not sympathetic to the idea of state research contracts with specified goals for which manufacturers must produce a technical solution. Consultancy firms should work towards solving general problems which could help the industry as a whole. Wind turbines which are cheap to produce and operate are of more interest to industry than those which are technologically advanced or of a lighter construction. It is not thought to be advantageous to concentrate the allocation of subsidies on one key project chosen by the Ministry itself, such as the current intense interest in turbine blades. ...
The windmill industry in Denmark is currently confronted with making a choice between competing technologies so that the role of the stimulus of state subsidies for research has lately increased in importance. The Ministry of Energy, it is claimed, must be aware of this as possibilities for making use of research results are dictated by the market and competition. The industry is not sympathetic to the idea of state research contracts with specified goals for which manufacturers must produce a technical solution. Consultancy firms should work towards solving general problems which could help the industry as a whole. Wind turbines which are cheap to produce and operate are of more interest to industry than those which are technologically advanced or of a lighter construction. It is not thought to be advantageous to concentrate the allocation of subsidies on one key project chosen by the Ministry itself, such as the current intense interest in turbine blades. ...
With the end of the Cold War and the election of President Clinton, the Department of Energy (DOE) set a new course which began with the publication of its first departmental strategic plan in April 1994. Entitled ``Fueling a Competitive Economy, it provided the framework and shared vision for meeting responsibilities in energy, national security, environmental quality, and science and technology. The strategic plan was the guidepost for the formulation of the Department`s FY 1996, FY 1997, and FY 1998 budgets and was critical to the development of the Department`s Strategic Alignment Initiative, designed to save $1.7 billion over five years. This current plan, which has been significantly improved through a very close consultation process with Congress and customers stakeholders, takes DOE to the next important performance level by being more directly linked to actions and results. It defines a strategic goal for each of the Department`s four business lines and, ...
France began atmospheric nuclear testing at Mururoa and Fangataufa atolls in the South Pacific in July 1966. Following international protest, atmospheric testing ceased in August 1970. In late 1995, an International Geomechanical Commission (IGC) was created to assess the short- and long-term effects of underground nuclear testing on the stability and hydrology of Mururoa and Fangataufa. With the aid of its consultants, the Commission sought to develop its own understanding of the mechanics and consequences of the underground nuclear tests. It carried out extensive numerical analyses of shock wave effects, seismic wave propagation, slope stability and pre- and post-test hydrology. However, in its studies, the IGC was constrained to use the data made available to it by the French authorities. The Commission's report (International Geomechanical Commission 1998) has been submitted to the French Government. This article draws heavily on parts of that report. The ...
This is the Fiscal Year 1995 Annual Report for the Advanced Manufacturing Science and Technology (AMST) sector of Los Alamos Tactical Goal 6, Industrial Partnering. During this past fiscal year, the AMST project leader formed a committee whose members represented the divisions and program offices with a manufacturing interest to examine the Laboratory`s expertise and needs in manufacturing. From a list of about two hundred interest areas, the committee selected nineteen of the most pressing needs for weapon manufacturing. Based upon Los Alamos mission requirements and the needs of the weapon manufacturing (Advanced Design and Production Technologies (ADaPT)) program plan and the other tactical goals, the committee selected four of the nineteen areas for strategic planning and possible industrial partnering. The areas selected were Casting Technology, Constitutive Modeling, Non-Destructive Testing and Evaluation, and Polymer Aging and Lifetime Prediction. For each area, the AMST ...
A study trip to a biomass gasification plant in Germany took place from 13-15 November 2000. The goal of the trip was to obtain information on German developments, experience, and possibilities in the field of biomass gasification. The participants were representatives of Dutch parties in the energy sector: waste sector, manufacturers, producers, policy makers and consultants. The most important feature was the visit to plants that were in operation. Due in particular to the new EEG (Emeuerbare-Energien-Gesetz/Renewable Energy) legislation, German policy makers have created an initial market for sustainable energy with a degree of success. The key feature is that EEG makes projects 'bankable' by guaranteeing a return delivery compensation. An EEG-type scheme designed to accelerate the development of sustainable energy could be an interesting instrument also for the Netherlands. The plan was to visit four plants and have a number of presentations in a period of ...
The assets that Citizen Potawatomi Nation holds were evaluated to help define the strengths and weaknesses to be used in pursuing economic prosperity. With this baseline assessment, a Planning Team will create a vision for the tribe to integrate into long-term energy and business strategies. Identification of energy efficiency devices, systems and technologies was made, and an estimation of cost benefits of the more promising ideas is submitted for possible inclusion into the final energy plan. Multiple energy resources and sources were identified and their attributes were assessed to determine the appropriateness of each. Methods of saving energy were evaluated and reported on and potential revenue-generating sources that specifically fit the tribe were identified and reported. A primary goal is to create long-term energy strategies to explore development of tribal utility options and analyze renewable energy and energy efficiency options. Associated goals are to consider exploring ...
In February 2001, the Minister of Environment Canada outlined a series of measures to be implemented over the next decades to reduce emissions from vehicles, engines and fuels. The agenda includes the development of new regulations under the authority of Part 7, Division 5 of the Canadian Environmental Protection Act (CEPA) to align Canada's emission standards for on-road vehicles with those of the United States Environmental Protection Agency. This paper presents a detailed summary of comments received by the interested parties that appeared at a public consultation in November 2001 to discuss and raise issues about the proposed regulations. The parties that provided submissions included: governments; the vehicle and engine manufacturing industry; the oil industry; other groups of associations such as the Canadian Trucking Alliance, David Suzuki Foundation, and West Coast Environmental Law; and, five private individuals. The report presents comments and ...
The Department of Toxic Substance Control (DTSC) requested that Lawrence Livermore National Laboratory (LLNL) evaluate the treatment process currently employed at the Department's Stringfellow Superfund Site Pretreatment Plant (PTP) site to determine if wastes originating from the site were properly managed with regards to their radioactivity. In order to evaluate the current management strategy, LLNL suggested that DTSC characterize the effluents from the waste treatment system for radionuclide content. A sampling plan was developed; samples were collected and analyzed for radioactive constituents. Following is brief summary of those results and what implications for waste characterization may be made. (1) The sampling and analysis provides strong evidence that the radionuclides present are Naturally Occurring Radioactive Material (NORM). (2) The greatest source of radioactivity in the samples was naturally occurring uranium. The sample results indicate that the uranium ...
The Department of Toxic Substance Control (DTSC) requested that Lawrence Livermore National Laboratory (LLNL) evaluate the treatment process currently employed at the Department's Stringfellow Superfund Site Pretreatment Plant (PTP) site to determine if wastes originating from the site were properly managed with regards to their radioactivity. In order to evaluate the current management strategy, LLNL suggested that DTSC characterize the effluents from the waste treatment system for radionuclide content. A sampling plan was developed; samples were collected and analyzed for radioactive constituents. Following is brief summary of those results and what implications for waste characterization may be made. (1) The sampling and analysis provides strong evidence that the radionuclides present are Naturally Occurring Radioactive Material (NORM). (2) The greatest source of radioactivity in the samples was naturally occurring uranium. The sample results indicate that the uranium concentration ...
Since mid-March the Commission on Water Management, with the assistance of the appropriate ministries, visited all regions of the province in order to acquaint themselves first hand with regional water management problems. During the month of June, the Commission also organized a series of ten workshops, attended by a limited number of experts, to explore in depth certain specific questions in the area of water management. During these public sessions the Commission hoped to discuss specifically the specific questions relating to water management problems of First Nations communities, bearing in mind the essential nature of water in maintaining traditional activities. The workshop took place on the Montanard reserve of Mashteuiatsh (Pointe-Bleu). The morning session was devoted to presentations by invited experts, followed by an exchange of views between the experts and the Commissioners, with opportunity for participants to address question to the experts. This document was compiled ...
After five years of implantation of a program for classification and signalling of restricted areas in the IPEN-CNEN-SP, we noticed that the applied measures of radio protection contributed for the improvement of the system of occupational radiological protection, promoting an improvement in the security of the workers, towards the planning in the execution of the activities involving the use of sources of ionizing radiation. Later, during the implantation of this program, the service of occupational radiological protection, there was great difficulty to conciliate its necessities in terms of security signalling, face the absence of existing standardisation in the country for the minimum disposals on the subject in question. Nowadays there are different interpretations of the specific criteria and many effective normative documents that exist in the country. This work presents as proposal the elaboration of a technical guide whose objective is to display the criteria and ...
The Northeast Gateway Energy Bridge Deepwater Port project was commissioned in 2005 and is based on a proprietary energy bridge shipboard regasification technology. The offshore liquefied natural gas (LNG) facility will be located in federal waters 13 miles southeast of Gloucester and was designed to cope with the extreme weather of the Massachusetts Bay. A dual-buoy system will be capable of ensuring continuous delivery of natural gas. Throughput capacity will range from 400 to over 800 MMcf/d. Vessels used at the port have capacities of 138,000 m{sup 3} and 150,900 m{sup 3} with peak sendout rates of 600 MMcf/d. The vessels have the capacity to rapidly increase and decrease their delivery rates. During periods of peak demand, 2 vessels can be simultaneously accommodated at the port, which has been designed to accommodate larger vessels to maximize future throughput. This presentation presented details of the port's design phases and the review processes undertaken to gain ...
As part of the licensing process to construct a new 230 kV transmission line on an existing right-of-way in Manitoba, an electrical effects study was conducted in 1998. The study was part of the environmental assessment program crucial in obtaining government approval to construct the line. Some residents living adjacent to the new transmission circuit expressed concerns about alleged adverse health effects associated with long-term exposure to magnetic fields from high voltage transmission lines. In order to verify the accuracy of the predicted magnetic field levels submitted to the regulatory body in the the electrical effects study and to instill confidence in the residents of the affected communities, a three-year magnetic monitoring project was conducted between 2003 and 2005 along the right-of-way after the new 230kV transmission line was energized by Manitoba Hydro. This paper described the monitoring program, with reference to location; equipment; data analysis; and discussion ...
This paper presents a technical feasibility study project for the large scale rooftop photovoltaics (PV) grid connected system at Charoenphol-Rama I green building super store of TESCO LOTUS (TL) in Thailand. The objective of this project is (i) to study the technical feasibility of installation 350 kWp PV systems on the top of the roof in this site (ii) and to determine the energy produce from this system. The technical factors are examined using a computerized PVS 2000 simulation and assessment tool. This super store building located in Bangkok, with latitude 14 N, longitude 100 E and the building direction is 16 from North direction. The building roof area is 14,000 m2; with 3 degree face East and 3 degree face West pitch. Average daily solar energy in this area is approximately 5.0 kWh. The study team for this project consists of educational institution as School of Renewable Energy Technology (SERT) and private institution as Panya Consultants (PC). TL is the ...
This handbook presents information and data for high explosives (HEs) of interest to programs at the Lawrence Livermore National Laboratory (LLNL) and other Department of Energy (DOE) facilities. It is intended to be useful to the scientist or engineer, the novice or expert, who needs to develop a new weapon system, design a physics experiment, or select and/or evaluate an existing explosive. This compilation is limited to production HEs and their components. High explosives are divided into two classes: initial detonating (or primary) and noninitiating (or secondary) explosives. The primary HEs, such as azides and fulminates, are extremely sensitive to ignition by heat, shock, and electrical discharge; ignition leads to high-order detonation of the material - even for milligram quantities. The use of these HEs is therefore limited to squibs and starting materials for low-energy detonators. Because primary explosives have little application at LLNL, this compilation includes only the ...
In November 1995, the Australian and New Zealand Environment and Conservation Council (ANZECC, the Council of State and National Environment Ministers) adopted a National Management Plan for PCBs. This was a significant milestone in the very long saga of Australian efforts to develop public policy and management structures for dealing with persistent organochlorine wastes. The author was part of a four-person consultation panel that carried out a public involvement program to assist and inform the process of developing the National Management Plan. The program involved, among other things, visiting every state and territory of Australia at least twice. This paper describes the development and delivery of the public involvement program, including ongoing interactions with Governments. The latter is often a complex (and many would say an unduly complex) matter in the federal system, where primary responsibility for waste management resides in the individual ...
This report presents findings from the first year of a two-year study of interactive efforts involving utilities and non-utility parties (NUPS) working together to prepare plans, develop Demand-Side Management (DSM) programs, or otherwise promote integrated planning and the use of cost-effective DSM measures. Of the ten cases covered in the current study, seven involved the collaborative approach to NUP involvement, which generally is marked by intensive utility-NUP interactions designed to reach consensus on a broad range of important issues; in collaboratives, outside consultants often are provided to enhance the technical capabilities of the NUPS. Another of the cases in this study involved a cooperative arrangement,'' whereby a utility and a NLT worked together in a focused short-term effort to develop a single DSM program. The intense interaction involved in this approach makes it very similar to a collaborative, except that both the scope ...
This report presents findings from the first year of a two-year study of interactive efforts involving utilities and non-utility parties (NUPS) working together to prepare plans, develop Demand-Side Management (DSM) programs, or otherwise promote integrated planning and the use of cost-effective DSM measures. Of the ten cases covered in the current study, seven involved the collaborative approach to NUP involvement, which generally is marked by intensive utility-NUP interactions designed to reach consensus on a broad range of important issues; in collaboratives, outside consultants often are provided to enhance the technical capabilities of the NUPS. Another of the cases in this study involved a ``cooperative arrangement,`` whereby a utility and a NLT worked together in a focused short-term effort to develop a single DSM program. The intense interaction involved in this approach makes it very similar to a collaborative, except that both the scope and the duration ...
This seminar dealt with the subject of indoor air pollution and welcomed participants from environmental consultancy agencies and authorities and institutions related with environmental protection. Leading scientists from research and authorities presented the current state of knowledge abut the risks of indoorair pollution. The papers contained in these proceedings addressed: room climate and sick-building syndrome; allergens in indoor spaces; pollutants emitted by exemplary building materials; pollutant levels of organic compounds in indoor spaces; air quality in motor vehicle interiors; indoor air pollution - risk assessment and need for actions. (Uhe) [Deutsch] Das Seminar zum Thema Innenraumluft wurde fuer TeilnehmerInnen von Umweltberatungsstellen und anderen mit Umwelt betrauten Behoerden und Institutionen veranstaltet. Fuehrende Wissenschaftlerinnen aus Forschung und Behoerden stellten den aktuellen Stand des Wissens ueber Risiken der Innenraumbelastung aus ...
Worker exposures to arsenic (7440382) (As), cadmium (7440439) (Cd), copper (7440508) (Cu), lead (7439921) (Pb) and sulfur-dioxide (7446095) (SO2) were surveyed at ASARCO, Incorporated (SIC-3331) in Hayden, Arizona on April 23 and 24, 1980. The evaluation was requested by an authorized representative of the United Steel Workers, Local 886, on behalf of an unspecified number of workers. Personal and area air samples were collected in the pug mill department, and workers were tested for blood Pb and urinary As concentrations. All four personal samples for As exceeded the OSHA standard of 10 micrograms per cubic meter, one sample exceeded the Cu dust standard of 1 milligram per cubic meter (mg/cu m), and one sample exceeded the Pb standard of 50 micrograms per cubic meter. Exposures to Cd fume, Cd dust, and SO2 were below the respective OSHA standard of 0.2mg/cu m, 1.0mg/cu m, and 5 parts per million. One worker had a urinary As concentration that exceeded 100 micrograms per liter, and two ...
The EMS Energy Institute at The Pennsylvania State University (Penn State) has managed the Gas Storage Technology Consortium (GSTC) since its inception in 2003. The GSTC infrastructure provided a means to accomplish industry-driven research and development designed to enhance the operational flexibility and deliverability of the nation's gas storage system, and provide a cost-effective, safe, and reliable supply of natural gas to meet domestic demand. The GSTC received base funding from the U.S. Department of Energy's (DOE) National Energy Technology Laboratory (NETL) Oil & Natural Gas Supply Program. The GSTC base funds were highly leveraged with industry funding for individual projects. Since its inception, the GSTC has engaged 67 members. The GSTC membership base was diverse, coming from 19 states, the District of Columbia, and Canada. The membership was comprised of natural gas storage field operators, service companies, industry ...
In the Netherlands, the interest in biomass for electricity generation has increased, mainly due to environmental reasons. Currently, the Dutch energy sector is investigating technologies which can reduce CO{sub 2} emissions. The growth of biomass and its subsequent utilization for energy purposes circulates recycled atmospheric carbon and has no net discharge of CO{sub 2}. To reduce emissions from coal-fired power plants biomass co-firing options are investigated. After exhaustion of internal supplies of wood wastes and other residues an extra amount of 1.02 Mt{sub 20} would be needed. Two supply options exist: the use of internal energy crops and the import of biomass. Because production of energy crops in the Netherlands is a rather expensive option, biomass procurement and production outside the Netherlands is studied. Two countries were investigated for the possible import of biomass: Estonia and Uruguay. Estonia has short-term opportunities for residue supply and long-term ...
The number of ERP (Enterprise Resource Planning) implementations within the oil industry has increased substantially in the past years. PETROBRAS has recently developed a business case, a 10 steps methodology developed by Symnetics-Benchmarking Partners (management consultancy), aimed at enhancing strategic and tangible ROI - Return on Investment of IT projects. The Business Case has not only provided alignment of PETROBRAS strategies with ERP capabilities, but also identified process gaps and opportunities for improvement as well as developing a high level implementation plan including timing, costs and potential benefits. Anticipated economic gains were mainly focused on the following business processes: materials management (30%), planning and controlling (25%), project management (24%) and order fulfillment (14%). PETROBRAS has chosen a phased approach for implementing the ERP. Two scenarios were considered: time, cost, risk and scope were the key issues ...
This project is sponsored by the United States Department of Energy (DOE) for the ``Engineering Design and Analysis of Advanced Physical Fine Coal Cleaning Technologies: The major goal is to provide the simulation tools for modeling both conventional and advanced coal cleaning technologies. This DOE project is part of a major research initiative by the Pittsburgh Energy Technology Center (PETC) aimed at advancing three advanced coal cleaning technologies-heavy-liquid cycloning, selective agglomeration, and advanced froth flotation through the proof-of-concept (POC) level. The commercially available ASPEN PLUS process simulation package will be extended to handle coal cleaning applications. Algorithms for predicting the process performance, equipment size, and flowsheet economics of commercial coal cleaning devices and related ancillary equipment will be incorporated into the coal cleaning simulator. This report is submitted to document the progress of Aspen Technology, Inc. ...
Objective: An evaluation of the application of DR in thoracic spine and a comparative study of the DR with the conventional radiography. Methods: DR images and the conventional radiogram of 89 cases respectively were evaluated by 3 vice-consultant doctors and 2 chief technicians. Statistics was processed with 2 categories: (1) images were classified into grade A, B, C and condemned according to the image quality; and (2) thoracic spine are divided into upper, middle and lower portions, in which the rate of successful imaging were compared respectively. Results: The image quality of DR: 74. 1% images in grade A, 20.2% in grade B, 5.7% in grade C, and no image condemned. Conventional radiogram: 45% images in grade A, 41.6% in grade B, 11.2% in grade C, and 2.2% images condemned. The successful imaging rate in each portion: DR films 87.6% in upper thoracic spine, 100% in middle portion, and 76.4% in lower portion with DR. While the rate was 15.3% in upper portion, ...
Fetal MRI can be performed in the second and third trimesters. During this time, the fetal brain undergoes profound structural changes. Interpretation of appropriate development might require comparison with normal age-based models. Consultation of a hard-copy atlas is limited by the inability to compare multiple ages simultaneously. To provide images of normal fetal brains from weeks 18 through 37 in a digital format that can be reviewed interactively. This will facilitate recognition of abnormal brain development. T2-W images for the atlas were obtained from fetal MR studies of normal brains scanned for other indications from 2005 to 2007. Images were oriented in standard axial, coronal and sagittal projections, with laterality established by situs. Gestational age was determined by last menstrual period, earliest US measurements and sonogram performed on the same day as the MR. The software program used for viewing the atlas, written in C, permits linked ...
The advantages offered by green roofs range from improvement in architectural and landscape aesthetics to reductions in building energy costs. Seattle Public Utilities (SPU) is encouraging sustainable community development through new policies and regulations that promote green roof installation on public and commercial rooftops in Seattle's urban center. An understanding of climate-specific green roof performance is required in order to develop an accurate representation of the stormwater benefits of green roofs. This paper explored the relative importance of green roofs in storm water management and low impact development (LID) in various areas of Seattle. It also examined the relative effectiveness and applicability of green roofs under various conditions and in various parts of the city compared to other LID strategies such as Seattle's natural drainage systems (NDS) designs, swales and ponds, rain gardens, rainwater harvesting, and porous pavements. SPU has ...
New furnaces were built based on fused silica with NiChrome heating elements custom-wound on alumina ceramic to self-compensate for induced magnetic fields during operation. During tests these furnaces failed due to thermal stresses caused by the high temperature cement used to hold the alumina ceramic in place. As a third solution pieces of boron nitride have been procured from which new furnace bodies will be machined during the third quarter. In order to increase the in-house capacity for machining ceramic parts a small lathe was ordered. The implementation of the LabView data acquisition software from National Instruments, Inc. took more time than anticipated and is still not completed. Major difficulties had to be overcome during the integration of the separate positive and negative high voltage supplies ({plus_minus}1000V). It became apparent that a custom-designed switch had to be installed to safeguard the data acquisition modules and the Apple Macintosh Quadra 700 computer ...
BACKGROUND: Denys-Drash Syndrome (DDS) is an uncommon disorder that appears sporadically and in rare cases may be inherited as an autosomal dominant trait It manifests either at birth or within the first year of life and typically consists of the triad of congenital nephropathy, Wilms tumour and intersex disorder. CASE REPORT: A 10 year-old Caucasian girl was referred to the Dental Department, at Glasgow Royal Hospital for Sick Children by her Paediatric Nephrologist Consultant. The patient was being teased by her peers over her markedly discoloured teeth. The dental history revealed that the patient was a regular dental attendee from an early age. She was dentally anxious having only experienced dental treatment under general anaesthesia (GA) when she was 4 years old. Apparently her primary dentition also showed a generalised discolouration. TREATMENT: This consisted of multiple visits for diet analysis and tooth brushing instruction with the use of disclosing ...
As part of its air quality monitoring activities, Alberta Environment conducts unannounced mobile air quality surveys each year using the Department's Mobile Air Monitoring Laboratory (MAML). This laboratory provides a snapshot of the air quality at the location monitored for a particular time and space. The MAML measures several pollutants in the air including ammonia, carbon monoxide, hydrocarbons, oxides of nitrogen, ozone, particulate matter, reduced sulphur compounds and sulphur dioxide. Alberta Environment conducted a series of ambient air quality monitoring surveys in the Lloydminster Area in 2002, 2003 and 2004. This report presents the results of the five monitored locations over eight seasons of monitoring, which were selected in consultation with stakeholders and staff from Alberta Environment's Central Region office. Canister samples were also collected during these surveys for later laboratory analyses of volatile organic compounds. ...
P.S. Lowell and Co., Inc. (Lowell and Co.) and Jay S. Dweck, Consultant, Inc. (JSD) under contract to the US Department of Energy (DOE) Morgantown Energy Technology Center (METC) have developed and implemented an aqueous electrolyte calculation capability into the ASPEN (Advanced System for Process Engineering) process simulator. This report documents the efforts of Task 1 which were to implement the basic calculational capability. Task 2 involves development of several unit operations models and demonstration of the models in simulating environmental control processes in coal gasification and shale oil processing plants. Task 1 of the project involved several subtasks: selection of a chemical equilibrium algorithm; selection of activity coefficient algorithms; selection of species for inclusion in the initial implementation; collection of required data for the selected species; regression of parameters not found in the data collection effort; and installation of ...
Aim.- To identify what determinants influence the prevalence and accuracy of nursing diagnosis documentation in clinical practice. Background.- Nursing diagnoses guide and direct nursing care. They are the foundation for goal setting and provide the basis for interventions. The literature mentions several factors that influences nurses- documentation of diagnoses, such as a nurse-s level of education, patient-s condition and the ward environment. Design.- Systematic review. Method.- MEDLINE and CINAHL databases were searched using the following headings and keywords: nursing diagnosis, nursing documentation, hospitals, influence, utilisation, quality, implementation and accuracy. The search was limited to articles published between 1995-October 2009. Studies were only selected if they were...
As the ground state potential curve is strongly related to spectral line shapes, the minumum position of the ground state potential is obtained from the experiemental absorption profile k({delta}{nu}, T) at high density of the radiating atoms. The temperature dependence of the absorption processes of Hg and Cd lines 253.65 and 326.1 nm, respectively perturbed by inert gases (Xe, Kr, Ar and Ne) had been carefully studied over a wide spectral range. Using the point of the maximum temperature dependence {delta}{nu} {sub m} in each case, we are able to calculate the position of the ground state potential R {sub m} using a simple formula.
This guide accompanies the following article: Gabrielle Poeschl, `What Family Organization Tells Us about Fairness and Power in Marital Relationships', Social and Personality Compass 1/1 (2007): 557-571, 10.1111/j.1751-9004.2007.00026.x Author's Introduction One thing that often strikes me, when I talk with people, is the human capacity to accept and defend surprising aspects of the social life. Thus, we have some feeling that the separation between the domestic and the public spheres has not always existed, but we are ready to assume that in the first human groups, men went out hunting to feed their family, while women stayed in the camp to take care of the children. Even in the face of evidence to the contrary, we are reluctant to question the opinion that men and women differ in persona...
The somatic and genetic radiation exposure of patients undergoing Digital Subtraction Angiography (DSA) and traditional Film Arteriography (FA) of cranial, cervical, thoracic and abdominal vascular territories are compared. The radiation doses absorbed within the critical organs - red bone marrow, lung, thyroid gland and female breast - and in the gonads were measured using an anthropomorphic Alderson phantom. A Somatic Dose Index was calculated in order to estimate the somatic radiation risk. The somatic radiation exposure depends upon the location of the critical organs with respect to the entrance site of the x-ray beam, and can be reduced by an appropriate choice of the angiographic projection. Under this condition, the radiation exposure of the patient during DSA can be lower than during FA. For renal DSA an a.p. projection, the use of an abdominal compression device and careful caudal shielding of the field are advocated. (orig.).
Women treated of localised stages of cervix cancer have a very good prognosis. But do health care professionals have a tendency to underestimate the potential need for rehabilitation of this group? To be able to answer this question this study aimed to develop knowledge concerning these women's own perception of their health during a long period after surgical cancer treatment. A total of 398 women who underwent radical hysterectomy in the period from the 1 January 1983 to 31 December 2000 participated in the study at Aarhus University Hospital, Skejby in Denmark 2001-2003. All patients initially filled in an internally validated questionnaire. Subsequently a sample of 100 women filled in the questionnaires Short Form -36 and Sense of Coherence to evaluate their self-reported health. Analy...
Background/Objectives: Cardiotoxic drug poisoning can lead to severe cardiac shock (CS) and death. B-type natriuretic peptide (BNP) is a well-established diagnostic and prognostic marker in heart failure but has never been assessed in patients with cardiotoxic drug poisoning. The aim of the study was to determine whether BNP could be useful for early stratification of patients admitted to intensive care unit. Methods: 30 consecutive patients experiencing shock and cardiotoxic drug exposure were enrolled in a prospective monocentric study and underwent at least two BNP measurements within the first 24 h after admission. Results: While BNP values on admission were poorly informative, subsequent BNP measurements (11 +- 6 h after admission) were significantly increased in patients with CS comp...
A prerequisite for a sensible estimate of moisture induced stresses in timber members is an accurate prediction of the members' moisture states during their service life. There are, however, an infinite number of possible moisture states for an arbitrary timber member in a natural varying climate. The naturally varying humidity is possible to describe as harmonic cycles, with different periods, superimposed. This work presents realizations of envelop curves over the possible moisture states in a timber member for some carefully chosen harmonic humidity variations. The calculations, on which the realizations were made, are based on a fully coupled transport model including a model for the influential sorption hysteresis of wood. A format containing required information suitable for assessin...
The recent literature in the field of supply chain management emphasizes the role of inter-organizational networks and the integration of vertical reproduction networks (supply chains) in particular as a key factor for value creation. However, the literature includes little empirical evidence. This situation suggests the need to appraise investments in such networks or supply chains carefully. How can a decision maker reliably assess the effect of investing in inter-organizational network arrangements on firm value? This article takes up this issue and suggests a framework consisting of five components to help answer the question. The task of the framework is to support the structuring and revelation of the causal chain between investments in the network on the one hand and the effect of t...
To discuss and share knowledge around advances in the care of patients with thrombotic disorders, the Third International Symposium of Thrombosis and Anticoagulation was held in S?o Paulo, Brazil, from October 14?16, 2010. This scientific program was developed by clinicians for clinicians, and was promoted by four major clinical research institutes: the Brazilian Clinical Research Institute, the Duke Clinical Research Institute of the Duke University School of Medicine, the Canadian VIGOUR Centre, and the Uppsala Clinical Research Center. Comprising 3?days of academic presentations and open discussion, the symposium had as its primary goal to educate, motivate, and inspire internists, cardiologists, hematologists, and other physicians by convening national and international visionaries, th...
The optimization of the safety characteristics of electrical installations in industrial plants with explosion or fire hazards can be obtained only through a careful interdisciplinary study and analysis carried out at the onset of the plant project design phase. The least complex and costly and safest solutions are those which are born from plant designs which take into account the typology of the industrial process or technology, or which incorporate pollution abatement measures and adequate safety measures for the electrical installations. This paper provides examples to illustrate how the global plant economy is fundamentally dependant upon a multi-disciplinary initial effort in design analyses. Comments are made relevant to the adequacy of the safety requirements established by existing and planned Italian norms in dealing with safety and fire protection for high-tech industrial plant electrical installations.
Among pharmaceuticals and personal care products released into the aquatic environment, antibiotics are of particular concern, because of their ubiquity and health effects. Although scientists have recently paid more attention to the threat of antibiotics to coastal ecosystems, researchers have often focused on relatively few antibiotics, because of the absence of suitable analytical methods. We have therefore developed a method for the rapid detection of 36 antibiotic residues in coastal waters, including tetracyclines (TCs), sulfanilamides (SAs), and quinolones (QLs). The method consists of solid-phase extraction (SPE) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis, using electrospray ionization (ESI) in positive mode. The SPE was performed with Oasis HLB and Oasi...
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