WorldWideScience

Sample records for care current capabilities

  1. Bubble Radiation Detection: Current and Future Capability

    Energy Technology Data Exchange (ETDEWEB)

    AJ Peurrung; RA Craig

    1999-11-15

    Despite a number of noteworthy achievements in other fields, superheated droplet detectors (SDDs) and bubble chambers (BCs) have not been used for nuclear nonproliferation and arms control. This report examines these two radiation-detection technologies in detail and answers the question of how they can be or should be ''adapted'' for use in national security applications. These technologies involve closely related approaches to radiation detection in which an energetic charged particle deposits sufficient energy to initiate the process of bubble nucleation in a superheated fluid. These detectors offer complete gamma-ray insensitivity when used to detect neutrons. They also provide controllable neutron-energy thresholds and excellent position resolution. SDDs are extraordinarily simple and inexpensive. BCs offer the promise of very high efficiency ({approximately}75%). A notable drawback for both technologies is temperature sensitivity. As a result of this problem, the temperature must be controlled whenever high accuracy is required, or harsh environmental conditions are encountered. The primary findings of this work are listed and briefly summarized below: (1) SDDs are ready to function as electronics-free neutron detectors on demand for arms-control applications. The elimination of electronics at the weapon's location greatly eases the negotiability of radiation-detection technologies in general. (2) As a result of their high efficiency and sharp energy threshold, current BCs are almost ready for use in the development of a next-generation active assay system. Development of an instrument based on appropriately safe materials is warranted. (3) Both kinds of bubble detectors are ready for use whenever very high gamma-ray fields must be confronted. Spent fuel MPC and A is a good example where this need presents itself. (4) Both kinds of bubble detectors have the potential to function as low-cost replacements for conventional neutron

  2. Capability to care and work: when dual roles intersect

    Directory of Open Access Journals (Sweden)

    Barbara Horrell

    2014-07-01

    Full Text Available Ageing in place is a cost-effective policy solution to eldercare that reflects a dominant positive ageing discourse of choice and independence. It satisfies older people's preference to remain at home and be involved in their community, but depends upon the provision of care and support for frail elders, particularly the oldest-old, who require assistance to achieve these goals. The traditional provision of unpaid eldercare by female relatives is changing as women are increasingly working outside the home, and they have to choose between, or manage, dual roles of caregiving and paid work. Negative effects on health, paid employment, and finances are associated with the intersection of eldercare and employment. Solutions involve reducing or relinquishing paid employment, which would have financial, social, physical, and emotional ramifications in the future. However, being able to successfully accommodate both roles provides a sense of satisfaction and fulfilment. To understand the complexity of managing the tension between work and eldercare requires a detailed analysis of unpaid caregivers’ daily lives. This paper presents findings about eldercare provision and paid work, derived from two qualitative studies that used a participatory methodology for an in-depth exploration of caregivers’ health. The participants’ stories demonstrate that rather than reflecting on access to a range of options, caregivers’ choices are constrained, and involve trading work and other capabilities for the capability to care. Providing care for a loved elder was the first priority, followed by paid work. Having the capability to maintain a healthy and balanced life was the caregivers’ lowest priority. Unpaid informal care has benefits for elders, and it is a valued emotional relationship for caregivers; however, future social policy should address the difficulties that caregiving creates in people's lives along with focusing on the benefits that such care

  3. Optimization of the EC Heating and Current Drive Capabilities

    International Nuclear Information System (INIS)

    Full text: A 24 MW CW Electron Cyclotron Heating and Current Drive (EC H&CD) system operating at 170 GHz is to be installed for the ITER tokamak. The ITER EC system will represent a large step forward in the use of microwave systems for plasma heating and current drive applications. Present day systems are operating in relatively short pulses (≤ 10 s) and installed power levels of ≤ 4.5 MW, while the ITER EC system parameters are CW operation and 20 MW injected power. The technical challenge facing the development and installation of the EC system is further complicated due to the harsh ITER in-vessel environment and complicated procurement strategy. The ITER EC international community has confronted these challenges, aiming at integrating the modifications proposed from the 2007 ITER design review and further enhancing the EC system capabilities. These changes have not only simplified the technical design, but have also simplified the procurement interfaces and increased the functional capabilities for plasma heating and current drive applications. The functional improvements include increasing the access of the EC power from ∼ 50% to nearly ∼ 90% of the plasma cross section. In particular the UL has been modified to allow power deposition over the range of ∼ 0.3 ≤ ρΤ ≤ 0.9 compared to previous access of ∼ 0.55 ≤ ρΤ ≤ 0.85 (where ρΤ is the square root of the normalized toroidal flux). This allows the UL to be applicable for a broader access for stabilization of neoclassical tearing modes (NTMs) and sawtooth instability. The EC heating is functionally limited in magnetic field region depending on the resonant harmonic. The heating access in ITER was assumed to be applicable over ∼ 33% of the range from 2.3 T to 5.3 T, regions of fundamental and second harmonics. Recent analysis associated with the EL has demonstrated that the EC system is applicable over a much broader range: ∼ 75% for central heating (ρΤ ≤ 0.5) and ∼ 90% for L

  4. Current status and scientific capabilities of the Rosetta lander payload

    Science.gov (United States)

    Biele, J.; Ulamec, S.; Feuerbacher, B.; Rosenbauer, H.; Mugnuolo, R.; Moura, D.; Bibring, J. P.

    ESA's cornerstone mission "ROSETTA" to comet 46P/Wirtanen will bring a 100 kg Lander (provided by an international European consortium) with a scientific payload of about 27 kg to the surface of the comet's nucleus. After a first scientific sequence it will operate for a considerable fraction of the cometary orbit around the sun (between 3 AU and 2 AU). The Lander is an autonomous spacecraft, powered with solar cells and using the ROSETTA Orbiter as a telemetry relais to Earth. The main scientific objectives are the in-situ investigation of the chemical, elemental, isotopic and mineralogical composition of the comet, study of the physical properties of the surface material, analyze the internal structure of the nucleus, observe temporal variations (day/night cycle, approach to sun), study the relationship between the comet and the interplanetary matter and provide ground reference data for Orbiter instruments. Ten experiments with a number of sub-experiments are foreseen to fulfil these objectives. In this paper we present the current status of the instrumental development and the scientific capabilities of each of the experiments.

  5. The ESA River & Lake System: Current Capabilities and Future Potential

    DEFF Research Database (Denmark)

    Smith, Richard G.; Salloway, Mark; Berry, Philippa A. M.;

    Measuring the earth's river and lake resources using satellite radar altimetry offers a unique global monitoring capability, which complements the detailed measurements made by the steadily decreasing number of in-situ gauges. To exploit this unique remote monitoring capability, a global pilot...... scheme was implemented in 2005 to derive river and lake surface height measurements from multi-mission satellite radar altimetry. Near-Real-Time (NRT) products from the Jason-2 satellite altimeter are automatically generated based on data acquired daily from CNES; allowing for estimates of river and lake...

  6. Current Capabilities and Development Potential in Surgical Robotics

    OpenAIRE

    Mathias Hoeckelmann; Imre J. Rudas; Paolo Fiorini; Frank Kirchner; Tamas Haidegger

    2015-01-01

    Commercial surgical robots have been in clinical use since the mid-1990s, supporting surgeons in various tasks. In the past decades, many systems emerged as research platforms, and a few entered the global market. This paper summarizes the currently available surgical systems and research directions in the broader field of surgical robotics. The widely deployed teleoperated manipulators aim to enhance human cognitive and physical skills and provide smart tools for surgeons, while image-guided...

  7. Single-phase Multilevel Current Source Inverter with Reduced Device Count and Current Balancing Capability

    Directory of Open Access Journals (Sweden)

    MOALLEMI KHIAVI, A.

    2015-08-01

    Full Text Available Nowadays power converters play an important role in power system and industrial centers. One of the most important and widely used types of conversion is DC to AC conversion that is also called inverters. Generally inverters are divided to voltage source inverter (VSI and current source inverter (CSI. From another view the inverters are divided to two-level and multilevel types. The multilevel inverters are attractive because of their good output waveform quality. However, there has been less attention to multilevel current source inverter (MLCSI when compared with multilevel VSI. In this paper, a new topology for MLCSI is proposed. The proposed topology employs reduced number of switches to generate desired multilevel output current. The proposed MLCSI is capable of balancing the currents of the inductors that are used in the MLCSI structure. A multicarrier PWM based switching strategy is also proposed for the MLCSI. The simulation results using PSCAD/EMTDC as well as the experimental results from a single-phase 5-level CSI laboratory prototype demonstrate its validity.

  8. Computational fluid dynamics - Current capabilities and directions for the future

    Science.gov (United States)

    Kutler, Paul

    1989-01-01

    Computational fluid dynamics (CFD) has made great strides in the detailed simulation of complex fluid flows, including some of those not before understood. It is now being routinely applied to some rather complicated problems and starting to affect the design cycle of aerospace flight vehicles and their components. It is being used to complement, and is being complemented by, experimental studies. Several examples are presented in the paper to illustrate the current state of the art. Included is a discussion of the barriers to accomplishing the basic objective of numerical simulation. In addition, the directions for the future in the discipline of computational fluid dynamics are addressed.

  9. Current Capabilities and Development Potential in Surgical Robotics

    Directory of Open Access Journals (Sweden)

    Mathias Hoeckelmann

    2015-05-01

    Full Text Available Commercial surgical robots have been in clinical use since the mid-1990s, supporting surgeons in various tasks. In the past decades, many systems emerged as research platforms, and a few entered the global market. This paper summarizes the currently available surgical systems and research directions in the broader field of surgical robotics. The widely deployed teleoperated manipulators aim to enhance human cognitive and physical skills and provide smart tools for surgeons, while image-guided robotics focus on surpassing human limitations by introducing automated targeting and treatment delivery methods. Both concepts are discussed based on prototypes and commercial systems. Through concrete examples the possible future development paths of surgical robots are illustrated. While research efforts are taking different approaches to improve the capacity of such systems, the aim of this survey is to assess their maturity from the commercialization point of view.

  10. Adaptive optics at the Subaru telescope: current capabilities and development

    Science.gov (United States)

    Guyon, Olivier; Hayano, Yutaka; Tamura, Motohide; Kudo, Tomoyuki; Oya, Shin; Minowa, Yosuke; Lai, Olivier; Jovanovic, Nemanja; Takato, Naruhisa; Kasdin, Jeremy; Groff, Tyler; Hayashi, Masahiko; Arimoto, Nobuo; Takami, Hideki; Bradley, Colin; Sugai, Hajime; Perrin, Guy; Tuthill, Peter; Mazin, Ben

    2014-08-01

    Current AO observations rely heavily on the AO188 instrument, a 188-elements system that can operate in natural or laser guide star (LGS) mode, and delivers diffraction-limited images in near-IR. In its LGS mode, laser light is transported from the solid state laser to the launch telescope by a single mode fiber. AO188 can feed several instruments: the infrared camera and spectrograph (IRCS), a high contrast imaging instrument (HiCIAO) or an optical integral field spectrograph (Kyoto-3DII). Adaptive optics development in support of exoplanet observations has been and continues to be very active. The Subaru Coronagraphic Extreme-AO (SCExAO) system, which combines extreme-AO correction with advanced coronagraphy, is in the commissioning phase, and will greatly increase Subaru Telescope's ability to image and study exoplanets. SCExAO currently feeds light to HiCIAO, and will soon be combined with the CHARIS integral field spectrograph and the fast frame MKIDs exoplanet camera, which have both been specifically designed for high contrast imaging. SCExAO also feeds two visible-light single pupil interferometers: VAMPIRES and FIRST. In parallel to these direct imaging activities, a near-IR high precision spectrograph (IRD) is under development for observing exoplanets with the radial velocity technique. Wide-field adaptive optics techniques are also being pursued. The RAVEN multi-object adaptive optics instrument was installed on Subaru telescope in early 2014. Subaru Telescope is also planning wide field imaging with ground-layer AO with the ULTIMATE-Subaru project.

  11. Analysis of current driving capability of pentacene TFTs for OLEDs

    Science.gov (United States)

    Ryu, Gi Seong; Byun, Hyun Sook; Xu, Yong Xian; Pyo, Kyung Soo; Choe, Ki Beom; Song, Chung Kun

    2005-01-01

    The flexible display and the application of Roll-To-Roll process is difficult because high temperature process of a-Si;H TFT and poly-Si TFT limited the use of plastic substrate. We proposed AMOLED using Pentacene TFT (OTFT) to fabricate flexible display. The first stage for OTFT application to OLED, we analyzed OTFT as driving device of OLED. The process performed on glass and plastic (PET) substrate that is coated ITO and PVP is used for gate insulator. The field effect mobility of the fabricated OTFT is 0.1~0.3cm2/V"sec and Ion/Ioff current ratio is 103~105. OLED is fabricated with two stories structure of TPD and Alq3, and we can observe the light at 5V by the naked eye. The wavelength of observed lights is 530nm ~550nm. We can confirm the driving of OLED due to OTFT using Test panel and observe OLED control by gate voltage of OTFT. Also, we verify designed structure and process, and make a demonstration fabricating 64 by 64 backplane based on Test panel.

  12. Air Quality Study Using Satellites - Current Capability and Future Plans

    Science.gov (United States)

    Bhartia, Pawan K.; Joiner, Joanna; Gleason, James; Liu, Xiong; Torres, Omar; Krotkov, Nickolay; Ziemke, Jerry; Chandra, Sushil

    2008-01-01

    Satellite instruments have had great success in monitoring the stratospheric ozone and in understanding the processes that control its daily to decadal scale variations. This field is now reaching its zenith with a number of satellite instruments from the US, Europe and Canada capping several decades of active research in this field. The primary public policy imperative of this research was to make reliable prediction of increases in biologically active surface UV radiation due to human activity. By contrast retrieval from satellite data of atmospheric constituents and photo-chemically active radiation that affect air quality is a new and growing field that is presenting us with unique challenges in measurement and data interpretation. A key distinction compared to stratospheric sensors is the greatly enhanced role of clouds, aerosols, and surfaces (CAS) in determining the quality and quantity of useful data that is available for air quality research. In our presentation we will use data from several sensors that are currently flying on the A-train satellite constellation, including OMI, MODIS, CLOUDSAT, and CALIPSO, to highlight that CAS can have both positive and negative effects on the information content of satellite measurements. This is in sharp contrast to other fields of remote sensing where CAS are usually considered an interference except in those cases when they are the primary subject of study. Our analysis has revealed that in the reflected wavelengths one often sees much further down into the atmosphere, through most cirrus, than one does in the emitted wavelengths. The lower level clouds provide a nice background against which one can track long-range transport of trace gases and aerosols. In addition, differences in trace gas columns estimated over cloudy and adjacent clear pixels can be used to measure boundary layer trace gases. However, in order to take full advantage of these features it will be necessary to greatly advance our understanding of

  13. Dark Current and Multipacting Capabilities in OPAL: Model Benchmarks and Applications

    CERN Document Server

    Wang, C; Yin, Z G; Zhang, T J

    2012-01-01

    Dark current and multiple electron impacts (multipacting), as for example observed in radio frequency (RF) structures of accelerators, are usually harmful to the equipment and the beam quality. These effects need to be suppressed to guarantee efficient and stable operation. Large scale simulations can be used to understand causes and develop strategies to suppress these phenomenas. We extend \\opal, a parallel framework for charged particle optics in accelerator structures and beam lines, with the necessary physics models to efficiently and precisely simulate multipacting phenomenas. We added a Fowler-Nordheim field emission model, two secondary electron emission models, developed by Furman-Pivi and Vaughan respectively, as well as efficient 3D boundary geometry handling capabilities. The models and their implementation are carefully benchmark against a non-stationary multipacting theory for the classic parallel plate geometry. A dedicated, parallel plate experiment is sketched.

  14. Organizational Context and Capabilities for Integrating Care: A Framework for Improvement

    Directory of Open Access Journals (Sweden)

    Jenna M. Evans

    2016-08-01

    Full Text Available Background: Interventions aimed at integrating care have become widespread in healthcare; however, there is significant variability in their success. Differences in organizational contexts and associated capabilities may be responsible for some of this variability. Purpose: This study develops and validates a conceptual framework of organizational capabilities for integrating care, identifies which of these capabilities may be most important, and explores the mechanisms by which they influence integrated care efforts.  Methods: The Context and Capabilities for Integrating Care (CCIC Framework was developed through a literature review, and revised and validated through interviews with leaders and care providers engaged in integrated care networks in Ontario, Canada. Interviews involved open-ended questions and graphic elicitation. Quantitative content analysis was used to summarize the data.  Results: The CCIC Framework consists of eighteen organizational factors in three categories: Basic Structures, People and Values, and Key Processes. The three most important capabilities shaping the capacity of organizations to implement integrated care interventions include Leadership Approach, Clinician Engagement and Leadership, and Readiness for Change. The majority of hypothesized relationships among organizational capabilities involved Readiness for Change and Partnering, emphasizing the complexity, interrelatedness and importance of these two factors to integrated care efforts.  Conclusions: Organizational leaders can use the framework to determine readiness to integrate care, develop targeted change management strategies, and select appropriate partners with overlapping or complementary profiles on key capabilities. Researchers may use the results to test and refine the proposed framework, with a focus on the hypothesized relationships among organizational capabilities and between organizational capabilities and performance outcomes.

  15. Telemedicine deployments within NATO military forces: a data analysis of current and projected capabilities.

    Science.gov (United States)

    Lam, David M; Poropatich, Ronald K

    2008-11-01

    Since the creation of the NATO Telemedicine Expert Panel (now renamed the TMED Expert Team) in 2000, when few nations had deployed telemedicine systems to support military field operations, this group has been encouraging the nations to deploy telemedicine (TMED) in support of their forces, and to write the use of TMED into NATO doctrine. This has been a relatively successful effort, and TMED is increasingly being used within the military medical structures of some NATO and Partnership for Peace nations to provide medical care to deployed military personnel. We report the results of a multinational survey of current and projected availability of various telemedicine modalities within the NATO medical services that are participating in the work of the TMED expert team (ET). Though only a "snapshot in time," and not representing all NATO nations, this is the first attempt to identify both current and planned TMED utilization within the multinational military medical community. Participating nations report that communication systems now in place at the lowest levels of medical support increasingly enable the routine use of Web-based teleconsultation modalities. Teleradiology is now being seen as the de facto standard for imaging support. While a number of nations report they have deployed capabilities for obtaining clinical consultations at a distance, most responding nations do not have a formal organizational structure to control and manage remote consultation and rely on informal clinical relationships (e.g., requesting consults from the deployed clinician's home hospital or from friends). Military electronic health records are in use by only a minority of nations and fewer still are capable of civilian interface. Less common TMED capabilities (e.g., tele-microbiology, tele-pathology, tele-medical maintenance) are being increasingly used, but are still rarely deployed. As a result of the findings of this survey, specific recommendations for expanding the use of

  16. The health capability paradigm and the right to health care in the United States.

    Science.gov (United States)

    Ruger, Jennifer Prah

    2016-08-01

    Against a backdrop of non-ideal political and legal conditions, this article examines the health capability paradigm and how its principles can help determine what aspects of health care might legitimately constitute positive health care rights-and if indeed human rights are even the best approach to equitable health care provision. This article addresses the long American preoccupation with negative rights rather than positive rights in health care. Positive health care rights are an exception to the overall moral range and general thrust of U.S. legal doctrine. Some positive rights to health care have arisen from U.S. Constitutional Eighth Amendment cases and federal and state laws like Medicare, Medicaid, the State Children's Health Insurance Program, the Emergency Medical Treatment and Active Labor Act, and the Patient Protection and Affordable Care Act. Finally, this article discusses some of the difficulties inherent in implementing a positive right to health care in the U.S. PMID:27543139

  17. Sharing the Caring: Rethinking Current Policies.

    Science.gov (United States)

    Edgar, Don

    1992-01-01

    This article presents an argument for reforming Australian public policy in favor of social care, rather than family, residential, or community care, for the elderly, sick, and disabled. After noting policy assumptions that families are the focus of caring and women are the natural caregivers, the paper describes changes in Australian family…

  18. Health care retail clinics: current perspectives

    OpenAIRE

    Kaissi, Amer

    2016-01-01

    Amer Kaissi Department of Health Care Administration, Trinity University, San Antonio, TX, USA Abstract: Retail clinics represent a major innovation with a radical value proposition in American health care: convenient locations and hours, walk-in care, short waiting times, and transparent pricing. Many organizations, groups, associations, and individual providers affect and are affected by retail clinics. The main winners from the retail clinic trend are insurance companies and third-party p...

  19. Assessing organizational readiness for depression care quality improvement: relative commitment and implementation capability

    OpenAIRE

    Rubenstein, Lisa V; Danz, Marjorie S; Crain, A. Lauren; Glasgow, Russell E.; Whitebird, Robin R.; Solberg, Leif I.

    2014-01-01

    Background Depression is a major cause of morbidity and cost in primary care patient populations. Successful depression improvement models, however, are complex. Based on organizational readiness theory, a practice’s commitment to change and its capability to carry out the change are both important predictors of initiating improvement. We empirically explored the links between relative commitment (i.e., the intention to move forward within the following year) and implementation capability. Me...

  20. Current physiotherapy approaches in intensive care units

    OpenAIRE

    Yurdalan, S. Ufuk

    2011-01-01

    Physiotherapy is a part of the multidisciplinary treatment in different intensive care units. Respiratory, cardiovascular and neuromusculoskeletal- focused physiotherapy programmes and prevention of the respiratory, neuromuscular complications which may be possible, developing the exercise capacity related to inspiratory muscle function in critically patients internalized and postoperative cases in intensive care unit are clinical targets. It is known that physiotherapy initiated early is rel...

  1. IT capabilities within the Dutch SME first line health care sector

    OpenAIRE

    Maris, Arjen; Ravesteijn, Pascal; Versendaal, Johan; Smit, Kobus

    2015-01-01

    The complexity of Information Technology (IT) is increasing; so are customer expectations. Consequently it is not easy for especially small and medium enterprises (SMEs) to keep track of all IT-developments, let alone leverage them in business operations with the aim to satisfy increasingly demanding customers. This also holds for the health care sector. This research is focussed on first line health care, and deals with the following research question; ‘which IT capabilities do SMEs within t...

  2. Care pathways for dementia: current perspectives

    Directory of Open Access Journals (Sweden)

    Samsi K

    2014-11-01

    Full Text Available Kritika Samsi, Jill ManthorpeSocial Care Workforce Research Unit, King’s College London, London, UKAbstract: Uncertainty appears to typify the experience of living with dementia. With an uncertain illness trajectory and unpredictable levels of deterioration and stability in symptoms, people with a diagnosis of dementia may live with uncertainty and anxiety and find it hard to make plans or decisions for their future. People with memory problems and caregivers seeking a diagnosis of dementia may also potentially find themselves navigating a labyrinth-like maze of services, practitioners, assessments, and memory tests, with limited understanding of test scores and little information about what support is available. In this context of uncertainty, the apparent clarity and certainty of a “dementia care pathway” may be attractive. However, the term “dementia care pathway” has multiple and overlapping meanings, which can potentially give rise to further confusion if these are ill-defined or a false consensus is presumed. This review distinguishes four meanings: 1 a mechanism for the management and containment of uncertainty and confusion, useful for the professional as well as the person with dementia; 2 a manual for sequencing care activities; 3 a guide to consumers, indicating eligibility for care activities, or a guide to self-management for dementia dyads, indicating the appropriateness of care activities; and 4 a manual for “walking with” the person. Examples of these approaches are presented from UK dementia services with illustrations of existing care pathways and associated time points, specifically focusing on: 1 early symptom identification and first service encounters, 2 assessment process, 3 diagnostic disclosure, 4 postdiagnostic support, and 5 appropriate interventions. We review the evidence around these themes, as well as discuss service pathways and referral routes used by some services in England and internationally. We

  3. Five-Level Current-Source Inverters With Buck–Boost and Inductive-Current Balancing Capabilities

    DEFF Research Database (Denmark)

    Gao, Feng; Loh, Poh Chiang; Blaabjerg, Frede;

    2010-01-01

    This paper presents new five-level current-source inverters (CSIs) with voltage/current buck–boost capability, unlike existing five-level CSIs where only voltage–boost operation is supported. The proposed inverters attain self-inductive-currentbalancing per switching cycle at their dc front ends...... without having to include additional balancing hardware or complex control manipulation. The inverters can conveniently be controlled by using the well-established phase-shifted carrier modulation scheme with only two additional linear references and a mapping logic table needed. Existing modulators can...

  4. Dignity and the capabilities approach in long-term care for older people.

    Science.gov (United States)

    Pirhonen, Jari

    2015-01-01

    The ageing populations of the Western world present a wide range of economic, social, and cultural implications, and given the challenges posed by deteriorating maintenance ratios, the scenario is somewhat worrying. In this paper, I investigate whether Martha C. Nussbaum's capabilities approach could secure dignity for older people in long-term care, despite the per capita decreases in resources. My key research question asks, 'What implications does Nussbaum's list of central human capabilities have for practical social care?' My methodology combines Nussbaum's list with ethnographic data gathered from a Finnish sheltered home for older people. On the basis of this study, it seems that the capabilities approach is a plausible framework for the ethics of care because it highlights differences in the ability to function and thus differences in opportunities to pursue a good life. The ideas presented in this article could assist social policy planners and executives in creating policies and practices that help old people to maintain their dignity until the end of their days.

  5. Access To Medical Health Care And its Current Health Care Policy: Malaysia

    OpenAIRE

    Chong, Chyi Ming

    2005-01-01

    The indications of Malaysia government to remove its subsidize policy in its health care system and privatizing certain hospitals and health care services has inflicted numerous heated debates and discussions among individuals and Non-Governmental Organizations (NGO). The author wishes to contribute some insightful information to the public through her research about Malaysia citizen’s access to medical health care inline with its current health care system and policy. Health care systems of ...

  6. Current wound healing procedures and potential care.

    Science.gov (United States)

    Dreifke, Michael B; Jayasuriya, Amil A; Jayasuriya, Ambalangodage C

    2015-03-01

    In this review, we describe current and future potential wound healing treatments for acute and chronic wounds. The current wound healing approaches are based on autografts, allografts, and cultured epithelial autografts, and wound dressings based on biocompatible and biodegradable polymers. The Food and Drug Administration approved wound healing dressings based on several polymers including collagen, silicon, chitosan, and hyaluronic acid. The new potential therapeutic intervention for wound healing includes sustained delivery of growth factors, and siRNA delivery, targeting microRNA, and stem cell therapy. In addition, environment sensors can also potentially utilize to monitor and manage microenvironment at wound site. Sensors use optical, odor, pH, and hydration sensors to detect such characteristics as uric acid level, pH, protease level, and infection - all in the hopes of early detection of complications.

  7. Capabilities of the ITER Electron Cyclotron Equatorial Launcher for Heating and Current Drive

    Directory of Open Access Journals (Sweden)

    Ramponi G.

    2012-09-01

    Full Text Available The ITER Electron Cyclotron Equatorial Launcher is designed to be one of the heating systems to assist and sustain the development of various ITER plasma scenarios starting with the very first plasma operation. Here the capabilities for Heating and Current Drive of this system are reviewed. In particular, the optimum launching conditions are investigated for two scenarios at burn, comparing toroidal and poloidal steering options. Then, the EC capabilities are investigated for different plasma parameters corresponding to various phases of the ITER plasma discharge, from current ramp-up up to burn, and for a wide range of magnetic field, focusing in particular on the EC potential for heating and for L to H-mode assist. It is found that the EC system can contribute to a wide range of heating scenarios during the ramp-up of the magnetic field, significantly increasing the applicable range as a function of magnetic field.

  8. On the Current Drive Capability of Low Dimensional Semiconductors: 1D versus 2D.

    Science.gov (United States)

    Zhu, Y; Appenzeller, J

    2015-12-01

    Low-dimensional electronic systems are at the heart of many scaling approaches currently pursuit for electronic applications. Here, we present a comparative study between an array of one-dimensional (1D) channels and its two-dimensional (2D) counterpart in terms of current drive capability. Our findings from analytical expressions derived in this article reveal that under certain conditions an array of 1D channels can outperform a 2D field-effect transistor because of the added degree of freedom to adjust the threshold voltage in an array of 1D devices.

  9. Influence of the helicopter environment on patient care capabilities: flight crew perceptions

    Science.gov (United States)

    Myers, K. J.; Rodenberg, H.; Woodard, D.

    1995-01-01

    INTRODUCTION: Flight crew perceptions of the effect of the rotary-wing environment on patient-care capabilities have not been subject to statistical analysis. We hypothesized that flight crew members perceived significant difficulties in performing patient-care tasks during air medical transport. METHODS: A survey was distributed to a convenience sample of flight crew members from 20 flight programs. Respondents were asked to compare the difficulty of performing patient-care tasks in rotary-wing and standard (emergency department or intensive care unit) settings. Demographic data collected on respondents included years of flight experience, flights per month, crew duty position and primary aircraft in which the respondent worked. Statistical analysis was performed as appropriate using Student's t-test, type III sum of squares, and analysis of variance. Alpha was defined as p responded. All tasks were significantly rated more difficult in the rotary-wing environment. Ratings were not significantly correlated with flight experience, duty position, flights per month or aircraft used. CONCLUSIONS: We conclude that the performance of patient-care tasks are perceived by air medical flight crew to be significantly more difficult during rotary-wing air medical transport than in hospital settings.

  10. Current status of neonatal intensive care in India.

    Science.gov (United States)

    Karthik Nagesh, N; Razak, Abdul

    2016-05-01

    Globally, newborn health is now considered as high-level national priority. The current neonatal and infant mortality rate in India is 29 per 1000 live births and 42 per 1000 live births, respectively. The last decade has seen a tremendous growth of neonatal intensive care in India. The proliferation of neonatal intensive care units, as also the infusion of newer technologies with availability of well-trained medical and nursing manpower, has led to good survival and intact outcomes. There is good care available for neonates whose parents can afford the high-end healthcare, but unfortunately, there is a deep divide and the poor rural population is still underserved with lack of even basic newborn care in few areas! There is increasing disparity where the 'well to do' and the 'increasingly affordable middle class' is able to get the most advanced care for their sick neonates. The underserved urban poor and those in rural areas still contribute to the overall high neonatal morbidity and mortality in India. The recent government initiative, the India Newborn Action Plan, is the step in the right direction to bridge this gap. A strong public-private partnership and prioritisation is needed to achieve this goal. This review highlights the current situation of neonatal intensive care in India with a suggested plan for the way forward to achieve better neonatal care.

  11. Spinal pain: current understanding, trends, and the future of care

    Directory of Open Access Journals (Sweden)

    Parkin-Smith GF

    2015-10-01

    Full Text Available Gregory F Parkin-Smith,1 Lyndon G Amorin-Woods,2–4 Stephanie J Davies,5–7 Barrett E Losco,8 Jon Adams9,10 1General Practice, Surgery 82, Busselton, WA, Australia; 2School of Health Professions, Murdoch University, Murdoch, WA, Australia; 3Chiropractors’ Association of Australia, Nedlands, WA, Australia; 4ACORN Project, 5WA Specialist Pain Services, WA, Australia; 6School of Physiotherapy, Curtin University, Bentley, WA, Australia; 7School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia; 8Murdoch University, Murdoch, WA, Australia; 9Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia; 10Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW, Australia Abstract: This commissioned review paper offers a summary of our current understanding of nonmalignant spinal pain, particularly persistent pain. Spinal pain can be a complex problem, requiring management that addresses both the physical and psychosocial components of the pain experience. We propose a model of care that includes the necessary components of care services that would address the multidimensional nature of spinal pain. Emerging care services that tailor care to the individual person with pain seems to achieve better outcomes and greater consumer satisfaction with care, while most likely containing costs. However, we recommend that any model of care and care framework should be developed on the basis of a multidisciplinary approach to care, with the scaffold being the principles of evidence-based practice. Importantly, we propose that any care services recommended in new models or frameworks be matched with available resources and services – this matching we promote as the fourth principle of evidence-based practice. Ongoing research will be necessary to offer insight into clinical outcomes of complex interventions, while practice-based research would uncover

  12. Quantifying the Global Fresh Water Budget: Capabilities from Current and Future Satellite Sensors

    Science.gov (United States)

    Hildebrand, Peter; Zaitchik, Benjamin

    2007-01-01

    The global water cycle is complex and its components are difficult to measure, particularly at the global scales and with the precision needed for assessing climate impacts. Recent advances in satellite observational capabilities, however, are greatly improving our knowledge of the key terms in the fresh water flux budget. Many components of the of the global water budget, e.g. precipitation, atmospheric moisture profiles, soil moisture, snow cover, sea ice are now routinely measured globally using instruments on satellites such as TRMM, AQUA, TERRA, GRACE, and ICESat, as well as on operational satellites. New techniques, many using data assimilation approaches, are providing pathways toward measuring snow water equivalent, evapotranspiration, ground water, ice mass, as well as improving the measurement quality for other components of the global water budget. This paper evaluates these current and developing satellite capabilities to observe the global fresh water budget, then looks forward to evaluate the potential for improvements that may result from future space missions as detailed by the US Decadal Survey, and operational plans. Based on these analyses, and on the goal of improved knowledge of the global fresh water budget under the effects of climate change, we suggest some priorities for the future, based on new approaches that may provide the improved measurements and the analyses needed to understand and observe the potential speed-up of the global water cycle under the effects of climate change.

  13. Space Weather - Current Capabilities, Future Requirements, and the Path to Improved Forecasting

    Science.gov (United States)

    Mann, Ian

    2016-07-01

    We present an overview of Space Weather activities and future opportunities including assessments of current status and capabilities, knowledge gaps, and future directions in relation to both observations and modeling. The review includes input from the scientific community including from SCOSTEP scientific discipline representatives (SDRs), COSPAR Main Scientific Organizers (MSOs), and SCOSTEP/VarSITI leaders. The presentation also draws on results from the recent activities related to the production of the COSPAR-ILWS Space Weather Roadmap "Understanding Space Weather to Shield Society" [Schrijver et al., Advances in Space Research 55, 2745 (2015) http://dx.doi.org/10.1016/j.asr.2015.03.023], from the activities related to the United Nations (UN) Committee on the Peaceful Uses of Outer Space (COPUOS) actions in relation to the Long-term Sustainability of Outer Space (LTS), and most recently from the newly formed and ongoing efforts of the UN COPUOS Expert Group on Space Weather.

  14. [Update on current care guidelines: Self-medication, Current Care Guideline].

    Science.gov (United States)

    2016-01-01

    Self-medication should always be temporary. Self-medication can be used to relief or treat many symptoms and conditions. In general self-medication is safe when used properly. However all medicines may cause adverse events or have interactions with other drugs. It is important to consider all used drugs and other self-medication products when new drugs are added to the medication list. Persons using the drugs as well as health care personnel should be aware of benefits and harms of drugs.The guideline has recommendations for 10 symptoms that are typically treated with self-medication.

  15. [Physiotherapeutic care marketing research: current state-of-the art].

    Science.gov (United States)

    Babaskin, D V

    2011-01-01

    Successful introduction of modern technologies into the national health care systems strongly depends on the current pharmaceutical market situation. The present article is focused on the peculiarities of marketing research with special reference to physiotherapeutic services and commodities. Analysis of the structure and sequence of marketing research processes is described along with the methods applied for the purpose including their support by the use of Internet resources and technologies. PMID:21574299

  16. Arctic Observing Network Data Management: Current Capabilities and Their Promise for the Future

    Science.gov (United States)

    Collins, J.; Fetterer, F.; Moore, J. A.

    2008-12-01

    CADIS (the Cooperative Arctic Data and Information Service) serves as the data management, discovery and delivery component of the Arctic Observing Network (AON). As an International Polar Year (IPY) initiative, AON comprises 34 land, atmosphere and ocean observation sites, and will acquire much of the data coming from the interagency Study of Environmental Arctic Change (SEARCH). CADIS is tasked with ensuring that these observational data are managed for long term use by members of the entire Earth System Science community. Portions of CADIS are either in use by the community or available for testing. We now have an opportunity to evaluate the feedback received from our users, to identify any design shortcomings, and to identify those elements which serve their purpose well and will support future development. This presentation will focus on the nuts-and-bolts of the CADIS development to date, with an eye towards presenting lessons learned and best practices based on our experiences so far. The topics include: - How did we assess our users' needs, and how are those contributions reflected in the end product and its capabilities? - Why did we develop a CADIS metadata profile, and how does it allow CADIS to support preservation and scientific interoperability? - How can we shield the user from metadata complexities (especially those associated with various standards) while still obtaining the metadata needed to support an effective data management system? - How can we bridge the gap between the data storage formats considered convenient by researchers in the field, and those which are necessary to provide data interoperability? - What challenges have been encountered in our efforts to provide access to federated data (data stored outside of the CADIS system)? - What are the data browsing and visualization needs of the AON community, and which tools and technologies are most promising in terms of supporting those needs? A live demonstration of the current

  17. ADVANCED SIMULATION CAPABILITY FOR ENVIRONMENTAL MANAGEMENT- CURRENT STATUS AND PHASE II DEMONSTRATION RESULTS

    Energy Technology Data Exchange (ETDEWEB)

    Seitz, R.

    2013-02-26

    The U.S. Department of Energy (USDOE) Office of Environmental Management (EM), Office of Soil and Groundwater, is supporting development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach for understanding and predicting contaminant fate and transport in natural and engineered systems. The modular and open source high-performance computing tool facilitates integrated approaches to modeling and site characterization that enable robust and standardized assessments of performance and risk for EM cleanup and closure activities. The ASCEM project continues to make significant progress in development of computer software capabilities with an emphasis on integration of capabilities in FY12. Capability development is occurring for both the Platform and Integrated Toolsets and High-Performance Computing (HPC) Multiprocess Simulator. The Platform capabilities provide the user interface and tools for end-to-end model development, starting with definition of the conceptual model, management of data for model input, model calibration and uncertainty analysis, and processing of model output, including visualization. The HPC capabilities target increased functionality of process model representations, toolsets for interaction with Platform, and verification and model confidence testing. The Platform and HPC capabilities are being tested and evaluated for EM applications in a set of demonstrations as part of Site Applications Thrust Area activities. The Phase I demonstration focusing on individual capabilities of the initial toolsets was completed in 2010. The Phase II demonstration completed in 2012 focused on showcasing integrated ASCEM capabilities. For Phase II, the Hanford Site deep vadose zone (BC Cribs) served as an application site for an end-to-end demonstration of capabilities, with emphasis on integration and linkages between the Platform and HPC components. Other demonstrations

  18. Targeted temperature management: Current evidence and practices in critical care

    Directory of Open Access Journals (Sweden)

    Saurabh Saigal

    2015-01-01

    Full Text Available Targeted temperature management (TTM in today′s modern era, especially in intensive care units represents a promising multifaceted therapy for a variety of conditions. Though hypothermia is being used since Hippocratic era, the renewed interest of late has been since early 21 st century. There have been multiple advancements in this field and varieties of cooling devices are available at present. TTM requires careful titration of its depth, duration and rewarming as it is associated with side-effects. The purpose of this review is to find out the best evidence-based clinical practice criteria of therapeutic hypothermia in critical care settings. TTM is an unique therapeutic modality for salvaging neurological tissue viability in critically ill patients viz. Post-cardiac arrest, traumatic brain injury (TBI, meningitis, acute liver failure and stroke. TTM is standard of care in post-cardiac arrest situations; there has been a lot of controversy of late regarding temperature ranges to be used for the same. In patients with TBI, it reduces intracranial pressure, but has not shown any favorable neurologic outcome. Hypothermia is generally accepted treatment for hypoxic ischemic encephalopathy in newborns. The current available technology to induce and maintain hypothermia allows for precise temperature control. Future studies should focus on optimizing hypothermic treatment to full benefit of our patients and its application in other clinical scenarios.

  19. Targeted temperature management: Current evidence and practices in critical care.

    Science.gov (United States)

    Saigal, Saurabh; Sharma, Jai Prakash; Dhurwe, Ritika; Kumar, Sanjay; Gurjar, Mohan

    2015-09-01

    Targeted temperature management (TTM) in today's modern era, especially in intensive care units represents a promising multifaceted therapy for a variety of conditions. Though hypothermia is being used since Hippocratic era, the renewed interest of late has been since early 21(st) century. There have been multiple advancements in this field and varieties of cooling devices are available at present. TTM requires careful titration of its depth, duration and rewarming as it is associated with side-effects. The purpose of this review is to find out the best evidence-based clinical practice criteria of therapeutic hypothermia in critical care settings. TTM is an unique therapeutic modality for salvaging neurological tissue viability in critically ill patients viz. Post-cardiac arrest, traumatic brain injury (TBI), meningitis, acute liver failure and stroke. TTM is standard of care in post-cardiac arrest situations; there has been a lot of controversy of late regarding temperature ranges to be used for the same. In patients with TBI, it reduces intracranial pressure, but has not shown any favorable neurologic outcome. Hypothermia is generally accepted treatment for hypoxic ischemic encephalopathy in newborns. The current available technology to induce and maintain hypothermia allows for precise temperature control. Future studies should focus on optimizing hypothermic treatment to full benefit of our patients and its application in other clinical scenarios. PMID:26430341

  20. Current concepts: management of diarrhea in acute care.

    Science.gov (United States)

    Fruto, L V

    1994-09-01

    Diarrhea is common in the acute care setting, particularly among critically ill patients. Factors that cause diarrhea are usually multifactorial; some of the most common include medications, hyperosmolar or rapidly delivered tube feedings, atrophy of intestinal epithelium or ischemic bowel, short bowel syndrome, pseudomembranous colitis, infection (Salmonella and Shigella species), opportunistic infections in patients with acquired immunodeficiency syndrome and severe hypoproteinemia. This article reviews different types and mechanisms of diarrhea commonly encountered in acute care. It includes current concepts of managing diarrhea, such as calculation of stool osmotic gap, identification of medications that cause diarrhea, modification of enteral therapy, and the use of antisecretory agents. Nursing responsibilities and contributions in the collaborative assessment and clinical management of diarrhea are also explored. PMID:7704125

  1. The SCEC Community Modeling Environment (SCEC/CME) - An Overview of its Architecture and Current Capabilities

    Science.gov (United States)

    Maechling, P. J.; Jordan, T. H.; Minster, B.; Moore, R.; Kesselman, C.; SCEC ITR Collaboration

    2004-12-01

    these models. In some cases, the CME system also provides alternatives to the SCEC community models. The CME system hosts a collection of community geophysical software codes. These codes include seismic hazard analysis (SHA) programs developed by the SCEC/USGS OpenSHA group. Also, the CME system hosts anelastic wave propagation codes including Kim Olsen's Finite Difference code and Carnegie Mellon's Hercules Finite Element tool chain. The CME system can execute a workflow, that is, a series of geophysical computations using the output of one processing step as the input to a subsequent step. Our workflow capability utilizes grid-based computing software that can submit calculations to a pool of computing resources as well as data management tools that help us maintain an association between data files and metadata descriptions of those files. The CME system maintains, and provides access to, a collection of valuable geophysical data sets. The current CME Digital Library holdings include a collection of 60 ground motion simulation results calculated by a SCEC/PEER working group and a collection of Greens Functions calculated for 33 TriNet broadband receiver sites in the Los Angeles area.

  2. Coordination between Fault-Ride-Through Capability and Over-current Protection of DFIG Generators for Wind Farms

    DEFF Research Database (Denmark)

    Bak-Jensen, Birgitte; Kawady, T.A.; Abdel-Rahman, Mansour Hassan

    2010-01-01

    Fault Ride-Through (FRT) capabilities set up according to the grid codes may affect the performance of related protective elements during fault periods. Therefore, in this paper the coordination between the FRT capability and over-current protection of DFIG Wind Generators in MV networks is...... investigated. Simulation test cases using MATLAB-Simulink are implemented on a 365-MW wind farm in AL-Zaafarana, Egypt. The simulation results show the influence of the FRT capability on the protective relaying coordination in wind farms, showing that the FRT may work in situations where is were expected not...

  3. Trainers’ Attitudes towards Cardiopulmonary Resuscitation, Current Care Guidelines, and Training

    Directory of Open Access Journals (Sweden)

    M. Mäkinen

    2016-01-01

    Full Text Available Objectives. Studies have shown that healthcare personnel hesitate to perform defibrillation due to individual or organisational attitudes. We aimed to assess trainers’ attitudes towards cardiopulmonary resuscitation and defibrillation (CPR-D, Current Care Guidelines, and associated training. Methods. A questionnaire was distributed to CPR trainers attending seminars in Finland (N=185 focusing on the updated national Current Care Guidelines 2011. The questions were answered using Likert scale (1 = totally disagree, 7 = totally agree. Factor loading of the questionnaire was made using maximum likelihood analysis and varimax rotation. Seven scales were constructed (Hesitation, Nurse’s Role, Nontechnical Skill, Usefulness, Restrictions, Personal, and Organisation. Cronbach’s alphas were 0.92–0.51. Statistics were Student’s t-test, ANOVA, stepwise regression analysis, and Pearson Correlation. Results. The questionnaire was returned by 124/185, 67% CPR trainers, of whom two-thirds felt that their undergraduate training in CPR-D had not been adequate. Satisfaction with undergraduate defibrillation training correlated with the Nontechnical Skills scale (p<0.01. Participants scoring high on Hesitation scale (p<0.01 were less confident about their Nurse’s Role (p<0.01 and Nontechnical Skills (p<0.01. Conclusion. Quality of undergraduate education affects the work of CPR trainers and some feel uncertain of defibrillation. The train-the-trainers courses and undergraduate medical education should focus more on practical scenarios with defibrillators and nontechnical skills.

  4. Speed Control of Brushless Dc Motor Using Current Fed Quasi Z-source Inverter with Regeneration Capability

    Directory of Open Access Journals (Sweden)

    A. Santhi Mary Antony

    2015-06-01

    Full Text Available Current fed Quasi Z-Source Inverters (qZSI have the advantages of voltage buck-boost capability, improved reliability, reduced passive component ratings, continuous input current, a common dc rail between source and inverter and unique regeneration capability. This current-fed qZSIs are bidirectional with an additional diode, unlike the voltage-fed ZSI that needs a switch to achieve bidirectional power flow. Since current fed quasi Z Source Inverter has many advantages it can be employed for motor drive applications such as Brushless DC motor (BLDC drive. Therefore this study proposes the use of qZSI for BLDC motor. The simulation results for the same are presented in this study.

  5. Correlational and Differential Influence of Historical Cost and Current Cost Profits on the Operating Capabilities of the Firm

    OpenAIRE

    S. A. Effiong; J. O. Udoayang; A. I. Asuquo

    2011-01-01

    The study investigated the correlation and differential influence of historical cost and current cost profits on the operating capabilities of the firm. The financial statements of thirty-one Nigerian Companies were surveyed and adjusted for effects of price changes using the Consumers¡¯ Price Index (CPI). Correlation influence between the historical cost profits on the operating ability of the firm was measured and established on one hand and that of current cost profit on the other hand. Di...

  6. Solid state transformer with low-voltage ride-through and current unbalance management capabilities

    OpenAIRE

    Alepuz Menéndez, Salvador; González, Francisco; Martín-Arnedo, Jacinto; Martínez Velasco, Juan Antonio

    2013-01-01

    The solid state transformer is an emerging technology which aims at replacing the conventional lowfrequency power transformer by means of a high-frequency transformer driven by a proper AC/AC power electronics conversion system, at both transformer sides. In comparison with the conventional power transformer, the solid state transformer provides extended and enhanced operating capabilities that can be achieved with an appropriate controller design for the power electronics converters. I...

  7. Substrate decoration for improvement of current-carrying capabilities of YBa2Cu3Ox thin films

    DEFF Research Database (Denmark)

    Khoryushin, Alexey; Mozhaev, Peter; Mozhaeva, Julia;

    2013-01-01

    , a template layer of nanoparticles and an uniform ultra-thin layer. Significant improvement of current-carrying capabilities was observed, especially at high external magnetic fields. Structural studies of these films reveal the presence of extended linear defects in the YBCO matrix. The formation...

  8. Cutaneous wound healing: Current concepts and advances in wound care

    Directory of Open Access Journals (Sweden)

    Kenneth C Klein

    2014-01-01

    Full Text Available A non-healing wound is defined as showing no measurable signs of healing for at least 30 consecutive treatments with standard wound care. [1] It is a snapshot of a patient′s total health as well as the ongoing battle between noxious factors and the restoration of optimal macro and micro circulation, oxygenation and nutrition. In practice, standard therapies for non-healing cutaneous wounds include application of appropriate dressings, periodic debridement and eliminating causative factors. [2] The vast majority of wounds would heal by such approach with variable degrees of residual morbidity, disability and even mortality. Globally, beyond the above therapies, newer tools of healing are selectively accessible to caregivers, for various logistical or financial reasons. Our review will focus on the use of hyperbaric oxygen therapy (HBOT, as used at our institution (CAMC, and some other modalities that are relatively accessible to patients. HBOT is a relatively safe and technologically simpler way to deliver care worldwide. However, the expense for including HBOT as standard of care for recognized indications per UHMS(Undersea and Hyperbaric Medical Society may vary widely from country to country and payment system. [3] In the USA, CMS (Centers for Medicare and Medicaid Services approved indications for HBOT vary from that of the UHMS for logistical reasons. [1] We shall also briefly look into other newer therapies per current clinical usage and general acceptance by the medical community. Admittedly, there would be other novel tools with variable success in wound healing worldwide, but it would be difficult to include all in this treatise.

  9. Music therapy in cardiac health care: current issues in research.

    Science.gov (United States)

    Hanser, Suzanne B

    2014-01-01

    Music therapy is a service that has become more prevalent as an adjunct to medical practice-as its evidence base expands and music therapists begin to join the cardiology team in every phase of care, from the most serious cases to those maintaining good heart health. Although applications of music medicine, primarily listening to short segments of music, are capable of stabilizing vital signs and managing symptoms in the short-term, music therapy interventions by a qualified practitioner are showing promise in establishing deeper and more lasting impact. On the basis of mind-body approaches, stress/coping models, the neuromatrix theory of pain, and entrainment, music therapy capitalizes on the ability of music to affect the autonomic nervous system. Although only a limited number of randomized controlled trials pinpoint the efficacy of specific music therapy interventions, qualitative research reveals some profound outcomes in certain individuals. A depth of understanding related to the experience of living with a cardiovascular disease can be gained through music therapy approaches such as nonverbal music psychotherapy and guided imagery and music. The multifaceted nature of musical responsiveness contributes to strong individual variability and must be taken into account in the development of research protocols for future music therapy and music medicine interventions. The extant research provides a foundation for exploring the many potential psychosocial, physiological, and spiritual outcomes of a music therapy service for cardiology patients. PMID:23535529

  10. Music therapy in cardiac health care: current issues in research.

    Science.gov (United States)

    Hanser, Suzanne B

    2014-01-01

    Music therapy is a service that has become more prevalent as an adjunct to medical practice-as its evidence base expands and music therapists begin to join the cardiology team in every phase of care, from the most serious cases to those maintaining good heart health. Although applications of music medicine, primarily listening to short segments of music, are capable of stabilizing vital signs and managing symptoms in the short-term, music therapy interventions by a qualified practitioner are showing promise in establishing deeper and more lasting impact. On the basis of mind-body approaches, stress/coping models, the neuromatrix theory of pain, and entrainment, music therapy capitalizes on the ability of music to affect the autonomic nervous system. Although only a limited number of randomized controlled trials pinpoint the efficacy of specific music therapy interventions, qualitative research reveals some profound outcomes in certain individuals. A depth of understanding related to the experience of living with a cardiovascular disease can be gained through music therapy approaches such as nonverbal music psychotherapy and guided imagery and music. The multifaceted nature of musical responsiveness contributes to strong individual variability and must be taken into account in the development of research protocols for future music therapy and music medicine interventions. The extant research provides a foundation for exploring the many potential psychosocial, physiological, and spiritual outcomes of a music therapy service for cardiology patients.

  11. Current Capabilities, Requirements and a Proposed Strategy for Interdependency Analysis in the UK

    Science.gov (United States)

    Bloomfield, Robin; Chozos, Nick; Salako, Kizito

    The UK government recently commissioned a research study to identify the state-of-the-art in Critical Infrastructure modelling and analysis, and the government/industry requirements for such tools and services. This study (Cetifs) concluded with a strategy aiming to bridge the gaps between the capabilities and requirements, which would establish interdependency analysis as a commercially viable service in the near future. This paper presents the findings of this study that was carried out by CSR, City University London, Adelard LLP, a safety/security consultancy and Cranfield University, defense academy of the UK.

  12. A compact 45 kV curve tracer with picoampere current measurement capability

    Science.gov (United States)

    Sullivan, W. W.; Mauch, D.; Bullick, A.; Hettler, C.; Neuber, A.; Dickens, J.

    2013-03-01

    This paper discusses a compact high voltage curve tracer for high voltage semiconductor device characterization. The system sources up to 3 mA at up to 45 kV in dc conditions. It measures from 328 V to 60 kV with 15 V resolution and from 9.4 pA to 4 mA with 100 fA minimum resolution. Control software for the system is written in Microsoft Visual C# and features real-time measurement control and IV plotting, arc-protection and detection, an electrically isolated universal serial bus interface, and easy data exporting capabilities. The system has survived numerous catastrophic high voltage device-under-test arcing failures with no loss of measurement capability or system damage. Overall sweep times are typically under 2 min, and the curve tracer system was used to characterize the blocking performance of high voltage ceramic capacitors, high voltage silicon carbide photoconductive semiconductor switches, and high voltage coaxial cable.

  13. Current state of knowledge about nutritional care of pregnant women

    Directory of Open Access Journals (Sweden)

    Luciana Barretto

    2014-12-01

    Full Text Available Pregnancy involves a significant anabolic activity that leads to increased nutritional needs relative to the preconception period. This paper aims to review the current understanding of the energy needs of macro and micronutrients during pregnancy as well as guidelines to address common gastrointestinal disorders during pregnancy, the issue of pica and anthropometric assessment to ensure an optimum weight gain. With the exception of iron, most of the nutrients needed by the pregnancy can be provided by a complete and balanced diet. Currently the scientific evidence shows that routine supplementation with iron and folic acid during pregnancy is a practice that prevents iron deficiency anemia, neural tube disorders and preterm births. Intermittent iron supplementation can also be an appropriated intervention. If the diet does not guarantee and adequate support, iodine, vitamin B12 and vitamin D supplements should also be necessaries. The anthropometric assessment by the pattern of weight gain should be present at each prenatal care visit to prevent maternal and fetal complications. In situations where the mother’s weight cannot be assessed, arm muscle circumference is possible to make an overall assessment as it correlates with maternal weight gain alternative. Measurements of biceps, triceps and subscapular skinfolds are another alternative that is useful to evaluate the fatty deposits and their location, in a complementary way to gain weight.

  14. The Current Crisis in Emergency Care and the Impact on Disaster Preparedness

    Directory of Open Access Journals (Sweden)

    Trainer Marcia

    2008-05-01

    Full Text Available Abstract Background The Homeland Security Act (HSA of 2002 provided for the designation of a critical infrastructure protection program. This ultimately led to the designation of emergency services as a targeted critical infrastructure. In the context of an evolving crisis in hospital-based emergency care, the extent to which federal funding has addressed disaster preparedness will be examined. Discussion After 9/11, federal plans, procedures and benchmarks were mandated to assure a unified, comprehensive disaster response, ranging from local to federal activation of resources. Nevertheless, insufficient federal funding has contributed to a long-standing counter-trend which has eroded emergency medical care. The causes are complex and multifactorial, but they have converged to present a severely overburdened system that regularly exceeds emergency capacity and capabilities. This constant acute overcrowding, felt in communities all across the country, indicates a nation at risk. Federal funding has not sufficiently prioritized the improvements necessary for an emergency care infrastructure that is critical for an all hazards response to disaster and terrorist emergencies. Summary Currently, the nation is unable to meet presidential preparedness mandates for emergency and disaster care. Federal funding strategies must therefore be re-prioritized and targeted in a way that reasonably and consistently follows need.

  15. The culture of care within psychiatric services: tackling inequalities and improving clinical and organisational capabilities

    Directory of Open Access Journals (Sweden)

    Ascoli Micol

    2012-09-01

    Full Text Available Abstract Introduction Cultural Consultation is a clinical process that emerged from anthropological critiques of mental healthcare. It includes attention to therapeutic communication, research observations and research methods that capture cultural practices and narratives in mental healthcare. This essay describes the work of a Cultural Consultation Service (ToCCS that improves service user outcomes by offering cultural consultation to mental health practitioners. The setting is a psychiatric service with complex and challenging work located in an ethnically diverse inner city urban area. Following a period of 18 months of cultural consultation, we gather the dominant narratives that emerged during our evaluation of our service. Results These narratives highlight how culture is conceptualized and acted upon in the day-to-day practices of individual health and social care professionals, specialist psychiatric teams and in care systems. The findings reveal common narratives and themes about culture, ethnicity, race and their perceived place and meaningfulness in clinical care. These narratives express underlying assumptions and covert rules for managing, and sometimes negating, dilemmas and difficulties when considering “culture” in the presentation and expression of mental distress. The narratives reveal an overall “culture of understanding cultural issues” and specific “cultures of care”. These emerged as necessary foci of intervention to improve service user outcomes. Conclusion Understanding the cultures of care showed that clinical and managerial over-structuring of care prioritises organisational proficiency, but it leads to inflexibility. Consequently, the care provided is less personalised and less accommodating of cultural issues, therefore, professionals are unable to see or consider cultural influences in recovery.

  16. The current status of ARAC (Atmospheric Release Advisory Capability) and its application to the Chernobyl event

    Energy Technology Data Exchange (ETDEWEB)

    Gudiksen, P.H.; Sullivan, T.J.; Harvey, T.F.

    1986-10-01

    The Atmospheric Release Advisory Capability (ARAC) project, developed by the Lawrence Livermore National Laboratory (LLNL), provides real-time dose assessments and estimates of the extent of surface contamination that may result from an atmospheric release of radioactivity. It utilizes advanced computer-based data communication and processing systems to acquire the meteorological and source term information needed by the three-dimensional atmospheric dispersion models to derive the consequence assessments. The ARAC responded to the recent Chernobyl reactor accident in the Soviet Union by estimating the source term and the radiation dose distribution due to exposure to the radioactive cloud over Europe and the Northern Hemisphere. This analysis revealed that approximately 50% of the estimated core inventories of I-131 and Cs-137 were released. The estimated committed effective dose equivalent due to inhalation of radioactivty during cloud passage is of the order of 10 mrem within parts of Scandinavia and eastern Europe, while most of the populations within central Europe were exposed to levels ranging from 1 to 10 mrem. The amount of Cs-137 released by the Chernobyl accident far exceeds that released by previous reactor accidents, but is only about 6% of the Cs-137 produced by the atmospheric weapon testing programs. 9 refs., 4 figs., 2 tabs.

  17. Developing Low-Conductance Window Frames: Capabilities and Limitations of Current Window Heat Transfer Design Tools

    Energy Technology Data Exchange (ETDEWEB)

    Gustavsen, Arild; Arasteh, Dariush; Jelle, Bjorn Petter; Curcija, Charlie; Kohler, Christian

    2008-09-11

    While window frames typically represent 20-30% of the overall window area, their impact on the total window heat transfer rates may be much larger. This effect is even greater in low-conductance (highly insulating) windows that incorporate very low-conductance glazing. Developing low-conductance window frames requires accurate simulation tools for product research and development. Based on a literature review and an evaluation of current methods of modeling heat transfer through window frames, we conclude that current procedures specified in ISO standards are not sufficiently adequate for accurately evaluating heat transfer through the low-conductance frames. We conclude that the near-term priorities for improving the modeling of heat transfer through low-conductance frames are: (1) Add 2D view-factor radiation to standard modeling and examine the current practice of averaging surface emissivity based on area weighting and the process of making an equivalent rectangular frame cavity. (2) Asses 3D radiation effects in frame cavities and develop recommendation for inclusion into the design fenestration tools. (3) Assess existing correlations for convection in vertical cavities using CFD. (4) Study 2D and 3D natural convection heat transfer in frame cavities for cavities that are proven to be deficient from item 3 above. Recommend improved correlations or full CFD modeling into ISO standards and design fenestration tools, if appropriate. (5) Study 3D hardware short-circuits and propose methods to ensure that these effects are incorporated into ratings. (6) Study the heat transfer effects of ventilated frame cavities and propose updated correlations.

  18. Ultra-fast dynamic imaging: an overview of current techniques, their capabilities and future prospects

    Science.gov (United States)

    Altucci, C.; Velotta, R.; Marangos, J. P.

    2010-06-01

    In this review we attempt to sketch an overview of the various methods currently being used or under development to enable ultra-fast dynamic imaging of matter. We concentrate on those techniques which combine atomic scale spatial resolution and femtosecond or even sub-femtosecond temporal resolution. In part this review was inspired and informed by the material presented at the 'Ultrafast Dynamic Imaging II' workshop held in Ischia, Italy in April 2009, but we also have drawn on a wider background of material especially when discussing the emerging laser-based methods.

  19. Current Sounding Capability From Satellite Meteorological Observation With Ultraspectral Infrared Instruments

    Science.gov (United States)

    Zhou, Daniel K.; Liu, Xu; Larar, Allen M.

    2008-01-01

    cloud top level are obtained. For both optically thin and thick cloud situations, the cloud top height can be retrieved with relatively high accuracy (i.e., error less than 1 km). Retrievals of atmospheric soundings, surface properties, and cloud microphysical properties with the AIRS and IASI observations are obtained and presented. These retrievals are further inter-compared with those obtained from airborne FTS system, such as the NPOESS Airborne Sounder Testbed? Interferometer (NAST I), dedicated dropsondes, radiosondes, and ground based Raman Lidar. The capabilities of satellite ultra-spectral sounder such as the AIRS and IASI are investigated. These advanced satellite ultraspectral infrared instruments are now playing an important role in satellite meteorological observation for numerical weather prediction.

  20. Palliative care in India: Current progress and future needs

    Directory of Open Access Journals (Sweden)

    Divya Khosla

    2012-01-01

    Full Text Available Despite its limited coverage, palliative care has been present in India for about 20 years. Obstacles in the growth of palliative care in India are too many and not only include factors like population density, poverty, geographical diversity, restrictive policies regarding opioid prescription, workforce development at base level, but also limited national palliative care policy and lack of institutional interest in palliative care. Nonetheless we have reasons to be proud in that we have overcome several hurdles and last two decades have seen palpable changes in the mindset of health care providers and policy makers with respect to need of palliative care in India. Systematic and continuous education for medical staff is mandatory, and a major break-through for achieving this purpose would be to increase the number of courses and faculties in palliative medicine at most universities.

  1. Thorium-230 dating of carbonates: current technical capabilities and major applications

    Science.gov (United States)

    Edwards, R. L.; Cheng, H.; Pythoud, M.; Lu, Y.; Zhang, P.; Nissen, J.; Berry, A.; Cross, M.

    2015-12-01

    Uranium-thorium or Th-230 dating has proven to be an important tool in determining the timing of events in the late Quaternary. Among the major applications are: the timing of sea level change, the timing of continental climate change as preserved in cave archives, the timing of climate change in marine and ice core archives through correlation to Th-230 - dated cave records, and calibration of the radiocarbon timescale. The success of these applications has been driven by continuing technical advances in the measurement of the rare actinide isotopes, U-234 and Th-230. The advances have improved the precision, sensitivity, and accuracy of the measurements. The main factor in measurement improvement has been an increase of about 5 orders of magnitude (over the past 30 years) in the fraction of the sample that can be detected, dramatically improving counting statistics, as well as measurement sensitivity. The 5-order of magnitude improvement, comes largely from the shift to mass spectrometric measurement techniques, but also has resulted from subsequent improvement in ionization plus transmission efficiency. While additional improvement above the 5-order of magnitude figure may be possible, current efforts are focused on improving the accuracy of the measurements, standardizing gravimetric standards among laboratories, and shortening measurement times. These efforts will be discussed along with summary results of some of the major applications.

  2. The Current State of Health Care for People with Disabilities

    Science.gov (United States)

    Breslin, Mary Lou; Yee, Silvia

    2009-01-01

    The National Council on Disabilities (NCD) undertook this study in 2007 to focus the nation's attention on the health care disparities experienced by people with disabilities, and to provide information and recommendations that can help to eliminate health care inequities for people with disabilities. Among the key findings were that: (1) People…

  3. [Current status of palliative care in medical oncology].

    Science.gov (United States)

    Sasaki, Tsubasa; Ohta, Syuji; Seki, Nobuhiko; Eguchi, Kenji

    2010-06-01

    A team approach is efficient in palliative care for cancer patients. People suffered from cancer have a right to receive high-quality palliative care earlier in cancer treatment. In Japan the National Act for Strategy against Cancer was enacted in 2007. Systematic educational programs supported by the Ministry of Health Labor and Welfare has been conducted for medical staffs, home care staffs, local pharmacists, care managers etc. at core institutes in each district. Pain control is still major target for cancer palliative medicine. Recently various types of opioids can be used routinely in daily clinical setting for Japanese cancer patients. Complementary and alternative medicine (CAM) may also effective in some patients but further study for proving scientific evidence in CAM should be warranted. Tailor-maid pain control will be established in the near future with molecular based pharmacogenomics.

  4. Drought Predictability and Prediction in a Changing Climate: Assessing Current Predictive Knowledge and Capabilities, User Requirements and Research Priorities

    Science.gov (United States)

    Schubert, Siegfried

    2011-01-01

    Drought is fundamentally the result of an extended period of reduced precipitation lasting anywhere from a few weeks to decades and even longer. As such, addressing drought predictability and prediction in a changing climate requires foremost that we make progress on the ability to predict precipitation anomalies on subseasonal and longer time scales. From the perspective of the users of drought forecasts and information, drought is however most directly viewed through its impacts (e.g., on soil moisture, streamflow, crop yields). As such, the question of the predictability of drought must extend to those quantities as well. In order to make progress on these issues, the WCRP drought information group (DIG), with the support of WCRP, the Catalan Institute of Climate Sciences, the La Caixa Foundation, the National Aeronautics and Space Administration, the National Oceanic and Atmospheric Administration, and the National Science Foundation, has organized a workshop to focus on: 1. User requirements for drought prediction information on sub-seasonal to centennial time scales 2. Current understanding of the mechanisms and predictability of drought on sub-seasonal to centennial time scales 3. Current drought prediction/projection capabilities on sub-seasonal to centennial time scales 4. Advancing regional drought prediction capabilities for variables and scales most relevant to user needs on sub-seasonal to centennial time scales. This introductory talk provides an overview of these goals, and outlines the occurrence and mechanisms of drought world-wide.

  5. THE IDEA IS TO USEMODIS IN CONJUNCTION WITH THE CURRENT LIMITED LANDSAT CAPABILITY, COMMERCIAL SATELLITES, ANDUNMANNED AERIAL VEHICLES (UAV), IN A MULTI-STAGE APPROACH TO MEET EPA INFORMATION NEEDS.REMOTE SENSING OVERVIEW: EPA CAPABILITIES, PRIORITY AGENCY APPLICATIONS, SENSOR/AIRCRAFT CAPABILITIES, COST CONSIDERATIONS, SPECTRAL AND SPATIAL RESOLUTIONS, AND TEMPORAL CONSIDERATIONS

    Science.gov (United States)

    EPA remote sensing capabilities include applied research for priority applications and technology support for operational assistance to clients across the Agency. The idea is to use MODIS in conjunction with the current limited Landsat capability, commercial satellites, and Unma...

  6. [Update on Current Care Guideline: Low back pain].

    Science.gov (United States)

    Pohjolainen, Timo; Leinonen, Ville; Frantén, Janek; Haanpää, Maija; Jousimaa, Jukkapekka; Karppinen, Jaro; Kuukkanen, Tiina; Luoma, Katariina; Salmenkivi, Jyrki; Osterman, Heikki; Malmivaara, Antti

    2015-01-01

    Classification to severe diseases, sciatic symptoms or non-specific back pain is recommended. Radiography in acute or subacute non-specific back pain is not recommended in the primary health care. In specialized care magnetic resonance imaging is the main imaging modality. Importance of patient information is emphasized. In acute non-specific pain avoidance of bed rest, advice and paracetamol are recommended. Indications for an emergency referral should be considered. In disabling pain for 6 weeks, multidisciplinary measures are needed. Pain over 3 months indicates intensive multidisciplinary rehabilitation, and also surgery may be considered. PMID:26245063

  7. Fostering prevention and care delivery services capability on HIV pandemic and Ebola outbreak symbiosis in Africa.

    Science.gov (United States)

    Tambo, Ernest; Yah, Clarence S; Ugwu, Chidiebere E; Olalubi, Oluwasogo A; Wurie, Isatta; Jonhson, Jeannetta K; Ngogang, Jeanne Y

    2016-01-01

    Human immunodeficiency virus (HIV) and the re-emerging Ebola virus disease (EVD) are closely intertwined and remain a persistent public health threat and global challenge. Their origin and rapid transmission and spread have similar boundaries and share overlapping impact characteristics, including related symptoms and other interactions. The controversies and global threat of these viruses require rapid response policy and evidence-based implementation findings. The constraints and dual burden inflicted by Ebola and HIV infections are highly characterized by similar socio-demographics, socio-economic and political factors. EVD has similar effects and burdens to HIV infection. This study seeks to understand EVD in the context of HIV epidemic despite the challenges in developing an effective vaccine against HIV and EVD. Our findings show that early understanding, prevention and treatment of these diseases a global health threat mainly in Africa is important and valuable. The lessons learned so far from HIV and Ebola epidemics are crucial in health programming and execution of rapid response interventions and continued vigilance against EVD before it become another worldwide health menace. Therefore, the current regional West Africa EVD requires strengthening healthcare systems and building preparedness and response capacity. Importantly, appropriate community participation, health education and resilience coupled with deployment of effective novel diagnostic approaches in early warning and surveillance of threats and emerging diseases. Therefore, there is an urgent need to develop novel key strategies are crucial in curbing the constant viral resurgence, persistence transmission dynamics and spread, as well in accelerating Ebola vaccines regimen (immunization) development and national implementation plans in achieving sustained control, and eventual elimination. PMID:26829532

  8. Postpartum depression on the neonatal intensive care unit: current perspectives

    Directory of Open Access Journals (Sweden)

    Tahirkheli NN

    2014-11-01

    Full Text Available Noor N Tahirkheli,1 Amanda S Cherry,1 Alayna P Tackett,2 Mary Anne McCaffree,3 Stephen R Gillaspy11Section of General and Community Pediatrics, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; 2Department of Psychology, Oklahoma State University, Stillwater, OK, USA; 3Section of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USAAbstract: As the most common complication of childbirth affecting 10%–15% of women, postpartum depression (PPD goes vastly undetected and untreated, inflicting long-term consequences on both mother and child. Studies consistently show that mothers of infants in the neonatal intensive care unit (NICU experience PPD at higher rates with more elevated symptomatology than mothers of healthy infants. Although there has been increased awareness regarding the overall prevalence of PPD and recognition of the need for health care providers to address this health issue, there has not been adequate attention to PPD in the context of the NICU. This review will focus on an overview of PPD and psychological morbidities, the prevalence of PPD in mothers of infants admitted to NICU, associated risk factors, potential PPD screening measures, promising intervention programs, the role of NICU health care providers in addressing PPD in the NICU, and suggested future research directions.Keywords: neonatal intensive care unit, postpartum depression, mothers

  9. Cutaneous wound healing: Current concepts and advances in wound care

    OpenAIRE

    Kenneth C Klein; Somes Chandra Guha

    2014-01-01

    A non-healing wound is defined as showing no measurable signs of healing for at least 30 consecutive treatments with standard wound care. [1] It is a snapshot of a patient′s total health as well as the ongoing battle between noxious factors and the restoration of optimal macro and micro circulation, oxygenation and nutrition. In practice, standard therapies for non-healing cutaneous wounds include application of appropriate dressings, periodic debridement and eliminating causative factors. [2...

  10. An Overview of Current Capabilities and Research Activities in the Airspace Operations Laboratory at NASA Ames Research Center

    Science.gov (United States)

    Prevot, Thomas; Smith, Nancy M.; Palmer, Everett; Callantine, Todd; Lee, Paul; Mercer, Joey; Homola, Jeff; Martin, Lynne; Brasil, Connie; Cabrall, Christopher

    2014-01-01

    The Airspace Operations Laboratory at NASA Ames conducts research to provide a better understanding of roles, responsibilities, and requirements for human operators and automation in future air traffic management (ATM) systems. The research encompasses developing, evaluating, and integrating operational concepts and technologies for near-, mid-, and far-term air traffic operations. Current research threads include efficient arrival operations, function allocation in separation assurance and efficient airspace and trajectory management. The AOL has developed powerful air traffic simulation capabilities, most notably the Multi Aircraft Control System (MACS) that is used for many air traffic control simulations at NASA and its partners in government, academia and industry. Several additional NASA technologies have been integrated with the AOL's primary simulation capabilities where appropriate. Using this environment, large and small-scale system-level evaluations can be conducted to help make near-term improvements and transition NASA technologies to the FAA, such as the technologies developed under NASA's Air Traffic Management Demonstration-1 (ATD-1). The AOL's rapid prototyping and flexible simulation capabilities have proven a highly effective environment to progress the initiation of trajectory-based operations and support the mid-term implementation of NextGen. Fundamental questions about accuracy requirements have been investigated as well as realworld problems on how to improve operations in some of the most complex airspaces in the US. This includes using advanced trajectory-based operations and prototype tools for coordinating arrivals to converging runways at Newark airport and coordinating departures and arrivals in the San Francisco and the New York metro areas. Looking beyond NextGen, the AOL has started exploring hybrid human/automation control strategies as well as highly autonomous operations in the air traffic control domain. Initial results

  11. Analysis of American Health Care System with respect to current affairs: Is Universal Health Care a Potential Reality?

    OpenAIRE

    Šotolová, Petra

    2009-01-01

    The main task of the Thesis is to analyze an American health care system, its management and behavior including its pros and cons. To describe and study the system will help to understand its eventual future progress and to answer a basic question "Is Universal Health Care a Potential Reality in U.S.A.?". With a respect to current affairs, as was the comprehensive health care reform signing, it will be possible to think and forecast relevant course of events that might improve consciousness a...

  12. Current management of diabetes mellitus and future directions in care.

    Science.gov (United States)

    Chatterjee, Sudesna; Davies, Melanie J

    2015-11-01

    The last 90 years have seen considerable advances in the management of type 1 and type 2 diabetes. Prof MacLean of Guy's Hospital wrote in the Postgraduate Medical Journal in 1926 about the numerous challenges that faced patients and their healthcare professionals in delivering safe and effective diabetes care at that time. The discovery of insulin in 1922 heralded a new age in enabling long-term glycaemic control, which reduced morbidity and mortality. Thirty years later, the first oral agents for diabetes, the biguanides and sulfonylureas, appeared and freed type 2 patients from having to inject insulin following diagnosis. Improvements in insulin formulations over the decades, including rapid-acting and long-acting insulin analogues that more closely mimic physiological insulin secretion, have increased the flexibility and efficacy of type 1 diabetes management. The last two decades have seen major advances in technology, which has manifested in more accurate glucose monitoring systems and insulin delivery devices ('insulin pump'). Increased understanding of the pathophysiological deficits underlying type 2 diabetes has led to the development of targeted therapeutic approaches such as on the small intestine (glucagon-like peptide-1 receptor analogues and dipeptidyl-peptidase IV inhibitors) and kidneys (sodium-glucose cotransporter-2 inhibitors). A patient-centred approach delivered by a multidisciplinary team is now advocated. Glycaemic targets are set according to individual circumstances, taking into account factors such as weight, hypoglycaemia risk and patient preference. Stepwise treatment guidelines devised by international diabetes organisations standardise and rationalise management. Structured education programmes and psychological support are now well-established as essential for improving patient motivation and self-empowerment. Large multicentre randomised trials have confirmed the effectiveness of intensive glycaemic control on microvascular

  13. Current and future impact of osteoarthritis on health care

    DEFF Research Database (Denmark)

    Turkiewicz, A; Petersson, I F; Björk, J;

    2014-01-01

    specialist outpatient care and hospitalizations. We studied all Skåne region residents aged ≥45 by the end of 2012 (n = 531, 254) and determined the prevalence of doctor-diagnosed OA defined as the proportion of the prevalent population that had received a diagnosis of OA of the knee, hip, hand, or other.......6% (95% confidence interval (CI): 26.5-26.8) (men 22.4%, women 30.5%). The most common locations were knee (13.8%), hip (5.8%) and hand (3.1%). Of the prevalent cases 26.8% had OA in multiple joints. By the year 2032, the proportion of the population aged ≥45 with doctor-diagnosed OA is estimated to...... increase from 26.6% to 29.5% (any location), from 13.8% to 15.7% for the knee and 5.8-6.9% for the hip. CONCLUSION: In 2032, at least an additional 26,000 individuals per 1 million population aged ≥45 years are estimated to have consulted a physician for OA in a peripheral joint compared to 2012. These...

  14. Diagnosing the uncertainty and detectability of emission reductions for REDD + under current capabilities: an example for Panama

    International Nuclear Information System (INIS)

    In preparation for the deployment of a new mechanism that could address as much as one fifth of global greenhouse gas emissions by reducing emissions from deforestation and forest degradation (REDD +), important work on methodological issues is still needed to secure the capacity to produce measurable, reportable, and verifiable emissions reductions from REDD + in developing countries. To contribute to this effort, we have diagnosed the main sources of uncertainty in the quantification of emission from deforestation for Panama, one of the first countries to be supported by the Forest Carbon Partnership Facility of the World Bank and by UN-REDD. Performing sensitivity analyses using a land-cover change emissions model, we identified forest carbon stocks and the quality of land-cover maps as the key parameters influencing model uncertainty. The time interval between two land-cover assessments, carbon density in fallow and secondary forest, and the accuracy of land-cover classifications also affect our ability to produce accurate estimates. Further, we used the model to compare emission reductions from five different deforestation reduction scenarios drawn from governmental input. Only the scenario simulating a reduction in deforestation by half succeeds in crossing outside the confidence bounds surrounding the baseline emission obtained from the uncertainty analysis. These results suggest that with current data, real emission reductions in developing countries could be obscured by their associated uncertainties. Ways of addressing the key sources of error are proposed, for developing countries involved in REDD + , for improving the accuracy of their estimates in the future. These new considerations confirm the importance of current efforts to establish forest monitoring systems and enhance capabilities for REDD + in developing countries.

  15. Diagnosing the uncertainty and detectability of emission reductions for REDD + under current capabilities: an example for Panama

    Science.gov (United States)

    Pelletier, Johanne; Ramankutty, Navin; Potvin, Catherine

    2011-04-01

    In preparation for the deployment of a new mechanism that could address as much as one fifth of global greenhouse gas emissions by reducing emissions from deforestation and forest degradation (REDD +), important work on methodological issues is still needed to secure the capacity to produce measurable, reportable, and verifiable emissions reductions from REDD + in developing countries. To contribute to this effort, we have diagnosed the main sources of uncertainty in the quantification of emission from deforestation for Panama, one of the first countries to be supported by the Forest Carbon Partnership Facility of the World Bank and by UN-REDD. Performing sensitivity analyses using a land-cover change emissions model, we identified forest carbon stocks and the quality of land-cover maps as the key parameters influencing model uncertainty. The time interval between two land-cover assessments, carbon density in fallow and secondary forest, and the accuracy of land-cover classifications also affect our ability to produce accurate estimates. Further, we used the model to compare emission reductions from five different deforestation reduction scenarios drawn from governmental input. Only the scenario simulating a reduction in deforestation by half succeeds in crossing outside the confidence bounds surrounding the baseline emission obtained from the uncertainty analysis. These results suggest that with current data, real emission reductions in developing countries could be obscured by their associated uncertainties. Ways of addressing the key sources of error are proposed, for developing countries involved in REDD + , for improving the accuracy of their estimates in the future. These new considerations confirm the importance of current efforts to establish forest monitoring systems and enhance capabilities for REDD + in developing countries.

  16. Diagnosing the uncertainty and detectability of emission reductions for REDD + under current capabilities: an example for Panama

    Energy Technology Data Exchange (ETDEWEB)

    Pelletier, Johanne; Potvin, Catherine [Department of Biology and Global Environmental and Climate Change Center, McGill University, 1205 Dr Penfield, Montreal, QC, H3A 1B1 (Canada); Ramankutty, Navin, E-mail: johannepelletier@gmail.com [Department of Geography and Global Environmental and Climate Change Center, McGill University, 805 Sherbrooke Street W., Montreal, QC, H3A 2K6 (Canada)

    2011-04-15

    In preparation for the deployment of a new mechanism that could address as much as one fifth of global greenhouse gas emissions by reducing emissions from deforestation and forest degradation (REDD +), important work on methodological issues is still needed to secure the capacity to produce measurable, reportable, and verifiable emissions reductions from REDD + in developing countries. To contribute to this effort, we have diagnosed the main sources of uncertainty in the quantification of emission from deforestation for Panama, one of the first countries to be supported by the Forest Carbon Partnership Facility of the World Bank and by UN-REDD. Performing sensitivity analyses using a land-cover change emissions model, we identified forest carbon stocks and the quality of land-cover maps as the key parameters influencing model uncertainty. The time interval between two land-cover assessments, carbon density in fallow and secondary forest, and the accuracy of land-cover classifications also affect our ability to produce accurate estimates. Further, we used the model to compare emission reductions from five different deforestation reduction scenarios drawn from governmental input. Only the scenario simulating a reduction in deforestation by half succeeds in crossing outside the confidence bounds surrounding the baseline emission obtained from the uncertainty analysis. These results suggest that with current data, real emission reductions in developing countries could be obscured by their associated uncertainties. Ways of addressing the key sources of error are proposed, for developing countries involved in REDD + , for improving the accuracy of their estimates in the future. These new considerations confirm the importance of current efforts to establish forest monitoring systems and enhance capabilities for REDD + in developing countries.

  17. Current trends, figures and challenges in out of home child care: An internationalcomparative analysis

    Directory of Open Access Journals (Sweden)

    Jorge F. del Valle

    2014-03-01

    Full Text Available This article closes the special issue of this journal about an international review of out-of-home child care, principally family foster care and residential care, tough several aspects related to adoption were included as well. Although a comparison on some data about residential and foster care, or kinship and non-kinship care, is carried out, the article tries above all to make a reflection on the implications of several themes that have emerged as more interesting or important. Matters such as the use of residential care and its role in the current child care system, the overrepresentation of ethnic minorities in foster care in several countries, the situation of unaccompanied young people asylum seeking, the use of adoption as a permanent solution, the challenges of the transition to the adulthood from care, the relevance of the professionalization and models based on social pedagogy, the evaluation and planning based on data, and the current financial crisis and its impact on child care systems are some of the remarkable topics that will be reviewed.

  18. Evolution, current structure, and role of a primary care clinical pharmacy service in an integrated managed care organization.

    Science.gov (United States)

    Heilmann, Rachel M F; Campbell, Stephanie M; Kroner, Beverly A; Proksel, Jenel R; Billups, Sarah J; Witt, Daniel M; Helling, Dennis K

    2013-01-01

    The impact of the declining number of primary care physicians is exacerbated by a growing elderly population in need of chronic disease management. Primary care clinical pharmacy specialists, with their unique knowledge and skill set, are well suited to address this gap. At Kaiser Permanente of Colorado (KPCO), primary care clinical pharmacy specialists have a long history of integration with medical practices and are located in close proximity to physicians, nurses, and other members of the health care team. Since 1992, Primary Care Clinical Pharmacy Services (PCCPS) has expanded from 4 to 30 full-time equivalents (FTEs) to provide services in all KPCO medical office buildings. With this growth in size, PCCPS has evolved to play a vital role in working with primary care medical teams to ensure that drug therapy is effective, safe, and affordable. In addition, PCCPS specialists provide ambulatory teaching sites for pharmacy students and pharmacy residents. There is approximately 1 specialist FTE for every 13,000 adult KPCO members and every 9 clinical FTEs of internal medicine and family medicine physicians. All clinical pharmacy specialists in the pharmacy department are required to have a PharmD degree, to complete postgraduate year 2 residencies, and, as a condition of employment, to become board certified in an applicable specialty. The evolution, current structure, and role of PCCPS at KPCO, including factors facilitating successful integration within the medical team, are highlighted. Patient and nonpatient care responsibilities are described.

  19. Treatment of Hip Dislocations and Associated Injuries: Current State of Care.

    Science.gov (United States)

    Beebe, Michael J; Bauer, Jennifer M; Mir, Hassan R

    2016-07-01

    Hip dislocations, most often caused by motor vehicle accidents or similar high-energy trauma, traverse a large subset of distinct injury patterns. Understanding these patterns and their associated injuries allows surgeons to provide optimal care for these patients both in the early and late postinjury periods. Nonoperative care requires surgeons to understand the indications. Surgical care requires the surgeon to understand the benefits and limitations of several surgical approaches. This article presents the current understanding of hip dislocation treatment, focusing on anatomy, injury classifications, nonoperative and operative management, and postinjury care.

  20. Focus group reflections on the current and future state of cognitive assessment tools in geriatric health care

    Directory of Open Access Journals (Sweden)

    Whitehead JC

    2015-06-01

    Full Text Available Jocelyne C Whitehead,1 Sara A Gambino,1 Jeffrey D Richter,2 Jennifer D Ryan1,3,41Rotman Research Institute, Baycrest, 2Independent Human Factors Consultant, Toronto, ON, Canada; 3Department of Psychology, 4Department of Psychiatry, University of Toronto, Toronto, ON, CanadaObjective: This study provides insight into the thoughts and opinions of geriatric health-care professionals toward cognitive assessments and the use of emerging technologies, such as eye-tracking, to supplement current tools.Methods: Two focus group sessions were conducted with nurses and physicians who routinely administer neurocognitive assessments to geriatric populations. Video recordings of the focus group sessions were transcribed and a thematic analysis was performed.Results: Participants reported the need for assessment and diagnostic tools that are accessible and efficient, and that are capable of accommodating the rapid growth in the aging population. The prevalence of more complex ailments experienced by older adults has had repercussions in the quality of care that the clients receive, and has contributed to lengthy wait times and resource shortages. Health-care professionals stated that they are hampered by the disjointed structure of the health-care system and that they would benefit from a more efficient allocation of responsibilities made possible through tools that did not require extensive training or certification. Eyetracking-based cognitive assessments were thought to strongly complement this system, yet it was thought that difficulty would be faced in gaining the support and increased uptake by health-care professionals due to the nonintuitive relationship between eyetracking and cognition.Conclusion: The findings suggest that health-care professionals are receptive to the use of eyetracking technology to assess for cognitive health as it would conserve resources by allowing frontline staff to administer assessments with minimal training

  1. Current issues in providing primary medical care to people with serious mental illness.

    Science.gov (United States)

    Lester, Helen

    2006-01-01

    This article explores some of the current issues in providing primary care for people with serious mental illness. In contrast to many patients in the United States, up to half of patients with serious mental illness in the United Kingdom are seen only by the primary care team. However many General Practitioners feel that the care of this patient group is beyond their remit. In the United Kingdom during the last decade, there have been a variety of policy initiatives, influenced by the generic principle of "partnership working" and the increasing recognition of the importance of patient choice, that have aimed to increase the role of primary care in the delivery of health care to people with serious mental illness. On the ground, these policy imperatives have been realised through different models of shared care and schemes to encourage better communication across the primary/secondary interface. Most recently, and perhaps most effectively, the introduction of a type of performance related pay into primary care may lead to changes to the way in which General Practitioners think and act in terms of their roles and responsibilities with this patient group. Theoretically, therefore the United Kingdom may be entering a new "golden age" of primary care based mental health services for people with serious mental illness, where holistic care, preventive care and health promotion are increasingly seen not as the gold standard, but the norm. PMID:16927575

  2. Current legal initiative to integrated care - effects of outpatient care in hospitals

    International Nuclear Information System (INIS)

    The strict separation of the out-patient and hospital-based health care delivery sectors in Germany leads to deficits in effectiveness and efficiency. Newly introduced legal initiatives to overcome this separation, namely 'Ambulantes Operieren' (Paragraph 115b SGB V), 'Ambulante Behandlung durch Krankenhaeuser' and Disease Management Programs (Paragraphen 116a-b SGB V) are described in detail in this article. Their impact on hospital-based health provision for out-patients is discussed. The aim of a better integration of different sectors with a better quality and a more efficient use of resources seems to be the target of these initiatives. (orig.)

  3. Fault Ride Though Control of Photovoltaic Grid-connected Inverter with Current-limited Capability under Offshore Unbalanced Voltage Conditions

    DEFF Research Database (Denmark)

    Liu, Wenzhao; Guo, Xiaoqiang; Savaghebi, Mehdi;

    2016-01-01

    of the excessive current phenomenon with the conventional fault ride through control is discussed. The quantitative analysis of the current peak value is conducted and a new current-limiting control strategy is proposed to achieve the flexible power control and successful fault ride through in a safe current...

  4. Transformer-based asymmetrical embedded Z-source neutral point clamped inverters with continuous input current and enhanced voltage boost capability

    DEFF Research Database (Denmark)

    Mo, W.; Loh, Poh Chiang; Blaabjerg, Frede

    2013-01-01

    Z-source Neutral Point Clamped (NPC) inverters were introduced to integrate both the advantages of Z-source inverters and NPC inverters. However, traditional Z-source inverters suffer from high voltage stress and chopping input current. This paper proposes six types transformer-based impedance......-source NPC inverters which have enhanced voltage boost capability and continuous input current by utilizing of transformer and embedded dc source configuration. Experimental results are presented to verify the theory validation....

  5. In-vitro diagnostic devices introduction to current point-of-care diagnostic devices

    CERN Document Server

    Cheng, Chao-Min; Chen, Chien-Fu

    2016-01-01

    Addressing the origin, current status, and future development of point-of-care diagnostics, and serving to integrate knowledge and tools from Analytical Chemistry, Bioengineering, Biomaterials, and Nanotechnology, this book focusses on addressing the collective and combined needs of industry and academia (including medical schools) to effectively conduct interdisciplinary research. In addition to summarizing and detailing developed diagnostic devices, this book will attempt to point out the possible future trends of development for point-of-care diagnostics using both scientifically based research and practical engineering needs with the aim to help novices comprehensively understand the development of point-of-care diagnostics. This includes demonstrating several common but critical principles and mechanisms used in point-of-care diagnostics that address practical needs (e.g., disease or healthcare monitoring) using two well-developed examples so far: 1) blood glucose meters (via electrochemistry); and, 2) p...

  6. Proficiency testing for bacterial whole genome sequencing: an end-user survey of current capabilities, requirements and priorities

    DEFF Research Database (Denmark)

    Moran-Gilad, Jacob; Sintchenko, Vitali; Karlsmose Pedersen, Susanne;

    2015-01-01

    Group 4 among GMI members in order to ascertain NGS end-use requirements and attitudes towards NGS PT. The survey identified the high professional diversity of laboratories engaged in NGS-based public health projects and the wide range of capabilities within institutions, at a notable range of costs....... The priority pathogens reported by respondents reflected the key drivers for NGS use (high burden disease and 'high profile' pathogens). The performance of and participation in PT was perceived as important by most respondents. The wide range of sequencing and bioinformatics practices reported by end...

  7. Proficiency Testing for Bacterial Whole Genome Sequencing: An End-User Survey of Current Capabilities, Requirements and Priorities

    DEFF Research Database (Denmark)

    Moran-Gilad, Jacob; Sintchenko, Vitali; Karlsmose Pedersen, Susanne;

    2015-01-01

    by Working Group 4 among GMI members in order to ascertain NGS end-use requirements and attitudes towards NGS PT. The survey identified the high professional diversity of laboratories engaged in NGS-based public health projects and the wide range of capabilities within institutions, at a notable range...... of costs. The priority pathogens reported by respondents reflected the key drivers for NGS use (high burden disease and ‘high profile’ pathogens). The performance of and participation in PT was perceived as important by most respondents. The wide range of sequencing and bioinformatics practices reported...

  8. Powerful leverages and counter-currents in the unborn child spiritual care: a qualitative study.

    Science.gov (United States)

    Heidari, Tooba; Ziaei, Saeideh; Ahmadi, Fazlollah; Mohammadi, Eesa

    2015-01-01

    In different cultures, pregnancy, birth and motherhood are perceived as spiritual events through their miraculous processes and create an ideal context for spiritual enrichment. However, studies on spirituality and birth are at very early stages. The purpose of this study was to understand the facilitators and barriers of the unborn child spiritual care in Iranian women. Twenty-two mothers with live pregnancy experience who were willing and able to share their life stories were selected purposefully in Tehran (Iran) from May 2012 to April 2013. Qualitative content analysis was used to analyze 27 interviews. Active and passive acquisition of information, inner inspirational messages, receiving effective support from the people around as well as modeling of self and significant others created "powerful leverages" to accelerate mother for caring her unborn child. "Counter-currents" in the form of unsuitable physical conditions during pregnancy, poor economic and social conditions, unsuitable psychological and cognitive conditions and finally understanding unsuitable ideological conditions of the self and care giver were identified as barriers. Iranian cultural and religious perspective on the unborn child physical and mental influence from mother has an important role in mother's self-care behaviors during pregnancy. It seems that using interdisciplinary professionals' skills based on understanding facilitators and barriers of mother care of the unborn child can lead to providing comprehensive prenatal care according to mothers' cultural, religious and social context. PMID:25560343

  9. Early childhood care and education and equality of opportunity: theoretical and empirical perspectives on current social challenges

    OpenAIRE

    Burger, Kaspar; Stamm, Margrit

    2012-01-01

    Early childhood care and education has become a key issue in social science as well as in politics. Different actors increasingly use early childhood care and education to tackle a variety of societal challenges. This research contributes innovative theoretical and empirical dimension to the field, highlighting that early care and education can promote beneficial child development where informal learning environments do not support the acquisition of important capabilities sufficiently and th...

  10. Assessing thermochromatography as a separation method for nuclear forensics. Current capability vis-a-vis forensic requirements

    International Nuclear Information System (INIS)

    Nuclear forensic science has become increasingly important for global nuclear security. However, many current laboratory analysis techniques are based on methods developed without the imperative for timely analysis that underlies the post-detonation forensics mission requirements. Current analysis of actinides, fission products, and fuel-specific materials requires time-consuming chemical separation coupled with nuclear counting or mass spectrometry. High-temperature gas-phase separations have been used in the past for the rapid separation of newly created elements/isotopes and as a basis for chemical classification of that element. We are assessing the utility of this method for rapid separation in the gas-phase to accelerate the separations of radioisotopes germane to post-detonation nuclear forensic investigations. The existing state of the art for thermo chromatographic separations, and its applicability to nuclear forensics, will be reviewed. (author)

  11. A new hybrid cycloconverter with smooth output voltage generation capability and accurate control of the circulating current

    OpenAIRE

    Klumpner, Christian; Xu, Tianning; Clare, Jon

    2006-01-01

    Nowadays, power electronic converters based exclusively on IGBTs deliver excellent load side performance up to megawatt powers in the low voltage range (200-690V) and are steadily gaining performance in the medium voltage range as well. However, the medium and high voltage/high power range remains dominated by converters using naturally commutated thyristors (i.e. cycloconverters, current source inverters), which offer poorer output side performance. This paper proposes a new hybrid arrangeme...

  12. Educating Medical Laboratory Technologists: Revisiting Our Assumptions in the Current Economic and Health-Care Environment

    Directory of Open Access Journals (Sweden)

    Regina Linder

    2012-08-01

    Full Text Available Health care occupies a distinct niche in an economy struggling to recover from recession. Professions related to the care of patients are thought to be relatively resistant to downturns, and thus become attractive to students typically drawn to more lucrative pursuits. Currently, a higher profile for clinical laboratory technology among college students and those considering career change results in larger and better prepared applicant pools. However, after decades of contraction marked by closing of programs, prospective students encounter an educational system without the capacity or vigor to meet their needs. Here discussed are some principles and proposals to allow universities, partnering with health-care providers, government agencies, and other stakeholders to develop new programs, or reenergize existing ones to serve our students and patients. Principles include academic rigor in biomedical and clinical science, multiple points of entry for students, flexibility in format, cost effectiveness, career ladders and robust partnerships.

  13. Multimodality Neuromonitoring in Pediatric Neurocritical Care: Review of the Current Resources

    Science.gov (United States)

    Tovar-Spinoza, Zulma

    2015-01-01

    Brain insults in children represent a daily challenge in neurocritical care. Having a constant grasp on various parameters in the pediatric injured brain may affect the patient’s outcome. Currently, new advances provide clinicians with the ability to utilize several modalities to monitor brain function. This multi-modal approach allows real-time information, leading to faster responses in management and furthermore avoiding secondary insults in the injured brain.  PMID:26719828

  14. Leakage Current Optimization Techniques During Test Based on Don't Care Bits Assignment

    Institute of Scientific and Technical Information of China (English)

    Wei Wang; Yu Hu; Yin-He Han; Xiao-Wei Li; You-Sheng Zhang

    2007-01-01

    It is a well-known fact that test power consumption may exceed that during functional operation. Leakage power dissipation caused by leakage current in Complementary Metal-Oxide-Semiconductor (CMOS) circuits during test has become a significant part of the total power dissipation. Hence, it is important to reduce leakage power to prolong battery life in portable systems which employ periodic self-test, to increase test reliability and to reduce test cost. This paper analyzes leakage current and presents a kind of leakage current simulator based on the transistor stacking effect.Using it, we propose techniques based on don't care bits (denoted by Xs) in test vectors to optimize leakage current in integrated circuit (IC) test by genetic algorithm. The techniques identify a set of don't care inputs in given test vectors and reassign specified logic values to the X inputs by the genetic algorithm to get minimum leakage vector (MLV).Experimental results indicate that the techniques can effectually optimize leakage current of combinational circuits and sequential circuits during test while maintaining high fault coverage.

  15. The LLNL High Accuracy Volume Renderer for Unstructured Data: Capabilities, Current Limits, and Potential for ASCI/VIEWS Deployment

    Energy Technology Data Exchange (ETDEWEB)

    Williams, P L; Max, N L

    2001-06-04

    This report describes a volume rendering system for unstructured data, especially finite element data, that creates images with very high accuracy. The system will currently handle meshes whose cells are either linear or quadratic tetrahedra, or meshes with mixed cell types: tetrahedra, bricks, prisms, and pyramids. The cells may have nonplanar facets. Whenever possible, exact mathematical solutions for the radiance integrals and for interpolation are used. Accurate semitransparent shaded isosurfaces may be embedded in the volume rendering. For very small cells, subpixel accumulation by splatting is used to avoid sampling error. A new exact and efficient visibility ordering algorithm is described. The most accurate images are generated in software, however, more efficient algorithms utilizing graphics hardware may also be selected. The report describes the parallelization of the system for a distributed-shared memory multiprocessor machine, and concludes by discussing the system's limits, desirable future work, and ways to extend the system so as to be compatible with projected ASCI/VIEWS architectures.

  16. Growth monitoring: a survey of current practices of primary care paediatricians in Europe.

    Directory of Open Access Journals (Sweden)

    Pauline Scherdel

    Full Text Available OBJECTIVE: We aimed to study current practices in growth monitoring by European primary care paediatricians and to explore their perceived needs in this field. METHODS: We developed a cross-sectional, anonymous on-line survey and contacted primary care paediatricians listed in national directories in the 18 European countries with a confederation of primary care paediatricians. Paediatricians participated in the survey between April and September 2011. RESULTS: Of the 1,198 paediatricians from 11 European countries (response rate 13% who participated, 29% used the 2006 World Health Organization Multicentre Growth Reference Study growth charts, 69% used national growth charts; 61% used software to draw growth charts and 79% did not use a formal algorithm to detect abnormal growth on growth charts. Among the 21% of paediatricians who used algorithms, many used non-algorithmic simple thresholds for height and weight and none used the algorithms published in the international literature. In all, 69% of paediatricians declared that a validated algorithm to monitor growth would be useful in daily practice. We found important between-country variations. CONCLUSION: The varied growth-monitoring practices declared by primary care paediatricians reveals the need for standardization and evidence-based algorithms to define abnormal growth and the development of software that would use such algorithms.

  17. Pulmonary (cardio) diagnostic system for combat casualty care capable of extracting embedded characteristics of obstructive or restrictive flow

    Science.gov (United States)

    Allgood, Glenn O.; Treece, Dale A.; Pearce, Fred J.; Bentley, Timothy B.

    2000-08-01

    Walter Reed Army Institute of Research and Oak Ridge National Laboratory have developed a prototype pulmonary diagnostic system capable of extracting signatures from adventitious lung sounds that characterize obstructive and/or restrictive flow. Examples of disorders that have been detailed include emphysema, asthma, pulmonary fibrosis, and pneumothorax. The system is based on the premise that acoustic signals associated with pulmonary disorders can be characterized by a set of embedded signatures unique to the disease. The concept is being extended to include cardio signals correlated with pulmonary data to provide an accurate and timely diagnoses of pulmonary function and distress in critically injured soldiers that will allow medical personnel to anticipate the need for accurate therapeutic intervention as well as monitor soldiers whose injuries may lead to pulmonary compromise later. The basic operation of the diagnostic system is as follows: (1) create an image from the acoustic signature based on higher order statistics, (2) deconstruct the image based on a predefined map, (3) compare the deconstructed image with stored images of pulmonary symptoms, and (4) classify the disorder based on a clustering of known symptoms and provide a statistical measure of confidence. The system has produced conformity between adults and infants and provided effective measures of physiology in the presence of noise.

  18. Learning to Care during Storytime in the Current Context: Moral Education from the Perspective of Care Ethics

    Science.gov (United States)

    Rabin, Colette

    2011-01-01

    Through an examination of storytelling in the present context, this study addresses the teaching of moral education from the standpoint of care ethics. Through observations, interviews, and surveys in one school committed to care ethics, this study aims to show how the philosophical perspective of care ethics can inform practice. Teachers engaged…

  19. Current state of chronic wound care in Kazakhstan: focus on topical treatments

    Directory of Open Access Journals (Sweden)

    Alma Akhmetova

    2015-02-01

    Full Text Available Background — The presence of chronic hard-to-heal wounds significantly affects patients’ quality of life causing pain, discomfort, decrease of mobility and consequently leads to social isolation and depression. This type of wound is more prevalent among older population. It has been estimated that up to 1-2% of the world population have this condition. The treatment of hard-to-heal wounds is expensive and long-term process, and, stresses healthcare systems of every country. Unfortunately, limited information is available about the situation with chronic wounds in Kazakhstan as the statistical data on such patients is not monitored and not registered in this country. Methods — The search was conducted by using available electronic sources, including Google Scholar, PubMed, Web of Sciences, Medline, Wiley Online Library, and Cochrane Library databases as well as hard copy versions of peer-reviewed publications in Russian, Kazakh, and English languages. Results — We have identified and analyzed current situation with wound care in the Republic of Kazakhstan. Research has demonstrated a variety of types of treatments utilized in the country, particularly the treatment of the diabetic foot.It also indicates the lack of statistics on wound care. Conclusions — The review highlights the mechanisms of wound healing process, methods for wound care, and encompasses the information available on wound healing in Republic of Kazakhstan. The article emphasizes the necessity of establishing the systemic monitoring of wound care and formation of electronic database. Apart from that, the importance of developing and manufacturing of domestic novel wound treatments have been also stressed out.

  20. Current status of quality evaluation of nursing care through director review and reflection from the Nursing Quality Control Centers

    OpenAIRE

    Duan, Xia; Shi, Yan

    2014-01-01

    Background: The quality evaluation of nursing care is a key link in medical quality management. It is important and worth studying for the nursing supervisors to know the disadvantages during the process of quality evaluation of nursing care and then to improve the whole nursing quality. This study was to provide director insight on the current status of quality evaluation of nursing care from Nursing Quality Control Centers (NQCCs). Material and Methods: This qualitative study used a sample ...

  1. Capability Paternalism

    NARCIS (Netherlands)

    Claassen, R.J.G.

    2014-01-01

    A capability approach prescribes paternalist government actions to the extent that it requires the promotion of specific functionings, instead of the corresponding capabilities. Capability theorists have argued that their theories do not have much of these paternalist implications, since promoting c

  2. Human resources for mental health care: current situation and strategies for action.

    Science.gov (United States)

    Kakuma, Ritsuko; Minas, Harry; van Ginneken, Nadja; Dal Poz, Mario R; Desiraju, Keshav; Morris, Jodi E; Saxena, Shekhar; Scheffler, Richard M

    2011-11-01

    A challenge faced by many countries is to provide adequate human resources for delivery of essential mental health interventions. The overwhelming worldwide shortage of human resources for mental health, particularly in low-income and middle-income countries, is well established. Here, we review the current state of human resources for mental health, needs, and strategies for action. At present, human resources for mental health in countries of low and middle income show a serious shortfall that is likely to grow unless effective steps are taken. Evidence suggests that mental health care can be delivered effectively in primary health-care settings, through community-based programmes and task-shifting approaches. Non-specialist health professionals, lay workers, affected individuals, and caregivers with brief training and appropriate supervision by mental health specialists are able to detect, diagnose, treat, and monitor individuals with mental disorders and reduce caregiver burden. We also discuss scale-up costs, human resources management, and leadership for mental health, particularly within the context of low-income and middle-income countries.

  3. The History and Current Status of Federal Legislation Pertaining to Day Care Programs.

    Science.gov (United States)

    Searcy, Ellen O.; Ouellet, Ronald

    This report is a brief summary of the history of Federal Day Care provisions through the sixties and an analysis of the child care legislation pending in Congress during 1971. The 92nd Congress, in attempts to answer the growing demands for Federally-sponsored child care, introduced four separate bills dealing with child care financing: HR. 1…

  4. Current trends, figures and challenges in out of home child care: An internationalcomparative analysis

    OpenAIRE

    Del Valle, Jorge F; Amaia Bravo

    2014-01-01

    This article closes the special issue of this journal about an international review of out-of-home child care, principally family foster care and residential care, tough several aspects related to adoption were included as well. Although a comparison on some data about residential and foster care, or kinship and non-kinship care, is carried out, the article tries above all to make a reflection on the implications of several themes that have emerged as more interesting or important. Matters su...

  5. Finite element analysis of ageing reinforced and prestressed concrete structures in nuclear plant - An international review of current capabilities and priorities for future developments

    International Nuclear Information System (INIS)

    Nuclear plants contain a variety of concrete structures whose structural performance is essential to the safety of the plant. There is a requirement to demonstrate the robustness of these structures during normal operating and extreme accident conditions, throughout their life. During this time, the concrete may degrade due to the effects of ageing. This degradation must be accounted for during the assessment of their performance. Finite Element Analysis (FEA) techniques have tremendous potential for providing valuable insight into the behaviour of these aged concrete structures under a range of different loading conditions. Advanced FEA techniques currently enjoy widespread use within the nuclear industry for the non-linear analysis of concrete. Many practitioners within the nuclear industry are at the forefront of the industrial application of these methods. However, in some areas, the programs that are commercially available lag behind the best information available from research. This document is an international review of current capabilities and priorities for future development relating to non-linear finite element analysis of reinforced and prestressed concrete in the nuclear industry in the various member states. Particular attention is paid to the analysis of degraded or ageing structures. This report: 1. Summarises the needs for FEA of aged concrete nuclear structures; 2. Details the existing capabilities, not just in terms of what the software is capable of, but also in terms of the current practices employed by those in industry; 3. Looks at how engineers, within the nuclear industry, working in this field would like to see methods improved, and identifies the factors that are limiting current practice; 4. Summarises ongoing research that may provide beneficial technological advances; 5. Assigns priorities to the different development requests; 6. Selects those developments that are felt to be of greatest benefit to industry and provides a qualitative

  6. Self-reported interoceptive awareness in primary care patients with past or current low back pain

    Directory of Open Access Journals (Sweden)

    Mehling WE

    2013-05-01

    Full Text Available Wolf E Mehling,1,2 Jennifer Daubenmier,1,3 Cynthia J Price,5 Mike Acree,1 Elizabeth Bartmess,1 Anita L Stewart41Osher Center for Integrative Medicine, 2Department of Family and Community Medicine, 3Department of Medicine, 4School of Nursing, Institute for Health and Aging, University of California, San Francisco, CA, 5School of Nursing, Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USABackground: Mind–body interactions play a major role in the prognosis of chronic pain, and mind–body therapies such as meditation, yoga, Tai Chi, and Feldenkrais presumably provide benefits for pain patients. The Multidimensional Assessment of Interoceptive Awareness (MAIA scales, designed to measure key aspects of mind–body interaction, were developed and validated with individuals practicing mind–body therapies, but have never been used in pain patients.Methods: We administered the MAIA to primary care patients with past or current low back pain and explored differences in the performance of the MAIA scales between this and the original validation sample. We compared scale means, exploratory item cluster and confirmatory factor analyses, scale–scale correlations, and internal-consistency reliability between the two samples and explored correlations with validity measures.Results: Responses were analyzed from 435 patients, of whom 40% reported current pain. Cross-sectional comparison between the two groups showed marked differences in eight aspects of interoceptive awareness. Factor and cluster analyses generally confirmed the conceptual model with its eight dimensions in a pain population. Correlations with validity measures were in the expected direction. Internal-consistency reliability was good for six of eight MAIA scales. We provided specific suggestions for their further development.Conclusion: Self-reported aspects of interoceptive awareness differ between primary care patients with past or current

  7. Chest Pain of Suspected Cardiac Origin: Current Evidence-based Recommendations for Prehospital Care

    Directory of Open Access Journals (Sweden)

    P. Brian Savino

    2015-12-01

    Full Text Available Introduction: In the United States, emergency medical services (EMS protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of chest pain of suspected cardiac origin and to compare these recommendations against the current protocols used by the 33 EMS agencies in the state of California. Methods: We performed a literature review of the current evidence in the prehospital treatment of chest pain and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the chest pain protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were use of supplemental oxygen, aspirin, nitrates, opiates, 12-lead electrocardiogram (ECG, ST segment elevation myocardial infarction (STEMI regionalization systems, prehospital fibrinolysis and β-blockers. Results: The protocols varied widely in terms of medication and dosing choices, as well as listed contraindications to treatments. Every agency uses oxygen with 54% recommending titrated dosing. All agencies use aspirin (64% recommending 325mg, 24% recommending 162mg and 15% recommending either, as well as nitroglycerin and opiates (58% choosing morphine. Prehospital 12- Lead ECGs are used in 97% of agencies, and all but one agency has some form of regionalized care for their STEMI patients. No agency is currently employing prehospital fibrinolysis or β-blocker use. Conclusion: Protocols for chest pain of suspected cardiac origin vary widely across California. The evidence-based recommendations that we present for the prehospital diagnosis and treatment of this condition may be useful for EMS medical directors tasked with creating and revising these protocols.

  8. Capability ethics

    NARCIS (Netherlands)

    I.A.M. Robeyns (Ingrid)

    2012-01-01

    textabstractThe capability approach is one of the most recent additions to the landscape of normative theories in ethics and political philosophy. Yet in its present stage of development, the capability approach is not a full-blown normative theory, in contrast to utilitarianism, deontological theor

  9. Dynamic Capabilities

    DEFF Research Database (Denmark)

    Grünbaum, Niels Nolsøe; Stenger, Marianne

    2013-01-01

    The findings reveal a positive relationship between dynamic capabilities and innovation performance in the case enterprises, as we would expect. It was, however, not possible to establish a positive relationship between innovation performance and profitability. Nor was there any positive...... relationship between dynamic capabilities and profitability....

  10. Overcoming Roadblocks: Current and Emerging Reimbursement Strategies for Integrated Mental Health Services in Primary Care

    OpenAIRE

    O’Donnell, Allison N.; Williams, Mark; Kilbourne, Amy M.

    2013-01-01

    The Chronic Care Model (CCM) has been shown to improve medical and psychiatric outcomes for persons with mental disorders in primary care settings, and has been proposed as a model to integrate mental health care in the patient-centered medical home under healthcare reform. However, the CCM has not been widely implemented in primary care settings, primarily because of a lack of a comprehensive reimbursement strategy to compensate providers for day-to-day provision of its core components, incl...

  11. Surveying Consumer Satisfaction to Assess Managed-Care Quality: Current Practices

    OpenAIRE

    Gold, Marsha; Wooldridge, Judith

    1995-01-01

    Growing interest in using consumer satisfaction information to enhance quality of care and promote informed consumer choice has accompanied recent expansions in managed care. This article synthesizes information about consumer satisfaction surveys conducted by managed-care plans, government and other agencies, community groups, and purchasers of care. We discuss survey content, methods, and use of consumer survey information. Differences in the use of consumer surveys preclude one instrument ...

  12. The Challenge to Prepare Teachers to Care in the Current Context: Perspectives of Teachers of Color

    Science.gov (United States)

    Rabin, Colette

    2010-01-01

    Teacher educators have a civic responsibility to prepare novice teachers to foster relationships across cultural, racial, and socioeconomic divides. Care ethics acknowledges this imperative and context's role in determining varied meanings of care. The voices of teachers of color can help us to understand the demands of care across differences.…

  13. Dynamic Capabilities

    DEFF Research Database (Denmark)

    Grünbaum, Niels Nolsøe; Stenger, Marianne

    2013-01-01

    The findings reveal a positive relationship between dynamic capabilities and innovation performance in the case enterprises, as we would expect. It was, however, not possible to establish a positive relationship between innovation performance and profitability. Nor was there any positive relation......The findings reveal a positive relationship between dynamic capabilities and innovation performance in the case enterprises, as we would expect. It was, however, not possible to establish a positive relationship between innovation performance and profitability. Nor was there any positive...... relationship between dynamic capabilities and profitability....

  14. Prostate cancer screening in Primary Health Care: the current state of affairs.

    Science.gov (United States)

    Ranasinghe, Weranja Kb; Kim, Simon P; Papa, Nathan P; Sengupta, Shomik; Frydenberg, Mark; Bolton, Damien; Pond, Dimity; Ried, Karin; Marshall, Melanie J; Persad, Raj; Lawrentschuk, Nathan

    2015-01-01

    This study aims to examine the current practice of General practitioners (GPs)/primary care physicians in opportunistic screening for prostate cancer (PC) by digital rectal examination(DRE) and Prostate Specific Antigen(PSA) testing and identify any difference in screening practice. Printed copies and/or electronic versions of a survey was distributed amongst 438 GPs throughout Australia in 2012. Statistical analyses (Wilcoxon rank-sum test, Fisher's exact test or Pearson chi-square test)were performed by outcomes and GP characteristics.There were a total of 149 responses received (34%), with similar gender distribution in rural and metropolitan settings. 74% GPs believed PSA testing was at least 'somewhat effective' in reducing PC mortality with annual PSA screening being conducted by more GPs in the metropolitan setting compared to the rural GPs (35% vs 18.4%), while 25% of rural GPs would not advocate routine PSA screening. When examining the concordance between DRE and PSA testing by gender of GP, the male GPs reported performing PSA testing more frequently than DRE in patients between ages 40 to 69 (p = 0.011). Urology Society guidelines (77.2%) and College of GPs (73.2%) recommendations for PC screening were thought to be at least 'somewhat useful'. Although reference ranges for PSA tests were felt to be useful, the majority (65.8%) found it easier to refer to an urologist due to the disagreements in guidelines. In conclusion, the current guidelines for PSA screening appear to cause more confusion due to their conflicting advice, leaving GPs to formulate their own practice methods, calling for an urgent need for uniform collaborative guidelines. PMID:25713765

  15. Gossiping Capabilities

    DEFF Research Database (Denmark)

    Mogensen, Martin; Frey, Davide; Guerraoui, Rachid;

    declare a high capability in order to augment their perceived quality without contributing accordingly. We evaluate HEAP in the context of a video streaming application on a 236 PlanetLab nodes testbed. Our results shows that HEAP improves the quality of the streaming by 25% over a standard gossip......Gossip-based protocols are now acknowledged as a sound basis to implement collaborative high-bandwidth content dissemination: content location is disseminated through gossip, the actual contents being subsequently pulled. In this paper, we present HEAP, HEterogeneity Aware gossip Protocol, where...... nodes dynamically adjust their contribution to gossip dissemination according to their capabilities. Using a continuous, itself gossip-based, approximation of relative capabilities, HEAP dynamically leverages the most capable nodes by (a) increasing their fanouts (while decreasing by the same proportion...

  16. Connecting Current Research on Climate and Snow with Individuals Who Care

    Science.gov (United States)

    Moore, C. E.; Denning, S.

    2015-12-01

    A growing body of research explores the effects of climate change on snow in the Southern Rocky Mountains. This research includes observing climate and weather patterns, modeling potential future winter climate and snowpack, and exploring how these changes will affect the ecosystems, people, and industries that rely on frozen reservoirs of seasonal snow. We review existing resources for non-scientists on this topic, and explain how climate and snow are changing in the Southern Rocky Mountains. The Southern Rockies urban corridor is home to a growing population of people who rely directly on snowmelt runoff for daily life, health, and prosperity. Many of these people also seek refuge from growing urbanization by escaping to the mountains. Meanwhile, high elevations in the Rockies are already experiencing noticeable effects of climate change. Individuals with personal connections to the mountains make a ready audience to receive accessible science communication grounded in current research. People who care about mountains may be inspired to join the conversation and take action in their own lives as they learn what is already changing and what they might expect to find in winters to come.

  17. [The current status, feasibility and difficulties of tele-home care].

    Science.gov (United States)

    Lou, Mei-Ling; Chang, Tsai-Shiu; Yeh, Ming-Chen; Hung, Li-Chen

    2005-02-01

    Tele-home care (THC) is an innovative nursing care mode and has been applied in home care services in European countries and America. It has shown tremendous effects and benefits in disease administration and care costs. In view of increases in medical expenditure, and increases in the aged, chronically diseased population, our government has been actively supporting long-term care networks and has listed THC as an important plan in the nation's development. However, whether this new medical electron technology is applicable to the home-care practice in Taiwan or what will be its impact on the competitive medical care market, have been little discussed. The purpose of this paper, therefore, was to introduce the THC experience from abroad in order to provide a new direction for the nursing staff. In this article, we will introduce and define THC, the equipment it requires, its application, feasibility and difficulties. In preparation for the advent of a scientific and technological 21st century, we hope that nursing staff will be able to consider alternatives to traditional forms of home care and give a try to this revolutionary care mode in order to provide continued care for patients and their families. Furthermore, we hope to encourage experts and scholars in the field of nursing and medical information to invest their effort and intelligence in the study of THC. PMID:15712062

  18. Managed care and economic dynamics.

    Science.gov (United States)

    Riggs, J E

    1996-09-01

    Over the past several decades, health care delivery in the United States evolved in an environment lacking marketplace constraints. The unforeseen result was the current health care crisis--uncontrolled costs, shrinking access, and redundant technological capabilities. Managed care is a strategy to impose fiscal constraints on health care delivery. A diagrammatic analysis of the economic dynamics between consumers and producers in an open marketplace is compared with that of patients, providers, and payers under the health care scheme that produced the health care crisis and under managed care. Patient demands, expectations, and needs for health care are not subject to fiscal constraint under managed care since the dislinkage between consumer and payer still exits. Managed care does not impose true open marketplace fiscal constraints on health care delivery. Furthermore, any solution to the US health care crisis that used true marketplace fiscal constraints would necessitate fundamental changes in societal values concerning individual rights to health care.

  19. ENTREPRENEURIAL CAPABILITIES

    DEFF Research Database (Denmark)

    Rasmussen, Lauge Baungaard; Nielsen, Thorkild

    2003-01-01

    The aim of this article is to analyse entrepreneurship from an action research perspective. What is entrepreneurship about? Which are the fundamental capabilities and processes of entrepreneurship? To answer these questions the article includes a case study of a Danish entrepreneur and his networks...

  20. Capability approach

    DEFF Research Database (Denmark)

    Jensen, Niels Rosendal; Kjeldsen, Christian Christrup

    Lærebogen er den første samlede danske præsentation af den af Amartya Sen og Martha Nussbaum udviklede Capability Approach. Bogen indeholder en præsentation og diskussion af Sen og Nussbaums teoretiske platform. I bogen indgår eksempler fra såvel uddannelse/uddannelsespolitik, pædagogik og omsorg....

  1. Mental Health Care in Nepal : Current Situation and Challenges for Development of a District Mental Health Care Plan

    NARCIS (Netherlands)

    Luitel, N.P., Jordans, M.J.D., Adhikari, Al, Upadhaya, N.P., Hanlon, C., Lund, C. & Komproe, I.H.

    2015-01-01

    Background Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of

  2. Toward a Public Toxicogenomics Capability for Supporting Predictive Toxicology: Survey of Current Resources and Chemical Indexing of Experiments in GEO and ArrayExpress

    Science.gov (United States)

    A publicly available toxicogenomics capability for supporting predictive toxicology and meta-analysis depends on availability of gene expression data for chemical treatment scenarios, the ability to locate and aggregate such information by chemical, and broad data coverage within...

  3. Integrated primary health care in Greece, a missing issue in the current health policy agenda: a systematic review

    Directory of Open Access Journals (Sweden)

    Christos Lionis

    2009-07-01

    Full Text Available Background: Over the past years, Greece has undergone several endeavors aimed at modernizing and improving national health care services with a focus on PHC. However, the extent to which integrated primary health care has been achieved is still questioned. Purpose: This paper explores the extent to which integrated primary health care (PHC is an issue in the current agenda of policy makers in Greece, reporting constraints and opportunities and highlighting the need for a policy perspective in developing integrated PHC in this Southern European country. Methods: A systematic review in PubMed/Medline and SCOPUS, along with a hand search in selected Greek biomedical journals was undertaken to identify key papers, reports, editorials or opinion letters relevant to integrated health care. Results: Our systematic review identified 198 papers and 161 out of them were derived from electronic search. Fifty-three papers in total served the scope of this review and are shortly reported. A key finding is that the long-standing dominance of medical perspectives in Greek health policy has been paving the way towards vertical integration, pushing aside any discussions about horizontal or comprehensive integration of care. Conclusion: Establishment of integrated PHC in Greece is still at its infancy, requiring major restructuring of the current national health system, as well as organizational culture changes. Moving towards a new policy-based model would bring this missing issue on the discussion table, facilitating further development.

  4. Reducing inappropriate antibiotic prescribing in the residential care setting: current perspectives

    OpenAIRE

    Lim CJ; Kong DCM; Stuart RL

    2014-01-01

    Ching Jou Lim,1 David CM Kong,1 Rhonda L Stuart2,31Centre for Medicine Use and Safety, Monash University, Parkville, VIC, Australia; 2Monash Infectious Diseases, Monash Health, Clayton, VIC, Australia; 3Department of Medicine, Monash University, Clayton, VIC, AustraliaAbstract: Residential aged care facilities are increasingly identified as having a high burden of infection, resulting in subsequent antibiotic use, compounded by the complexity of patient demographics and medical care. Of parti...

  5. Efectos del Programa Cuidando al Cuidador, en la mejora de la habilidad de cuidado Efeitos do Programa Cuidando o cuidador, na melhora da capacidade de cuidado Effects of the Program Caring for the Caregiver in improving caring capability

    Directory of Open Access Journals (Sweden)

    ORFA NINETH MORALES PADILLA

    2008-12-01

    valor. Na pós-prova ambos os grupos aumentaram o conhecimento e paciência; o último em menor escala. Discussão: o gênero feminino continua assumindo o cuidado de seus familiares, com alto conhecimento e paciência que poderiam estar vinculadas com características sóciodemográficas, e baixo valor porque o instrumento, talvez, a presenta problemas na hora de ser avaliado. Embora na pós-prova o grupo em geral atingiu a pontuação máxima nas duas dimensões descritas com antecedência e pouco fortalecimento do valor, o que argumenta a necessidade de continuar desenvolvendo o Programa Cuidando ao Cuidador e promover a criação de uma nova ferramenta, considerando o produto obtido. Conclusões: o grupo experimental e o de controle conseguiram um bom nível de capacidade de cuidado inicial. Com a execução do programa se observa o incremento em conhecimento e paciência e, em menor grau, na dimensão de valor, é por isso que concluímos que essa é uma área não tão sensível ao tratamento efetuado.Objective of the Study: to evaluate the effectiveness of the Program Caring for the Caregiver to strengthen capabilities with similar groups cared for in Hospital Nacional de Ortopedia y Rehabilitación Dr. Jorge von Ahn,in León,Gua-temala. Methodology: quantitative, quasi-experimental method, with the participation of one sample and one control group. Results: both, experimental and control groups had a high general care capability in the pre-test, except for value. In the post-test, both groups enhanced knowledge and patience, the latter to a lesser extend. Discussion: Women continue assuming the care for their relatives, with a high degree of knowledge and patience which may be associated to social and demographic characteristics and low value, because, probably, the instrument has assessment problems. Although in the post-test the group in general reached a maximum score in the two dimensions previously described and low strengthening of value, which supports

  6. Effects of the Program Caring for the Caregiver in improving caring capability Efectos del Programa Cuidando al Cuidador, en la mejora de la habilidad de cuidado Efeitos do Programa Cuidando o cuidador, na melhora da capacidade de cuidado

    Directory of Open Access Journals (Sweden)

    MORALES PADILLA ORFA NINETH

    2008-12-01

    Full Text Available Objective of the Study: to evaluate the effectiveness of the Program Caring for the Caregiver to strengthen capabilities with similar groups cared for in Hospital Nacional de Ortopedia y Rehabilitación Dr. Jorge von Ahn,in León,Guatemala. Methodology: quantitative, quasi-experimental method, with the participation of one sample and one control group. Results: both, experimental and control groups had a high general care capability in the pre-test, except for value. In the post-test, both groups enhanced knowledge and patience, the latter to a lesser extend. Discussion: Women continue assuming the care for their relatives, with a high degree of knowledge and patience which may be associated to social and demographic characteristics and low value, because, probably, the instrument has assessment problems. Although in the post-test the group in general reached a maximum score in the two dimensions previously described and low strengthening of value, which supports the need to continue developing the Program Caring for the Caregiver and to promote the creation of a new tool, taking into consideration the product obtained. Conclusions: the experimental Group and the control Group obtained a good initial care capability. When executing the program, an increase in knowledge and patience is observed and to a lesser extend in dimension of value, deducing from this that the latter is not really an area sensitive for the treatment carried out.Objetivo del estudio: evaluar la efectividad del Programa Cuidando al Cuidador, para el fortalecimiento de habilidades con grupos similares atendidos en el Hospital Nacional de Ortopedia y Rehabilitación Dr. Jorge von Ahn, de León, Guatemala. Metodología: cuantitativa de tipo cuasi experimental, con participación de un grupo muestra y otro de control. Resultados: tanto el grupo experimental como el de control tuvieron en la preprueba una alta habilidad de cuidado general, exceptuando el

  7. Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector

    Directory of Open Access Journals (Sweden)

    Abiiro Gilbert

    2012-10-01

    Full Text Available Abstract Background Globally, extending financial protection and equitable access to health services to those outside the formal sector employment is a major challenge for achieving universal coverage. While some favour contributory schemes, others have embraced tax-funded health service cover for those outside the formal sector. This paper critically examines the issue of how to cover those outside the formal sector through the lens of stakeholder views on the proposed one-time premium payment (OTPP policy in Ghana. Discussion Ghana in 2004 implemented a National Health Insurance Scheme, based on a contributory model where service benefits are restricted to those who contribute (with some groups exempted from contributing, as the policy direction for moving towards universal coverage. In 2008, the OTPP system was proposed as an alternative way of ensuring coverage for those outside formal sector employment. There are divergent stakeholder views with regard to the meaning of the one-time premium and how it will be financed and sustained. Our stakeholder interviews indicate that the underlying issue being debated is whether the current contributory NHIS model for those outside the formal employment sector should be maintained or whether services for this group should be tax funded. However, the advantages and disadvantages of these alternatives are not being explored in an explicit or systematic way and are obscured by the considerable confusion about the likely design of the OTPP policy. We attempt to contribute to the broader debate about how best to fund coverage for those outside the formal sector by unpacking some of these issues and pointing to the empirical evidence needed to shed even further light on appropriate funding mechanisms for universal health systems. Summary The Ghanaian debate on OTPP is related to one of the most important challenges facing low- and middle-income countries seeking to achieve a universal health care system. It

  8. Physician payment 2008 for interventionalists: current state of health care policy.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Giordano, James

    2007-09-01

    Physicians in the United States have been affected by significant changes in the pattern(s) of medical practice evolving over the last several decades. These changes include new measures to 1) curb increasing costs, 2) increase access to patient care, 3) improve quality of healthcare, and 4) pay for prescription drugs. Escalating healthcare costs have focused concerns about the financial solvency of Medicare and this in turn has fostered a renewed interest in the economic basis of interventional pain management practices. The provision and systemization of healthcare in North America and several European countries are difficult enterprises to manage irrespective of whether these provisions and systems are privatized (as in the United States) or nationalized or seminationalized (as in Great Britain, Canada, Australia and France). Consequently, while many management options have been put forth, none seem to be optimally geared toward affording healthcare as a maximized individual and social good, and none have been completely enacted. The current physician fee schedule (released on July 12, 2007) includes a 9.9% cut in payment rate. Since the Medicare program was created in 1965, several methods have been used to determine physicians' rate(s) for each covered service. The sustained growth rate (SGR) system, established in 1998, has evoked negative consequences on physician payment(s). Based on the current Medicare expenditure index, practice expenses are projected to increase by 34.5% from 2002 to 2016, whereas, if actual practice inflation is considered, this increase will be 90%. This is in contrast to projected physician payment cuts that are depicted to be 51%. No doubt, this scenario will be devastating to many practices and the US medical community at large. Resolutions to this problem have been offered by MedPAC, the Government Accountability Office, physician organizations, economists, and various other interested groups. In the past, temporary measures have

  9. Physician payment 2008 for interventionalists: current state of health care policy.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Giordano, James

    2007-09-01

    Physicians in the United States have been affected by significant changes in the pattern(s) of medical practice evolving over the last several decades. These changes include new measures to 1) curb increasing costs, 2) increase access to patient care, 3) improve quality of healthcare, and 4) pay for prescription drugs. Escalating healthcare costs have focused concerns about the financial solvency of Medicare and this in turn has fostered a renewed interest in the economic basis of interventional pain management practices. The provision and systemization of healthcare in North America and several European countries are difficult enterprises to manage irrespective of whether these provisions and systems are privatized (as in the United States) or nationalized or seminationalized (as in Great Britain, Canada, Australia and France). Consequently, while many management options have been put forth, none seem to be optimally geared toward affording healthcare as a maximized individual and social good, and none have been completely enacted. The current physician fee schedule (released on July 12, 2007) includes a 9.9% cut in payment rate. Since the Medicare program was created in 1965, several methods have been used to determine physicians' rate(s) for each covered service. The sustained growth rate (SGR) system, established in 1998, has evoked negative consequences on physician payment(s). Based on the current Medicare expenditure index, practice expenses are projected to increase by 34.5% from 2002 to 2016, whereas, if actual practice inflation is considered, this increase will be 90%. This is in contrast to projected physician payment cuts that are depicted to be 51%. No doubt, this scenario will be devastating to many practices and the US medical community at large. Resolutions to this problem have been offered by MedPAC, the Government Accountability Office, physician organizations, economists, and various other interested groups. In the past, temporary measures have

  10. Long-term care of the elderly: Current status, policies and dilemmas

    Directory of Open Access Journals (Sweden)

    Matković Gordana

    2012-01-01

    Full Text Available In Serbia, the long-term care as a system does not actually exist. One part of the system is regulated through cash benefits, one part through institutional social care and community-based social services, and one part is just being established under the health care system. The linkages among these segments are not strong and there is insufficient awareness of the need to regard the different parts of the system as being interdependent and interconnected. According to the different surveys, home care is needed for the daily functioning of more than 80,000 elderly people, especially for around 27,000 of those who are completely immobile. More than 300 thousand elderly persons have indicated that they are in need of some type of self-care support. By tradition, elderly people in Serbia rely primarily on family support. Some are getting the state support as well. Research shows that 62 thousand elderly persons (5 percent receive attendance allowance; 9,000 elderly are accommodated in institutions (0.7 percent, while 11.7 thousand (1 percent persons received some type of support through home care community based services. In addition, in Belgrade there are also 2,000 elderly who are beneficiaries of medical and palliative care at home. The government expenditures for these purposes can be very roughly estimated at 0.55 percent of GDP, largely for cash benefits (0.37 percent. Considered over a medium and longer term, the government expenditures on longterm care in Serbia will inevitably increase significantly, primarily due to an increase in the number and share of elderly people and the increase in additional life years spent in ill health or in need of assistance. An increase in the expenditures will also be influenced by a change in the family models and the increasing number of elderly that will be living alone, as well as the diminishing possibilities for reliance on the closest family members, especially due to emigration flows both at local

  11. Reducing inappropriate antibiotic prescribing in the residential care setting: current perspectives

    Directory of Open Access Journals (Sweden)

    Lim CJ

    2014-01-01

    Full Text Available Ching Jou Lim,1 David CM Kong,1 Rhonda L Stuart2,31Centre for Medicine Use and Safety, Monash University, Parkville, VIC, Australia; 2Monash Infectious Diseases, Monash Health, Clayton, VIC, Australia; 3Department of Medicine, Monash University, Clayton, VIC, AustraliaAbstract: Residential aged care facilities are increasingly identified as having a high burden of infection, resulting in subsequent antibiotic use, compounded by the complexity of patient demographics and medical care. Of particular concern is the recent emergence of multidrug-resistant organisms among this vulnerable population. Accordingly, antimicrobial stewardship (AMS programs have started to be introduced into the residential aged care facilities setting to promote judicious antimicrobial use. However, to successfully implement AMS programs, there are unique challenges pertaining to this resource-limited setting that need to be addressed. In this review, we summarize the epidemiology of infections in this population and review studies that explore antibiotic use and prescribing patterns. Specific attention is paid to issues relating to inappropriate or suboptimal antibiotic prescribing to guide future AMS interventions.Keywords: residential aged care, health care-associated infection, surveillance, multidrug-resistant, antibiotic prescribing, antimicrobial stewardship

  12. [Current aspects of war surgery. From the trauma center to precarious medical care].

    Science.gov (United States)

    Houdelette, P

    1997-01-01

    War, said Carl von Clausewitz, is a cameleon. In this century, each armed conflict has proved to be unique, particularly in its medical aspects, with its own features and teaching its won lessons. As recent events show, no conflict is a fact of the past. Medical care delivered to war casualties depend on the circumstances of the war, on the medical resources available, but also on the price that cultures or circumstances place on it. Everything separates these two paradigms; on the one hand the "precious" casualty of western armies whose medical support is organized in a concept (forward medical and surgical care, ultra-rapid medical evacuation) tailored to each case, and as close as possible to the medical care of a civilian trauma patient whose models remains the North-American ballistic wound managed in trauma centers; on the other hand, civilian victims, in large numbers, in poor and disorganized countries, often abandoned to their own fate or sorted by "epidemiological" triage, which guarantees a distribution, as efficient as possible, of limited medical care. In war, advanced medical care and precarious medicine may work side by side according to two logics which do not exclude one another and constantly improve. PMID:9297902

  13. Reducing inappropriate antibiotic prescribing in the residential care setting: current perspectives.

    Science.gov (United States)

    Lim, Ching Jou; Kong, David C M; Stuart, Rhonda L

    2014-01-01

    Residential aged care facilities are increasingly identified as having a high burden of infection, resulting in subsequent antibiotic use, compounded by the complexity of patient demographics and medical care. Of particular concern is the recent emergence of multidrug-resistant organisms among this vulnerable population. Accordingly, antimicrobial stewardship (AMS) programs have started to be introduced into the residential aged care facilities setting to promote judicious antimicrobial use. However, to successfully implement AMS programs, there are unique challenges pertaining to this resource-limited setting that need to be addressed. In this review, we summarize the epidemiology of infections in this population and review studies that explore antibiotic use and prescribing patterns. Specific attention is paid to issues relating to inappropriate or suboptimal antibiotic prescribing to guide future AMS interventions.

  14. Current experiences and educational preferences of general practitioners and staff caring for people with dementia living in residential facilities

    Directory of Open Access Journals (Sweden)

    Scherer Samuel

    2009-08-01

    Full Text Available Abstract Background Residential care is important for older adults, particularly for those with advanced dementia and their families. Education interventions that achieve sustainable improvement in the care of older adults are critical to quality care. There are few systematic data available regarding the educational needs of Residential Care Facility (RCF staff and General Practitioners (GPs relating to dementia, or the sustainability of educational interventions. We sought to determine participation in dementia education, perceived levels of current knowledge regarding dementia, perceived unmet educational needs, current barriers, facilitators and preferences for dementia education. Methods A mixed methods study design was utilised. A survey was distributed to a convenience sample of general practitioners, and staff in 223 consecutive residential care facilities in Perth, Western Australia. Responses were received from 102 RCF staff working in 10 facilities (out of 33 facilities who agreed to distribute the survey and 202 GPs (19% of metropolitan GPs. Quantitative survey data were summarised descriptively and chi squared statistics were used to analyse the distribution of categorical variables. Qualitative data were collected from general practitioners, staff in residential care facilities and family carers of people with dementia utilizing individual interviews, surveys and focus groups. Qualitative data were analysed thematically. Results Among RCF staff and GPs attending RCF, participation in dementia education was high, and knowledge levels generally perceived as good. The individual experiences and needs of people with dementia and their families were emphasised. Participants identified the need for a person centred philosophy to underpin educational interventions. Limited time was a frequently mentioned barrier, especially in relation to attending dementia care education. Perceived educational needs relating to behaviours of concern

  15. The current politics of residential care on spot by lightning of the child and adolescent statute

    Directory of Open Access Journals (Sweden)

    Vanessa Rombola Machado

    2011-12-01

    Full Text Available The article come up with presenting the politics of residential care based on the principles established by legislation backed to children and adolescents – The Child and Adolescent Statute – addressing the normative, notably the National Family and Community and Technical Guidelines for care services for children and adolescents, given that such rules that have been incorporated by the politics of attention to childhood and youth with the proposed changes in legislation from 2009 with the called New Adoption Law. It also presents a reflection on the reality of these host institutions, commonly known as shelters. In conclusion reflects about the importance about legal changes.

  16. Current situation of sexual and reproductive health of men deprived of liberty in the Institutional Care Center of San Jose

    OpenAIRE

    Dorita Rivas Fonseca; Adriana Ortiz Obando

    2013-01-01

    The objective of this research was to determine the current status of the issue of sexual and reproductive health ofthe prisoners Institutional Care Center (CAI) of San Jose. It is a descriptive study. Through a strategic samplingdetermined the participation of 102 men. The information was obtained by applying a self-administeredquestionnaire with closed and open questions. As a result relevant to your socio-demographic profile, it appearsthat deprived of their liberty is a very heterogeneous...

  17. Focus group reflections on the current and future state of cognitive assessment tools in geriatric health care

    OpenAIRE

    Whitehead JC; Gambino SA; Richter JD; Ryan JD

    2015-01-01

    Jocelyne C Whitehead,1 Sara A Gambino,1 Jeffrey D Richter,2 Jennifer D Ryan1,3,41Rotman Research Institute, Baycrest, 2Independent Human Factors Consultant, Toronto, ON, Canada; 3Department of Psychology, 4Department of Psychiatry, University of Toronto, Toronto, ON, CanadaObjective: This study provides insight into the thoughts and opinions of geriatric health-care professionals toward cognitive assessments and the use of emerging technologies, such as eye-tracking, to supplement current too...

  18. Lipid emulsions in parenteral nutrition of intensive care patients: current thinking and future directions.

    NARCIS (Netherlands)

    Calder, P.C.; Jensen, G.L.; Koletzko, B.V.; Singer, P.; Wanten, G.J.A.

    2010-01-01

    BACKGROUND: Energy deficit is a common and serious problem in intensive care units and is associated with increased rates of complications, length of stay, and mortality. Parenteral nutrition (PN), either alone or in combination with enteral nutrition, can improve nutrient delivery to critically ill

  19. Current state of information technology use in a US primary care practice-based research network

    Directory of Open Access Journals (Sweden)

    James Andrews

    2004-02-01

    Conclusion While interest in enabling information technologies was high in KAN, adoption was variable, with use of several key technologies reported as low.The results suggest that research in this network that would be dependent on or enhanced by IT might be impeded and, generally, greater attention should be given to enhancing the IT infrastructure in primary care.

  20. Subsurface flow and transport of organic chemicals: an assessment of current modeling capability and priority directions for future research (1987-1995)

    Energy Technology Data Exchange (ETDEWEB)

    Streile, G.P.; Simmons, C.S.

    1986-09-01

    Theoretical and computer modeling capability for assessing the subsurface movement and fate of organic contaminants in groundwater was examined. Hence, this study is particularly concerned with energy-related, organic compounds that could enter a subsurface environment and move as components of a liquid phase separate from groundwater. The migration of organic chemicals that exist in an aqueous dissolved state is certainly a part of this more general scenario. However, modeling of the transport of chemicals in aqueous solution has already been the subject of several reviews. Hence, this study emphasizes the multiphase scenario. This study was initiated to focus on the important physicochemical processes that control the behavior of organic substances in groundwater systems, to evaluate the theory describing these processes, and to search for and evaluate computer codes that implement models that correctly conceptualize the problem situation. This study is not a code inventory, and no effort was made to identify every available code capable of representing a particular process.

  1. CURRENT ECONOMIC AND MEDICAL REFORMS IN THE ROMANIAN HEALTH CARE SYSTEM

    Directory of Open Access Journals (Sweden)

    Dragoi Mihaela Cristina

    2011-12-01

    Full Text Available The issue of health has always been, both in social reality and in academia and research, a sensitive topic considering the relationship each individual has with his own health and the health care system as a public policy. At public opinion levels and not only, health care is the most important sector demanding the outmost attention, considering that individual health is the fundamental prerequisite for well-being, happiness and a satisfying life. The ever present research and practical question is on the optimal financing of the health care system. Any answer to this question is also a political decision, reflecting the social-economic value of health for a particular country. The size of the resource pool and the criteria and methods for resource allocation are the central economic problems for any health system. This paper takes into consideration the limited resources of the national health care system (the rationalization of health services, the common methods of health financing, the specificity of health services market (the health market being highly asymmetric, with health professionals knowing most if not all of the relevant information, such as diagnosis, treatment options and costs and consumers fully dependent on the information provided in each case and the performance of all hospitals in Romania, in order to assess the latest strategic decisions (introduction of co-payment and merging and reconversion of hospitals taken within the Romanian health care system and their social and economic implications. The main finding show that, even though the intention of reforming and transforming the Romanian health care system into a more efficient one is obvious, the lack of economic and demographic analysis may results into greater discrepancies nationwide. This paper is aimed to renew the necessity of joint collaboration between the economic and medical field, since the relationship between health and economic development runs both ways

  2. Evidence-Based Point-of-Care Diagnostics: Current Status and Emerging Technologies

    Science.gov (United States)

    Chan, Cangel Pui Yee; Mak, Wing Cheung; Cheung, Kwan Yee; Sin, King Keung; Yu, Cheuk Man; Rainer, Timothy H.; Renneberg, Reinhard

    2013-06-01

    Point-of-care (POC) diagnostics brings tests nearer to the site of patient care. The turnaround time is short, and minimal manual interference enables quick clinical management decisions. Growth in POC diagnostics is being continuously fueled by the global burden of cardiovascular and infectious diseases. Early diagnosis and rapid initiation of treatment are crucial in the management of such patients. This review provides the rationale for the use of POC tests in acute coronary syndrome, heart failure, human immunodeficiency virus, and tuberculosis. We also consider emerging technologies that are based on advanced nanomaterials and microfluidics, improved assay sensitivity, miniaturization in device design, reduced costs, and high-throughput multiplex detection, all of which may shape the future development of POC diagnostics.

  3. Transitional care in clinical networks for young people with juvenile idiopathic arthritis: current situation and challenges.

    Science.gov (United States)

    Cruikshank, Mary; Foster, Helen E; Stewart, Jane; Davidson, Joyce E; Rapley, Tim

    2016-04-01

    Clinical networks for paediatric and adolescent rheumatology are evolving, and their effect and role in the transition process between paediatric and adult services are unknown. We therefore explored the experiences of those involved to try and understand this further. Health professionals, young people with juvenile idiopathic arthritis and their families were recruited via five national health service paediatric and adolescent rheumatology specialist centres and networks across the UK. Seventy participants took part in focus groups and one-to-one interviews. Data was analysed using coding, memoing and mapping techniques to identify features of transitional services across the sector. Variation and inequities in transitional care exist. Although transition services in networks are evolving, development has lagged behind other areas with network establishment focusing more on access to paediatric rheumatology multidisciplinary teams. Challenges include workforce shortfalls, differences in service priorities, standards and healthcare infrastructures, and managing the legacy of historic encounters. Providing equitable high-quality clinically effective services for transition across the UK has a long way to go. There is a call from within the sector for more protected time, staff and resources to develop transition roles and services, as well as streamlining of local referral pathways between paediatric and adult healthcare services. In addition, there is a need to support professionals in developing their understanding of transitional care in clinical networks, particularly around service design, organisational change and the interpersonal skills required for collaborative working. Key messages • Transitional care in clinical networks requires collaborative working and an effective interface with paediatric and adult rheumatology.• Professional centrism and historic encounters may affect collaborative relationships within clinical networks.• Education

  4. The Transformation of China’s Health Care System and Accounting Methods: Current Reforms and Developments

    OpenAIRE

    David Chu; Kolleen Rask

    2000-01-01

    This paper is a case study of China’s recent reforms in hospital accounting. We analyze the Chinese health care system in transition to highlight the changing role and nature of accounting services before and after the recent reforms. Prior to reforms, the accounting system provided data solely for government central planning purposes. Reforms were supposed to decentralize hospital decision making, thus signaling a need for a new accounting system that would provide information to managers an...

  5. Dengue: Moving from Current Standard of Care to State-of-the-Art Treatment

    OpenAIRE

    Gan, Victor C

    2014-01-01

    Opinion statement Treatment of dengue remains supportive in the absence of targeted antiviral therapy or approved vaccines. Responsive fluid management is key to preventing progression to shock or other severe manifestations. The dynamic natural history of dengue infection and its influence on hemodynamic homeostasis needs to be carefully considered in the planning of individualized therapy. Though largely self-limiting, the sheer burden of dengue disease on the global population will result ...

  6. The Medical Care Advisory Committee for State Medicaid programs: Current status and trends

    OpenAIRE

    Davidson, Stephen M.; Herold, Terry E.; Simon, Marlene B.

    1984-01-01

    Each State Medicaid program is required by Federal Regulations to have a Medical Care Advisory Committee (MCAC) which includes provider, consumer, and government representatives and which participates in policy development and program administration. Data are presented about the composition of these committees, their structure, the administrative and financial support they receive, and the nature of their activities. It is argued that they can play an important role in policy formulation and ...

  7. Transitional care in clinical networks for young people with juvenile idiopathic arthritis: current situation and challenges.

    Science.gov (United States)

    Cruikshank, Mary; Foster, Helen E; Stewart, Jane; Davidson, Joyce E; Rapley, Tim

    2016-04-01

    Clinical networks for paediatric and adolescent rheumatology are evolving, and their effect and role in the transition process between paediatric and adult services are unknown. We therefore explored the experiences of those involved to try and understand this further. Health professionals, young people with juvenile idiopathic arthritis and their families were recruited via five national health service paediatric and adolescent rheumatology specialist centres and networks across the UK. Seventy participants took part in focus groups and one-to-one interviews. Data was analysed using coding, memoing and mapping techniques to identify features of transitional services across the sector. Variation and inequities in transitional care exist. Although transition services in networks are evolving, development has lagged behind other areas with network establishment focusing more on access to paediatric rheumatology multidisciplinary teams. Challenges include workforce shortfalls, differences in service priorities, standards and healthcare infrastructures, and managing the legacy of historic encounters. Providing equitable high-quality clinically effective services for transition across the UK has a long way to go. There is a call from within the sector for more protected time, staff and resources to develop transition roles and services, as well as streamlining of local referral pathways between paediatric and adult healthcare services. In addition, there is a need to support professionals in developing their understanding of transitional care in clinical networks, particularly around service design, organisational change and the interpersonal skills required for collaborative working. Key messages • Transitional care in clinical networks requires collaborative working and an effective interface with paediatric and adult rheumatology.• Professional centrism and historic encounters may affect collaborative relationships within clinical networks.• Education

  8. Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research

    Science.gov (United States)

    Magnuson, Allison; Allore, Heather; Cohen, Harvey Jay; Mohile, Supriya G.; Williams, Grant R.; Chapman, Andrew; Extermann, Martine; Olin, Rebecca L.; Targia, Valerie; Mackenzie, Amy; Holmes, Holly M.; Hurria, Arti

    2016-01-01

    Older adults with cancer represent a complex patient population. Geriatric assessment (GA) is recommended to evaluate the medical and supportive care needs of this group. “GA with management” is a term encompassing the resultant medical decisions and interventions implemented in response to vulnerabilities identified on GA. In older, non-cancer patients, GA with management has been shown to improve a variety of outcomes, such as reducing functional decline and health care utilization. However, the role of GA with management in the older adult with cancer is less well established. Rigorous clinical trials of GA with management are necessary to develop an evidence base and support its use in the routine oncology care of older adults. At the recent U-13 conference, “Design and Implementation of Intervention Studies to Improve or Maintain Quality of Survivorship in Older and/or Frail Adults with Cancer,” a session was dedicated to developing research priorities in GA with management. Here we summarize identified knowledge gaps in GA with management studies for older patients with cancer and propose areas for future research. PMID:27197915

  9. Retention in care and medication adherence: current challenges to antiretroviral therapy success.

    Science.gov (United States)

    Holtzman, Carol W; Brady, Kathleen A; Yehia, Baligh R

    2015-04-01

    Health behaviors such as retention in HIV medical care and adherence to antiretroviral therapy (ART) pose major challenges to reducing new HIV infections, addressing health disparities, and improving health outcomes. Andersen's Behavioral Model of Health Service Use provides a conceptual framework for understanding how patient and environmental factors affect health behaviors and outcomes, which can inform the design of intervention strategies. Factors affecting retention and adherence among persons with HIV include patient predisposing factors (e.g., mental illness, substance abuse), patient-enabling factors (e.g., social support, reminder strategies, medication characteristics, transportation, housing, insurance), and healthcare environment factors (e.g., pharmacy services, clinic experiences, provider characteristics). Evidence-based recommendations for improving retention and adherence include (1) systematic monitoring of clinic attendance and ART adherence; (2) use of peer or paraprofessional navigators to re-engage patients in care and help them remain in care; (3) optimization of ART regimens and pharmaceutical supply chain management systems; (4) provision of reminder devices and tools; (5) general education and counseling; (6) engagement of peer, family, and community support groups; (7) case management; and (8) targeting patients with substance abuse and mental illness. Further research is needed on effective monitoring strategies and interventions that focus on improving retention and adherence, with specific attention to the healthcare environment. PMID:25792300

  10. Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research.

    Science.gov (United States)

    Magnuson, Allison; Allore, Heather; Cohen, Harvey Jay; Mohile, Supriya G; Williams, Grant R; Chapman, Andrew; Extermann, Martine; Olin, Rebecca L; Targia, Valerie; Mackenzie, Amy; Holmes, Holly M; Hurria, Arti

    2016-07-01

    Older adults with cancer represent a complex patient population. Geriatric assessment (GA) is recommended to evaluate the medical and supportive care needs of this group. "GA with management" is a term encompassing the resultant medical decisions and interventions implemented in response to vulnerabilities identified on GA. In older, non-cancer patients, GA with management has been shown to improve a variety of outcomes, such as reducing functional decline and health care utilization. However, the role of GA with management in the older adult with cancer is less well established. Rigorous clinical trials of GA with management are necessary to develop an evidence base and support its use in the routine oncology care of older adults. At the recent U-13 conference, "Design and Implementation of Intervention Studies to Improve or Maintain Quality of Survivorship in Older and/or Frail Adults with Cancer," a session was dedicated to developing research priorities in GA with management. Here we summarize identified knowledge gaps in GA with management studies for older patients with cancer and propose areas for future research. PMID:27197915

  11. Current care services provided for patients with COPD in the Eastern province in Saudi Arabia: a descriptive study

    Directory of Open Access Journals (Sweden)

    Alsubaiei ME

    2015-11-01

    Full Text Available Mohammed E Alsubaiei,1,2 Paul A Cafarella,1,2 Peter A Frith,1,2 R Doug McEvoy,2,3 Tanja W Effing1,2 1Repatriation General Hospital, Department of Respiratory Medicine, Adelaide, SA, Australia; 2Flinders University, School of Medicine, Adelaide, SA, Australia; 3Repatriation General Hospital, Sleep and Respiratory Medicine, Southern Adelaide Local Health Network, Daw Park, SA, Australia Background: COPD is a leading cause of morbidity and mortality worldwide. The prevalence rate of COPD in the general Saudi population is estimated to be 2.4% and 14.2% among smokers. Not much is known about current health care services for patients with COPD in Saudi Arabia. The objective of this study was to determine the current care services for patients with COPD provided by government hospitals in the Eastern province of Saudi Arabia.Methods: A cross-sectional study was conducted in the Eastern province of Saudi Arabia. Directors of the Department of Internal Medicine from all 22 general government hospitals that are under the responsibility of the Ministry of Health or the Ministry of Higher Education in this region were asked to participate. Data were collected using a questionnaire.Results: The study results indicated that there are limited hospital facilities for patients with COPD: no respiratory departments in any of the included hospitals, no spirometry in 77.3% of the hospitals, no intensive care units in 63.7% of the hospitals, and no pulmonary rehabilitation program in any of the hospitals. Among the included 22 hospitals, 24 respiratory physicians, 29 respiratory therapists, and three physiotherapists were involved in COPD care.Conclusion: In conclusion, current care services provided by government hospitals in the Eastern province of Saudi Arabia for patients with COPD do not meet international recommendations for COPD management. Increased awareness, knowledge, and implementation of COPD guidelines by health care providers will most probably

  12. Current issues in the respiratory care of patients with amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Marco Orsini

    2015-10-01

    Full Text Available Amyotrophic lateral sclerosis is a progressive neuromuscular disease, resulting in respiratory muscle weakness, reduced pulmonary volumes, ineffective cough, secretion retention, and respiratory failure. Measures as vital capacity, maximal inspiratory and expiratory pressures, sniff nasal inspiratory pressure, cough peak flow and pulse oximetry are recommended to monitor the respiratory function. The patients should be followed up by a multidisciplinary team, focused in improving the quality of life and deal with the respiratory symptoms. The respiratory care approach includes airway clearance techniques, mechanically assisted cough and noninvasive mechanical ventilation. Vaccination and respiratory pharmacological support are also recommended. To date, there is no enough evidence supporting the inspiratory muscle training and diaphragmatic pacing.

  13. An Empirical Analysis of the Current Need for Teleneuromedical Care in German Hospitals without Neurology Departments.

    Science.gov (United States)

    Ickenstein, G W; Groß, S; Tenckhoff, D; Hausn, P; Becker, U; Klisch, J; Isenmann, S

    2010-01-01

    Indroduction. At present, modern telemedicine methods are being introduced, that may contribute to reducing lack of qualified stroke patient care, particularly in less populated regions. With the help of video conferencing systems, a so-called neuromedical teleconsultation is carried out. Methods. The study included a multicentered, completely standardized survey of physicians in hospitals by means of a computerized on-line questionnaire. Descriptive statistical methods were used for data analysis. Results. 119 acute hospitals without neurology departments were included in the study. The most important reasons for participating in a teleneuromedical network is seen as the improvement in the quality of treatment (82%), the ability to avoid unnecessary patient transport (76%), easier and faster access to stroke expertise (72%) as well as better competitiveness among medical services (67%). The most significant problem areas are the financing system of teleneuromedicine with regard to the acquisition costs of the technical equipment (43%) and the compensation for the stroke-unit center with the specialists' consultation service (31%) as well as legal aspects of teleneuromedicine (27%). Conclusions. This investigation showed that there is a high acceptance for teleneuromedicine among co-operating hospitals. However these facilities have goals in addition to improved quality in stroke treatment. Therefore the use of teleneuromedicine must be also associated with long term incentives for the overall health care system, particularly since the implementation of a teleneuromedicine network system is time consuming and associated with high implementation costs. PMID:20671991

  14. An Empirical Analysis of the Current Need for Teleneuromedical Care in German Hospitals without Neurology Departments

    Directory of Open Access Journals (Sweden)

    G. W. Ickenstein

    2010-01-01

    Full Text Available Indroduction. At present, modern telemedicine methods are being introduced, that may contribute to reducing lack of qualified stroke patient care, particularly in less populated regions. With the help of video conferencing systems, a so-called neuromedical teleconsultation is carried out. Methods. The study included a multicentered, completely standardized survey of physicians in hospitals by means of a computerized on-line questionnaire. Descriptive statistical methods were used for data analysis. Results. 119 acute hospitals without neurology departments were included in the study. The most important reasons for participating in a teleneuromedical network is seen as the improvement in the quality of treatment (82%, the ability to avoid unnecessary patient transport (76%, easier and faster access to stroke expertise (72% as well as better competitiveness among medical services (67%. The most significant problem areas are the financing system of teleneuromedicine with regard to the acquisition costs of the technical equipment (43% and the compensation for the stroke-unit center with the specialists' consultation service (31% as well as legal aspects of teleneuromedicine (27%. Conclusions. This investigation showed that there is a high acceptance for teleneuromedicine among co-operating hospitals. However these facilities have goals in addition to improved quality in stroke treatment. Therefore the use of teleneuromedicine must be also associated with long term incentives for the overall health care system, particularly since the implementation of a teleneuromedicine network system is time consuming and associated with high implementation costs.

  15. Characterization of Electrical Current-Generation Capabilities from Thermophilic Bacterium Thermoanaerobacter pseudethanolicus Using Xylose, Glucose, Cellobiose, or Acetate with Fixed Anode Potentials.

    Science.gov (United States)

    Lusk, Bradley G; Khan, Qaiser Farid; Parameswaran, Prathap; Hameed, Abdul; Ali, Naeem; Rittmann, Bruce E; Torres, Cesar I

    2015-12-15

    Thermoanaerobacter pseudethanolicus 39E (ATCC 33223), a thermophilic, Fe(III)-reducing, and fermentative bacterium, was evaluated for its ability to produce current from four electron donors-xylose, glucose, cellobiose, and acetate-with a fixed anode potential (+ 0.042 V vs SHE) in a microbial electrochemical cell (MXC). Under thermophilic conditions (60 °C), T. pseudethanolicus produced high current densities from xylose (5.8 ± 2.4 A m(-2)), glucose (4.3 ± 1.9 A m(-2)), and cellobiose (5.2 ± 1.6 A m(-2)). It produced insignificant current when grown with acetate, but consumed the acetate produced from sugar fermentation to produce electrical current. Low-scan cyclic voltammetry (LSCV) revealed a sigmoidal response with a midpoint potential of -0.17 V vs SHE. Coulombic efficiency (CE) varied by electron donor, with xylose at 34.8% ± 0.7%, glucose at 65.3% ± 1.0%, and cellobiose at 27.7% ± 1.5%. Anode respiration was sustained over a pH range of 5.4-8.3, with higher current densities observed at higher pH values. Scanning electron microscopy showed a well-developed biofilm of T. pseudethanolicus on the anode, and confocal laser scanning microscopy demonstrated a maximum biofilm thickness (Lf) greater than ~150 μm for the glucose-fed biofilm.

  16. Meeting Earth Observation Requirements for Global Agricultural Monitoring: An Evaluation of the Revisit Capabilities of Current and Planned Moderate Resolution Optical Earth Observing Missions

    Directory of Open Access Journals (Sweden)

    Alyssa K. Whitcraft

    2015-01-01

    Full Text Available Agriculture is a highly dynamic process in space and time, with many applications requiring data with both a relatively high temporal resolution (at least every 8 days and fine-to-moderate (FTM < 100 m spatial resolution. The relatively infrequent revisit of FTM optical satellite observatories coupled with the impacts of cloud occultation have translated into a barrier for the derivation of agricultural information at the regional-to-global scale. Drawing upon the Group on Earth Observations Global Agricultural Monitoring (GEOGLAM Initiative’s general satellite Earth observation (EO requirements for monitoring of major production areas, Whitcraft et al. (this issue have described where, when, and how frequently satellite data acquisitions are required throughout the agricultural growing season at 0.05°, globally. The majority of areas and times of year require multiple revisits to probabilistically yield a view at least 70%, 80%, 90%, or 95% clear within eight days, something that no present single FTM optical observatory is capable of delivering. As such, there is a great potential to meet these moderate spatial resolution optical data requirements through a multi-space agency/multi-mission constellation approach. This research models the combined revisit capabilities of seven hypothetical constellations made from five satellite sensors—Landsat 7 Enhanced Thematic Mapper (Landsat 7 ETM+, Landsat 8 Operational Land Imager and Thermal Infrared Sensor (Landsat 8 OLI/TIRS, Resourcesat-2 Advanced Wide Field Sensor (Resourcesat-2 AWiFS, Sentinel-2A Multi-Spectral Instrument (MSI, and Sentinel-2B MSI—and compares these capabilities with the revisit frequency requirements for a reasonably cloud-free clear view within eight days throughout the agricultural growing season. Supplementing Landsat 7 and 8 with missions from different space agencies leads to an improved capacity to meet requirements, with Resourcesat-2 providing the largest

  17. Evaluation of state-of-the-art imaging systems for in vivo monitoring of retinal structure in mice: current capabilities and limitations

    Science.gov (United States)

    Zhang, Pengfei; Zam, Azhar; Pugh, Edward N.; Zawadzki, Robert J.

    2014-02-01

    Animal models of human diseases play an important role in studying and advancing our understanding of these conditions, allowing molecular level studies of pathogenesis as well as testing of new therapies. Recently several non-invasive imaging modalities including Fundus Camera, Scanning Laser Ophthalmoscopy (SLO) and Optical Coherence Tomography (OCT) have been successfully applied to monitor changes in the retinas of the living animals in experiments in which a single animal is followed over a portion of its lifespan. Here we evaluate the capabilities and limitations of these three imaging modalities for visualization of specific structures in the mouse eye. Example images acquired from different types of mice are presented. Future directions of development for these instruments and potential advantages of multi-modal imaging systems are discussed as well.

  18. An Overview of the Current Status of Talent Care and Talent Support in Hungary

    Directory of Open Access Journals (Sweden)

    Csilla Fuszek

    2014-09-01

    Full Text Available After a short historical introduction, the article provides an overview of the current talent support trends in Hungary. It gives an insight into the legislation, guidelines and institutional system associated with the national talent support strategy, and presents the main NGO initiatives present in the early 21st century, in particular the organisations brought to life by the Hungarian Talent Support Council and their effect on current education policy. At the same time, the article seeks to present the strengths and weaknesses of the national talent support strategy and the Hungarian talent support cooperation model.

  19. The current situation and future scope of radiation emergency medical care network in Nagasaki

    International Nuclear Information System (INIS)

    Under the framework of the International Consortium for Medical Care of Hibakusha and Radiation Life Science (Nagasaki University 21st Century COE Program) and bearing in mind the unique history and responsibility of Nagasaki University, several projects on radiation emergency preparedness are in progress. The critical accident in Tokaimura, Japan in 1999 made us realize that nuclear emergencies happen anywhere radionuclides exist. In fact, nuclear accidents possibly take place in factories, research facilities, hospital and wherever radioactive materials are in transit. Therefore, it is necessary to establish an effective preparedness network system for potential radiation emergency that may occur in Nagasaki and nearby prefectures and to cooperate with other Japanese and worldwide networks. (author)

  20. Current status of multidrug resistant tuberculosis in a tertiary care hospital of East Delhi

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    T Sagar

    2013-01-01

    Full Text Available Background and Objective: Multidrug resistant tuberculosis (MDR-TB is caused by infection due to Mycobacterium tuberculosis which is resistant to both isoniazid (INH and rifampicin (RIF. It is caused by selection of resistant mutant strains due to inadequate treatment and poor compliance. MDR-TB is a major public health problem as the treatment is complicated, cure rates are well below those for drug susceptible tuberculosis and patient remains infectious for months despite receiving the best available therapy. The drug susceptibility pattern of M. tuberculosis is essential for proper control of MDR-TB in every health care setting, hence the study was initiated with the aim of studying the prevalence of MDR-TB in patients attending a tertiary care hospital in east Delhi. Materials and Methods: Five hundred and forty-three pulmonary and extrapulmonary samples from suspected cases of tuberculosis received in the mycobacteriology laboratory from November 2009 through October 2010 were investigated for M. tuberculosis. All the samples were subjected to direct microscopic examination for demonstration of acid fast bacilli followed by culture on Lowenstein-Jensen (LJ medium to isolate M. tuberculosis. Identification was done by conventional biochemical methods. Drug susceptibility of isolated M. tuberculosis strains was done by conventional 1% proportion method followed by sequencing of RIF resistant isolates to detect mutations to confirm resistance. Results and Conclusions: M. tuberculosis was isolated from 75 out of 543 suspected cases of pulmonary/extrapulmonary TB. Three of the total 75 M. tuberculosis isolates (4% showed resistance to any one of the first line drugs. Prevalence of MDR-TB was 1.3%. The sequencing of single MDR strain showed mutations at codons 516, 517, and 518. Amplification of rpoB and sequential analysis of the amplicon is a better way of detection of mutation and the evidence of new mutation in this study indicate that

  1. Care of the patient with interstitial cystitis: current theories and management.

    Science.gov (United States)

    Burrell, M; Hurm, R

    1999-02-01

    Interstitial cystitis is a disease process that has only come into focus over recent years. Researchers are looking for a cause of this painful and frustrating disorder of the bladder, but currently, only theories exist. Nurses must understand the pathophysiology of the disease and the dysfunction of the bladder to educate and assist the patient in the management of this chronic process. This report provides the nurse with information and education on the symptoms, pathophysiology, nursing diagnoses, and potential treatment modalities.

  2. Current situation of sexual and reproductive health of men deprived of liberty in the Institutional Care Center of San Jose

    Directory of Open Access Journals (Sweden)

    Dorita Rivas Fonseca

    2013-10-01

    Full Text Available The objective of this research was to determine the current status of the issue of sexual and reproductive health ofthe prisoners Institutional Care Center (CAI of San Jose. It is a descriptive study. Through a strategic samplingdetermined the participation of 102 men. The information was obtained by applying a self-administeredquestionnaire with closed and open questions. As a result relevant to your socio-demographic profile, it appearsthat deprived of their liberty is a very heterogeneous group. As regards sexual and reproductive health, the firstconcept they relate to the prevention of disease and the second reproductive aspects, this shows limitations inknowledge on the topics, something that affects the daily life activities and self-care. It is concluded that researchby nurses Gyneco-obstetric in the deprived of liberty is almost null not only in the country but in the world,especially if it comes with the male population. In the case of CAI Prison, health care is not enough for thenumber of inmates who inhabit (overpopulation of almost 50%, this implies a deterioration in health and physicalcondition of these people, as well as sexual and reproductive health

  3. Adoption of standard ERP solution in health care sector: is SAP ERP all-in-one capable to meet specific requirements?

    OpenAIRE

    Kraljic, Adnan; Kraljic, Tarik; Delismajlović, Denis

    2012-01-01

    Objective of this experience report is to address specific issues regarding standard SAP ERP implementation in a medical institution. Target Company is a state owned health care institution from Bosnia and Herzegovina. Report will treat selected issues which could trouble standard SAP ERP implementation trough predefined ERP implementation methodology for SAP ERP. This report presents observations/ remarks based on experience of authors in particular SAP ERP implementation project in health c...

  4. Radiotherapy for pediatric brain tumors: Standard of care, current clinical trials, and new directions

    International Nuclear Information System (INIS)

    Objectives: To review the clinical characteristics of childhood brain tumors, including neurologic signs, neuroimaging and neuropathology. To critically assess indications for therapy relevant to presenting characteristics, age, and disease status. To discuss current management strategies including neurosurgery, radiation therapy, and chemotherapy. To analyze current clinical trials and future directions of clinical research. Brain tumors account for 20% of neoplastic diseases in children. The most common tumors include astrocytoma and malignant gliomas, medulloblastoma and supratentorial PNET's, ependymoma, craniopharyngioma, and intracranial germ cell tumors. Tumor type and clinical course are often correlated with age at presentation and anatomic site. The clinical characteristics and disease extent largely determine the relative merits of available 'standard' and investigational therapeutic approaches. Treatment outcome, including disease control and functional integrity, is dependent upon age at presentation, tumor type, and disease extent. An understanding of the clinical, neuroimaging, and histologic characteristics as they relate to decisions regarding therapy is critical to the radiation oncologist. Appropriate radiation therapy is central to curative therapy for a majority of pediatric brain tumor presentations. Technical advances in neurosurgery provide greater safety for 'gross total resection' in a majority of hemispheric astrocytomas and medulloblastomas. The relative roles of 'standard' radiation therapy and evolving chemotherapy for centrally located astrocytomas (e.g., diencephalic, optic pathway) need to be analyzed in the context of initial and overall disease control, neurotoxicities, and potential modifications in the risk:benefit ratio apparent in the introduction of precision radiation techniques. Modifications in radiation delivery are fundamental to current investigations in medulloblastoma; the rationale for contemporary and projected

  5. The Uncertainty Reducing Capabilities of Primary Care Physicians' Video Biographies for Choosing a New Doctor: Is a Video Worth More Than Two Hundred Words?

    Science.gov (United States)

    Perrault, Evan K; Silk, Kami J

    2016-12-01

    Choosing a primary care physician for the first time is an important decision, one that health care systems do not make particularly easy for prospective patients to make solely through the limited information provided on their websites. Without knowledge from others, a new patient is likely to have uncertainty about the physician he or she chooses. Three hundred and twenty participants completed an online experiment and were exposed to two biographies of different doctors with different media and either professional or personal information. Predictions generated by media richness theory revealed greater reductions in uncertainty for video biographies than traditional text biographies. Video biographies, and those containing personal information about the physician, were also related to higher levels of anticipated patient satisfaction and care quality. When asked to choose the physicians they would want to visit, participants overwhelmingly chose the physician with whom they perceived the greatest similarity to themselves, as well as the doctor who provided a video biography. Both theoretical and practical implications of this research are discussed. PMID:27054561

  6. Building a clinical leadership community to drive improvement: a multi-case educational study to inform 21st century clinical commissioning, professional capability and patient care.

    Science.gov (United States)

    Lynch, Marion; Verner, Elizabeth

    2013-01-01

    The new NHS requires transformational leadership; people with the knowledge and motivation to make effective change combined with an understanding of the system they work in. The aim of the Practice Leaders' Programme (PLP) is to generate the conditions needed to focus the energy and collaborative creativity required for innovation to enhance leadership skills across the health economy improving patient care. The PLP engaged 60 local leaders from central England in a new approach enabling them to influence others. It has informed educational policy and practice and helped change professional behaviours. Each participant implemented improvements in care and participated in six action learning sets (ALS) and up to six coaching sessions. Evidence of progress, learning and impact was identified in project reports, reflective diaries and evaluations. The ALS brought together key individuals from clinical and management disciplines across a diverse organisation to redesign a system by developing a shared vision for improving the quality of patient care. The links forged, the projects initiated, and the skills cultivated through the PLP produced ongoing benefits and outcomes beyond the course itself. Coaching sessions helped participants focus their efforts to achieve maximum impact and to become resilient in managing service change effectively. The programme has evolved over four years, building on recommendations from external evaluation which identified statistically significant increases in leadership competences. Further enhancement of this programme secured an International Health Improvement Award. Three key findings of positive impact have emerged; personal growth, service improvement, and legacy and sustainability.

  7. Building a clinical leadership community to drive improvement: a multi-case educational study to inform 21st century clinical commissioning, professional capability and patient care.

    Science.gov (United States)

    Lynch, Marion; Verner, Elizabeth

    2013-01-01

    The new NHS requires transformational leadership; people with the knowledge and motivation to make effective change combined with an understanding of the system they work in. The aim of the Practice Leaders' Programme (PLP) is to generate the conditions needed to focus the energy and collaborative creativity required for innovation to enhance leadership skills across the health economy improving patient care. The PLP engaged 60 local leaders from central England in a new approach enabling them to influence others. It has informed educational policy and practice and helped change professional behaviours. Each participant implemented improvements in care and participated in six action learning sets (ALS) and up to six coaching sessions. Evidence of progress, learning and impact was identified in project reports, reflective diaries and evaluations. The ALS brought together key individuals from clinical and management disciplines across a diverse organisation to redesign a system by developing a shared vision for improving the quality of patient care. The links forged, the projects initiated, and the skills cultivated through the PLP produced ongoing benefits and outcomes beyond the course itself. Coaching sessions helped participants focus their efforts to achieve maximum impact and to become resilient in managing service change effectively. The programme has evolved over four years, building on recommendations from external evaluation which identified statistically significant increases in leadership competences. Further enhancement of this programme secured an International Health Improvement Award. Three key findings of positive impact have emerged; personal growth, service improvement, and legacy and sustainability. PMID:23356759

  8. A Current View of Functional Biomaterials for Wound Care, Molecular and Cellular Therapies

    Directory of Open Access Journals (Sweden)

    Francesco Piraino

    2015-01-01

    Full Text Available The intricate process of wound healing involves activation of biological pathways that work in concert to regenerate a tissue microenvironment consisting of cells and external cellular matrix (ECM with enzymes, cytokines, and growth factors. Distinct stages characterize the mammalian response to tissue injury: hemostasis, inflammation, new tissue formation, and tissue remodeling. Hemostasis and inflammation start right after the injury, while the formation of new tissue, along with migration and proliferation of cells within the wound site, occurs during the first week to ten days after the injury. In this review paper, we discuss approaches in tissue engineering and regenerative medicine to address each of these processes through the application of biomaterials, either as support to the native microenvironment or as delivery vehicles for functional hemostatic, antibacterial, or anti-inflammatory agents. Molecular therapies are also discussed with particular attention to drug delivery methods and gene therapies. Finally, cellular treatments are reviewed, and an outlook on the future of drug delivery and wound care biomaterials is provided.

  9. Disinfection and Sterilization in Health Care Facilities: An Overview and Current Issues.

    Science.gov (United States)

    Rutala, William A; Weber, David J

    2016-09-01

    When properly used, disinfection and sterilization can ensure the safe use of invasive and noninvasive medical devices. The method of disinfection and sterilization depends on the intended use of the medical device: critical items (contact sterile tissue) must be sterilized before use; semicritical items (contact mucous membranes or nonintact skin) must be high-level disinfected; and noncritical items (contact intact skin) should receive low-level disinfection. Cleaning should always precede high-level disinfection and sterilization. Current disinfection and sterilization guidelines must be strictly followed. PMID:27515140

  10. 怀化市基层儿童保健服务能力现状调查分析%Huaihua grassroots child care investigation and analysis capability

    Institute of Scientific and Technical Information of China (English)

    张爱平; 黄志

    2016-01-01

    目的:为了解怀化市基层儿童保健服务现状、存在的问题以及探讨解决办法,促进全市儿童保健门诊规范化建设工作的开展。方法:根据《湖南省儿童保健工作规范实施细则(试行)》对乡级儿保门诊的要求,自拟调查表,对318家乡级医疗机构进行问卷调查。结果:在儿保人员构成、门诊用房和设备和可开展的服务项目均存在不足。结论:我市儿保服务能力的提升,主要需要加大财政投入,改善硬件设施,稳定儿保队伍以及加强儿保专干的技能培训。%Objective For Huaihua City, grass-roots child care services status quo, existing problems and explore solutions to promote standardization of child health clinics in the city. Methods According to“regulate child care Hunan Implementing Rules (Trial)”child health clinic on the township level requirements, since the proposed questionnaire, 318 home-class medical institu-tions survey. Results the city and township levels are his personnel structure, outpatient room and equipment, information registra-tion, outpatient service system and can carry out service shortcomings. Conclusion our city protect their service skills, and need to increase its financial input, improve the hardware facilities, stability and his team to strengthen Child care workers skills training.

  11. Herbal extracts in oral health care - A review of the current scenario and its future needs

    Directory of Open Access Journals (Sweden)

    Byalakere Rudraiah Chandra Shekar

    2015-01-01

    Full Text Available Background: Oral diseases are among the major public health problems and the commonest of chronic diseases that affect mankind. The application of natural products for the control of oral diseases is considered as an interesting alternative to synthetic antimicrobials due to their lower negative impact, and for the effort to overcome primary or secondary resistance to the drug during therapy. Objective: To review the current evidence on the antimicrobial efficacy of 10 plant extracts on dental caries and plaque microorganisms. Materials and Methods: A comprehensive literature search was made by one of the authors for 2 months in PubMed, PubMed Central, MEDLINE, LILACS/BBO, Cochrane database of systematic reviews, SCIENCE DIRECT, and Google scholar databases. The results from the relevant published literatures are discussed. Summary and Conclusion: The extracts of Azadirachta Indica, Ocimum sanctum, Murraya koenigii L., Acacia nilotica, Eucalyptus camaldulensis, Hibiscus sabdariffa, Mangifera indica, Psidium guajava, Rosa indica, and Aloe barbadensis Miller have all been found to inhibit certain dental caries and periodontal pathogens. The current evidence is on individual plant extracts against bacteria involved in either caries or periodontitis. "Herbal shotgun" or "synergistic multitarget effects" are the terms used for the strategy of combining different extracts. The research assessing the antimicrobial efficacy of a combination of these plant extracts against dental caries and periodontal pathogens is the need of the hour, and such research will aid in the development of a novel, innovative method that can simultaneously inhibit two of the most common dental diseases of mankind, besides slowing the development of drug resistance.

  12. Currents issues in cardiorespiratory care of patients with post-polio syndrome

    Directory of Open Access Journals (Sweden)

    Marco Orsini

    2016-07-01

    Full Text Available ABSTRACT Post-polio syndrome (PPS is a condition that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. Most often, polio survivors experience a gradual new weakening in muscles that were previously affected by the polio infection. The actual incidence of cardiovascular diseases (CVDs in individuals suffering from PPS is not known. However, there is a reason to suspect that individuals with PPS might be at increased risk. Method A search for papers was made in the databases Bireme, Scielo and Pubmed with the following keywords: post polio syndrome, cardiorespiratory and rehabilitation in English, French and Spanish languages. Although we targeted only seek current studies on the topic in question, only the relevant (double-blind, randomized-controlled and consensus articles were considered. Results and Discussion Certain features of PPS such as generalized fatigue, generalized and specific muscle weakness, joint and/or muscle pain may result in physical inactivity deconditioning obesity and dyslipidemia. Respiratory difficulties are common and may result in hypoxemia. Conclusion Only when evaluated and treated promptly, somE patients can obtain the full benefits of the use of respiratory muscles aids as far as quality of life is concerned.

  13. Effect of transcranial direct current stimulation on visual perception function and performance capability of activities of daily living in stroke patients

    Science.gov (United States)

    Kim, Ko-Un; Kim, Su-Han; An, Tae-Gyu

    2016-01-01

    [Purpose] The purpose of this study was to examine the effects of transcranial direct current stimulation (tDCS) on visual perception and performance of activities of daily living in patients with stroke. [Subjects and Methods] Thirty subjects were assigned equally to a tDCS plus traditional occupational therapy group (experimental group) and a traditional occupational therapy group (control group). The intervention was implemented five times per week, 30 minutes each, for six weeks. In order to assess visual perception function before and after the intervention, the motor-free visual perception test (MVPT) was conducted, and in order to compare the performance of activities of daily living, the Functional Independence Measure scale was employed. [Results] According to the results, both groups improved in visual perception function and in performance of activities of daily living. Although there was no significant difference between the two groups, the experimental group exhibited higher scores. [Conclusion] In conclusion, the application of tDCS for the rehabilitation of patients with stroke may positively affect their visual perception and ability to perform activities of daily living.

  14. Exploration Medical Capability

    Science.gov (United States)

    Watkins, Sharmila; Baumann, David; Wu, Jimmy; Barsten, Kristina

    2010-01-01

    Exploration Medical Capability (ExMC) is an element of NASA's Human Research Program (HRP). ExMC's goal is to address the risk of the Inability to Adequately Recognize or Treat an Ill or Injured Crewmember. This poster highlights the approach ExMC has taken to address this goal and our current areas of interest. The Space Medicine Exploration Medical Condition List (SMEMCL) was created to identify medical conditions of concern during exploration missions. The list was derived from space flight medical incidents, the shuttle medical checklist, the International Space Station medical checklist, and expert opinion. The conditions on the list were prioritized according to mission type by a panel comprised of flight surgeons, physician astronauts, engineers, and scientists. From the prioritized list, the ExMC element determined the capabilities needed to address the medical conditions of concern. Where such capabilities were not currently available, a gap was identified. The element s research plan outlines these gaps and the tasks identified to achieve the desired capabilities for exploration missions. This poster is being presented to inform the audience of the gaps and tasks being investigated by ExMC and to encourage discussions of shared interests and possible future collaborations.

  15. Current problems in national hospitals of Phnom Penh: finance and health care.

    Science.gov (United States)

    Uy, Sophoat; Akashi, Hidechika; Taki, Kazumi; Ito, Katsuki

    2007-01-01

    The current problems in Cambodia's national hospitals subsist in a geographic imbalance in the location of staff and health facilities, and low staff motivation largely due to inadequate payment. This paper aims to investigate the associations among hospital performance, hospital finances, and other related issues in five national hospitals in Phnom Penh, using annual reports of the five hospitals and annual statistics of the Ministry of Health, from 2000 to 2004. The bed occupancy rates (BOR), average lengths of stay (ALS), hospital mortality rates (HMR), maternal and neonatal mortality rates, numbers of patients, main health problems of inpatients, numbers of health personnel, staff incentives, and annual hospital income were used in this study as indicators of five hospitals in Phnom Penh city. The ALS varied from 3.8 to 9 days. The numbers of health personnel (physician, medical assistant, secondary nurses, primary nurses, secondary midwives, and primary midwives) per 100 beds were from 114 to 282. Supplemental salary per staff also differed greatly among these hospitals; the salaries were the highest at Calmette hospital (US$ 212.8) and the lowest at Preah Kossamak (US$ 12.4). In the five hospitals, the average BOR was 58.8%, and the mean of total annual income was US$ 1,427,852 per year. Although not significant, there was a tendency for higher supplemental salaries to be associated with higher BOR (Spearman rank correlation coefficient 0.70, p = 0.188). This study showed the differences in the hospital indicators among five national hospitals in Phnom Penh city, and the tendency of higher BOR in the hospitals paying higher supplemental salaries to the staff. Higher supplemental salary to the staff seemed to contribute the better hospital performance. PMID:17378183

  16. Current situation of health care in India and corporation in emerging economies--what is the way forward?

    Science.gov (United States)

    Surendra, Kumar; Amit, Sengupta; Kumar, Agarwal Vishnu

    2012-01-01

    In this study, we examine the management and operational problems faced by different categories of health care delivery platforms such as corporate hospitals, medium level private hospitals and public hospitals in Mumbai. Some suggestions are made and we believe many of the short falls or limitations that exist in the current set up can be removed and a way forward can be made in alleviating the suffering of vast majority of humankind living in our mega cities. Three major issues emerged as far as a public health system is concerned--that is shifting of trained health manpower from the public system to private or corporate hospitals, severe strain on the public health system's infrastructure and support services compounded by lack of accountability as far as management and governance are concerned. PMID:23342758

  17. Current situation of health care in India and corporation in emerging economies--what is the way forward?

    Science.gov (United States)

    Surendra, Kumar; Amit, Sengupta; Kumar, Agarwal Vishnu

    2012-01-01

    In this study, we examine the management and operational problems faced by different categories of health care delivery platforms such as corporate hospitals, medium level private hospitals and public hospitals in Mumbai. Some suggestions are made and we believe many of the short falls or limitations that exist in the current set up can be removed and a way forward can be made in alleviating the suffering of vast majority of humankind living in our mega cities. Three major issues emerged as far as a public health system is concerned--that is shifting of trained health manpower from the public system to private or corporate hospitals, severe strain on the public health system's infrastructure and support services compounded by lack of accountability as far as management and governance are concerned.

  18. Efficacy of misoprostol for the treatment of postpartum hemorrhage: current knowledge and implications for health care planning

    Directory of Open Access Journals (Sweden)

    Prata N

    2016-07-01

    Full Text Available Ndola Prata, Karen Weidert Bixby Center for Population, Health and Sustainability, School of Public Health, University of California at Berkeley, Berkeley, CA, USA Background: A myriad of interventions exist to treat postpartum hemorrhage (PPH, ranging from uterotonics and hemostatics to surgical and aortic compression devices. Nonetheless, PPH remains the leading cause of maternal mortality worldwide. The purpose of this article is to review the available evidence on the efficacy of misoprostol for the treatment of primary PPH and discuss implications for health care planning. Data and methods: Using PubMed, Web of Science, and GoogleScholar, we reviewed the literature on randomized controlled trials of interventions to treat PPH with misoprostol and non-randomized field trials with controls. We discuss the current knowledge and implications for health care planning, especially in resource-poor settings. Results: The treatment of PPH with 800 µg of misoprostol is equivalent to 40 IU of intravenous oxytocin in women who have received oxytocin for the prevention of PPH. The same dose might be an option for the treatment of PPH in women who did not receive oxytocin for the prevention of PPH and do not have access to oxytocin for treatment. Adding misoprostol to standard uterotonics has no additional benefits to women being treated for PPH, but the beneficial adjunctive role of misoprostol to conventional uterotonics is important in reducing intra- and postoperative hemorrhage during cesarean section. Conclusion: Misoprostol is an effective uterotonic agent in the treatment of PPH. Clinical guidelines and treatment protocols should be updated to reflect the current knowledge on the efficacy of misoprostol for the treatment of PPH with 800 µg sublingually. Keywords: PPH treatment, uterotonics, low-resource settings, cesarean section, retained placenta

  19. Nuclear Magnetic Resonance Imaging: Current Capabilities

    OpenAIRE

    Davis, Peter L.; Crooks, Lawrence E.; Margulis, Alexander R.; Kaufman, Leon

    1982-01-01

    Nuclear magnetic resonance imaging can produce tomographic images of the body without ionizing radiation. Images of the head, chest, abdomen, pelvis and extremities have been obtained and normal structures and pathology have been identified. Soft tissue contrast with this method is superior to that with x-ray computerized tomography and its spatial resolution is approaching that of x-ray computerized tomography. In addition, nuclear magnetic resonance imaging enables us to image along the sag...

  20. Effectiveness of the palliative care ‘Availability, Current issues and Anticipation’ (ACA) communication training programme for general practitioners on patient outcomes: A controlled trial

    Science.gov (United States)

    Blankenstein, Annette H; Schweitzer, Bart PM; Knol, Dirk L; van der Horst, Henriëtte E; Aaronson, Neil K; Deliens, Luc

    2014-01-01

    Background: Although communicating effectively with patients receiving palliative care can be difficult, it may contribute to maintaining or enhancing patients’ quality of life. Little is known about the effect of training general practitioners in palliative care–specific communication. We hypothesized that palliative care patients of general practitioners exposed to the ‘Availability, Current issues and Anticipation’ communication training programme would report better outcomes than patients of control general practitioners. Aim: To evaluate the effectiveness of the Availability, Current issues and Anticipation training programme for general practitioners on patient-reported outcomes. Design: In a controlled trial, general practitioners followed the Availability, Current issues and Anticipation programme or were part of the control group. Patients receiving palliative care of participating general practitioners completed the Palliative Care Outcome Scale, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative, the Rest & Peace Scale, the Patient Satisfaction Questionnaire–III and the Availability, Current issues and Anticipation Scale, at baseline and 12 months follow-up. We analysed differences between groups using linear mixed models. Trial registration: ISRCTN56722368. Setting/participants: General practitioners who attended a 2-year Palliative Care Training Course in the Netherlands. Results: Questionnaire data were available for 145 patients (89 in intervention and 56 in control group). We found no significant differences over time between the intervention and control groups in any of the five outcome measures. Ceiling effects were observed for the Rest & Peace Scale, Patient Satisfaction Questionnaire–III and Availability, Current issues and Anticipation Scale. Conclusion: General practitioner participation in the Availability, Current issues and Anticipation training programme did not have

  1. Building Service Provider Capabilities

    DEFF Research Database (Denmark)

    Brandl, Kristin; Jaura, Manya; Ørberg Jensen, Peter D.

    process. We find that clients influence the development of human capital capabilities and management capabilities in reciprocally produced services. While in sequential produced services clients influence the development of organizational capital capabilities and management capital capabilities....

  2. Atmospheric Release Advisory Capability

    International Nuclear Information System (INIS)

    The Atmospheric Release Advisory Capability (ARAC) project is a Department of Energy (DOE) sponsored real-time emergency response service available for use by both federal and state agencies in case of a potential or actual atmospheric release of nuclear material. The project, initiated in 1972, is currently evolving from the research and development phase to full operation. Plans are underway to expand the existing capability to continuous operation by 1984 and to establish a National ARAC Center (NARAC) by 1988. This report describes the ARAC system, its utilization during the past two years, and plans for its expansion during the next five to six years. An integral part of this expansion is due to a very important and crucial effort sponsored by the Defense Nuclear Agency to extend the ARAC service to approximately 45 Department of Defense (DOD) sites throughout the continental US over the next three years

  3. Age-friendly primary health care: an assessment of current service provision for older adults in Hong Kong.

    Science.gov (United States)

    Woo, Jean; Mak, Benise; Yeung, Fannie

    2013-01-01

    There has been no study evaluating whether primary care services are sufficiently oriented towards the older population in Hong Kong, particularly those with increasing frailty. Since primary care is a key first interface in promotion and maintenance of health in older people, an assessment of the age-friendliness of service provisions is of critical importance in optimizing the health of aging populations. The age-friendliness of primary care services for older people was assessed using focus groups of elderly people and also of service providers who care for them. Discussion content was based on the WHO guidelines for age-friendly primary care in the following areas: Information, education and training, community-based health care management systems, and the physical environment. Desirable improvements were identified in all domains. The findings underscore the need for wider dissemination of health care needs of older people in the primary care setting.

  4. QALYs and the capability approach.

    Science.gov (United States)

    Cookson, Richard

    2005-08-01

    This explores the applicability of Sen's capability approach to the economic evaluation of health care programmes. An individual's 'capability set' describes his freedom to choose valuable activities and states of being ('functionings'). Direct estimation and valuation of capability sets is not feasible at present. Standard preference-based methods such as willingness to pay are feasible, but problematic due to the adaptive and constructed nature of individual preferences over time and under uncertainty. An alternative is to re-interpret the QALY as a cardinal and interpersonally comparable index of the value of the individual's capability set. This approach has limitations, since the link between QALYs and capabilities is not straightforward. Nevertheless, the QALY approach is recognisable as an application of the capability approach since it pays close attention to functionings, through the use of survey-based multi-attribute health state valuation instruments, and permits conceptions of value other than the traditional utilitarian ones of choice, desire-fulfilment and happiness. Furthermore, suitably re-interpreted, it can account for (i) non-separability between health and non-health components of value; and suitably modified it can also account for (ii) process attributes of care, which may have a direct effect on non-health functionings such as comfort and dignity, and (iii) sub-group diversity in the value of the same health functionings. PMID:15693028

  5. The Use of Emergency Medication Kits in Community Palliative Care: An Exploratory Survey of Views of Current Practice in Australian Home-Based Palliative Care Services.

    Science.gov (United States)

    Bullen, Tracey; Rosenberg, John P; Smith, Bradley; Maher, Kate

    2015-09-01

    Improving symptom management for palliative care patients has obvious benefits for patients and advantages for the clinicians, as workload demands and work-related stress can be reduced when the emergent symptoms of patients are managed in a timely manner. The use of emergency medication kits (EMKs) can provide such timely symptom relief. The purpose of this study was to conduct a survey of a local service to examine views on medication management before and after the implementation of an EMK and to conduct a nationwide prevalence survey examining the use of EMKs in Australia. Most respondents from community palliative care services indicated that EMKs were not being supplied to palliative care patients but believed such an intervention could improve patient care. PMID:24871345

  6. Group Capability Model

    Science.gov (United States)

    Olejarski, Michael; Appleton, Amy; Deltorchio, Stephen

    2009-01-01

    The Group Capability Model (GCM) is a software tool that allows an organization, from first line management to senior executive, to monitor and track the health (capability) of various groups in performing their contractual obligations. GCM calculates a Group Capability Index (GCI) by comparing actual head counts, certifications, and/or skills within a group. The model can also be used to simulate the effects of employee usage, training, and attrition on the GCI. A universal tool and common method was required due to the high risk of losing skills necessary to complete the Space Shuttle Program and meet the needs of the Constellation Program. During this transition from one space vehicle to another, the uncertainty among the critical skilled workforce is high and attrition has the potential to be unmanageable. GCM allows managers to establish requirements for their group in the form of head counts, certification requirements, or skills requirements. GCM then calculates a Group Capability Index (GCI), where a score of 1 indicates that the group is at the appropriate level; anything less than 1 indicates a potential for improvement. This shows the health of a group, both currently and over time. GCM accepts as input head count, certification needs, critical needs, competency needs, and competency critical needs. In addition, team members are categorized by years of experience, percentage of contribution, ex-members and their skills, availability, function, and in-work requirements. Outputs are several reports, including actual vs. required head count, actual vs. required certificates, CGI change over time (by month), and more. The program stores historical data for summary and historical reporting, which is done via an Excel spreadsheet that is color-coded to show health statistics at a glance. GCM has provided the Shuttle Ground Processing team with a quantifiable, repeatable approach to assessing and managing the skills in their organization. They now have a common

  7. Developing new models of shared primary and specialist HIV care in the UK: a survey of current practice.

    Science.gov (United States)

    Hutchinson, Jane; Sutcliffe, Loma J; Williams, Andy J; Estcourt, Claudia S

    2016-07-01

    HIV care in the UK is led by hospital-based specialists with limited general practitioner (GP) involvement. As GPs have expertise in some non-microbial HIV-associated co-morbidities (e.g. cardiovascular disease), and more people are disclosing their HIV status to their GPs, there could be benefits in sharing HIV care. We describe contemporary models of shared HIV care in relevant developed world settings to inform future shared HIV care in the UK. An interview survey of key informants was used to explore experiences and models of shared care, and identify promoting and inhibiting factors. We interviewed ten key informants from six shared care models. There were three broad categories of shared care, with varying degrees of GP involvement. Strong clinical leadership in primary care, good professional relationships and communication, and tailored GP training were facilitators. Barriers included stigma, confidentiality concerns, and low prevalence of HIV outside major conurbations. Contemporary shared HIV care models have emerged organically and seem to work when grounded in good collaboration between a small number of dedicated GPs and specialist units. We propose two models for further study which may only be feasible in high HIV caseload practices. User acceptability, clinical and cost effectiveness must be considered. PMID:26113516

  8. The concept of "intercultural opening": the development of an assessment tool for the appraisal of its current implementation in the mental health care system.

    Science.gov (United States)

    Penka, S; Kluge, U; Vardar, A; Borde, T; Ingleby, D

    2012-06-01

    The German concept of "intercultural opening" is an approach to facilitating migrants' access to the health care system and improving the care they receive. No data exist concerning the current status of the implementation of this approach in Germany, and the concept has never been analysed in practice. To assess the status of "intercultural opening" in the German mental health care system and to further analyse the concept, we developed a tool by combining pre-existing instruments. In order to review the preliminary tool we combined experts' knowledge by carrying out a consensusoriented, expert-based Delphi process with actual practice by piloting the instrument in each type of institution to be assessed. The assessment tool thus developed(1) is the first one to evaluate the current status of "intercultural opening" in the community mental health care system in Germany from a broad perspective. This paper is intended to present the development process of our assessment tool for demonstrating the benefits of this approach and as a model for future studies, as well as to increase transparency in relation to the current German approach to health care structures in dealing with migrants. PMID:22863253

  9. MEDEVAC: critical care transport from the battlefield.

    Science.gov (United States)

    Higgins, R A

    2010-01-01

    In current military operations, the survival rates of critically injured casualties are unprecedented. An often hidden aspect of casualty care is safe transport from the point of injury to a field hospital and subsequently on to higher levels of care. This en route critical care, which is provided by flight medics under the most austere and rigorous conditions, is a crucial link in the care continuum. This article introduces the role and capabilities of US Army MEDEVAC and reflects the author's recent experience in Afghanistan as a flight medic. This article provides an assessment of the operational issues, medical capabilities, and transport experiences to provide a real-world view of critical care transport from the battlefield. The MEDEVAC helicopter environment is one of the most difficult, if not the most demanding, critical care environments. This overview brings to light a small but important piece of the care continuum.

  10. The current state of ethnic and racial disparities in cardiovascular care: lessons from the past and opportunities for the future.

    Science.gov (United States)

    Lewey, Jennifer; Choudhry, Niteesh K

    2014-01-01

    Significant racial/ethnic disparities have been documented in cardiovascular care. Although health care quality is improving for many Americans, differences in clinical outcomes have persisted between racial/ethnic minority patients and non-minorities, even when income, education level, and site of care are taken into consideration. Potential causes of disparities are complex and are related to differences in risk factor prevalence and control, use of evidence-based procedures and medications, and social and environmental factors. Minority patients are more likely to receive care from lower-quality health care providers and institutions and experience more barriers to accessing care. Factors such as stereotyping and bias in medicine are hard to quantify, but likely contribute to differences in treatment. Recent trends suggest that some disparities are decreasing. Opportunities for change and improvement exist for patients, providers, and health care systems. Promising interventions, such as health policy changes, quality improvement programs, and culturally targeted community and clinic-based interventions offer hope that high-quality health care in the USA can be provided to all patients. PMID:25135343

  11. Pain management in trauma patients in (pre)hospital based emergency care: Current practice versus new guideline

    NARCIS (Netherlands)

    A.C. Scholten (Annemieke); S.A.A. Berben (Sivera); A.H. Westmaas (Alvin H); P.M. van Grunsven (Pierre); E.T. de Vaal; P.P.M. Rood (Pleunie); N. Hoogerwerf (N.); C.J.M. Doggen (Carine); R. van Schoonhoven (Renee)

    2015-01-01

    textabstractIntroduction Acute pain in trauma patients in emergency care is still undertreated. Early pain treatment is assumed to effectively reduce pain in patients and improve long-term outcomes. In order to improve pain management in the chain of emergency care, a national evidence-based guideli

  12. Pain management in trauma patients in (pre)hospital based emergency care: current practice versus new guideline

    NARCIS (Netherlands)

    Scholten, A.C.; Berben, S.A.A.; Westmaas, A.H.; Grunsven, P.M.; Vaal, de E.T.; Rood, Pleunie P.M.; Hoogerwerf, N.; Doggen, C.J.M.; Schoonhoven, L.

    2015-01-01

    Introduction Acute pain in trauma patients in emergency care is still undertreated. Early pain treatment is assumed to effectively reduce pain in patients and improve long-term outcomes. In order to improve pain management in the chain of emergency care, a national evidence-based guideline was devel

  13. Pain management in trauma patients in (pre)hospital based emergency care: current practice versus new guideline

    NARCIS (Netherlands)

    Scholten, A.C.; Berben, S.A.A.; Westmaas, A.H.; Grunsven, P.M. van; Vaal, E.T. de; Hoogerwerf, N.; Doggen, C.J.; Schoonhoven, L.

    2015-01-01

    INTRODUCTION: Acute pain in trauma patients in emergency care is still undertreated. Early pain treatment is assumed to effectively reduce pain in patients and improve long-term outcomes. In order to improve pain management in the chain of emergency care, a national evidence-based guideline was deve

  14. Nondisclosure of smoking status to health care providers among current and former smokers in the United States.

    Science.gov (United States)

    Curry, Laurel Erin; Richardson, Amanda; Xiao, Haijun; Niaura, Raymond S

    2013-06-01

    An unintended consequence of tobacco control's success in marginalizing smoking is that smokers may conceal their smoking from those who are best positioned to help them quit: health care providers (HCPs). The purpose of this study was to identify the prevalence of, and factors related to, nondisclosure of smoking to HCPs. Data were obtained from a cross-sectional survey of adults from a nationally representative Knowledge Networks online panel in March to April 2011. Current and former smokers (n = 2,803) were asked questions about nondisclosure, tobacco use, cessation behavior, and perceived social unacceptability of smoking. All variables significantly related (p < .05) to nondisclosure in bivariate logistic regression were included in the multivariate logistic regression model, which also adjusted for gender, age, race, marital status, and education. Approximately 1 in 10 smokers (12.9%) and 5.8% of former smokers has withheld their smoking status from HCPs. Ever smokers who were 18 to 34 years, those who had used a prescription medication or behavioral therapy in their last quit attempt, and those who were uncomfortable discussing smoking with their HCP were more likely to report nondisclosure than those in their respective comparison groups. Respondents who perceived either medium or high smoker-related stigma (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.05, 2.77 and OR = 2.60, 95% CI = 1.51, 4.48, respectively) and those who reported concealing smoking to gain benefits from health insurance were also significantly more likely to have kept smoking a secret from an HCP (OR = 5.66, 95% CI = 1.88, 17.02). Smokers should be encouraged to be forthright about their smoking in order for practitioners to offer treatment and services that increase their chances of quitting. PMID:22984217

  15. Mobile Test Capabilities

    Data.gov (United States)

    Federal Laboratory Consortium — The Electrical Power Mobile Test capabilities are utilized to conduct electrical power quality testing on aircraft and helicopters. This capability allows that the...

  16. [Current Status of Preoperative Professional Oral Care by Dentists for Elderly Patients Undergoing Lung Resection and Occurrence of Postoperative Pneumonia].

    Science.gov (United States)

    Hoshikawa, Yasushi; Tanda, Naoko; Matsuda, Yasushi; Katsumata, Hiroshi; Notsuda, Hirotsugu; Watanabe, Tatsuaki; Niikawa, Hiromichi; Noda, Masafumi; Sakurada, Akira; Kondo, Takashi; Okada, Yoshinori

    2016-01-01

    Pneumonia in elderly people is mainly caused by silent aspiration due to an age-related impairment of cough and swallowing reflexes. Because most of the patients with lung cancer are elderly people, we hypothesized that the age-related impairment of these protective reflexes might exist or occur in patients undergoing lung surgery, and cause postoperative pneumonia. We revealed that many elderly patients showed depressed swallowing reflex even before surgery and transient attenuation of cough reflex after surgery, and that postoperative pneumonia occurred only in the patients whose cough and/or swallowing reflex was abnormal postoperatively. Then, we prospectively showed that 30 elderly patients who received perioperative intensive oral care, including professional assessment of oral status, dental cleaning, and patient education for self-oral care by dentists, followed by intensive oral care by intensive care unit nurses, and encouragement of self-oral care by floor nurses, did not develop pneumonia after lung resection. In this study, we retrospectively reviewed the execution status of professional oral care by dentists and the occurrence of postoperative pneumonia in 159 consecutive patients aged 65 or older undergoing lung resection from 2013 to 2014. Thoracic surgeons in our institute asked dentists to provide professional oral care before lung resection only in 30.3% of the subjects in 2013, and 45.8% in 2014. Postoperative pneumonia occurred in 3 out of 76 subjects(3.9%)in 2013, and 1 out of 83(1.2%) in 2014. In 2013, 1 patient who did not receive preoperative professional oral care developed aspiration pneumonia postoperatively followed by acute exacerbation of idiopathic pulmonary fibrosis and in-hospital death. We need to make an effective system to provide preoperative professional oral care by dentists especially for elderly patients and high-risk patients before lung resection.

  17. Community care: the impact of current welfare policies and ideologies on older people in Hertfordshire and Bedfordshire

    OpenAIRE

    Barrett, David

    1992-01-01

    This thesis investigates whether community care policy and service delivery is rhetoric or reality. The social policy and under-pinning ideologies that surround community care are reviewed. Important benchmarks are presented in the form of a chronology and aetiology of The National Health Service and Community Care Act, 1990. An interview schedule was designed from the perspective of older people and was used with a sample of 40 older people, 20 at Luton in an inner-city setting and 20 in Red...

  18. The capability conundrum

    International Nuclear Information System (INIS)

    Full text: AMEC Nuclear recognises that a skilled workforce is essential to the success of its business. In the current global climate, the potential for new build in the UK, new build underway in Europe and across the world and the acceleration of Clean Up programmes, the competition for skilled staff is fierce. So how do companies develop and grow their Capability? What are the issues? There have been several initiatives undertaken in the UK to identify skills gaps. One example is an exercise undertaken by COGENT, the sector skills council for the Nuclear Sector, who undertook a comprehensive forward looking gap analysis for the industry in 2005 and who have now proposed a number of interventions to address the gaps identified, one of which is the creation of a Nuclear Skills Academy a second is the creation of Career Pathways. Some of the gaps identified cover shortages of skills that we face today but, more worryingly for the future, the projected down turn in the numbers of young people studying Science and Engineering subjects, both in schools and Universities and a shortage of apprenticeship places in the UK paints a gloomy picture. Where will our future capability come from? At AMEC Nuclear we recognise that we need to act now to protect our business and ensure we maintain, develop and grow our capability. We are working closely with COGENT to help to develop Career Pathways to encourage young people to the industry and we are delighted to have secured a place on the shadow board of the National Nuclear Skills Academy, an exciting project which will provide a focus for excellence in workforce skills development. Employers in the Nuclear industry have said that they want a Skills Academy that will provide national leadership in training provision and will move employers and employees from their current level of skills to those which will be needed to take these critical industries forward into a sustainable future in the UK. In order for us to assess what we

  19. IAC - INTEGRATED ANALYSIS CAPABILITY

    Science.gov (United States)

    Frisch, H. P.

    1994-01-01

    Integration via Mesh Interpolation Coefficients), which transforms field values from one model to another; LINK, which simplifies incorporation of user specific modules into IAC modules; and DATAPAC, the National Bureau of Standards statistical analysis package. The IAC database contains structured files which provide a common basis for communication between modules and the executive system, and can contain unstructured files such as NASTRAN checkpoint files, DISCOS plot files, object code, etc. The user can define groups of data and relations between them. A full data manipulation and query system operates with the database. The current interface modules comprise five groups: 1) Structural analysis - IAC contains a NASTRAN interface for standalone analysis or certain structural/control/thermal combinations. IAC provides enhanced structural capabilities for normal modes and static deformation analysis via special DMAP sequences. IAC 2.5 contains several specialized interfaces from NASTRAN in support of multidisciplinary analysis. 2) Thermal analysis - IAC supports finite element and finite difference techniques for steady state or transient analysis. There are interfaces for the NASTRAN thermal analyzer, SINDA/SINFLO, and TRASYS II. FEMNET, which converts finite element structural analysis models to finite difference thermal analysis models, is also interfaced with the IAC database. 3) System dynamics - The DISCOS simulation program which allows for either nonlinear time domain analysis or linear frequency domain analysis, is fully interfaced to the IAC database management capability. 4) Control analysis - Interfaces for the ORACLS, SAMSAN, NBOD2, and INCA programs allow a wide range of control system analyses and synthesis techniques. Level 2.5 includes EIGEN, which provides tools for large order system eigenanalysis, and BOPACE, which allows for geometric capabilities and finite element analysis with nonlinear material. Also included in IAC level 2.5 is SAMSAN 3.1, an

  20. Comparison of satisfaction with current prosthetic care in veterans and servicemembers from Vietnam and OIF/OEF conflicts with major traumatic limb loss

    Directory of Open Access Journals (Sweden)

    Gary M. Berke, MS, CP, FAAOP

    2010-07-01

    Full Text Available Prosthetic care is a vital aspect of healthcare and rehabilitation for veterans and servicemembers with major traumaticlimb loss. Our survey queried 581 veterans and servicememberswith limb loss from the Vietnam and Operation Iraqi Freedom (OIF/Operation Enduring Freedom (OEF conflicts. Among survey participants, 78.2% from the Vietnam conflict and 90.5% from the OIF/OEF conflict currently use prosthetic devices. In Vietnam respondents, 78% received prosthetic care from private sources, 16% from Department of Veterans Affairs (VA prosthetic laboratories, 0.9% from Department of Defense (DOD, and 5% from multiple sources. In OIF/OEF respondents,42% received prosthetic care from private sources, 9% percent from VA, 39% from DOD, and 10% from multiple sources. Participants identified their satisfaction with current prosthetic devices and prosthetic services. Reports of pain, sweating, skin irritation, and problems with socket fit continue to be significant issues for participants from both conflicts regardless of level of amputation or site of service. In those with upper-limb loss who used myoelectric prostheses, minimal effect on prosthesis use and satisfaction was noted. Among lower-limb loss participants from both conflicts, notable differencesexisted in prosthesis satisfaction by source of care.

  1. Nondisclosure of Smoking Status to Health Care Providers among Current and Former Smokers in the United States

    Science.gov (United States)

    Curry, Laurel Erin; Richardson, Amanda; Xiao, Haijun; Niaura, Raymond S.

    2013-01-01

    An unintended consequence of tobacco control's success in marginalizing smoking is that smokers may conceal their smoking from those who are best positioned to help them quit: health care providers (HCPs). The purpose of this study was to identify the prevalence of, and factors related to, nondisclosure of smoking to HCPs. Data were obtained from…

  2. Evaluation of Current Literature to Determine the Potential Effects of Radio Frequency Identification on Technology Used in Diabetes Care

    OpenAIRE

    Christe, Barbara

    2009-01-01

    This article examines recently published studies exploring the impact of radio frequency identification (RFID) systems on the technology involved in patient care. The conclusions will be extrapolated to include insulin delivery devices. Background material will also be presented to support examination of the variables involved in electromagnetic fields and potential interference from these RFID systems.

  3. Work, Subjective Well-being and Capabilities

    OpenAIRE

    Suppa, Nicolai

    2014-01-01

    Chapter 2: This chapter explores the link between poverty as capability deprivation and current life satisfaction. Using German panel data, I examine both whether capability deprivation does hurt and whether individuals eventually adapt. To detect capability deprivation I draw on the notion of an inadequate income together with nonconsumption data of specific commodities. Assumptions and conditions rendering this approach valid are scrutinised. The results indicate that capability...

  4. Capabilities for Strategic Adaptation

    DEFF Research Database (Denmark)

    Distel, Andreas Philipp

    firms’ ability to absorb and leverage new knowledge. The third paper is an empirical study which conceptualizes top managers’ resource cognition as a managerial capability underlying firms’ resource adaptation; it empirically examines the performance implications of this capability and organizational......This dissertation explores capabilities that enable firms to strategically adapt to environmental changes and preserve competitiveness over time – often referred to as dynamic capabilities. While dynamic capabilities being a popular research domain, too little is known about what these capabilities...... empirical studies through the dynamic capabilities lens and develops propositions for future research. The second paper is an empirical study on the origins of firm-level absorptive capacity; it explores how organization-level antecedents, through their impact on individual-level antecedents, influence...

  5. Late presentation to HIV care despite good access to health services: current epidemiological trends and how to do better.

    Science.gov (United States)

    Darling, Katharine Ea; Hachfeld, Anna; Cavassini, Matthias; Kirk, Ole; Furrer, Hansjakob; Wandeler, Gilles

    2016-01-01

    In 2014, there were 36.9 million people worldwide living with human immunodeficiency virus (PLWH), of whom 17.1 million did not know they were infected. Whilst the number of new human immunodeficiency virus (HIV) infections has declined globally since 2000, there are still regions where new infection rates are rising, and diagnosing HIV early in the course of infection remains a challenge. Late presentation to care in HIV refers to individuals newly presenting for HIV care with a CD4 count below 350 cells/µl or with an acquired immune deficiency syndrome (AIDS)-defining event. Late presentation is associated with increased patient morbidity and mortality, healthcare costs and risk of onward transmission by individuals unaware of their status. Further, late presentation limits the effectiveness of all subsequent steps in the cascade of HIV care. Recent figures from 34 countries in Europe show that late presentation occurs in 38.3% to 49.8% of patients newly presenting for care, depending on region. In Switzerland, data from patients enrolled in the Swiss HIV Cohort Study put the rate of late presentation at 49.8% and show that patients outside established HIV risk groups are most likely to be late presenters. Provider-initiated testing needs to be improved to reach these groups, which include heterosexual men and women and older patients. The aim of this review is to describe the scale and implications of late presentation using cohort data from Switzerland and elsewhere in Europe, and to highlight initiatives to improve early HIV diagnosis. The importance of recognising indicator conditions and the potential for missed opportunities for HIV testing is illustrated in three clinical case studies. PMID:27544642

  6. Predicting and reducing risk of exacerbations in children with asthma in the primary care setting: current perspectives

    OpenAIRE

    Turner, Steve

    2016-01-01

    Steve Turner Child Health, Royal Aberdeen Children’s Hospital, University of Aberdeen, Aberdeen, UK Abstract: Childhood asthma is a very common condition in western countries and is becoming more prevalent worldwide. Asthma attacks (or exacerbations) affect the quality of life for child and parent, can rarely result in death, and also come at a cost for health care providers and the economy. The aims of this review were to 1) describe the burden of asthma exacerbations, 2) describe ...

  7. Developing Alliance Capabilities

    DEFF Research Database (Denmark)

    Heimeriks, Koen H.; Duysters, Geert; Vanhaverbeke, Wim

    This paper assesses the differential performance effects of learning mechanisms on the development of alliance capabilities. Prior research has suggested that different capability levels could be identified in which specific intra-firm learning mechanisms are used to enhance a firm's alliance...... capability. However, empirical testing in this field is scarce and little is known as to what extent different learning mechanisms are indeed useful in advancing a firm's alliance capability. This paper analyzes to what extent intra-firm learning mechanisms help firms develop their alliance capability....... Differential learning may explain in what way firms yield superior returns from their alliances in comparison to competitors. The empirical results show that different learning mechanisms have different performance effects at different stages of the alliance capability development process. The main lesson from...

  8. A pilot survey of the current scope of the practice of South African physiotherapists in the intensive care units

    Directory of Open Access Journals (Sweden)

    H. van Aswegen

    2005-02-01

    Full Text Available Objective: A pilot study was conducted to determine the currentscope of practice of South African physiotherapists working in intensive care units in the government and the private sectors. These findings were compared to the findings from a European survey with regard to the role of the physiotherapist in European intensive care units.Methodology: Ninety questionnaires were distributed nationwide to secondary and tertiary government hospitals as well as to private practitioners involved in cardiopulmonary physiotherapy. The private practitioners included in this survey were listed in the Private Practitioners Association Official Members Directory. Junior and senior physiotherapists working in the intensive care units of their respective hospitals participated in completing the questionnaire. Comparisons between government and private sector data and between the South African survey and the European survey were carried out using the 2test for non-parametric data. A p-value of less than 0.05 was considered to be statistically significant.Results: Fifty-four questionnaires were analyzed and represented 60% of questionnaires sent out. Respondents to the South African survey reported 28% percent of all ICUs had between 9 - 12 beds; 83% physiotherapists indicated the availability of an on-call service during the night and 96% physiotherapists had a weekend physiotherapy service. Ninety-two percent of physiotherapists working in the government sector supervised students compared to 44% of physiotherapists in the private sector. Between 9% and 27% of physiotherapists in government and private hospitalsactively participated in research in ICU. There were no statistically significant differences in the use of respiratory physiotherapy, mobilization and positioning between respondents to the European survey and those of the South African survey respectively.Conclusion: The response rate to this questionnaire was good. It was evident from this pilot

  9. Dynamic Capabilities and Performance

    DEFF Research Database (Denmark)

    Wilden, Ralf; Gudergan, Siegfried P.; Nielsen, Bo Bernhard;

    2013-01-01

    Dynamic capabilities are widely considered to incorporate those processes that enable organizations to sustain superior performance over time. In this paper, we argue theoretically and demonstrate empirically that these effects are contingent on organizational structure and the competitive...... are contingent on the competitive intensity faced by firms. Our findings demonstrate the performance effects of internal alignment between organizational structure and dynamic capabilities, as well as the external fit of dynamic capabilities with competitive intensity. We outline the advantages of PLS...

  10. Determining your organization's 'risk capability'.

    Science.gov (United States)

    Hannah, Bill; Hancock, Melinda

    2014-05-01

    An assessment of a provider's level of risk capability should focus on three key elements: Business intelligence, including sophisticated analytical models that can offer insight into the expected cost and quality of care for a given population. Clinical enterprise maturity, marked by the ability to improve health outcomes and to manage utilization and costs to drive change. Revenue transformation, emphasizing the need for a revenue cycle platform that allows for risk acceptance and management and that provides incentives for performance against defined objectives. PMID:24851456

  11. Integrated Process Capability Analysis

    Institute of Scientific and Technical Information of China (English)

    Chen; H; T; Huang; M; L; Hung; Y; H; Chen; K; S

    2002-01-01

    Process Capability Analysis (PCA) is a powerful too l to assess the ability of a process for manufacturing product that meets specific ations. The larger process capability index implies the higher process yield, a nd the larger process capability index also indicates the lower process expected loss. Chen et al. (2001) has applied indices C pu, C pl, and C pk for evaluating the process capability for a multi-process product wi th smaller-the-better, larger-the-better, and nominal-the-best spec...

  12. Problems and the potential direction of reforms for the current individual medical savings accounts in the Chinese health care system.

    Science.gov (United States)

    Kong, Xiangjin; Yang, Yang; Gong, Fuqing; Zhao, Mingjie

    2012-12-01

    Individual health savings accounts are an important part of the current basic medical insurance system for urban workers in China. Since 1998 when the system of personal medical insurance accounts was first implemented, there has been considerable controversy over its function and significance within different social communities. This paper analyzes the main problems in the practical implementation of individual medical insurance accounts and discusses the social and cultural foundations for the establishment of family health savings accounts from the perspective of Chinese Confucian familism. Accordingly, it addresses the direction of the reform and the development of the current system of individual health insurance accounts in China. PMID:23192456

  13. Accelerator and electrodynamics capability review

    Energy Technology Data Exchange (ETDEWEB)

    Jones, Kevin W [Los Alamos National Laboratory

    2010-01-01

    Los Alamos National Laboratory (LANL) uses capability reviews to assess the science, technology and engineering (STE) quality and institutional integration and to advise Laboratory Management on the current and future health of the STE. Capability reviews address the STE integration that LANL uses to meet mission requirements. The Capability Review Committees serve a dual role of providing assessment of the Laboratory's technical contributions and integration towards its missions and providing advice to Laboratory Management. The assessments and advice are documented in reports prepared by the Capability Review Committees that are delivered to the Director and to the Principal Associate Director for Science, Technology and Engineering (PADSTE). Laboratory Management will use this report for STE assessment and planning. LANL has defined fifteen STE capabilities. Electrodynamics and Accelerators is one of the seven STE capabilities that LANL Management (Director, PADSTE, technical Associate Directors) has identified for review in Fiscal Year (FY) 2010. Accelerators and electrodynamics at LANL comprise a blend of large-scale facilities and innovative small-scale research with a growing focus on national security applications. This review is organized into five topical areas: (1) Free Electron Lasers; (2) Linear Accelerator Science and Technology; (3) Advanced Electromagnetics; (4) Next Generation Accelerator Concepts; and (5) National Security Accelerator Applications. The focus is on innovative technology with an emphasis on applications relevant to Laboratory mission. The role of Laboratory Directed Research and Development (LDRD) in support of accelerators/electrodynamics will be discussed. The review provides an opportunity for interaction with early career staff. Program sponsors and customers will provide their input on the value of the accelerator and electrodynamics capability to the Laboratory mission.

  14. Community mental health care in the Asia-Pacific region: using current best-practice models to inform future policy

    OpenAIRE

    Ng, Chee; HERRMAN, HELEN; CHIU, EDMOND; SINGH, BRUCE

    2009-01-01

    The reporting of child sexual abuse (CSA) and physician-patient sexual relationships (PPSR) are currently the focus of professional, legal and media attention in several countries. This paper briefly reviews mental health policies on these issues and reports on a WPA survey of them. While the WPA Madrid Declaration permits breaching confidentiality for mandatory reporting of CSA and clearly prohibits PPSR, it is not known how or to what extent these policies are implemented in WPA Member Soci...

  15. Capabilities for innovation

    DEFF Research Database (Denmark)

    Nielsen, Peter; Nielsen, René Nesgaard; Bamberger, Simon Grandjean;

    2012-01-01

    Technological developments combined with increasing levels of competition related to the ongoing globalization imply that firms find themselves in dynamic, changing environments that call for dynamic capabilities. This challenges the internal human and organizational resources of firms in general...... and in particular their ability to develop firm-specific innovative capabilities through employee participation and creation of innovative workplaces. In this article, we argue that national institutional conditions can play an enhancing or hampering role in this. Especially the norms and values governing relations...... between employers and employees are expected to be of vital importance. This article will follow a resource-based perspective on developing dynamic capabilities in order to test the importance of enhancing human and organizational capabilities for innovation in firms. In particular, the article will focus...

  16. Education and Innovative Capabilities

    OpenAIRE

    A. Leiponen

    1996-01-01

    This study investigates the role of capabilities, acquired through education and on the job learning, in innovation. It is argued that education enhances learning and innovation because it provides employees with communication and interaction skills, and, more importantly, with abilities to receive, understand and utilize relevant knowledge, and solve problems. These dynamic capabilities are one of the sources of innovation. A dataset of 333 Finnish manufacturing firms is used to estimat...

  17. Structural Capability of an Organization toward Innovation Capability

    DEFF Research Database (Denmark)

    Nielsen, Susanne Balslev; Momeni, Mostafa

    2016-01-01

    competitive advantage in the organizations is the innovation capability. The innovation capability is associated with other organizational capabilities, and many organizations have focused on the need to identify innovation capabilities.This research focuses on recognition of the structural aspect...

  18. Are managed care organizations in the United States impeding the delivery of primary care by nurse practitioners? A 2012 update on managed care organization credentialing and reimbursement practices.

    Science.gov (United States)

    Hansen-Turton, Tine; Ware, Jamie; Bond, Lisa; Doria, Natalie; Cunningham, Patrick

    2013-10-01

    In 2014, the Affordable Care Act will create an estimated 16 million newly insured people. Coupled with an estimated shortage of over 60,000 primary care physicians, the country's public health care system will be at a challenging crossroads, as there will be more patients waiting to see fewer doctors. Nurse practitioners (NPs) can help to ease this crisis. NPs are health care professionals with the capability to provide important and critical access to primary care, particularly for vulnerable populations. However, despite convincing data about the quality of care provided by NPs, many managed care organizations (MCOs) across the country do not credential NPs as primary care providers, limiting the ability of NPs to be reimbursed by private insurers. To assess current credentialing practices of health plans across the United States, a brief telephone survey was administered to 258 of the largest health maintenance organizations (HMOs) in the United States, operated by 98 different MCOs. Results indicated that 74% of these HMOs currently credential NPs as primary care providers. Although this represents progress over prior assessments, findings suggest that just over one fourth of major HMOs still do not recognize NPs as primary care providers. Given the documented shortage of primary care physicians in low-income communities in the United States, these credentialing policies continue to diminish the ability of NPs to deliver primary care to vulnerable populations. Furthermore, these policies could negatively impact access to care for thousands of newly insured Americans who will be seeking a primary care provider in 2014.

  19. Building server capabilities

    DEFF Research Database (Denmark)

    Adeyemi, Oluseyi

    Many western companies have moved part of their operations to China in order to take advantage of cheap resources and/or to gain access to a high potential market. Depending on motive, offshore facilities usually start either as “sales-only” of products exported by headquarters or “production......-only”, exporting parts and components back to headquarter for sales in the home country. In the course of time, the role of offshore subsidiaries in a company’s operations network tends to change and, with that, the capabilities, of the subsidiaries. Focusing on Danish subsidiaries in China, the objective...... of this project is to identify and explain trajectories of offshore subsidiary capability development. The domain of inquiry is defined as value chain capabilities. Given the nature of this objective the chief methodology is longitudinal, partly retrospective, partly real-time, case studies....

  20. A comprehensive estimation method for enterprise capability

    Directory of Open Access Journals (Sweden)

    Tetiana Kuzhda

    2015-11-01

    Full Text Available In today’s highly competitive business world, the need for efficient enterprise capability management is greater than ever. As more enterprises begin to compete on a global scale, the effective use of enterprise capability will become imperative for them to improve their business activities. The definition of socio-economic capability of the enterprise has been given and the main components of enterprise capability have been pointed out. The comprehensive method to estimate enterprise capability that takes into account both social and economic components has been offered. The methodical approach concerning integrated estimation of the enterprise capability has been developed. Novelty deals with the inclusion of summary measure of the social component of enterprise capability to define the integrated index of enterprise capability. The practical significance of methodological approach is that the method allows assessing the enterprise capability comprehensively through combining two kinds of estimates – social and economic and converts them into a single integrated indicator. It provides a comprehensive approach to socio-economic estimation of enterprise capability, sets a formal basis for making decisions and helps allocate enterprise resources reasonably. Practical implementation of this method will affect the current condition and trends of the enterprise, help to make forecasts and plans for its development and capability efficient use.

  1. Capability Handbook- offline metrology

    DEFF Research Database (Denmark)

    Islam, Aminul; Marhöfer, David Maximilian; Tosello, Guido;

    This offline metrological capability handbook has been made in relation to HiMicro Task 3.3. The purpose of this document is to assess the metrological capability of the HiMicro partners and to gather the information of all available metrological instruments in the one single document. It provides...... a quick overview of what is possible today by the state of the art, what the HiMicro consortium can do and what metrological requirements we have concerning the HiMicro industrial demonstrators....

  2. Management Innovation Capabilities

    DEFF Research Database (Denmark)

    Harder, Mie

    , the paper introduces the concept of management innovation capabilities which refers to the ability of a firm to purposefully create, extend and modify its managerial resource base to address rapidly changing environments. Drawing upon behavioral theory of the firm and the dynamic capabilities framework......Management innovation is the implementation of a new management practice, process, technique or structure that significantly alters the way the work of management is performed. This paper presents a typology categorizing management innovation along two dimensions; radicalness and complexity. Then......, the paper proposes a model of the foundations of management innovation. Propositions and implications for future research are discussed....

  3. Social work, general practice and evidence-based policy in the collaborative care of older people: current problems and future possibilities.

    Science.gov (United States)

    Kharicha, Kalpa; Levin, Enid; Iliffe, Steve; Davey, Barbara

    2004-03-01

    While collaborative (or joint) working between social services and primary healthcare continues to rise up the policy agenda, current policy is not based on sound evidence of benefit to either patients or the wider community. Both sets of practitioners report benefits for their own work from adopting new arrangements for collaboration. The underlying assumption behind much of this activity is that a greater degree of integration provides benefits to both users and their carers, a perspective that at times obscures the issue of resource availability, especially in the form of practical community services such as district nursing and home help. At the present time there is insufficient evidence to demonstrate that formal arrangements for collaborative working (CW) are better than those forged informally between committed individuals or teams. Furthermore, arrangements for CW have not hitherto been widely evaluated in systematic studies with a comparative design and focus on outcomes for users and carers rather than on processes. In this paper we propose a number of process measures for future evaluation of CW: (1) study populations must be comparable; (2) details of how services are actually delivered must be obtained and colocation should not be assumed to mean collaboration; (3) care packages in areas of comparable resources should be examined; (4) both destinational outcomes and user-defined evaluations of benefit should be considered; (5) possible disadvantages of integrated care also need to be actively considered; (6) evaluations should include an economic analysis. Those implementing new policies in Primary Care Trusts have, at present, little sound evidence to guide them in their innovative work. However, they should take the opportunity to rigorously test the advantages and disadvantages of collaboration.

  4. Metrology Measurement Capabilities

    Energy Technology Data Exchange (ETDEWEB)

    Dr. Glen E. Gronniger

    2007-10-02

    This document contains descriptions of Federal Manufacturing & Technologies (FM&T) Metrology capabilities, traceability flow charts, and the measurement uncertainty of each measurement capability. Metrology provides NIST traceable precision measurements or equipment calibration for a wide variety of parameters, ranges, and state-of-the-art uncertainties. Metrology laboratories conform to the requirements of the Department of Energy Development and Production Manual Chapter 13.2, ANSI/ISO/IEC ANSI/ISO/IEC 17025:2005, and ANSI/NCSL Z540-1. FM&T Metrology laboratories are accredited by NVLAP for the parameters, ranges, and uncertainties listed in the specific scope of accreditation under NVLAP Lab code 200108-0. See the Internet at http://ts.nist.gov/Standards/scopes/2001080.pdf. These parameters are summarized. The Honeywell Federal Manufacturing & Technologies (FM&T) Metrology Department has developed measurement technology and calibration capability in four major fields of measurement: (1) Mechanical; (2) Environmental, Gas, Liquid; (3) Electrical (DC, AC, RF/Microwave); and (4) Optical and Radiation. Metrology Engineering provides the expertise to develop measurement capabilities for virtually any type of measurement in the fields listed above. A strong audit function has been developed to provide a means to evaluate the calibration programs of our suppliers and internal calibration organizations. Evaluation includes measurement audits and technical surveys.

  5. Capabilities for Intercultural Dialogue

    Science.gov (United States)

    Crosbie, Veronica

    2014-01-01

    The capabilities approach offers a valuable analytical lens for exploring the challenge and complexity of intercultural dialogue in contemporary settings. The central tenets of the approach, developed by Amartya Sen and Martha Nussbaum, involve a set of humanistic goals including the recognition that development is a process whereby people's…

  6. ISOPHOT - Capabilities and performance

    DEFF Research Database (Denmark)

    Lemke, D.; Klaas, U.; Abolins, J.;

    1996-01-01

    ISOPHOT covers the largest wavelength range on ISO from 2.5 to 240 mu m. Its scientific capabilities include multi filter and multi-aperture photometry, polarimetry, imaging and spectrophotometry. All modes can optionally include a focal plane chopper. The backbone of the photometric calibration ...

  7. STRATEGIC AIRLIFT CAPABILITY: FROM THEORY TO PRACTICE

    Directory of Open Access Journals (Sweden)

    Cezar VASILESCU

    2011-01-01

    Full Text Available Strategic airlift remains a critical supporting capability that should be achieved, maintained and improved. This capability ensures the ability to deploy and sustain military forces across possible distant battlefields. The paper analyses the growing strategic airlift capabilities gap between operational needs and current realities, and underlines the need for an enhanced strategic airlift capability to meet current and future NATO alliance needs. By analyzing requirements against the existing/potential solutions, this paper further ponders over options like the organic national capability, partnerships such as the Strategic Airlift Consortium (SAC or leasing aircraft through a venture such as the Strategic Airlift Interim Solution (SALIS. The paper also evaluates the feasibility of applying these solutions to European Union airlift needs.

  8. Capitalizing on capabilities.

    Science.gov (United States)

    Ulrich, Dave; Smallwood, Norm

    2004-06-01

    By making the most of organizational capabilities--employees' collective skills and fields of expertise--you can dramatically improve your company's market value. Although there is no magic list of proficiencies that every organization needs in order to succeed, the authors identify 11 intangible assets that well-managed companies tend to have: talent, speed, shared mind-set and coherent brand identity, accountability, collaboration, learning, leadership, customer connectivity, strategic unity, innovation, and efficiency. Such companies typically excel in only three of these capabilities while maintaining industry parity in the other areas. Organizations that fall below the norm in any of the 11 are likely candidates for dysfunction and competitive disadvantage. So you can determine how your company fares in these categories (or others, if the generic list doesn't suit your needs), the authors explain how to conduct a "capabilities audit," describing in particular the experiences and findings of two companies that recently performed such audits. In addition to highlighting which intangible assets are most important given the organization's history and strategy, this exercise will gauge how well your company delivers on its capabilities and will guide you in developing an action plan for improvement. A capabilities audit can work for an entire organization, a business unit, or a region--indeed, for any part of a company that has a strategy to generate financial or customer-related results. It enables executives to assess overall company strengths and weaknesses, senior leaders to define strategy, midlevel managers to execute strategy, and frontline leaders to achieve tactical results. In short, it helps turn intangible assets into concrete strengths. PMID:15202293

  9. Reforming health care in Canada: current issues La reforma del sistema de atención a la salud en Canadá: situación actual

    Directory of Open Access Journals (Sweden)

    Enis Baris

    1998-05-01

    Full Text Available This paper examines the current health care reform issues in Canada. The provincial health insurance plans of the 1960s and 1970s had the untoward effects of limiting the federal government’s clout for cost control and of promoting a system centered on inpatient and medical care. Recently, several provincial commissions reported that the current governance structures and management processes are outmoded in light of new knowledge, new fiscal realities and the evolution of power among stake-holders. They recommend decentralized governance and restructuring for better management and more citizen participation. Although Canada’s health care system remains committed to safeguarding its guiding principles, the balance of power may be shifting from providers to citizens and "technocrats". Also, all provinces are likely to increase their pressure on physicians by means of salary caps, by exploring payment methods such as capitation, limiting access to costly technology, and by demanding practice changes based on evidence of cost-effectiveness.Este artículo examina los temas más recientes en las reformas del sistema de atención a la salud en Canadá. Los planes de seguridad en el sector salud durante los años sesenta y setenta tuvieron efectos inapropiados en cuanto a que limitaron el poder del gobierno federal para controlar costos y promover un sistema centrado en la atención médico-hospitalaria. Recientemente, varias comisiones provinciales reportaron que las actuales estructuras de gobierno y gestión de los procesos no están actualizadas en términos del nuevo conocimiento, las nuevas realidades fiscales y la evolución en las formas de poder entre los grupos de interés. Sus recomendaciones incluyen formas descentralizadas de gobierno y mayor participación ciudadana. A pesar de que el sistema de atención a la salud en Canadá permanece comprometido a garantizar sus principios centrales, el balance de poder estaría cambiando de los

  10. Testing an intervention to improve functional capability in advanced cardiopulmonary illness.

    Science.gov (United States)

    Dougherty, Cynthia M; Steele, Bonnie G; Hunziker, Jim

    2011-01-01

    The development of a conceptually driven exercise and self-management intervention for improving functional capability and reducing health care costs using social cognitive theory is described. The intervention has 2 components: a 1-month outpatient exercise intervention followed by a home component, lasting 5 months. The intervention is expected to have significant impact on daily function, quality of life, gait/balance, self-efficacy, and health care utilization in persons with advanced heart failure or chronic obstructive pulmonary disease. We report preliminary results related to process-related variables, including feasibility, safety, and intervention adherence. Intervention outcomes are currently under study and will be reported when available.

  11. Layered Composite Analysis Capability

    Science.gov (United States)

    Narayanaswami, R.; Cole, J. G.

    1985-01-01

    Laminated composite material construction is gaining popularity within industry as an attractive alternative to metallic designs where high strength at reduced weights is of prime consideration. This has necessitated the development of an effective analysis capability for the static, dynamic and buckling analyses of structural components constructed of layered composites. Theoretical and user aspects of layered composite analysis and its incorporation into CSA/NASTRAN are discussed. The availability of stress and strain based failure criteria is described which aids the user in reviewing the voluminous output normally produced in such analyses. Simple strategies to obtain minimum weight designs of composite structures are discussed. Several example problems are presented to demonstrate the accuracy and user convenient features of the capability.

  12. Building Server Capabilities

    DEFF Research Database (Denmark)

    Adeyemi, Oluseyi

    2013-01-01

    Many western companies have moved part of their operations to China in order to take advantage of cheap resources and/or to gain access to a high potential market. Depending on motive, offshore facilities usually start either as “sales-only” of products exported by headquarters or “production......-only”, exporting parts and components back to headquarter for sales in the home country. In the course of time, the role of offshore subsidiaries in a company’s operations network tends to change and, with that, the capabilities, of the subsidiaries. Focusing on Danish subsidiaries in China, the objective...... of this project is to identify and explain trajectories of offshore subsidiary capability development. Given the nature of this objective the chief methodology is longitudinal, partly retrospective, partly real-time, case studies....

  13. Management Innovation Capabilities

    OpenAIRE

    Harder, Mie

    2011-01-01

    Management innovation is the implementation of a new management practice, process, technique or structure that significantly alters the way the work of management is performed. This paper presents a typology categorizing management innovation along two dimensions; radicalness and complexity. Then, the paper introduces the concept of management innovation capabilities which refers to the ability of a firm to purposefully create, extend and modify its managerial resource base to add...

  14. Knowledge Management Capabilities Rubrics

    OpenAIRE

    Azizah B.A. Rahman; Sara Hassani

    2011-01-01

    Problem statement: Recently researchers discerned the vitality and importance of Knowledge Management Capabilities (KMC) evaluation in organizations. In fact evaluation of KMC helps to prevent failure in Knowledge Management (KM) projects. Approach: One of the most popular methods in the phase of evaluating KMC is Fuzzy method which evaluates seven attributes of KMC. Fuzzy needs KM experts to give their opinion about these attributes as input data. However in some organizations these experts ...

  15. Atmospheric release advisory capability

    International Nuclear Information System (INIS)

    The ARAC system (Atmospheric Release Advisory Capability) is described. The system is a collection of people, computers, computer models, topographic data and meteorological input data that together permits a calculation of, in a quasi-predictive sense, where effluent from an accident will migrate through the atmosphere, where it will be deposited on the ground, and what instantaneous and integrated dose an exposed individual would receive

  16. Analytical Chemistry Core Capability Assessment - Preliminary Report

    Energy Technology Data Exchange (ETDEWEB)

    Barr, Mary E. [Los Alamos National Laboratory; Farish, Thomas J. [Los Alamos National Laboratory

    2012-05-16

    The concept of 'core capability' can be nebulous one. Even at a fairly specific level, where core capability equals maintaining essential services, it is highly dependent upon the perspective of the requestor. Samples are submitted to analytical services because the requesters do not have the capability to conduct adequate analyses themselves. Some requests are for general chemical information in support of R and D, process control, or process improvement. Many analyses, however, are part of a product certification package and must comply with higher-level customer quality assurance requirements. So which services are essential to that customer - just those for product certification? Does the customer also (indirectly) need services that support process control and improvement? And what is the timeframe? Capability is often expressed in terms of the currently utilized procedures, and most programmatic customers can only plan a few years out, at best. But should core capability consider the long term where new technologies, aging facilities, and personnel replacements must be considered? These questions, and a multitude of others, explain why attempts to gain long-term consensus on the definition of core capability have consistently failed. This preliminary report will not try to define core capability for any specific program or set of programs. Instead, it will try to address the underlying concerns that drive the desire to determine core capability. Essentially, programmatic customers want to be able to call upon analytical chemistry services to provide all the assays they need, and they don't want to pay for analytical chemistry services they don't currently use (or use infrequently). This report will focus on explaining how the current analytical capabilities and methods evolved to serve a variety of needs with a focus on why some analytes have multiple analytical techniques, and what determines the infrastructure for these analyses. This

  17. Analytical Chemistry Core Capability Assessment - Preliminary Report

    International Nuclear Information System (INIS)

    The concept of 'core capability' can be nebulous one. Even at a fairly specific level, where core capability equals maintaining essential services, it is highly dependent upon the perspective of the requestor. Samples are submitted to analytical services because the requesters do not have the capability to conduct adequate analyses themselves. Some requests are for general chemical information in support of R and D, process control, or process improvement. Many analyses, however, are part of a product certification package and must comply with higher-level customer quality assurance requirements. So which services are essential to that customer - just those for product certification? Does the customer also (indirectly) need services that support process control and improvement? And what is the timeframe? Capability is often expressed in terms of the currently utilized procedures, and most programmatic customers can only plan a few years out, at best. But should core capability consider the long term where new technologies, aging facilities, and personnel replacements must be considered? These questions, and a multitude of others, explain why attempts to gain long-term consensus on the definition of core capability have consistently failed. This preliminary report will not try to define core capability for any specific program or set of programs. Instead, it will try to address the underlying concerns that drive the desire to determine core capability. Essentially, programmatic customers want to be able to call upon analytical chemistry services to provide all the assays they need, and they don't want to pay for analytical chemistry services they don't currently use (or use infrequently). This report will focus on explaining how the current analytical capabilities and methods evolved to serve a variety of needs with a focus on why some analytes have multiple analytical techniques, and what determines the infrastructure for these analyses. This information will be

  18. [Pregnancy contraception (Current Care Guideline)].

    Science.gov (United States)

    Halttunen-Nieminen, Mervi; Piltonen, Terhi; Alenius, Heidi; Apukka, Laura; Kosunen, Elise; Pietilä, Kirsi; Sihvo, Sinikka; Vuorela, Piia; Väänänen, Eija; Yli-Kivistö, Tiina

    2016-01-01

    There are no age limits for the start or use of contraception. Prior gynecological examination or cervical smear is not needed. Condom is the only method that protects from sexually transmitted diseases. An increase in the risk of venous thromboembolism (VTE) is associated only with combined contraceptives. However, the risk is remarkably higher with pregnancy, puerperium or with smoking. The most effective reversible methods are intrauterine devices (IUD) and implants, as these do not depend on daily memory. Natural family planning methods are not reliable, and effective contraception should be easily available for all at all times. PMID:27382829

  19. Current practices of mobilization, analgesia, relaxants and sedation in Indian ICUs: A survey conducted by the Indian Society of Critical Care Medicine

    Directory of Open Access Journals (Sweden)

    Rajesh Chawla

    2014-01-01

    Full Text Available Background and Aim: Use of sedation, analgesia and neuromuscular blocking agents is widely practiced in Intensive Care Units (ICUs. Our aim is to study the current practice patterns related to mobilization, analgesia, relaxants and sedation (MARS to help in standardizing best practices in these areas in the ICU. Materials and Methods: A web-based nationwide survey involving physicians of the Indian Society of Critical Care Medicine (ISCCM and the Indian Society of Anesthesiologists (ISA was carried out. A questionnaire included questions on demographics, assessment scales for delirium, sedation and pain, as also the pharmacological agents and the practice methods. Results: Most ICUs function in a semi-closed model. Midazolam (94.99% and Fentanyl (47.04% were the most common sedative and analgesic agents used, respectively. Vecuronium was the preferred neuromuscular agent. Monitoring of sedation, analgesia and delirium in the ICU. Ramsay′s Sedation Scale (56.1% and Visual Analogue Scale (48.07% were the preferred sedation and pain scales, respectively. CAM (Confusion Assessment Method-ICU was the most preferred method of delirium assessment. Haloperidol was the most commonly used agent for delirium. Majority of the respondents were aware of the benefit of early mobilization, but lack of support staff and safety concerns were the main obstacles to its implementation. Conclusion: The results of the survey suggest that compliance with existing guidelines is low. Benzodiazepines still remain the predominant ICU sedative. The recommended practice of giving analgesia before sedation is almost non-existent. Delirium remains an underrecognized entity. Monitoring of sedation levels, analgesia and delirium is low and validated and recommended scales for the same are rarely used. Although awareness of the benefits of early mobilization are high, the implementation is low.

  20. The UPBEAT nurse-delivered personalized care intervention for people with coronary heart disease who report current chest pain and depression: a randomised controlled pilot study.

    Directory of Open Access Journals (Sweden)

    Elizabeth A Barley

    Full Text Available BACKGROUND: Depression is common in people with coronary heart disease (CHD and associated with worse outcome. This study explored the acceptability and feasibility of procedures for a trial and for an intervention, including its potential costs, to inform a definitive randomized controlled trial (RCT of a nurse-led personalised care intervention for primary care CHD patients with current chest pain and probable depression. METHODS: Multi-centre, outcome assessor-blinded, randomized parallel group study. CHD patients reporting chest pain and scoring 8 or more on the HADS were randomized to personalized care (PC or treatment as usual (TAU for 6 months and followed for 1 year. Primary outcome was acceptability and feasibility of procedures; secondary outcomes included mood, chest pain, functional status, well being and psychological process variables. RESULT: 1001 people from 17 General Practice CHD registers in South London consented to be contacted; out of 126 who were potentially eligible, 81 (35% female, mean age = 65 SD11 years were randomized. PC participants (n = 41 identified wide ranging problems to work on with nurse-case managers. Good acceptability and feasibility was indicated by low attrition (9%, high engagement and minimal nurse time used (mean/SD = 78/19 mins assessment, 125/91 mins telephone follow up. Both groups improved on all outcomes. The largest between group difference was in the proportion no longer reporting chest pain (PC 37% vs TAU 18%; mixed effects model OR 2.21 95% CI 0.69, 7.03. Some evidence was seen that self efficacy (mean scale increase of 2.5 vs 0.9 and illness perceptions (mean scale increase of 7.8 vs 2.5 had improved in PC vs TAU participants at 1 year. PC appeared to be more cost effective up to a QALY threshold of approximately £3,000. CONCLUSIONS: Trial and intervention procedures appeared to be feasible and acceptable. PC allowed patients to work on unaddressed problems and appears cheaper than TAU

  1. Capabilities and Special Needs

    DEFF Research Database (Denmark)

    Kjeldsen, Christian Christrup

    into international consideration in relation to the implementation of the UN convention on the rights of persons with disabilities. As for the theoretical basis, the research makes use of the sociological open-ended and relational concepts of Pierre Bourdieu and the normative yardstick of the Capability Approach....... An approach that has been formulated by Amartya Sen and Martha Nussbaum, it introduces, discusses and finally analyses data with an emphasis on Martha Nussbaum’s central human functionings of practical reason and bodily health with a particular focus on the freedom to choose....

  2. Laboratory microfusion capability study

    International Nuclear Information System (INIS)

    The purpose of this study is to elucidate the issues involved in developing a Laboratory Microfusion Capability (LMC) which is the major objective of the Inertial Confinement Fusion (ICF) program within the purview of the Department of Energy's Defense Programs. The study was initiated to support a number of DOE management needs: to provide insight for the evolution of the ICF program; to afford guidance to the ICF laboratories in planning their research and development programs; to inform Congress and others of the details and implications of the LMC; to identify criteria for selection of a concept for the Laboratory Microfusion Facility and to develop a coordinated plan for the realization of an LMC. As originally proposed, the LMC study was divided into two phases. The first phase identifies the purpose and potential utility of the LMC, the regime of its performance parameters, driver independent design issues and requirements, its development goals and requirements, and associated technical, management, staffing, environmental, and other developmental and operational issues. The second phase addresses driver-dependent issues such as specific design, range of performance capabilities, and cost. The study includes four driver options; the neodymium-glass solid state laser, the krypton fluoride excimer gas laser, the light-ion accelerator, and the heavy-ion induction linear accelerator. The results of the Phase II study are described in the present report

  3. 提高整流装置输出电流能力的研究及试验验证%Study and Experimental Test about the Increasing Output Current Capability of the Rectifier

    Institute of Scientific and Technical Information of China (English)

    王海军; 霍乾涛; 刘国华

    2011-01-01

    :The rectifier is one of the key devices in the excitation system. If the output of the rectifier is improved, the number of the parallel arms will be reduced, and the stability of the power system will be improved.Based on the theory of thermal circuit and the characteristics of excitation system, the thermal resistance was analyzed,and the main factor that block the heat fluid was found by a heavy current test. The test proves that it must choose the heat sink of high efficiency,not choose the SCR with the greater rated current,if the output current of rectifier want to be improved. And it also provides a method of design for the rectifier of the excitation system, and it is important for the engineering design.%晶闸管整流装置是自并励励磁系统的核心装置之一,提高该装置单柜的电流输出能力,可以降低整流装置并联运行的数量,提高励磁系统的稳定性.从晶闸管元件热量流通原理的励磁系统的特点出发,通过数据分析和试验验证得出了影响晶闸管散热的主要因素,并通过试验得到了证实,说明了要提高晶闸管整流装置输出能力,需要选择较好的散热器,而非提高晶闸管元件的额定电流,对于大型机组励磁系统功率柜的设计和器件的选择提供了选择依据,具有重要的指导意义.

  4. Current HIV/AIDS end-of-life care in sub-Saharan Africa: a survey of models, services, challenges and priorities

    Directory of Open Access Journals (Sweden)

    O'Neill Joseph F

    2003-10-01

    Full Text Available Abstract Background In response to increased global public health funding initiatives to HIV/AIDS care in Africa, this study aimed to describe practice models, strategies and challenges to delivering end-of-life care in sub-Saharan Africa. Methods A survey end-of-life care programs was conducted, addressing the domains of service aims and configuration, barriers to pain control, governmental endorsement and strategies, funding, monitoring and evaluation, and research. Both closed and qualitative responses were sought. Results Despite great structural challenges, data from 48 programs in 14 countries with a mean annual funding of US $374,884 demonstrated integrated care delivery across diverse settings. Care was commonly integrated with all advanced disease care (67% and disease stages (65% offering care from diagnosis. The majority (98% provided home-based care for a mean of 301 patients. Ninety-four percent reported challenges in pain control (including availability, lack of trained providers, stigma and legal restrictions, and 77% addressed the effects of poverty on disease progression and management. Although 85% of programs reported Government endorsement, end-of-life and palliative care National strategies were largely absent. Conclusions The interdependent tasks of expanding pain control, balancing quality and coverage of care, providing technical assistance in monitoring and evaluation, collaborating between donor agencies and governments, and educating policy makers and program directors of end-of-life care are all necessary if resources are to reach their goals.

  5. Professionals and Public Good Capabilities

    Directory of Open Access Journals (Sweden)

    Melanie Walker

    2015-12-01

    Full Text Available Martha Nussbaum (2011 reminds us that, all over the world people are struggling for a life that is fully human - a life worthy of human dignity. Purely income-based and preference-based evaluations, as Sen (1999 argues, do not adequately capture what it means for each person to have quality of life. There are other things that make life good for a person, including access to publicly provided professional services. The question then is what version of education inflects more towards the intrinsic and transformational possibilities of professional work and contributions to decent societies? This paper suggests that we need a normative approach to professional education and professionalism; it is not the case that any old version will do. We also need normative criteria to move beyond social critique and to overcome a merely defensive attitude and to give a positive definition to the potential achievements of the professions. Moreover universities are connected to society, most especially through the professionals they educate; it is reasonable in our contemporary world to educate professional graduates to be in a position to alleviate inequalities, and to have the knowledge, skills and values to be able to do so. To make this case, we draw on the human capabilities approach of Sen (1999, 2009 and Nussbaum (2000, 2011 to conceptualise professional education for the public good as an ally of the struggles of people living in poverty and experiencing inequalities, expanding the well-being of people to be and to do in ways they have reason to value – to be mobile, cared for, respected, and so on. In particular we are interested in which human capabilities and functionings are most needed for a professional practice and professionalism that can contribute to transformative social change and how professional development is enabled via pedagogical arrangements.

  6. Knowledge Management Capabilities Rubrics

    Directory of Open Access Journals (Sweden)

    Azizah B.A. Rahman

    2011-01-01

    Full Text Available Problem statement: Recently researchers discerned the vitality and importance of Knowledge Management Capabilities (KMC evaluation in organizations. In fact evaluation of KMC helps to prevent failure in Knowledge Management (KM projects. Approach: One of the most popular methods in the phase of evaluating KMC is Fuzzy method which evaluates seven attributes of KMC. Fuzzy needs KM experts to give their opinion about these attributes as input data. However in some organizations these experts are not available. Results: Therefore in this study a rubric matrix is developed as an assessment tool with ordered rank (very high, medium and very low of descriptive characteristics of criteria (seven attributes that organizations wish to evaluate. Conclusion: This rubric is applicable for members of an organization which are not familiar completely with KMC and also will be maintained by analyzing and surveying many different researches.

  7. PHOBOS physics capabilities

    Energy Technology Data Exchange (ETDEWEB)

    Baker, M.D. [Massachusetts Institute of Technology, Cambridge, MA (United States)

    1995-07-15

    PHOBOS is the name of a detector and of a research program to study systematically the physics of relativistic heavy-ion collisions over a large range of impact parameters and nuclear species. Collisions with a center mass energy of 200 A GeV at RHIC are expected to produce the highest energy densities ever accessible in the laboratory. In this writeup, the authors outline the physics capabilities of the PHOBOS detector and describe the detector design in terms of the general philosophy behind the PHOBOS research program. In order to make the discussion concrete, they then focus on two specific examples of physics measurements that they plan to make at RHIC: dN/d{eta} for charged particles and the mass spectrum from {phi} {yields} K{sup +}K{sup {minus}} decays.

  8. General shape optimization capability

    Science.gov (United States)

    Chargin, Mladen K.; Raasch, Ingo; Bruns, Rudolf; Deuermeyer, Dawson

    1991-01-01

    A method is described for calculating shape sensitivities, within MSC/NASTRAN, in a simple manner without resort to external programs. The method uses natural design variables to define the shape changes in a given structure. Once the shape sensitivities are obtained, the shape optimization process is carried out in a manner similar to property optimization processes. The capability of this method is illustrated by two examples: the shape optimization of a cantilever beam with holes, loaded by a point load at the free end (with the shape of the holes and the thickness of the beam selected as the design variables), and the shape optimization of a connecting rod subjected to several different loading and boundary conditions.

  9. Knowing-how to care.

    Science.gov (United States)

    Dall'Agnol, Darlei

    2016-07-01

    This paper advances a new moral epistemology and explores some of its normative and practical, especially bioethical, implications. In the first part, it shows that there is moral knowledge and that it is best understood in terms of knowing-how. Thus, moral knowledge cannot be analysed purely in the traditional terms of knowing-that. The fundamental idea is that one knows-how to act morally only if she is capable of following the right normative standards. In the second part, the paper discusses ways of integrating two expressions of moral knowing-how, namely caring and respecting into a coherent normative theory. It builds up the concept of respectful care as the central ingredient of such a normative theory. Finally, it illustrates how respectful care may transform some of our current clinical bioethical practices. PMID:26933195

  10. Enhanced ocean observational capability

    Energy Technology Data Exchange (ETDEWEB)

    Volpe, A M; Esser, B K

    2000-01-10

    Coastal oceans are vital to world health and sustenance. Technology that enables new observations has always been the driver of discovery in ocean sciences. In this context, we describe the first at sea deployment and operation of an inductively coupled plasma mass spectrometer (ICPMS) for continuous measurement of trace elements in seawater. The purpose of these experiments was to demonstrate that an ICPMS could be operated in a corrosive and high vibration environment with no degradation in performance. Significant advances occurred this past year due to ship time provided by Scripps Institution of Oceanography (UCSD), as well as that funded through this project. Evaluation at sea involved performance testing and characterization of several real-time seawater analysis modes. We show that mass spectrometers can rapidly, precisely and accurately determine ultratrace metal concentrations in seawater, thus allowing high-resolution mapping of large areas of surface seawater. This analytical capability represents a significant advance toward real-time observation and understanding of water mass chemistry in dynamic coastal environments. In addition, a joint LLNL-SIO workshop was convened to define and design new technologies for ocean observation. Finally, collaborative efforts were initiated with atmospheric scientists at LLNL to identify realistic coastal ocean and river simulation models to support real-time analysis and modeling of hazardous material releases in coastal waterways.

  11. Mobile systems capability plan

    International Nuclear Information System (INIS)

    This plan was prepared to initiate contracting for and deployment of these mobile system services. 102,000 cubic meters of retrievable, contact-handled TRU waste are stored at many sites around the country. Also, an estimated 38,000 cubic meters of TRU waste will be generated in the course of waste inventory workoff and continuing DOE operations. All the defense TRU waste is destined for disposal in WIPP near Carlsbad NM. To ship TRU waste there, sites must first certify that the waste meets WIPP waste acceptance criteria. The waste must be characterized, and if not acceptable, subjected to additional processing, including repackaging. Most sites plan to use existing fixed facilities or open new ones between FY1997-2006 to perform these functions; small-quantity sites lack this capability. An alternative to fixed facilities is the use of mobile systems mounted in trailers or skids, and transported to sites. Mobile systems will be used for all characterization and certification at small sites; large sites can also use them. The Carlsbad Area Office plans to pursue a strategy of privatization of mobile system services, since this offers a number of advantages. To indicate the possible magnitude of the costs of deploying mobile systems, preliminary estimates of equipment, maintenance, and operating costs over a 10-year period were prepared and options for purchase, lease, and privatization through fixed-price contracts considered

  12. Open architecture for rapid deployment of capability

    Science.gov (United States)

    Glassman, Jacob

    2016-05-01

    Modern warfare has drastically changed from conventional to non-conventional and from fixed threats to dynamic ones over the past several decades. This unprecedented fundamental shift has now made our adversaries and their weapons more nebulous and ever changing. Our current acquisition system however is not suited to develop, test and deploy essential capability to counter these dynamic threats in time to combat them. This environment requires a new infrastructure in our system design to rapidly adopt capabilities that we do not currently plan for or even know about. The key to enabling this rapid implementation is Open Architecture in acquisition. The DoD has shown it can rapidly prototype capabilities such as unmanned vehicles but has severely struggled in moving from the prototyping to deployment. A major driver of this disconnect is the lack of established infrastructure to employ said capability such as launch and recovery systems and command and control. If we are to be successful in transitioning our rapid capability to the warfighter we must implement established well defined interfaces and enabling technologies to facilitate the rapid adoption of capability so the warfighter has the tools to effectively counter the threat.

  13. Small rover exploration capabilities

    Science.gov (United States)

    Salotti, Jean-Marc; Laithier, Corentin; Machut, Benoit; Marie, Aurélien; Bruneau, Audrey; Grömer, Gernot; Foing, Bernard H.

    2015-05-01

    For a human mission to the Moon or Mars, an important question is to determine the best strategy for the choice of surface vehicles. Recent studies suggest that the first missions to Mars will be strongly constrained and that only small unpressurized vehicles will be available. We analyze the exploration capabilities and limitations of small surface vehicles from the user perspective. Following the “human centered design” paradigm, the team focused on human systems interactions and conducted the following experiments: - Another member of our team participated in the ILEWG EuroMoonMars 2013 simulation at the Mars Desert Research Station in Utah during the same period of time. Although the possible traverses were restricted, a similar study with analog space suits and quads has been carried out. - Other experiments have been conducted in an old rock quarry close to Bordeaux, France. An expert in the use of quads for all types of terrains performed a demonstration and helped us to characterize the difficulties, the risks and advantages and drawbacks of different vehicles and tools. The vehicles that will be used on the surface of Mars have not been defined yet. Nevertheless, the results of our project already show that using a light and unpressurized vehicle (in the order of 150 kg) for the mobility on the Martian surface can be a true advantage. Part of the study was dedicated to the search for appropriate tools that could be used to make the vehicles easier to handle, safer to use and more efficient in the field to cross an obstacle. The final recommendation is to use winches and ramps, which already are widely used by quad drivers. We report on the extension of the reachable areas if such tools were available. This work has been supported by ILEWG, EuroMoonMars and the Austrian Space Forum (OEWF).

  14. The current status of foot self-care knowledge, behaviours, and analysis of influencing factors in patients with type 2 diabetes mellitus in China

    Directory of Open Access Journals (Sweden)

    Rao Li

    2014-09-01

    Conclusions: The status of foot self-care knowledge and behaviours are not optimistic. According to the patients' own characteristics, the theory of knowledge, attitude and practice applies to encouraging patients to go for periodic inspection and education about diabetic complications so as to enhance the knowledge and promote the self-care behaviours.

  15. Impact of Personnel Capabilities on Organizational Innovation Capability

    DEFF Research Database (Denmark)

    Nielsen, Susanne Balslev; Momeni, Mostafa

    2016-01-01

    One of the most dynamic capabilities that lead to the strongest competitive advantage in the organizations is the innovation capability. Analysing the development of a firm’s innovation capability is an important research project, and can help organizations to achieve competitive advantage in thi...

  16. Facility Interface Capability Assessment (FICA) project report

    International Nuclear Information System (INIS)

    The US Department of Energy's (DOE) Office of Civilian Radioactive Waste Management (OCRWM) is responsible for developing the Civilian Radioactive Waste Management System (CRWMS) to accept spent nuclear fuel from commercial facilities. The objective of the Facility Interface Capability Assessment (FICA) project was to assess the capability of each commercial spent nuclear fuel (SNF) storage facility, at which SNF is stored, to handle various SNF shipping casks. The purpose of this report is to present and analyze the results of the facility assessments completed within the FICA project. During Phase 1, the data items required to complete the facility assessments were identified and the database for the project was created. During Phase 2, visits were made to 122 facilities on 76 sites to collect data and information, the database was updated, and assessments of the cask-handling capabilities at each facility were performed. Each assessment of cask-handling capability contains three parts: the current capability of the facility (planning base); the potential enhanced capability if revisions were made to the facility licensing and/or administrative controls; and the potential enhanced capability if limited physical modifications were made to the facility. The main conclusion derived from the planning base assessments is that the current facility capabilities will not allow handling of any of the FICA Casks at 49 of the 122 facilities evaluated. However, consideration of potential revisions and/or modifications showed that all but one of the 49 facilities could be adapted to handle at least one of the FICA Casks. For this to be possible, facility licensing, administrative controls, and/or physical aspects of the facility would need to be modified

  17. Sandia Laboratories technical capabilities: testing

    International Nuclear Information System (INIS)

    The testing capabilities at Sandia Laboratories are characterized. Selected applications of these capabilities are presented to illustrate the extent to which they can be applied in research and development programs

  18. The development of capability indicators

    NARCIS (Netherlands)

    Anand, Paul; Hunter, Graham; Carter, Ian; Dowding, Keith; Guala, Francesco; Van Hees, Martin

    2009-01-01

    This paper is motivated by sustained interest in the capabilities approach to welfare economics combined with the paucity of economic statistics that measure capabilities at the individual level. Specifically, it takes a much discussed account of the normatively desirable capabilities constitutive o

  19. The Capability to Hold Property

    NARCIS (Netherlands)

    Claassen, Rutger

    2015-01-01

    This paper discusses the question of whether a capability theory of justice (such as that of Martha Nussbaum) should accept a basic “capability to hold property.” Answering this question is vital for bridging the gap between abstract capability theories of justice and their institutional implication

  20. Capability-based computer systems

    CERN Document Server

    Levy, Henry M

    2014-01-01

    Capability-Based Computer Systems focuses on computer programs and their capabilities. The text first elaborates capability- and object-based system concepts, including capability-based systems, object-based approach, and summary. The book then describes early descriptor architectures and explains the Burroughs B5000, Rice University Computer, and Basic Language Machine. The text also focuses on early capability architectures. Dennis and Van Horn's Supervisor; CAL-TSS System; MIT PDP-1 Timesharing System; and Chicago Magic Number Machine are discussed. The book then describes Plessey System 25

  1. Satellite broadcasting - Capabilities for public service

    Science.gov (United States)

    Marsten, R. B.

    1975-01-01

    Satellite broadcast services to support health-care and educational transmissions must work with small, low-cost terminals in allocated radio-frequency bands. The ATS-6 spacecraft has successfully demonstrated such capability in the bands of non-technical users. It supports interactive television broadcasting to simple, low-cost terminals in a nationwide series of experiments in the delivery of health-care and educational services. ATS-6 achieves this capability with a very large antenna and moderate transmitter power. The coverage limitations inherent in this approach will be overcome by the joint U.S.-Canadian Communications Technology Satellite to be launched in December 1975. The CTS will demonstrate broadcast capability with new, high-power technology in a newly-allocated radio-frequency band. This will make it possible to use smaller antennas, greatly enlarging the area coverage available to the many nontechnical experimenters using CTS for their own needs. A practical application of these technologies is now in development for operational broadcasting services in Japan.

  2. LANL capabilities towards bioenergy and biofuels programs

    Energy Technology Data Exchange (ETDEWEB)

    Olivares, Jose A [Los Alamos National Laboratory; Park, Min S [Los Alamos National Laboratory; Unkefer, Clifford J [Los Alamos National Laboratory; Bradbury, Andrew M [Los Alamos National Laboratory; Waldo, Geoffrey S [Los Alamos National Laboratory

    2009-01-01

    LANL invented technology for increasing growth and productivity of photosysnthetic organisms, including algae and higher plants. The technology has been extensively tested at the greenhouse and field scale for crop plants. Initial bioreactor testing of its efficacy on algal growth has shown promising results. It increases algal growth rates even under optimwn nutrient supply and careful pH control with CO{sub 2} continuously available. The technology uses a small organic molecule, applied to the plant surfaces or added to the algal growth medium. CO{sub 2} concentration is necessary to optimize algal production in either ponds or reactors. LANL has successfully designed, built and demonstrated an effective, efficient technology using DOE funding. Such a system would be very valuable for capitalizing on local inexpensive sources of CO{sub 2} for algal production operations. Furthermore, our protein engineering team has a concept to produce highly stable carbonic anhydyrase (CA) enzyme, which could be very useful to assure maximum utilization of the CO{sub 2} supply. Stable CA could be used either imnlobilized on solid supports or engineered into the algal strain. The current technologies for harvesting the algae and obtaining the lipids do not meet the needs for rapid, low cost separations for high volumes of material. LANL has obtained proof of concept for the high volume flowing stream concentration of algae, algal lysis and separation of the lipid, protein and water fractions, using acoustic platforms. This capability is targeted toward developing biosynthetics, chiral syntheses, high throughput protein expression and purification, organic chemistry, recognition ligands, and stable isotopes geared toward Bioenergy applications. Areas of expertise include stable isotope chemistry, biomaterials, polymers, biopolymers, organocatalysis, advanced characterization methods, and chemistry of model compounds. The ultimate realization of the ability to design and

  3. Current capabilities and future directions in computational fluid dynamics

    Science.gov (United States)

    1986-01-01

    A summary of significant findings is given, followed by specific recommendations for future directions of emphasis for computational fluid dynamics development. The discussion is organized into three application areas: external aerodynamics, hypersonics, and propulsion - and followed by a turbulence modeling synopsis.

  4. The New MCNP6 Depletion Capability

    Energy Technology Data Exchange (ETDEWEB)

    Fensin, Michael Lorne [Los Alamos National Laboratory; James, Michael R. [Los Alamos National Laboratory; Hendricks, John S. [Los Alamos National Laboratory; Goorley, John T. [Los Alamos National Laboratory

    2012-06-19

    The first MCNP based inline Monte Carlo depletion capability was officially released from the Radiation Safety Information and Computational Center as MCNPX 2.6.0. Both the MCNP5 and MCNPX codes have historically provided a successful combinatorial geometry based, continuous energy, Monte Carlo radiation transport solution for advanced reactor modeling and simulation. However, due to separate development pathways, useful simulation capabilities were dispersed between both codes and not unified in a single technology. MCNP6, the next evolution in the MCNP suite of codes, now combines the capability of both simulation tools, as well as providing new advanced technology, in a single radiation transport code. We describe here the new capabilities of the MCNP6 depletion code dating from the official RSICC release MCNPX 2.6.0, reported previously, to the now current state of MCNP6. NEA/OECD benchmark results are also reported. The MCNP6 depletion capability enhancements beyond MCNPX 2.6.0 reported here include: (1) new performance enhancing parallel architecture that implements both shared and distributed memory constructs; (2) enhanced memory management that maximizes calculation fidelity; and (3) improved burnup physics for better nuclide prediction. MCNP6 depletion enables complete, relatively easy-to-use depletion calculations in a single Monte Carlo code. The enhancements described here help provide a powerful capability as well as dictate a path forward for future development to improve the usefulness of the technology.

  5. Capabilities and Incapabilities of the Capabilities Approach to Health Justice.

    Science.gov (United States)

    Selgelid, Michael J

    2016-01-01

    This first part of this article critiques Sridhar Venkatapuram's conception of health as a capability. It argues that Venkatapuram relies on the problematic concept of dignity, implies that those who are unhealthy lack lives worthy of dignity (which seems politically incorrect), sets a low bar for health, appeals to metaphysically problematic thresholds, fails to draw clear connections between appealed-to capabilities and health, and downplays the importance/relevance of health functioning. It concludes by questioning whether justice entitlements should pertain to the capability for health versus health achievements, challenging Venkatapuram's claims about the strength of health entitlements, and demonstrating that the capabilities approach is unnecessary to address social determinants of health.

  6. Why Health Matters to Justice: A Capability Theory Perspective

    DEFF Research Database (Denmark)

    Nielsen, Lasse

    2015-01-01

    The capability approach, originated by Amartya Sen is among the most comprehensive and influential accounts of justice that applies to issues of health and health care. However, although health is always presumed as an important capability in Sen’s works, he never manages to fully explain why...... Venkatapuram’s conception of health as the central human meta-capability and, respectively, Norman Daniels’ embrace of the capability metric in his use of Rawls’ principle of fair equality of opportunity. The paper argues that none of these accounts succeed in providing a plausible justification of the value...

  7. Questions and current situation of the elders’ nursing care beds allocation in Shanghai%上海市老年护理床位配置现状及问题

    Institute of Scientific and Technical Information of China (English)

    许燕君; 杨颖华; 杨光; 丁汉升; 周萍; 庄悦红; 李明; 郑涛; 王颖

    2014-01-01

    目的:论证上海市老年护理床位的配置现状及存在问题。方法:通过横断面调查获得床位数据,引用卫生统计年鉴、卫生财务年报等资料,通过纵向和横向比较,分析老年护理服务床位数量及构成的合理性。结果:2012年上海市平均每千65岁及以上老年人口的护理床位数为49.3张,与发达国家齐平。老年护理医疗床位平均每千人口床位数仅6.4张,养老床位则为每千人口42.9张。老年医疗护理床位的使用率近90%,而养老床位入住率仅为70%左右。结论:上海市老年护理床位总体上基本满足需求,但医疗护理床位相对匮乏与养老床位相对宽裕并存。增加政府重视和协调、明确老年护理机构功能定位和需方需求评估标准,合理引导分流成为当前解决问题之策。%Objective:To figure out the current situation and existing problems of nursing care beds allocation in Shanghai. Methods:Beds data of skilled care facility were obtained through a cross-sectional survey,some data cited from health statistics yearbook and health financial annual report to analyze if the quantity and composition of nursing care beds were reasonable through vertical and horizontal comparison. Results:The elderly aged 65 years and above owned 49.3 nursing care beds per one thousand elders on average in Shanghai in 2012,the same as that in developed countries. Only 6.4 medical nursing care beds for every thousand elders,and beds for elder daily life care were 42.9. However,the bed utilization rate of the skilled nursing care beds came near to 90%,while only around 70%for daily life care beds. Conclusion:The nursing care beds for the elders in Shanghai have met the requirements on the whole,while the phenomenon of medical nursing beds in shortage and the daily care beds being adequate coexists. Thus,solutions to current problems should be paid more attention and what the government should do is to make sure

  8. LOFAR imaging capabilities and system sensitivity

    CERN Document Server

    Nijboer, R J; de Bruyn, A G

    2013-01-01

    This document describes the general astronomical capabilities of the LOw Frequency ARray (LOFAR). The frequency range covered by LOFAR is split into two bands denoted as low band (LB, 10 - 80 MHz) and high band (HB, 120 - 240 MHz). LOFAR stations are spread over a 100 km sized region in the northern part of the Netherlands. In addition to the Dutch stations there will be European stations providing baselines between 200 km and 1000 km. Most of the results in this document, however, are limited to the Dutch array. In section 2 the LBA and HBA station configurations are reviewed. Section 3 reviews the imaging capabilities as station Full Width Half Maximum, station Field of View, and array resolution. In section 4 the system sensitivity is considered and thermal noise levels in LOFAR images are given. Finally, in section 5 some cautionary notes are collected. We advise you to read these notes carefully before using the numbers that are presented in this report.

  9. Transactional capability: Innovation's missing link

    Directory of Open Access Journals (Sweden)

    Jorge Tello-Gamarra

    2013-06-01

    Full Text Available The topic of innovation as a source of competitive advantage for firms is consolidated in the literature. An innovation-based advantage is generally achieved by following a structured process, in which technological capability plays a key role. However, a question remains in studies into innovation, which is concerned with the reasons why not all firms that develop a technological capability are innovative. Where is the missing link? Great efforts have been made in attempts to answer to this question. However, the study of this link as a source of advantage for firms deserves further attention. This article aims to present a framework with two essential dimensions: (1 the technological capability and (2 the transactional capability. Technological capability is the ability of firms to make effective use of technical knowledge in order to improve production processes and develop new products and services. Transactional capability is defined as a repertoire of abilities, processes, experiences, skills, knowledge and routines that the firm uses to minimize its transaction costs (ex¿ante and ex¿post. Given that the present study is a theoretical paper, methodologically it is based on a literature review. The main finding of this study is the identification of transactional capability as the missing link in innovation. Accordingly, to be innovative, in addition to having a technological capability, a firm needs to develop its transactional capability.

  10. Technological Dynamics and Social Capability

    DEFF Research Database (Denmark)

    Fagerberg, Jan; Feldman, Maryann; Srholec, Martin

    2014-01-01

    for the sample as a whole between 1998 and 2008. The results indicate that social capabilities, such as well-developed public knowledge infrastructure, an egalitarian distribution of income, a participatory democracy and prevalence of public safety condition the growth of technological capabilities. Possible......This article analyzes factors shaping technological capabilities in USA and European countries, and shows that the differences between the two continents in this respect are much smaller than commonly assumed. The analysis demonstrates a tendency toward convergence in technological capabilities...

  11. Primary Health Care -基础医疗卫生服务应该在中国新医改中得到正确理解和全面实施%Primary Health Care,a Concept to Be Fully Understood and Implemented in Current China's Health Care Reform

    Institute of Scientific and Technical Information of China (English)

    徐国平; 王家骥

    2015-01-01

    The English concept " primary health care" (PHC)has been misunderstood and wrongly interpreted in Chinese as" entry level health care" [初级卫生保健]for more than a half century. On the other hand,specialty care was considered " advanced health care" . This misconception of PHC permeated the government and the health care field with many negative consequences for China's vision of health care and development strategy,in areas such as government policy - making, health care financing,infrastructure planning,and health care workforce training. This article elucidates how PHC has been misconstrued and translated into " entry level health Care" in China and why it is a wrong interpretation of the PHC concept from various angles,including the basic English meaning of " primary" and " health care" ,the concept of comprehensive PHC, the global PHC experience,and the harmful consequences of the misconception in China's PHC development and in society at large. China's current new health care reform towards a PHC - centered health system has made significant early achievements,but also faces huge challenges,including the widespread and ingrained misconception of PHC. It is hoped that academic scholars in the health care field,medical professionals,and officials in the government gain clearer insight into the PHC concept and rectify its harmful effects on PHC development in various sectors,and promote advancement of meaningful health care reform applicable to the masses.%英文“primary health care”(PHC)-基础(基本)医疗卫生服务这个概念在中国被错误地理解和翻译成“初级卫生保健”已经有半个多世纪。而专科医疗则被认为是“先进的高级医疗服务”。这种对 PHC 的错误理解渗透到中国政府和医疗卫生各个部门,在国家的医疗卫生服务宗旨和宏观发展战略决策中造成广泛的影响,如政府的卫生政策制定,医疗服务保障制度建立,医

  12. The Korean strategy and experience in developing nuclear power generation capability

    International Nuclear Information System (INIS)

    The Korean nuclear energy development program and future prospects are discussed. Korea has achieved the substantial level of nuclear power plant localization through Korean Standard Nuclear Power (KSNP) Plant approach. The KSNP approach includes plant standardization, equipment, fuel and service localization and codes and standards development. Korea could develop her own decision making capability as Korea took the total project management responsibility in the KSNP approach. Current Korean nuclear R and D program includes next generation nuclear power plant development and advanced fuel development. The PWR-CANDU symbiosis is carefully considered to improve the nuclear power economy

  13. The current and future role of the medical oncologist in the professional care for cancer patients : a position paper by the European Society for Medical Oncology (ESMO)

    NARCIS (Netherlands)

    Popescu, R. A.; Schaefer, R.; Califano, R.; Eckert, R.; Coleman, R.; Douillard, J. -Y.; Cervantess, A.; Casali, P. G.; Sessa, C.; Van Cutsem, E.; de Vries, E; Pavlidis, N.; Fumasoli, K.; Woermann, B.; Samonigg, H.; Cascinu, S.; Cruz Hernandez, J. J.; Howard, A. J.; Ciardiello, F.; Stahel, R. A.; Piccart, M.

    2014-01-01

    The number of cancer patients in Europe is rising and significant advances in basic and applied cancer research are making the provision of optimal care more challenging. The concept of cancer as a systemic, highly heterogeneous and complex disease has increased the awareness that quality cancer car

  14. 儿科药学监护现状及发展方向%Current Situation and Development Direction of Pharmaceutical care in Pediatrics

    Institute of Scientific and Technical Information of China (English)

    林玲

    2014-01-01

    Objective The review of our pediatric pharmaceutical care status and development direction,combined with domestic and foreign children's drug laws, discuss the importance and necessity of pediatric pharmaceutical care.Methods Through Wanfang database and Pubmed search in recent years pediatricpharmaceutical care and related professional Chinese and English literature,combined with literature analysis,status and development of pediatric pharmacycare and summarized.Results In recent years, the development of pediatric pharmacy care has made great progress, but the system has not been formed, evidence-based medicine, pharmacogenomics is the development direction of pediatric pharmaceutical care.Conclusion Pediatric pharmaceutical care is in its infancy, the development of clinicalpharmacy in China should pay attention to its necessity,focus on basic research, folow the international front,continuous innovation, establish pediatricpharmaceutical care system as soon as possible.%目的:综述我国儿科药学监护现状及发展方向,结合国内外儿童用药法规,探讨儿科药学监护的必要性和重要性。方法通过万方数据库和Pubmed检索近年来儿科药学监护及相关专业中文及英文文献,结合文献对儿科药学监护现状和发展方向进行分析、归纳及总结。结果近年来,儿科药学监护发展取得很大进展,但是目前尚未形成体系,循证药学、药物基因组学等是儿科药学监护的发展方向。结论儿科药学监护正处于起步阶段,我国临床药学发展应重视其必要性,注重基础研究,跟踪国际前沿,不断创新,尽快建立起儿科药学监护体系。

  15. Identifying 21st Century Capabilities

    Science.gov (United States)

    Stevens, Robert

    2012-01-01

    What are the capabilities necessary to meet 21st century challenges? Much of the literature on 21st century skills focuses on skills necessary to meet those challenges associated with future work in a globalised world. The result is a limited characterisation of those capabilities necessary to address 21st century social, health and particularly…

  16. A Multivariate Process Capability Index

    Institute of Scientific and Technical Information of China (English)

    WANG Shaoxi; JIA Xinzhang; JIAO Huifang; BIAN Yingchao; SONG Ning; ZHAO Luyu; WEN Xin

    2006-01-01

    Process capability indices have been widely used in the manufacturing industry, providing numerical measures on process precision, process accuracy, and process performance. Capability measures for processes with a single characteristic have been investigated extensively. However, capability measures for processes with multiple characteristics are comparatively neglected. In this paper, inspired by the approach and model of process capability index investigated by K.S.Chen et al.(2003) and A.B.Yeh et al.(1998), a note model of multivariate process capability index based on non-conformity is presented. As for this index, the data of each single characteristic don't require satisfying normal distribution, of which its computing is simple and particioners will not fell too theoretical. At last the application analysis is made.

  17. Developing Collaborative Product Development Capabilities

    DEFF Research Database (Denmark)

    Mahnke, Volker; Tran, Yen

    2012-01-01

    innovation strategies’. Our analyses suggest that developing such collaboration capabilities benefits from the search for complementary practices, the combination of learning styles, and the development of weak and strong ties. Results also underscore the crucial importance of co-evolution of multi......Collaborative product development capabilities support a company’s product innovation activities. In the context of the fast fashion sector, this paper examines the development of the product development capabilities (PDC) that align product development capabilities in a dual innovation context......, one, slow paced, where the firm is well established and the other, fast paced, which represents a new competitive arena in which the company competes. To understand the process associated with collaborative capability development, we studied three Scandinavian fashion companies pursuing ‘dual...

  18. Measurement capabilities of the Bendix Metrology Organization

    International Nuclear Information System (INIS)

    The purpose of this manual is to communicate the measurement and calibration capabilities of the Metrology Organization of the Bendix Kansas City Division. Included is a listing of the measurement types and ranges available, and the accuracies normally attainable under conditions at the Kansas City Division. Also described are currently used standards and measurement devices. The manual is divided into four major sections, each describing a broad general area of measurement: mechanical; environmental, gas, liquid; electrical; and optical and radiation

  19. A system-wide analysis using a senior-friendly hospital framework identifies current practices and opportunities for improvement in the care of hospitalized older adults.

    Science.gov (United States)

    Wong, Ken S; Ryan, David P; Liu, Barbara A

    2014-11-01

    Older adults are vulnerable to hospital-associated complications such as falls, pressure ulcers, functional decline, and delirium, which can contribute to prolonged hospital stay, readmission, and nursing home placement. These vulnerabilities are exacerbated when the hospital's practices, services, and physical environment are not sufficiently mindful of the complex, multidimensional needs of frail individuals. Several frameworks have emerged to help hospitals examine how organization-wide processes can be customized to avoid these complications. This article describes the application of one such framework-the Senior-Friendly Hospital (SFH) framework adopted in Ontario, Canada-which comprises five interrelated domains: organizational support, processes of care, emotional and behavioral environment, ethics in clinical care and research, and physical environment. This framework provided the blueprint for a self-assessment of all 155 adult hospitals across the province of Ontario. The system-wide analysis identified practice gaps and promising practices within each domain of the SFH framework. Taken together, these results informed 12 recommendations to support hospitals at all stages of development in becoming friendly to older adults. Priorities for system-wide action were identified, encouraging hospitals to implement or further develop their processes to better address hospital-acquired delirium and functional decline. These recommendations led to collaborative action across the province, including the development of an online toolkit and the identification of accountability indicators to support hospitals in quality improvement focusing on senior-friendly care.

  20. Is point of care testing in Irish hospitals ready for the laboratory modernisation process? An audit against the current national Irish guidelines.

    LENUS (Irish Health Repository)

    O'Kelly, R A

    2013-04-11

    BACKGROUND: The Laboratory modernisation process in Ireland will include point of care testing (POCT) as one of its central tenets. However, a previous baseline survey showed that POCT was under-resourced particularly with respect to information technology (IT) and staffing. AIMS: An audit was undertaken to see if POCT services had improved since the publication of National Guidelines and if such services were ready for the major changes in laboratory medicine as envisaged by the Health Service Executive. METHODS: The 15 recommendations of the 2007 Guidelines were used as a template for a questionnaire, which was distributed by the Irish External Quality Assessment Scheme. RESULTS: Thirty-nine of a possible 45 acute hospitals replied. Only a quarter of respondent hospitals had POCT committees, however, allocation of staff to POCT had doubled since the first baseline survey. Poor IT infrastructure, the use of unapproved devices, and low levels of adverse incident reporting were still major issues. CONCLUSIONS: Point of care testing remains under-resourced, despite the roll out of such devices throughout the health service including primary care. The present high standards of laboratory medicine may not be maintained if the quality and cost-effectiveness of POCT is not controlled. Adherence to national Guidelines and adequate resourcing is essential to ensure patient safety.

  1. Current and Future Challenges in Point-of-Care Technologies: A Paradigm-Shift in Affordable Global Healthcare With Personalized and Preventive Medicine.

    Science.gov (United States)

    Dhawan, Atam P; Heetderks, William J; Pavel, Misha; Acharya, Soumyadipta; Akay, Metin; Mairal, Anurag; Wheeler, Bruce; Dacso, Clifford C; Sunder, T; Lovell, Nigel; Gerber, Martin; Shah, Milind; Senthilvel, S G; Wang, May D; Bhargava, Balram

    2015-01-01

    This paper summarizes the panel discussion at the IEEE Engineering in Medicine and Biology Point-of-Care Healthcare Technology Conference (POCHT 2013) held in Bangalore India from Jan 16-18, 2013. Modern medicine has witnessed interdisciplinary technology innovations in healthcare with a continuous growth in life expectancy across the globe. However, there is also a growing global concern on the affordability of rapidly rising healthcare costs. To provide quality healthcare at reasonable costs, there has to be a convergence of preventive, personalized, and precision medicine with the help of technology innovations across the entire spectrum of point-of-care (POC) to critical care at hospitals. The first IEEE EMBS Special Topic POCHT conference held in Bangalore, India provided an international forum with clinicians, healthcare providers, industry experts, innovators, researchers, and students to define clinical needs and technology solutions toward commercialization and translation to clinical applications across different environments and infrastructures. This paper presents a summary of discussions that took place during the keynote presentations, panel discussions, and breakout sessions on needs, challenges, and technology innovations in POC technologies toward improving global healthcare. Also presented is an overview of challenges and trends in developing and developed economies with respect to priority clinical needs, technology innovations in medical devices, translational engineering, information and communication technologies, infrastructure support, and patient and clinician acceptance of POC healthcare technologies. PMID:27170902

  2. Current status of management, control, complications and psychosocial aspects of patients with diabetes in India: Results from the DiabCare India 2011 Study

    Directory of Open Access Journals (Sweden)

    Viswanathan Mohan

    2014-01-01

    Full Text Available Objectives: DiabCare India 2011 was a cross-sectional study in patients with diabetes mellitus, undertaken to investigate the relationship between diabetes control, management and complications in a subset of urban Indian diabetes patients treated at referral diabetes care centres in India. Materials and Methods: This was a cross-sectional, multicentre (330 centres survey in 6168 diabetes patients treated at general hospitals, diabetes clinics and referral clinics across India. Patient data, including medical and clinical examination reports during the past year were collected during their routine visit. The patients′ and physicians′ perceptions about diabetes management were recorded using a questionnaire. Results: A total of 6168 subjects with diabetes (95.8% type 2, mean age 51.9 ± 12.4 years and mean duration of diabetes, 6.9 ± 6.4 years were included. Mean HbA1c was 8.9 ± 2.1% and the mean fasting (FPG, post prandial (PPG and random (RBG plasma glucose levels were 148 ± 50 mg/dl 205 ± 66 mg/dl and 193 ± 68mg/dl respectively. Neuropathy was the most common complication (41.4%; other complications were: Foot (32.7%, eye (19.7%, cardiovascular (6.8% and nephropathy (6.2%. The number of diabetic complications increased with mean duration of diabetes. Most (93.2% of the patients were on oral anti-diabetic drugs (OADs and 35.2% were on insulin (±OADs. More than 15% physicians felt that the greatest barrier to insulin therapy from patient′s perspective were pain and fear of using injectable modality; 5.2% felt that the greatest barrier to insulin therapy from physician′s perspective was the treatment cost; 4.8% felt that the major barriers to achieve optimum diabetic care in practice was loss to follow-up followed by lack of counselling (3.9% and treatment compliance (3.6%. Conclusion: DiabCare India 2011 has shown that type 2 diabetes sets in early in Indians and glycaemic control is often sub-optimal in these patients. These

  3. Transforming organizational capabilities in strategizing

    DEFF Research Database (Denmark)

    Jørgensen, Claus; Friis, Ole Uhrskov; Koch, Christian

    2014-01-01

    reallocated over time thereby creating a growing need for new capabilities and transformed knowledge handling routines. IT emerged into an important resource to support more complex routines of product development as well as specific management and HRM processes assisting the transformation......Offshored and networked enterprises are becoming an important if not leading organizational form and this development seriously challenges their organizational capabilities. More specifically, over the last years, SMEs have commenced entering these kinds of arrangements. As the organizational...

  4. Earth Science Capability Demonstration Project

    Science.gov (United States)

    Cobleigh, Brent

    2006-01-01

    A viewgraph presentation reviewing the Earth Science Capability Demonstration Project is shown. The contents include: 1) ESCD Project; 2) Available Flight Assets; 3) Ikhana Procurement; 4) GCS Layout; 5) Baseline Predator B Architecture; 6) Ikhana Architecture; 7) UAV Capability Assessment; 8) The Big Picture; 9) NASA/NOAA UAV Demo (5/05 to 9/05); 10) NASA/USFS Western States Fire Mission (8/06); and 11) Suborbital Telepresence.

  5. 当前社区居家养老服务中的关键问题反思及前瞻%Retrospect the Problems about Current Community & Home Care Pattern and Putforward Development Strategy

    Institute of Scientific and Technical Information of China (English)

    陈为智

    2016-01-01

    Community&home care Pattern is one kind of upper-to-down caring pattern led by local government. In the policy context that the government assume welfare limited responsibility,and thinking about caring practice of Qingdao and Shanghai city, this thesis mainly retrospect main problems of current community&home care Pattern from the four dimensions: service providers, service recipients, service demanding, serving operating mechanism. The main problems are as follows,absence of caring system in local government,caring operation is led by the idea of government management performance, service providers are not clear, power and responsibility is not defined,service content and service demand is not consistent. The au-thor think the future sustainable development of Community & home care Pattern should adhere to six principles:centralizing aging policy,integrating service providers among government,market and society,service demand led,first making caring sys-tem,service socializing and marketing.%社区居家养老服务是典型的自上而下政府主导型养老模式。结合青岛、上海等地的养老实践,在政府承担有限福利责任背景下,围绕服务主体、服务对象、服务需求、运作机制四个关键要素,反思当前我国社区居家养老服务中的问题,表现为:基层制度安排缺位、绩效导向、服务主体不明,服务权责不清、服务内容与服务需求不契合等关键问题,社区居家养老福利政策中心化、服务主体三位一体,需求导向、制度植入,服务的社会化、市场化趋向等,是未来社区居家养老可持续发展的着重考虑因素。

  6. Survey on current caring behaviors in nursing students: the influencing factors%实习护生护理关怀行为及影响因素的调查

    Institute of Scientific and Technical Information of China (English)

    单君; 陈宏林; 朱健华

    2011-01-01

    目的 了解实习护生护理关怀行为实施现状及相关影响因素.方法 采用方便抽样方法,使用美国学者Wolf关怀行为量表修改版,对在江苏省某三甲医院实习的150名护生进行调查.结果 实习护生护理关怀行为得分为(80.98±8.92)分.护生的护理关怀行为主要体现在对患者信息保密(3.76±0.49)、懂得注射和滴注(3.69±0.54)、倾听主诉(3.71±0.50)、对患者表示关心(3.63±0.52)、按时治疗和给药(3.61±0.64)方面;但帮助患者成长(2.91±0.77)、让患者参与护理计划制定(2.88±0.91)得分最低.影响实习护生实施护理关怀行为的因素为护理关怀课程的学习及学历(P<0.05,P<0.01).结论 实习护生护理关怀行为得分呈中等偏上水平,并主要侧重于治疗性关怀,对患者的人文关怀尚欠缺.护理教育者应探讨合适的教学方法,开设护理关怀课程并付诸实践,不断提高护生护理关怀意识和行动力.%Objective To evaluate the current caring behaviors in nursing students and to explore the influencing factors.Methods Caring behaviors inventory revised by Wolf was used to investigate 150 nursing students by convenient sampling method.Results The mean score of caring behaviors in nursing studentas was(80.98± 8.92).The caring behaviors of nursing students mainly reflects on "treating patient' s information confidentially" (3.76 ± 0.49), "knowing how to give shots, and intravenous infusion" ( 3.69 ±0.54), "attentively listening to the patient"(3.71 ± 0.50), "showing concern for the patient" (3.63 ± 0.52), "giving patient's treatment and medications on time”(3.61±0.64).However, the scores of "helping the patient grow"(2.91±0.77) and "including the patient in planning his or her care" (2.88±0.91)were the lowest.Studying of nursing care curriculum or not and educational background were considered to be the principal influencing factors in students' practice of caring behaviors(P<0.05, P<0

  7. 农民视角下新农合保障能力及影响因素评估——基于宝鸡市421户参合农民的调研%The Evaluation on Medical Care Security Capability of New Rural Cooperative System and Influencing Factors from Perspective of Farmers: Take Baoji Area as an Example

    Institute of Scientific and Technical Information of China (English)

    魏凤; 金华旺

    2012-01-01

    本文使用对陕西省宝鸡市11个乡镇421户参合农民的调研资料,分析了新农合运行现状及保障能力状况,并运用Ordered Logit模型从农民视角对新农合保障能力及其影响因素进行了分析。研究结果显示,参合农户对新农合保障能力评价为"很强"和"较强"的占62.2%,"较差"及"很差"的占8.84%,评价为"一般"的占29.3%。新农合的贯彻执行力度、政府的资金支持力度、医疗机构的设备保障状况、药品的价格质量、基金管理的合理程度以及定点医疗机构对常见病的医治能力,是显著影响农民对新农合保障能力作出不同评价的因素。%Based on the survey data of 421 households in 11 villages and towns of baoji shi, using ordered logit model, this paper analyzed the medical care security capabilities of new-type rural cooperative medical system (NRCMS) and its influencing factors from the perspective of farmers. The results show that 62.3% participants of NRCMS believed it has a very good effect for medical care, 8.84% participants evaluated as poor level, and 29.3% assessed as general. The implementation level of the new-type rural cooperative system, the government's financial support degree, medical equipment protection status, the quality and the price of medicine, a reasonable degree of fund management, designated medical institutions for treatment of common diseases ability,which affect the evaluation results of farmers on NRCMS medical security capabilities significantly.

  8. Research in cardiovascular care

    DEFF Research Database (Denmark)

    Jaarsma, Tiny; Deaton, Christi; Fitzsimmons, Donna;

    2014-01-01

    To deliver optimal patient care, evidence-based care is advocated and research is needed to support health care staff of all disciplines in deciding which options to use in their daily practice. Due to the increasing complexity of cardiac care across the life span of patients combined...... of the body of knowledge that is needed to further improve cardiovascular care. In this paper, knowledge gaps in current research related to cardiovascular patient care are identified, upcoming challenges are explored and recommendations for future research are given....

  9. The current situation of construction and development of pediatric emergency and critical care system in China%我国儿童急救体系建设现状与发展思考

    Institute of Scientific and Technical Information of China (English)

    陆国平; 任晓旭; 宋国维

    2012-01-01

    通过分析儿童急危重症院前急救、急诊及重症医学科、急救护理、急救培训和急救科研现状,阐述我国儿童急救体系建设存在的问题,提出发展思路和建设建议.%Through analyzing the children's pre-hospital transport,emergency medicine,intensive care medicine,nursing,professional training and research,we reviewed the current status of construction and issues of pediatric emergency and critical care system,then put forward recommendations of its development.

  10. The Current Objectives and Measures of Beijing Health Care Reform%当前北京医疗卫生改革的重点和措施

    Institute of Scientific and Technical Information of China (English)

    毛羽

    2014-01-01

    在新医改的大背景下,北京作为国家公立医院改革试点城市之一,在公立医院改革方面做出了以“医药分开”和“医联体”建设为代表的有益探索,下一步继续深化公立医院改革的同时将着力于优化医疗服务体系,引入社会资本,发展健康服务产业。迎合京津冀协同发展契机,带动周边省份医疗水平进步等工作。%Under the context of the new health care reform, Beijing is one of the pilot cities in the national public hospital reform, which has explored the separation of clinic from pharmacy, and medical joint community. Meanwhile, it will focus on optimizing the medical service system in the next step, and introduce the social capital to develop the health service industry. To take the opportunity of collaborative development of Beijing, Tianjin and Hebei, surrounding areas will advance their medical and health care level.

  11. 当前北京医疗卫生改革的重点和措施%The Current Objectives and Measures of Beijing Health Care Reform

    Institute of Scientific and Technical Information of China (English)

    毛羽

    2014-01-01

    Under the context of the new health care reform, Beijing is one of the pilot cities in the national public hospital reform, which has explored the separation of clinic from pharmacy, and medical joint community. Meanwhile, it will focus on optimizing the medical service system in the next step, and introduce the social capital to develop the health service industry. To take the opportunity of collaborative development of Beijing, Tianjin and Hebei, surrounding areas will advance their medical and health care level.%在新医改的大背景下,北京作为国家公立医院改革试点城市之一,在公立医院改革方面做出了以“医药分开”和“医联体”建设为代表的有益探索,下一步继续深化公立医院改革的同时将着力于优化医疗服务体系,引入社会资本,发展健康服务产业。迎合京津冀协同发展契机,带动周边省份医疗水平进步等工作。

  12. Protocol for a national audit on self-reported confidence levels, training requirements and current practice among trainee doctors in the UK: The Trainees Own Perception of Delivery of Care in Diabetes (TOPDOC Study

    Directory of Open Access Journals (Sweden)

    Wilmot Emma G

    2010-07-01

    Full Text Available Abstract Background As the incidence and prevalence of diabetes increases across the world, resource pressures require doctors without specialist training to provide care for people with diabetes. In the UK, national standards have been set to ensure quality diabetes care from diagnosis to the management of complications. In a multi-centre pilot study, we have demonstrated a lack of confidence among UK trainee doctors in managing diabetes. Suboptimal confidence was identified in a number of areas, including the management of diabetes emergencies. A national survey would clarify whether the results of our pilot study are representative and reproducible. Methods/Design Target cohort: All postgraduate trainee doctors in the UK. Domains Studied: The self reported online survey questionnaire has 5 domains: (1 confidence levels in the diagnosis and management of diabetes, (2 working with diabetes specialists, (3 perceived adequacy of training in diabetes (4 current practice in optimising glycaemic control and (5 perceived barriers to seeking euglycaemia. Assessment tools: Self-reported confidence is assessed using the 'Confidence Rating' (CR scale for trainee doctors developed by the Royal College of Physicians. This scale has four points - ('not confident' (CR1, 'satisfactory but lacking confidence' (CR2, 'confident in some cases (CR3 and 'fully confident in most cases' (CR4. Frequency of aspects of day-to-day practice is assessed using a six-point scale. Respondents have a choice of 'always' (100%, 'almost always' (80-99%, 'often' (50-79%, 'not very often' (20-49% and 'rarely' (5-19% or never (less than 5%. Discussion It is anticipated that the results of this national study will clarify confidence levels and current practice among trainee doctors in the provision of care for people with diabetes. The responses will inform efforts to enhance postgraduate training in diabetes, potentially improving the quality of care for people with diabetes.

  13. Advancing Test Capabilities at NASA Wind Tunnels

    Science.gov (United States)

    Bell, James

    2015-01-01

    NASA maintains twelve major wind tunnels at three field centers capable of providing flows at 0.1 M 10 and unit Reynolds numbers up to 45106m. The maintenance and enhancement of these facilities is handled through a unified management structure under NASAs Aeronautics and Evaluation and Test Capability (AETC) project. The AETC facilities are; the 11x11 transonic and 9x7 supersonic wind tunnels at NASA Ames; the 10x10 and 8x6 supersonic wind tunnels, 9x15 low speed tunnel, Icing Research Tunnel, and Propulsion Simulator Laboratory, all at NASA Glenn; and the National Transonic Facility, Transonic Dynamics Tunnel, LAL aerothermodynamics laboratory, 8 High Temperature Tunnel, and 14x22 low speed tunnel, all at NASA Langley. This presentation describes the primary AETC facilities and their current capabilities, as well as improvements which are planned over the next five years. These improvements fall into three categories. The first are operations and maintenance improvements designed to increase the efficiency and reliability of the wind tunnels. These include new (possibly composite) fan blades at several facilities, new temperature control systems, and new and much more capable facility data systems. The second category of improvements are facility capability advancements. These include significant improvements to optical access in wind tunnel test sections at Ames, improvements to test section acoustics at Glenn and Langley, the development of a Supercooled Large Droplet capability for icing research, and the development of an icing capability for large engine testing. The final category of improvements consists of test technology enhancements which provide value across multiple facilities. These include projects to increase balance accuracy, provide NIST-traceable calibration characterization for wind tunnels, and to advance optical instruments for Computational Fluid Dynamics (CFD) validation. Taken as a whole, these individual projects provide significant

  14. Meeting the milestones. Strategies for including high-value care education in pulmonary and critical care fellowship training.

    Science.gov (United States)

    Courtright, Katherine R; Weinberger, Steven E; Wagner, Jason

    2015-04-01

    Physician decision making is partially responsible for the roughly 30% of U.S. healthcare expenditures that are wasted annually on low-value care. In response to both the widespread public demand for higher-quality care and the cost crisis, payers are transitioning toward value-based payment models whereby physicians are rewarded for high-value, cost-conscious care. Furthermore, to target physicians in training to practice with cost awareness, the Accreditation Council for Graduate Medical Education has created both individual objective milestones and institutional requirements to incorporate quality improvement and cost awareness into fellowship training. Subsequently, some professional medical societies have initiated high-value care educational campaigns, but the overwhelming majority target either medical students or residents in training. Currently, there are few resources available to help guide subspecialty fellowship programs to successfully design durable high-value care curricula. The resource-intensive nature of pulmonary and critical care medicine offers unique opportunities for the specialty to lead in modeling and teaching high-value care. To ensure that fellows graduate with the capability to practice high-value care, we recommend that fellowship programs focus on four major educational domains. These include fostering a value-based culture, providing a robust didactic experience, engaging trainees in process improvement projects, and encouraging scholarship. In doing so, pulmonary and critical care educators can strive to train future physicians who are prepared to provide care that is both high quality and informed by cost awareness. PMID:25714122

  15. ICU谵妄患者治疗护理的研究进展%Current situation of caring patients with ICU delirium

    Institute of Scientific and Technical Information of China (English)

    王玲; 刘畅; 岳鹏

    2012-01-01

    This article reviewed the research progress about ICU delirium from the aspects of definition , diagnosis, missed diagnosis,misdiagnosis and outcome,and summarized the influencing factors of nursing management of patients with ICU delirium. Based on these,the article also provided some suggestions in treating and caring patients of ICU delirium.%通过阐述ICU谵妄的概念、诊断、漏诊、误诊及ICU谵妄的后果等几个方面,归纳了ICU谵妄患者护理管理的影响因素,在此基础上,就ICU谵妄患者的治疗与护理提出了建议,并进行了展望.

  16. Advance Health Care Directives and “Public Guardian”: The Italian Supreme Court Requests the Status of Current and Not Future Inability

    Directory of Open Access Journals (Sweden)

    Francesco Paolo Busardò

    2014-01-01

    Full Text Available Advance health care decisions animate an intense debate in several European countries, which started more than 20 years ago in the USA and led to the adoption of different rules, based on the diverse legal, sociocultural and philosophical traditions of each society. In Italy, the controversial issue of advance directives and end of life’s rights, in the absence of a clear and comprehensive legislation, has been over time a subject of interest of the Supreme Court. Since 2004 a law introduced the “Public Guardian,” aiming to provide an instrument of assistance to the person lacking in autonomy because of an illness or incapacity. Recently, this critical issue has once again been brought to the interest of the Supreme Court, which passed a judgment trying to clarify the legislative application of the appointment of the Guardian in the field of advance directives.

  17. A unifying process capability metric

    Directory of Open Access Journals (Sweden)

    John Jay Flaig

    2009-07-01

    Full Text Available A new economic approach to process capability assessment is presented, which differs from the commonly used engineering metrics. The proposed metric consists of two economic capability measures – the expected profit and the variation in profit of the process. This dual economic metric offers a number of significant advantages over other engineering or economic metrics used in process capability analysis. First, it is easy to understand and communicate. Second, it is based on a measure of total system performance. Third, it unifies the fraction nonconforming approach and the expected loss approach. Fourth, it reflects the underlying interest of management in knowing the expected financial performance of a process and its potential variation.

  18. Current State of Education Support for Newcomer Nurses Involved in End-of-Life Care in General Hospitals : From the Perspective of Enforcement Managers of Newcomer Nursing Staff Training

    OpenAIRE

    NISHIDA, Kayo; SAKASHITA, Emiko; OKAWA, Yuriko; KONISHI, Madoka

    2015-01-01

    The purpose of this study is to survey the current state and reality of the implementation of new nursing staff training (from now on, “new staff training”), tolearn how the staff training directors perceive end-of-life care education for new graduate nurses, and to see how these training programs are implemented. Questionnaireswere sent to 179 facilities requesting one training director for the new nursing staff( hereinafter“ training director”) from each institution to answer anonymouslythe...

  19. NWCF maintenance features and capabilities

    International Nuclear Information System (INIS)

    A New Waste Calcining Facility is being built at the Idaho Chemical Processing Plant to replace the existing Waste Calcining Facility which was built to demonstrate fluidized-bed solidification of highly radioactive liquid wastes. The new facility is being designed to provide a higher waste throughput, more corrosion resistant materials of construction, more effective cleanup of effluent streams, and extensive remote maintenance and equipment replacement capability. The facility will also contain extensive decontamination capability should contact maintenance become necessary. The facility is presently in construction and is scheduled for hot operation in 1980

  20. NASA Biomedical Informatics Capabilities and Needs

    Science.gov (United States)

    Johnson-Throop, Kathy A.

    2009-01-01

    To improve on-orbit clinical capabilities by developing and providing operational support for intelligent, robust, reliable, and secure, enterprise-wide and comprehensive health care and biomedical informatics systems with increasing levels of autonomy, for use on Earth, low Earth orbit & exploration class missions. Biomedical Informatics is an emerging discipline that has been defined as the study, invention, and implementation of structures and algorithms to improve communication, understanding and management of medical information. The end objective of biomedical informatics is the coalescing of data, knowledge, and the tools necessary to apply that data and knowledge in the decision-making process, at the time and place that a decision needs to be made.

  1. Maritime in transit care.

    Science.gov (United States)

    Bott, G; Barnard, J; Prior, K

    2015-01-01

    Operation GRITROCK saw the first operational deployment of the Maritime In Transit Care team from the Role 2 (Enhanced) (R2(E)) Medical Treatment Facility, which is able to provide Damage Control Surgery and the limited holding of patients, situated on board RFA ARGUS. Whilst the Medical Emergency Response Team demonstrated the capability of advanced military Pre-Hospital Emergency Care (PHEC) on Op HERRICK, the need to provide a similar high level of care on contingency operations was recognised. Op GRITROCK allowed for the continued exploration of a maritime capability from an established R2(E) platform whilst providing medical evacuation capability for a significant population at risk distributed over a large Joint Operation Area. Although the patient load during the operation was low, key lessons were learnt and opportunities identified to further develop the newly recognised sub-speciality of PHEC, both medically and logistically, and these will be discussed in this article. PMID:26867404

  2. 社区医护团队的自我和谐现状研究%Current Status of Self Consistency and Congruence of Community Health Care Team

    Institute of Scientific and Technical Information of China (English)

    罗春玲; 黄莲; 叶巧如; 吴翠红; 苏芬; 苏春波

    2012-01-01

    To study the present situation of self consistency and congruence of the community health care team, to investigate the factors influencing the self consistency and congruence and how to improve its degree. Methods Self consistency and congruence scale ( SCCS ) was taken to investigate 245 members of the staff in the community health services centers under the Longhua People's Hospital of Bao'an District of Shenzhen. Results There was no difference of SCCS score between the community doctor and the community nurse ( P > 0. 05 ). The average total score of SCCS for community health care staff was ( 99. 96 ± 10. 85 ), of which the score of self - experience inconsistence was ( 48. 84 ± 7. 59 ), the self flexibility score was (41. 98 ±5. 53 ), and the self - stereotypes score was ( 21. 22 ± 3. 75 ), with statistically significant differences as compared with the nom of college students ( P < 0. 05 ) . Conclusion The community health care staffs are of lower self consistency and congruence. They need enhanced mental health education given by relevant management departments.%目的 了解社区医护团队的自我和谐现状,探讨影响社区医护团队自我和谐的因素及采取何种应对方式来提高社区医护团队的自我和谐程度.方法 采用自我和谐量表,对在深圳市宝安区龙华人民医院下属的社区卫生服务中心工作的245名医护人员进行调查.结果 社区医生和护士的自我和谐得分间差异无统计学意义(P>0.05).社区医护团队自我和谐量表总分均值为(99.96±10.85)分,其中自我与经验的不和谐得分为(48.84±7.59)分,自我的灵活性得分为(41.98±5.53)分,自我的刻板性得分为(21.22±3.75)分,与大学生常模比较差异均有统计学意义(P<0.05).结论 社区医护团队的自我和谐程度偏低,管理部门应加强对社区医护团队的心理健康教育.

  3. Acute and Impaired Wound Healing: Pathophysiology and Current Methods for Drug Delivery, Part 1: Normal and Chronic Wounds: Biology, Causes, and Approaches to Care

    OpenAIRE

    Tatiana N Demidova-Rice; Michael R Hamblin; Herman, Ira M.

    2012-01-01

    This is the first installment of 2 articles that discuss the biology and pathophysiology of wound healing, review the role that growth factors play in this process, and describe current ways of growth factor delivery into the wound bed. Part 1 discusses the latest advances in clinicians’ understanding of the control points that regulate wound healing. Importantly, biological similarities and differences between acute and chronic wounds are considered, including the signaling pathways that ini...

  4. Judgmental Forecasting of Operational Capabilities

    DEFF Research Database (Denmark)

    Hallin, Carina Antonia; Tveterås, Sigbjørn; Andersen, Torben Juul

    This paper explores a new judgmental forecasting indicator, the Employee Sensed Operational Capabilities (ESOC). The purpose of the ESOC is to establish a practical prediction tool that can provide early signals about changes in financial performance by gauging frontline employees’ sensing...

  5. Building server capabilities in China

    DEFF Research Database (Denmark)

    Adeyemi, Oluseyi; Slepniov, Dmitrij; Wæhrens, Brian Vejrum;

    2012-01-01

    The purpose of this paper is to further our understanding of multinational companies building server capabilities in China. The paper is based on the cases of two western companies with operations in China. The findings highlight a number of common patterns in the 1) managerial challenges related...

  6. Microfoundations of Routines and Capabilities

    DEFF Research Database (Denmark)

    Felin, Teppo; Foss, Nicolai Juul; Heimriks, Koen H.;

    We discuss the microfoundations of routines and capabilities, including why a microfoundations view is needed and how it may inform work on organizational and competitive heterogeneity. Building on extant research, we identify three primary categories of micro-level components underlying routines...

  7. Microfoundations of Routines and Capabilities

    DEFF Research Database (Denmark)

    Felin, Tippo; Foss, Nicolai Juul; Heimericks, Koen H.;

    2012-01-01

    This article introduces the Special Issue and discusses the microfoundations of routines and capabilities, including why a microfoundations view is needed and how it may inform work on organizational and competitive heterogeneity. Building on extant research, we identify three primary categories ...

  8. ABOUT SOLIDWORKS SUSTAINABILITY MODULE CAPABILITIES

    Directory of Open Access Journals (Sweden)

    Cătălin IANCU

    2014-05-01

    Full Text Available In the paper are presented the SolidWorks analysis steps to be taken in order to study sustainability of parts or assemblies designed. There are presented the software capabilities and the settings that have to be done for such analysis and the results shown by software.

  9. Demonstration MTI/SAR capability

    NARCIS (Netherlands)

    Vries, F.P.P. de; Broek, A.C. van den; Otten, M.P.G.; Groot, J.S.; Steeghs, T.P.H.; Dekker, R.J.; Rossum, W.L. van

    2001-01-01

    The aim of this project is to demonstrate to the Dutch armed forces the capability of MTI (Moving Target Indicator) and SAR (Synthetic Aperture Radar). This is done with the Dutch PHARUS sensor. The sensor is used to demonstrate how a phased array antenna can be used as an MTI/SAR sensor combination

  10. [The Development of Long-Term Care Policies and the Impact on Nursing].

    Science.gov (United States)

    Wu, Shiao-Chi; Tsai, Yin-Yin; Yeh, Shin-Ting

    2015-10-01

    The government must reform and enhance current medical and long-term care services in order to respond effectively to societal ageing and labor shortage trends and to ensure sustainable operations. The post-acute care system should be reoriented on the home and community instead of the hospital. The Long Term Care Service Act integrates long-term care services that were previously dispersed amongst different departments, sets up a long-term care development fund, and improves the quality and allocation of long-term care services. Moreover, the Long Term Care Insurance Act will implement a bundle payment system to assist disabled families. The integration of automation and information technology will make long-term care more efficient. Although nurses are more skilled at elderly care and counseling than other community care professionals, nurses generally lack training in business management. Home and community-based services thus require better-trained manpower, opportunities to set care agents, and opportunities to offer flexible caring jobs. Therefore, nurses should strengthen their capabilities in post-acute care, business management, cooperation, and coordination. PMID:26507622

  11. Communitarian claims and community capabilities: furthering priority setting?

    Science.gov (United States)

    Mooney, Gavin

    2005-01-01

    Priority setting in health care is generally not done well. This paper draws on ideas from Amartya Sen and Martha Nussbaum and adds some communitarian underpinnings to provide a way of improving on current uses of program budgeting and marginal analysis (PBMA) in priority setting. The paper suggests that shifting to a communitarian base for priority setting alters the distribution of property rights over health service decision making and increases the probability that recommendations from PBMA exercises will be implemented. The approach is built on a paradigm which departs from three tenets of welfarism as it is normally conceived: (i) individuals qua individuals seek to maximise their individual utility/well-being; (ii) individuals want to do this; and (iii) it is the values of individuals qua individuals that count. Some of the problems of PBMA, as it has been applied to date, are highlighted. It is argued that these are due largely to a lack of 'credible commitment'. Bringing in the community and communitarian values to PBMA priority setting exercises can help to overcome some of the barriers to getting PBMA recommendations implemented. The approach has the merit of reflecting Sen's concept of capabilities (but extending that to a community level). It avoids the often consequentialist base of a conventional welfarist framework, and it allows community values as opposed to individual values to come to the fore. How to elicit communitarian values is explored.

  12. Sistemas atuais de cuidados e manutenção de lentes de contato Current care and maintenance systems for contact lenses

    Directory of Open Access Journals (Sweden)

    César Lipener

    2008-12-01

    Full Text Available A correta manutenção das lentes de contato é fundamental para se obter sucesso e manter a continuidade de seu uso. É grande o número de pacientes que abandonam o uso de suas lentes por problemas que poderiam ser solucionados com tratamentos relativamente simples ou com uma orientação mais adequada. O mau uso das lentes, associado à má adaptação, contaminação, doenças oculares prévias e fatores ambientais, podem aumentar o número de infecções corneanas através da proliferação de microorganismos. O presente artigo visa apresentar as atualizações em relação aos cuidados e manutenção com as lentes de contato.The proper maintenance of contact lenses is crucial for their success and to maintain the continuity of their use. Many patients abandon the use of their lenses due to problems that could be solved with relatively simple treatments. The misuse of lenses, coupled with poor adjustment, contamination, eye disease and environmental factors may increase the number of corneal infections through the proliferation of microorganisms. This article aims to provide contact lens care and maintenance updates.

  13. Synthetic aperture radar capabilities in development

    Energy Technology Data Exchange (ETDEWEB)

    Miller, M. [Lawrence Livermore National Lab., CA (United States)

    1994-11-15

    The Imaging and Detection Program (IDP) within the Laser Program is currently developing an X-band Synthetic Aperture Radar (SAR) to support the Joint US/UK Radar Ocean Imaging Program. The radar system will be mounted in the program`s Airborne Experimental Test-Bed (AETB), where the initial mission is to image ocean surfaces and better understand the physics of low grazing angle backscatter. The Synthetic Aperture Radar presentation will discuss its overall functionality and a brief discussion on the AETB`s capabilities. Vital subsystems including radar, computer, navigation, antenna stabilization, and SAR focusing algorithms will be examined in more detail.

  14. Recent Investments by NASA's National Force Measurement Technology Capability

    Science.gov (United States)

    Commo, Sean A.; Ponder, Jonathan D.

    2016-01-01

    The National Force Measurement Technology Capability (NFMTC) is a nationwide partnership established in 2008 and sponsored by NASA's Aeronautics Evaluation and Test Capabilities (AETC) project to maintain and further develop force measurement capabilities. The NFMTC focuses on force measurement in wind tunnels and provides operational support in addition to conducting balance research. Based on force measurement capability challenges, strategic investments into research tasks are designed to meet the experimental requirements of current and future aerospace research programs and projects. This paper highlights recent and force measurement investments into several areas including recapitalizing the strain-gage balance inventory, developing balance best practices, improving calibration and facility capabilities, and researching potential technologies to advance balance capabilities.

  15. Enlightenment of Marx’s humanistic care on the current Chinese college students%浅谈马克思人文关怀思想对当下我国高校学生工作的启示

    Institute of Scientific and Technical Information of China (English)

    赵宁

    2016-01-01

    党的十七大对思政工作提出注重人文关怀和心理疏导的新要求,是对新时期高校学生工作的新指示。马克思主义是科学的世界观和方法论,其中蕴含着丰富的人文关怀思想,马克思人文关怀思想启示教师在开展高校思想工作时要以人为本,解决好“现实的人”的现实问题,尊重每个人的个性发展。深入理解并把握好马克思人文关怀思想,对当下我国高校学生工作人文关怀具有重要的指导作用。%New requirements focus on humanistic care and psychological counseling for the ideological and political work had been put forward on the Party Congress, and it’s a new indication of College Students work in the new period. Marxism is a scientific world outlook and methodology, which contains a wealth of humanistic care thought, Marx’s humanistic care revealed to us that carrying out ideological work in Universities should be people-oriented, to solve the "real man" in reality, respect for each person's personality development. Deeply understanding and grasping Marx’s ideology of humanistic care is important for the current college students work.

  16. Acute and impaired wound healing: pathophysiology and current methods for drug delivery, part 1: normal and chronic wounds: biology, causes, and approaches to care.

    Science.gov (United States)

    Demidova-Rice, Tatiana N; Hamblin, Michael R; Herman, Ira M

    2012-07-01

    This is the first installment of 2 articles that discuss the biology and pathophysiology of wound healing, review the role that growth factors play in this process, and describe current ways of growth factor delivery into the wound bed. Part 1 discusses the latest advances in clinicians' understanding of the control points that regulate wound healing. Importantly, biological similarities and differences between acute and chronic wounds are considered, including the signaling pathways that initiate cellular and tissue responses after injury, which may be impeded during chronic wound healing.

  17. Challenges faced by health-care providers offering infant-feeding counseling to HIV-positive women in sub-Saharan Africa: a review of current research.

    Science.gov (United States)

    Tuthill, Emily L; Chan, Jessica; Butler, Lisa M

    2015-01-01

    Exclusive breastfeeding (EBF) has been identified as the optimal nutrition and critical behavior in attaining human immunodeficiency virus (HIV)-free infant survival in resource-limited settings. Health-care providers (HCPs) in clinic- and community-settings throughout sub-Saharan Africa (sSA) provide infant-feeding counseling. However, rates of EBF at 6 months of age are suboptimal. HCPs are uniquely positioned to educate HIV-positive mothers and provide support by addressing known barriers to EBF. However, limited evidence exists on the experiences faced by HCPs in providing counseling on infant feeding to HIV-positive women. Our objective is to describe experiences faced by HCPs when delivering infant-feeding counseling in the context of HIV in program settings in sSA. We searched a range of electronic databases, including PubMed, CINAHL, and PsycINFO from January 1990 to February 2013, in addition to hand-searching, cross-reference searching, and personal communications. The search was limited to publications in English. Empirical studies of HCP experiences providing infant-feeding counseling in the prevention of mother-to-child transmission (PMTCT) of HIV programs in sSA were selected. We identified 10 peer-reviewed articles reporting HCP challenges in infant-feeding counseling that met inclusion criteria. Articles included qualitative, cross-sectional and mixed-method studies, and cumulatively reported 31 challenges faced by HCPs. Among the challenges identified, the most commonly reported were personal beliefs held by the HCPs toward infant feeding in the context of HIV, contradictory messages, staff workload, directive counseling styles, and a lack of practical strategies to offer mothers, often leading to improvised counseling approaches. Counseling strategies need to be developed that are relevant, meaningful, and responsive to the needs of both HCPs and mothers.

  18. Different Points of a Continuum? Cross Sectional Comparison of the Current and Pre-contact Psychosocial Problems among the Different Categories of Adolescents in Institutional Care in Nigeria

    Directory of Open Access Journals (Sweden)

    Atilola Olayinka

    2012-07-01

    provision while in custodial care.

  19. The Discrepancies Between the IEC Updated versions for Skin and Hair Care Appliances and the Current National Standards%IEC最新版皮肤及毛发护理器具标准与现行国标之间的差异

    Institute of Scientific and Technical Information of China (English)

    蓝艳莉

    2005-01-01

    The paper introduces the newest IEC standard for the skin & hair care appliance, and then compares them with the standards of the national standard that is carrying at present. The author puts his emphasis on the discrepancies between the IEC updated versions for skin and hair care appliances and the current national standards.

  20. Human-Centered Design Capability

    Science.gov (United States)

    Fitts, David J.; Howard, Robert

    2009-01-01

    For NASA, human-centered design (HCD) seeks opportunities to mitigate the challenges of living and working in space in order to enhance human productivity and well-being. Direct design participation during the development stage is difficult, however, during project formulation, a HCD approach can lead to better more cost-effective products. HCD can also help a program enter the development stage with a clear vision for product acquisition. HCD tools for clarifying design intent are listed. To infuse HCD into the spaceflight lifecycle the Space and Life Sciences Directorate developed the Habitability Design Center. The Center has collaborated successfully with program and project design teams and with JSC's Engineering Directorate. This presentation discusses HCD capabilities and depicts the Center's design examples and capabilities.

  1. Improving the RPC rate capability

    CERN Document Server

    Aielli, G; Cardarelli, R; Di Ciaccio, A; Di Stante, L; Iuppa, R; Liberti, B; Paolozzi, L; Pastori, E; Santonico, R; Toppi, M

    2016-01-01

    This paper has the purpose to study the rate capability of the Resistive Plate Chamber, RPC, starting from the basic physics of this detector. The effect of different working parameters determining the rate capability is analysed in detail, in order to optimize a new family of RPCs for applications to heavy irradiation environments and in particular to the LHC phase 2. A special emphasis is given to the improvement achievable by minimizing the avalanche charge delivered in the gas. The paper shows experimental results of Cosmic Ray tests, performed to study the avalanche features for different gas gap sizes, with particular attention to the overall delivered charge. For this purpose, the paper studies, in parallel to the prompt electronic signal, also the ionic signal which gives the main contribution to the delivered charge. Whenever possible the test results are interpreted on the base of the RPC detector physics and are intended to extend and reinforce our physical understanding of this detector.

  2. Pharmacists belong in accountable care organizations and integrated care teams.

    Science.gov (United States)

    Smith, Marie; Bates, David W; Bodenheimer, Thomas S

    2013-11-01

    Effective health care workforce development requires the adoption of team-based care delivery models, in which participating professionals practice at the full extent of their training in pursuit of care quality and cost goals. The proliferation of such new models as medical homes, accountable care organizations, and community-based care teams is creating new opportunities for pharmacists to assume roles and responsibilities commensurate with their capabilities. Some challenges to including pharmacists in team-based care delivery models, including the lack of payment mechanisms that explicitly provide for pharmacist services, have yet to be fully addressed by policy makers and others. Nevertheless, evolving models and strategies reveal a variety of ways to draw on pharmacists' expertise in such critical areas as medication management for high-risk patients. As Affordable Care Act provisions are implemented, health care workforce projections need to consider the growing number of pharmacists expected to play an increasing role in delivering primary care services.

  3. Self-care as a health resource of elders

    DEFF Research Database (Denmark)

    Høy, Bente; Wagner, Lis; Hall, Elisabeth O.C.

    2007-01-01

    capabilities and processes for health in self-care practice. The capabilities consisted of fundamental capabilities, power capabilities and performance capabilities. The action processes included a process of life experience, a learning process and an ecological process. CONCLUSION: This review offers insight......AIM: To review the literature related to self-care and health promotion for elders and to develop an understanding of self-care as a health resource. BACKGROUND: Self-care may improve health and prevent illness and disabilities in elders. Although studies of self-care are numerous, the significance...... of the concept as a health resource for elders lacks clarity. Before 1989, research focused principally on medical self-care at the expense of health care, and self-care was seen more as supplementary to professional health care rather than as a health-promoting approach in health care. METHOD...

  4. Satellite-based Tropical Cyclone Monitoring Capabilities

    Science.gov (United States)

    Hawkins, J.; Richardson, K.; Surratt, M.; Yang, S.; Lee, T. F.; Sampson, C. R.; Solbrig, J.; Kuciauskas, A. P.; Miller, S. D.; Kent, J.

    2012-12-01

    Satellite remote sensing capabilities to monitor tropical cyclone (TC) location, structure, and intensity have evolved by utilizing a combination of operational and research and development (R&D) sensors. The microwave imagers from the operational Defense Meteorological Satellite Program [Special Sensor Microwave/Imager (SSM/I) and the Special Sensor Microwave Imager Sounder (SSMIS)] form the "base" for structure observations due to their ability to view through upper-level clouds, modest size swaths and ability to capture most storm structure features. The NASA TRMM microwave imager and precipitation radar continue their 15+ yearlong missions in serving the TC warning and research communities. The cessation of NASA's QuikSCAT satellite after more than a decade of service is sorely missed, but India's OceanSat-2 scatterometer is now providing crucial ocean surface wind vectors in addition to the Navy's WindSat ocean surface wind vector retrievals. Another Advanced Scatterometer (ASCAT) onboard EUMETSAT's MetOp-2 satellite is slated for launch soon. Passive microwave imagery has received a much needed boost with the launch of the French/Indian Megha Tropiques imager in September 2011, basically greatly supplementing the very successful NASA TRMM pathfinder with a larger swath and more frequent temporal sampling. While initial data issues have delayed data utilization, current news indicates this data will be available in 2013. Future NASA Global Precipitation Mission (GPM) sensors starting in 2014 will provide enhanced capabilities. Also, the inclusion of the new microwave sounder data from the NPP ATMS (Oct 2011) will assist in mapping TC convective structures. The National Polar orbiting Partnership (NPP) program's VIIRS sensor includes a day night band (DNB) with the capability to view TC cloud structure at night when sufficient lunar illumination exits. Examples highlighting this new capability will be discussed in concert with additional data fusion efforts.

  5. Building EOS capability for Malaysia - the options

    Science.gov (United States)

    Subari, M. D.; Hassan, A.

    2014-06-01

    Earth observation satellite (EOS) is currently a major tool to monitor earth dynamics and increase human understanding of earth surface process. Since the early 80s, Malaysia has been using EOS images for various applications, such as weather forecasting, land use mapping, agriculture, environment monitoring and others. Until now, all EOS images were obtained from foreign satellite systems. Realising on the strategic need of having its own capability, Malaysia embarked into EOS development programs in the early 90s. Starting with TiungSAT-1, a micro-satellite carrying small camera, then followed by RazakSAT, a small satellite carrying 2.5 m panchromatic (PAN) medium-aperture-camera, the current satellite program development, the RazakSAT-2, designed to carry a 1.0 m high resolution PAN and 4.0m multi-spectral camera, would become a strategic initiative of the government in developing and accelerating the nation's capability in the area of satellite technology and its application. Would this effort continue until all needs of the remote sensing community being fulfilled by its own EOS? This paper will analyze the intention of the Malaysian government through its National Space Policy and other related policy documents, and proposes some policy options on this. Key factors to be considered are specific data need of the EOS community, data availability and the more subjective political motivations such as national pride.

  6. Design Mechanism as Territorial Strategic Capability

    Directory of Open Access Journals (Sweden)

    Gianita BLEOJU

    2009-01-01

    Full Text Available The current exigencies that a territory must faced in order to its’ optimalpositioning in future regional competition requires the ability to design theappropriate mechanism which better valorize the territory capability. Such aconstruct is vital for territorial sustainable development and supposes thecreation of a specific body of knowledge from distinctive local resourceexploitation and unique value creation and allocation. Territorial mechanismdesign is a typical management decision about identification, ownership andcontrol of specific strategic capabilities and their combination in a distinctiveterritorial portfolio. The most difficult responsibility is to allocate the territorialvalue added which is a source of conflict among territorial components. Ourcurrent paper research covers the basics of two complementary territorialpillars-rural and tourism potential and proves the lack of specific designmechanisms which explain the current diminishing value of Galati Brailaregion. The proposed management system, relying upon territorial controlmechanism, will ensure knowledge sharing process via collaborative learning,with the final role of appropriate territorial attractivity signals, reinforcingidentity as key factor of territorial attractability. Our paper is fully documentedon there years of data analyzing from territorial area of interest. This offers usthe necessary empiric contrasting for our proposed solution.

  7. Expanding capabilities of the debris analysis workstation

    Science.gov (United States)

    Spencer, David B.; Sorge, Marlon E.; Mains, Deanna L.; Shubert, Ann J.; Gerhart, Charlotte M.; Yates, Ken W.; Leake, Michael

    1996-10-01

    Determining the hazards from debris-generating events is a design and safety consideration for a number of space systems, both currently operating and planned. To meet these and other requirements, the United States Air Force (USAF) Phillips Laboratory (PL) Space Debris Research Program has developed a simulation software package called the Debris Analysis Workstation (DAW). This software provides an analysis capability for assessing a wide variety of debris hazards. DAW integrates several component debris analysis models and data visualization tools into a single analysis platform that meets the needs for Department of Defense space debris analysis, and is both user friendly and modular. This allows for studies to be performed expeditiously by analysts who are not debris experts. The current version of DAW includes models for spacecraft breakup, debris orbital lifetime, collision hazard risk assessment, and collision dispersion, as well as a satellite catalog database manager, a drag inclusive propagator, a graphical user interface, and data visualization routines. Together they provide capabilities to conduct several types of analyses, ranging from range safety assessments to satellite constellation risk assessment. Work is progressing to add new capabilities with the incorporation of additional models and improved designs. The existing tools are in their initial integrated form, but the 'glue' that will ultimately bring them together into an integrated system is an object oriented language layer scheduled to be added soon. Other candidate component models under consideration for incorporation include additional orbital propagators, error estimation routines, other dispersion models, and other breakup models. At present, DAW resides on a SUNR workstation, although future versions could be tailored for other platforms, depending on the need.

  8. 上海市社区创口护理工作开展现状的质性研究%Current Status of Wound Care in Shanghai Communities:A Qualitative Research

    Institute of Scientific and Technical Information of China (English)

    葛津津; 刘薇群; 杨阳; 奚弘妮; 汤培凤; 陆佳韵

    2015-01-01

    Objective To investigate the current status of wound care in Shanghai communities , in order to provide references for relevant work management and personnel training.Methods In April 2014, using purposive sampling method , we selected 12 community health service centers in Shanghai and enrolled the nursing leader or an outstanding nurse from each center.Focus group interviewing method was employed to collect data , and keywords analysis was conducted to analyze the data.Results At present, the wound care in Shanghai communities is in unfavorable condition.The primary type of wound is pressure sores , the cases of wound are usually in critical condition , and elderly patients take the majority.Household care givers are inadequate in nursing knowledge , and there is a lack of professional wound care givers and specialists.The relevant training is still at an initial stage.The management system of wound care in communities is imperfect.Conclusion Wound care in Shanghai is in high demand , while the relevant human resource is in shortage , and the management system is imperfect.We suggest the personnel training of community wound care should be strengthened and wound care modes fit for different communities should be established.%目的:了解上海市社区创口护理工作开展现状,以为其工作管理和人才培养提供依据。方法于2014年4月,采用立意抽样法,在上海市抽取12家社区卫生服务中心,在每家社区卫生服务中心抽取护理管理者或骨干护士1名,共纳入12名。采用焦点小组访谈法进行资料收集,采用主题词分析法进行资料分析。结果上海市社区创口护理情况较严峻,创口类型以压疮为主,创口损伤程度较严重,以老年患者居多,且家庭照护者创口护理知识相对缺乏;社区专业创口护理师缺乏,专家型人才缺如,教育尚处于初始阶段;社区创口护理管理体系不完善。结论上

  9. Current Status of Wound Care in Shanghai Communities:A Qualitative Research%上海市社区创口护理工作开展现状的质性研究

    Institute of Scientific and Technical Information of China (English)

    葛津津; 刘薇群; 杨阳; 奚弘妮; 汤培凤; 陆佳韵

    2015-01-01

    Objective To investigate the current status of wound care in Shanghai communities , in order to provide references for relevant work management and personnel training.Methods In April 2014, using purposive sampling method , we selected 12 community health service centers in Shanghai and enrolled the nursing leader or an outstanding nurse from each center.Focus group interviewing method was employed to collect data , and keywords analysis was conducted to analyze the data.Results At present, the wound care in Shanghai communities is in unfavorable condition.The primary type of wound is pressure sores , the cases of wound are usually in critical condition , and elderly patients take the majority.Household care givers are inadequate in nursing knowledge , and there is a lack of professional wound care givers and specialists.The relevant training is still at an initial stage.The management system of wound care in communities is imperfect.Conclusion Wound care in Shanghai is in high demand , while the relevant human resource is in shortage , and the management system is imperfect.We suggest the personnel training of community wound care should be strengthened and wound care modes fit for different communities should be established.%目的:了解上海市社区创口护理工作开展现状,以为其工作管理和人才培养提供依据。方法于2014年4月,采用立意抽样法,在上海市抽取12家社区卫生服务中心,在每家社区卫生服务中心抽取护理管理者或骨干护士1名,共纳入12名。采用焦点小组访谈法进行资料收集,采用主题词分析法进行资料分析。结果上海市社区创口护理情况较严峻,创口类型以压疮为主,创口损伤程度较严重,以老年患者居多,且家庭照护者创口护理知识相对缺乏;社区专业创口护理师缺乏,专家型人才缺如,教育尚处于初始阶段;社区创口护理管理体系不完善。结论上

  10. 深圳市盐田区孕前保健现状分析%Analysis on the current situation of progestational health care in Yantian District, Shenzhen

    Institute of Scientific and Technical Information of China (English)

    王明真; 郁晓慧; 苗云

    2011-01-01

    目的:通过分析深圳市盐田区妇女孕前保健检查资料,了解该群体健康状况,为今后的保健工作提供科学依据.方法:选择480例在盐田区妇幼保健院进行孕前检查的育龄期妇女为研究对象,按照孕前保健服务流程询问病史、体检及化验,对资料进行整理与统计分析.结果:调查对象年龄范围为23~38岁,检出疾病12种,排列前3位的依次为宫颈炎(29.58%)、阴道炎(26.67%)、支原体感染 (8.75%),患病率为79.58%(191/240).5种微量元素中钙缺乏为首位(95.21%),铁、铜、锌缺乏分别为(29.79%)、(60.00%)、(19.79%),镁未查到缺乏.调查对象中,孕前开始服用叶酸的女性仅31.00%,服用依从性与受调查者文化程度和职业有关.结论:孕前健康检查町以为准备怀孕的夫妇提供健康状况评估、健康指导,从而有效降低出生缺陷的发生,应加强孕前检查宣传力度和范围.%Objective: To understand the population health status by analyzing the data of progestational health examination among the women in Yantian District of Shenzhen, provide a scientific basis for future health care work. Methods: 480 women of childbearing age receiving progestational examination in the hospital were selected as study objects, their medical history, physical examination and laboratory reports were obtained according to the progestational health serving procedure, then the data were collected and analysed statistically. Results: The age range of investigated objects was 23 ~ 38 years old, 12 kinds of diseases were detected, the top three diseases were cervicitis (29. 58% ), vaginitis (26. 67% ) and mycoplasma infection (8.75%), the prevalence was 79. 58% (191/240) . Among five kinds of trace elements, the incidence of calcium deficiency was the highest, accounting for 95. 21%, the incidences of iron deficiency, copper deficiency and zinc deficiency were 29. 79%, 60. 00% and 19. 79%, respectively; magnesium deficiency

  11. Management of neovascular age-related macular degeneration: current state-of-the-art care for optimizing visual outcomes and therapies in development

    Directory of Open Access Journals (Sweden)

    Agarwal A

    2015-06-01

    Full Text Available Aniruddha Agarwal, William R Rhoades, Mostafa Hanout, Mohamed Kamel Soliman, Salman Sarwar, Mohammad Ali Sadiq, Yasir Jamal Sepah, Diana V Do, Quan Dong Nguyen Stanley M Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE, USA Abstract: Contemporary management of neovascular age-related macular degeneration (AMD has evolved significantly over the last few years. The goal of treatment is shifting from merely salvaging vision to maintaining a high quality of life. There have been significant breakthroughs in the identification of viable drug targets and gene therapies. Imaging tools with near-histological precision have enhanced our knowledge about pathophysiological mechanisms that play a role in vision loss due to AMD. Visual, social, and vocational rehabilitation are all important treatment goals. In this review, evidence from landmark clinical trials is summarized to elucidate the optimum modern-day management of neovascular AMD. Therapeutic strategies currently under development, such as gene therapy and personalized medicine, are also described. Keywords: AMD, neovascular AMD, choroidal neovascular membrane, pharmacogenomics, VEGF, low-vision rehabilitation, gene therapy

  12. Developing a dispersant spraying capability

    Energy Technology Data Exchange (ETDEWEB)

    Gill, S.D.

    1979-01-01

    In developing a national dispersant spraying capability, the Canadian Coast Guard (CCG) has undertaken a modification program to enable the conventional offshore spraying gear to be mounted on almost any vessel of convenience. Smaller, more versatile inshore spraying vessels and pumps have been designed and built. With the popularization of concentrated dispersants, the inshore pumping equipment can be used aboard hovercraft for special application situations. A program of acquiring mobile dispersant storage tanks has been undertaken with auxiliary equipment that will facilitate the shipment of dispersants in bulk by air freight. Work also has commenced on extending the dispersant application program to include the CCG fleet of helicopters.

  13. Production, innovation and service capabilities

    DEFF Research Database (Denmark)

    Slepniov, Dmitrij; Wæhrens, Brian Vejrum; Wu, Dong;

    2012-01-01

    Fragmentation and global dispersion are among the most prominent characteristics of contemporary operations. Not only routine transactional tasks, but also more knowledge-intensive proprietary tasks are subjected to this trend. As a result of this, complex configurations of assets and capabilities...... crossing both national and organisational borders emerge. The challenge of coordination in these configurations is an imperative which has not been adequately addressed so far. Therefore, by using explorative cases of Chinese and Danish companies, this paper seeks to develop a conceptual framework relating...

  14. Developing A/E Capabilities

    International Nuclear Information System (INIS)

    During the last few years, the methods used by EMPRESARIOS AGRUPADOS and INITEC to perform Architect-Engineering work in Spain for nuclear projects has undergone a process of significant change in project management and engineering approaches. Specific practical examples of management techniques and design practices which represent a good record of results will be discussed. They are identified as areas of special interest in developing A/E capabilities for nuclear projects . Command of these areas should produce major payoffs in local participation and contribute to achieving real nuclear engineering capabities in the country. (author)

  15. ITER EDA design confinement capability

    Science.gov (United States)

    Uckan, N. A.

    Major device parameters for ITER-EDA and CDA are given in this paper. Ignition capability of the EDA (and CDA) operational scenarios is evaluated using both the 1 1/2-D time-dependent transport simulations and 0-D global models under different confinement ((chi((gradient)(T)(sub e)(sub crit)), empirical global energy confinement scalings, chi(empirical), etc.) assumptions. Results from some of these transport simulations and confinement assessments are summarized in and compared with the ITER CDA results.

  16. ITER EDA design confinement capability

    Energy Technology Data Exchange (ETDEWEB)

    Uckan, N.A.

    1993-06-01

    Major device parameters for ITER-EDA and CDA are given in this paper. Ignition capability of the EDA (and CDA) operational scenarios is evaluated using both the 1-1/2-D time-dependent transport simulations and 0-D global models under different confinement [{chi}({triangledown}T{sub e}){sub crit}, empirical global energy confinement scalings, {chi}(empirical), etc.] assumptions. Results from some of these transport simulations and confinement assessments are summarized in and compared with the ITER CDA reference ignition scenario.

  17. ITER EDA design confinement capability

    Energy Technology Data Exchange (ETDEWEB)

    Uckan, N.A.

    1993-01-01

    Major device parameters for ITER-EDA and CDA are given in this paper. Ignition capability of the EDA (and CDA) operational scenarios is evaluated using both the 1-1/2-D time-dependent transport simulations and 0-D global models under different confinement [[chi]([triangledown]T[sub e])[sub crit], empirical global energy confinement scalings, [chi](empirical), etc.] assumptions. Results from some of these transport simulations and confinement assessments are summarized in and compared with the ITER CDA reference ignition scenario.

  18. Technological capability at the Brazilian official pharmaceutical laboratories

    Directory of Open Access Journals (Sweden)

    José Vitor Bomtempo Martins

    2008-10-01

    Full Text Available This paper studies the technological capability in the Brazilian Official Pharmaceutical Laboratories [OPL]. The technological capability analysis could contribute to organization strategies and governmental actions in order to improve OPL basic tasks as well to incorporate new ones, particularly concerning the innovation management. Inspired in Figueiredo (2000, 2003a, 2003b and Figueiredo and Ariffin (2003, a framework was drawn and adapted to pharmaceutical industry characteristics and current sanitary and health legislation. The framework allows to map different dimensions of the technological capability (installations, processes, products, equipments, organizational capability and knowledge management and the level attained by OPL (ordinary or innovating capability. OPL show a good development of ordinary capabilities, particularly in Product and Processes. Concerning the other dimensions, OPL are quite diverse. In general, innovating capabilities are not much developed. In the short term, it was identified a dispersion in the capacitating efforts. Considering their present level and the absorption efforts, good perspectives can be found in Installations, Processes and Organizational Capability. A lower level of efforts in Products and Knowledge Management could undermine these capabilities in the future.

  19. Optimizing Health Care Coalitions: Conceptual Frameworks and a Research Agenda.

    Science.gov (United States)

    Hupert, Nathaniel; Biala, Karen; Holland, Tara; Baehr, Avi; Hasan, Aisha; Harvey, Melissa

    2015-12-01

    The US health care system has maintained an objective of preparedness for natural or manmade catastrophic events as part of its larger charge to deliver health services for the American population. In 2002, support for hospital-based preparedness activities was bolstered by the creation of the National Bioterrorism Hospital Preparedness Program, now called the Hospital Preparedness Program, in the US Department of Health and Human Services. Since 2012, this program has promoted linking health care facilities into health care coalitions that build key preparedness and emergency response capabilities. Recognizing that well-functioning health care coalitions can have a positive impact on the health outcomes of the populations they serve, this article informs efforts to optimize health care coalition activity. We first review the landscape of health care coalitions in the United States. Then, using principles from supply chain management and high-reliability organization theory, we present 2 frameworks extending beyond the Office of the Assistant Secretary for Preparedness and Response's current guidance in a way that may help health care coalition leaders gain conceptual insight into how different enterprises achieve similar ends relevant to emergency response. We conclude with a proposed research agenda to advance understanding of how coalitions can contribute to the day-to-day functioning of health care systems and disaster preparedness. PMID:26545194

  20. Study of Injection Process Capability in Production of Plastic Boxes

    Directory of Open Access Journals (Sweden)

    Lestyánszka Škůrková Katarína

    2015-06-01

    Full Text Available Ensuring the process capability currently means the warranty that produced products will be in accordance with requirements, both on the company‘s as well as customer‘s side. This study focuses on the statistical control of injection process capability in serial production in a company focusing on products for healthcare. The injection process is evaluated by control charts, specifically by control chart for average and range ( x̄ , R. As the results showed, based on the chart for average and range, we are able to say that the injection process is under statistical control. The requirement for process capability was met; the indices of process capability Cp and Cpk are higher than the determined value 1.33. The normality of measured values was verified by histogram. The obtained values are: Cp = 1.85 and Cpk = 1.82. Therefore, we may consider the process as capable.

  1. Does Care Matter?

    DEFF Research Database (Denmark)

    Loft, Lisbeth Trille Gylling; Hogan, Dennis P.

    2014-01-01

    employment during the first 36 weeks following a birth, and its association with experienced non-parental child care use before labor force entry. Using data from the Early Childhood Longitudinal Survey – Birth Cohort (N = 10,400 mothers), results from discrete-time hazard models show that use of non-parental...... for care. The American setting is an ideal context to investigate the linkages between child care capital and maternal employment as the patterns of child care use tend to be more diverse compared to other national context. In the presented application of care capital, we examine mothers’ entry to paid...... child care prior to employment is independently and positively associated with the timing of maternal employment entry. This finding applies both to first-time mothers (n = 3,800) and to mothers of multiple children (n = 6,600). Although data currently available for investigating child care capital...

  2. Care, Europeanization and Gender

    DEFF Research Database (Denmark)

    Dyrberg, Torben Bech

    This book adresses the recent underexamined developments concerning care in Europe, including the negotiations about care at the top EU level to that of individual workers. Through a comparative and interdisciplinary approach, this collection examines and further develops current theoretical and ...

  3. Current enhancement update

    International Nuclear Information System (INIS)

    Net current enhancement to levels in excess of the beam current has been observed in gases at pressures excess of 50 torr. We delineate the regimes where enhancement is observed. The experimental results fall into two very distinct classes; current enhancement at injection where the beam is only slightly displaced and current enhancement clearly associated with the high amplitude hose instability. A careful theoretical and experimental study of the diagnostics revealed no fundamental flaws although there are several complex and unlikely scenarios which could introduce fictitious current enhancement. Theoretical efforts indicate several mechanisms for generating enhancement but none of the theories can account for the detailed observations. 4 references, 4 figures

  4. Volatile Anesthetics. Is a New Player Emerging in Critical Care Sedation?

    Science.gov (United States)

    Jerath, Angela; Parotto, Matteo; Wasowicz, Marcin; Ferguson, Niall D

    2016-06-01

    Volatile anesthetic agent use in the intensive care unit, aided by technological advances, has become more accessible to critical care physicians. With increasing concern over adverse patient consequences associated with our current sedation practice, there is growing interest to find non-benzodiazepine-based alternative sedatives. Research has demonstrated that volatile-based sedation may provide superior awakening and extubation times in comparison with current intravenous sedation agents (propofol and benzodiazepines). Volatile agents may possess important end-organ protective properties mediated via cytoprotective and antiinflammatory mechanisms. However, like all sedatives, volatile agents are capable of deeply sedating patients, which can have respiratory depressant effects and reduce patient mobility. This review seeks to critically appraise current volatile use in critical care medicine including current research, technical consideration of their use, contraindications, areas of controversy, and proposed future research topics. PMID:27002466

  5. Volatile Anesthetics. Is a New Player Emerging in Critical Care Sedation?

    Science.gov (United States)

    Jerath, Angela; Parotto, Matteo; Wasowicz, Marcin; Ferguson, Niall D

    2016-06-01

    Volatile anesthetic agent use in the intensive care unit, aided by technological advances, has become more accessible to critical care physicians. With increasing concern over adverse patient consequences associated with our current sedation practice, there is growing interest to find non-benzodiazepine-based alternative sedatives. Research has demonstrated that volatile-based sedation may provide superior awakening and extubation times in comparison with current intravenous sedation agents (propofol and benzodiazepines). Volatile agents may possess important end-organ protective properties mediated via cytoprotective and antiinflammatory mechanisms. However, like all sedatives, volatile agents are capable of deeply sedating patients, which can have respiratory depressant effects and reduce patient mobility. This review seeks to critically appraise current volatile use in critical care medicine including current research, technical consideration of their use, contraindications, areas of controversy, and proposed future research topics.

  6. The investigation of current situation and requirement of preconception care in Baoan district of Shenzhen%深圳市宝安区孕前保健现状及需求调查

    Institute of Scientific and Technical Information of China (English)

    刘小凤; 刘小雅; 宋秀玲; 王瑛; 翟剑

    2015-01-01

    Objective To explore current situation and requirement of preconception care in Baoan district of Shenzhen . Methods A total of 1 080 primiparas conducted prenatal examination in the Family Planning Specialist Hospital of Shenzhen Baoan District and Songgang People’ s Hospital from Jan 2013 to Jan 2014 were selected .Interview and questionnaire were used to analyze the current situation and requirement of preconception care among respondents .Results 1 038 valid questionnaires were retrieved , only 37.19%( 386/1038 ) primiparas had participated in preconception care .The preconception care rate of respondents with high education degree was higher than that of respondents with low education degree (P<0.05).76.49%(794/1038) respondents had heard of preconception care , while most of them didn ’ t comprehensive understand the content .34.10%(354/1038) respondents had taken folic acid supplements in progestation , but the correct use rate was only 6.78%(24/354).The priorities of approaches to acquire knowledge were friends and colleagues , network, community outreach and medical institutions .The priorities of expecting approaches to acquire knowledge were online media , community outreach and medical institutions .The priorities of medical institution choice were maternal and child health care or women's and children's hospital , community hospitals and comprehensive hospital . Conclusion The participation rate , cognition degree , compliance of preconception care and folic acid use rate are low in Baoan district of Shenzhen .It is imperative to improve the knowledge training on preconception care as well as the forms and contents of the services.The institution should improve service levels to meet the requirements of preconception care .%目的:了解深圳市宝安区孕前保健现状及需求情况。方法将2013年1月至2014年1月深圳宝安区首次到宝安区计划生育专科医院和松岗人民医院做产前检查的孕妇1080例作为调查

  7. REDUCTIONS WITHOUT REGRET: DEFINING THE NEEDED CAPABILITIES

    Energy Technology Data Exchange (ETDEWEB)

    Swegle, J.; Tincher, D.

    2013-09-10

    This is the second of three papers (in addition to an introductory summary) aimed at providing a framework for evaluating future reductions or modifications of the U.S. nuclear force, first by considering previous instances in which nuclear-force capabilities were eliminated; second by looking forward into at least the foreseeable future at the features of global and regional deterrence (recognizing that new weapon systems currently projected will have expected lifetimes stretching beyond our ability to predict the future); and third by providing examples of past or possible undesirable outcomes in the shaping of the future nuclear force, as well as some closing thoughts for the future. This paper begins with a discussion of the current nuclear force and the plans and procurement programs for the modernization of that force. Current weapon systems and warheads were conceived and built decades ago, and procurement programs have begun for the modernization or replacement of major elements of the nuclear force: the heavy bomber, the air-launched cruise missile, the ICBMs, and the ballistic-missile submarines. In addition, the Nuclear Weapons Council has approved a new framework for nuclear-warhead life extension not fully fleshed out yet that aims to reduce the current number of nuclear explosives from seven to five, the so-called 3+2 vision. This vision includes three interoperable warheads for both ICBMs and SLBMs (thus eliminating one backup weapon) and two warheads for aircraft delivery (one gravity bomb and one cruise-missile, eliminating a second backup gravity bomb). This paper also includes a discussion of the current and near-term nuclear-deterrence mission, both global and regional, and offers some observations on future of the strategic deterrence mission and the challenges of regional and extended nuclear deterrence.

  8. REDUCTIONS WITHOUT REGRET: DEFINING THE NEEDED CAPABILITIES

    Energy Technology Data Exchange (ETDEWEB)

    Swegle, J.; Tincher, D.

    2013-09-10

    This is the second of three papers (in addition to an introductory summary) aimed at providing a framework for evaluating future reductions or modifications of the U.S. nuclear force, first by considering previous instances in which nuclear-force capabilities were eliminated; second by looking forward into at least the foreseeable future at the features of global and regional deterrence (recognizing that new weapon systems currently projected will have expected lifetimes stretching beyond our ability to predict the future); and third by providing examples of past or possible undesirable outcomes in the shaping of the future nuclear force, as well as some closing thoughts for the future. This paper begins with a discussion of the current nuclear force and the plans and procurement programs for the modernization of that force. Current weapon systems and warheads were conceived and built decades ago, and procurement programs have begun for the modernization or replacement of major elements of the nuclear force: the heavy bomber, the air-launched cruise missile, the ICBMs, and the ballistic-missile submarines. In addition, the Nuclear Weapons Council has approved a new framework for nuclear-warhead life extension � not fully fleshed out yet � that aims to reduce the current number of nuclear explosives from seven to five, the so-called �3+2� vision. This vision includes three interoperable warheads for both ICBMs and SLBMs (thus eliminating one backup weapon) and two warheads for aircraft delivery (one gravity bomb and one cruise-missile, eliminating a second backup gravity bomb). This paper also includes a discussion of the current and near-term nuclear-deterrence mission, both global and regional, and offers some observations on future of the strategic deterrence mission and the challenges of regional and extended nuclear deterrence.

  9. Capabilities, programs, and economic benefits

    International Nuclear Information System (INIS)

    This document describes the activities and impacts of DOE's Grand Junction Project Office. Included are historical accounts of past programs, brief descriptions of current research and services, and evaluations of the economic effects of the facility on the local community and the state of Colorado. 16 figs., 5 tabs

  10. Tonopah Test Range capabilities: technical manual

    Energy Technology Data Exchange (ETDEWEB)

    Manhart, R.L.

    1982-11-01

    This manual describes Tonopah Test Range (TTR), defines its testing capabilities, and outlines the steps necessary to schedule tests on the Range. Operated by Sandia National Laboratories, TTR is a major test facility for DOE-funded weapon programs. The Range presents an integrated system for ballistic test vehicle tracking and data acquisition. Multiple radars, optical trackers, telemetry stations, a central computer complex, and combined landline/RF communications systems assure full Range coverage for any type of test. Range operations are conducted by a department within Sandia's Field Engineering Directorate. While the overall Range functions as a complete system, it is operationally divided into the Test Measurements, Instrumentation Development, and Range Operations divisions. The primary function of TTR is to support DOE weapons test activities. Management, however, encourages other Government agencies and their contractors to schedule tests on the Range which can make effective use of its capabilities. Information concerning Range use by organizations outside of DOE is presented. Range instrumentation and support facilities are described in detail. This equipment represents the current state-of-the-art and reflects a continuing commitment by TTR management to field the most effective tracking and data acquisition system available.

  11. Advanced test reactor. Testing capabilities and plans

    International Nuclear Information System (INIS)

    The Advanced Test Reactor (ATR), at the Idaho National Laboratory (INL), is one of the world's premier test reactors for providing the capability for studying the effects of intense neutron and gamma radiation on reactor materials and fuels. The physical configuration of the ATR, a 4-leaf clover shape, allows the reactor to be operated at different power levels in the corner 'lobes' to allow for different testing conditions for multiple simultaneous experiments. The combination of high flux (maximum thermal neutron fluxes of 1E15 neutrons per square centimeter per second and maximum fast [E>1.0 MeV] neutron fluxes of 5E14 neutrons per square centimeter per second) and large test volumes (up to 122 cm long and 12.7 cm diameter) provide unique testing opportunities. For future research, some ATR modifications and enhancements are currently planned. In 2007 the US Department of Energy designated the ATR as a National Scientific User Facility (NSUF) to facilitate greater access to the ATR for material testing research by a broader user community. This paper provides more details on some of the ATR capabilities, key design features, experiments, and plants for the NSUF. (author)

  12. Capable of Suicide: A Functional Model of the Acquired Capability Component of the Interpersonal-Psychological Theory of Suicide

    Science.gov (United States)

    Smith, Phillip N.; Cukrowicz, Kelly C.

    2016-01-01

    The current review aims to present a functional model of the acquired capability for suicide; a component of Joiner’s (2005) Interpersonal-Psychological Theory of Suicide. This review is aimed at integrating the points discussed by Joiner into a unified and specific conceptualization of acquired capability. Additionally, we offer some points of elaboration; such as the interaction between specific diatheses with life events, the role of short-term bolstering of the capability for suicide, and how contextual factors moderate the experience of painful and provocative life events; thereby leading to fearlessness and pain insensitivity to the actions and ideas involved in suicide. PMID:20560748

  13. The evolution of Western nuclear capabilities

    International Nuclear Information System (INIS)

    This paper reports on the evolution of western nuclear capabilities. Presidents Truman and Eisenhower largely cast the die that determined the role, size, and organization of today's nuclear forces. The milestones were Truman's vast expansion of the nuclear weapons stockpile, followed by a series of seminal decisions by Eisenhower: transfer of peacetime civilian custody of nuclear weapons to the military; creation of a streamlined chain of command and a centrally coordinated war plan for all U.S. strategic forces; and the commitment to develop and deploy land- and submarine-based missiles of intercontinental range. The current U.S. strategic forces have some 11,000 widely dispersed nuclear warheads, of which more than 6,000 are ready for launch within minutes, can be traced back to these initiatives. Naturally, they were not taken in a geopolitical vacuum. Truman and Eisenhower had to contend with the Berlin Blockade in 1948, followed shortly thereafter by the Korean War

  14. Numerical modeling capabilities to predict repository performance

    Energy Technology Data Exchange (ETDEWEB)

    1979-09-01

    This report presents a summary of current numerical modeling capabilities that are applicable to the design and performance evaluation of underground repositories for the storage of nuclear waste. The report includes codes that are available in-house, within Golder Associates and Lawrence Livermore Laboratories; as well as those that are generally available within the industry and universities. The first listing of programs are in-house codes in the subject areas of hydrology, solute transport, thermal and mechanical stress analysis, and structural geology. The second listing of programs are divided by subject into the following categories: site selection, structural geology, mine structural design, mine ventilation, hydrology, and mine design/construction/operation. These programs are not specifically designed for use in the design and evaluation of an underground repository for nuclear waste; but several or most of them may be so used.

  15. The NICER mission: Status and technical capabilities

    Science.gov (United States)

    Chakrabarty, Deepto; Arzoumanian, Zaven; Gendreau, Keith

    2016-07-01

    NASA's Neutron Star Interior Composition Explorer (NICER), in development for deployment to the International Space Station as an external attached payload, will address decades-old questions about the structure, dynamics, and energetics of neutron stars through high-precision timing of the soft X-ray emissions of rotation- and accretion-powered pulsars. NICER's performance in timing, spectroscopy, and high-throughput sensitivity to 0.2-12 keV X-rays represents a substantial enhancement over existing capabilities, enabling a rich diversity of investigations in both neutron star science as well as broader X-ray astrophysics, the latter through an approved Guest Observer program. This talk briefly summarizes the NICER design and the status of hardware fabrication and testing, currently on pace to deliver the NICER payload for its planned launch in early 2017.

  16. Numerical modeling capabilities to predict repository performance

    International Nuclear Information System (INIS)

    This report presents a summary of current numerical modeling capabilities that are applicable to the design and performance evaluation of underground repositories for the storage of nuclear waste. The report includes codes that are available in-house, within Golder Associates and Lawrence Livermore Laboratories; as well as those that are generally available within the industry and universities. The first listing of programs are in-house codes in the subject areas of hydrology, solute transport, thermal and mechanical stress analysis, and structural geology. The second listing of programs are divided by subject into the following categories: site selection, structural geology, mine structural design, mine ventilation, hydrology, and mine design/construction/operation. These programs are not specifically designed for use in the design and evaluation of an underground repository for nuclear waste; but several or most of them may be so used

  17. Prenatal Care

    Science.gov (United States)

    ... am thinking about getting pregnant. How can I take care of myself? You should start taking care of ... What should I do — or not do — to take care of myself and my unborn baby? Follow these ...

  18. Critical Care

    Science.gov (United States)

    Critical care helps people with life-threatening injuries and illnesses. It might treat problems such as complications from surgery, ... attention by a team of specially-trained health care providers. Critical care usually takes place in an ...

  19. Palliative Care

    Science.gov (United States)

    Palliative care is treatment of the discomfort, symptoms, and stress of serious illness. It provides relief from distressing symptoms ... of the medical treatments you're receiving. Hospice care, care at the end of life, always includes ...

  20. Self Care

    Science.gov (United States)

    ... Care Connections Experiences Research Learning Evaluation Print Email Self Care If you are living with a chronic ... help you cope can make a real difference. Self-care techniques are things you can do for ...

  1. A Strategic Approach to Medical Care for Exploration Missions

    Science.gov (United States)

    Antonsen, E.; Canga, M.

    2016-01-01

    Exploration missions will present significant new challenges to crew health, including effects of variable gravity environments, limited communication with Earth-based personnel for diagnosis and consultation for medical events, limited resupply, and limited ability for crew return. Providing health care capabilities for exploration class missions will require system trades be performed to identify a minimum set of requirements and crosscutting capabilities which can be used in design of exploration medical systems. Current and future medical data, information, and knowledge must be cataloged and put in formats that facilitate querying and analysis. These data may then be used to inform the medical research and development program through analysis of risk trade studies between medical care capabilities and system constraints such as mass, power, volume, and training. These studies will be used to define a Medical Concept of Operations to facilitate stakeholder discussions on expected medical capability for exploration missions. Medical Capability as a quantifiable variable is proposed as a surrogate risk metric and explored for trade space analysis that can improve communication between the medical and engineering approaches to mission design. The resulting medical system approach selected will inform NASA mission architecture, vehicle, and subsystem design for the next generation of spacecraft.

  2. Deburring: technical capabilities and cost-effective approaches. Lessons 7 and 8

    Energy Technology Data Exchange (ETDEWEB)

    Gillespie, L.K.

    1980-06-01

    This ten-lesson text on deburring is designed to provide engineers and production supervisors with an overall understanding of deburring economics and current capabilities. Chapter 7 discusses deburring techniques. Electropolish and electrochemical deburring (ECD) are not the answer to everyone's deburring problems. They are high technology processes when compared to tumbling processes. They require more care, skill, and knowledge than many of the older processes. They are not mass finishing processes. In contrast, they can deburr areas totally untouchable by other processes, and electropolish can produce brilliant finishes. ECD selectively works only in one area, and neither process exerts cutting forces which would distort thin sections. ECD is applicable to all metals and all sizes of burrs. Once established, both processes can be controlled by unskilled help.

  3. JEM/SMILES observation capability

    Science.gov (United States)

    Kasai, Yasuko J.; Baron, Philippe; Ochiai, Satoshi; Mendrok, Jana; Urban, Joachim; Murtagh, Donal; Moller, Joakim; Manabe, Takeshi; Kikuchi, Kenichi; Nishibori, Toshiyuki

    2009-09-01

    A new generation of sub-millimeter-wave receivers employing sensitive SIS (Superconductor-Insulator- Superconductor) detector technology will provide new opportunities for precise passive remote sensing observation of minor constituents in atmosphere. Superconducting Submillimeter-Wave Limb-Emission Sounder (SMILES) was designed to be onbord the Japanese Experiment Module (JEM) on the International Space Station (ISS) as a collaboration project of National Institute of Information and Communications Technology (NICT) and Japan Aerospace Exploration Agency (JAXA). SMILES scheduled to be launch in September 11, 2009 by the H-II Transfer Vehicle (HTV). Mission Objectives are: i) Space demonstration of superconductive mixer and 4-K mechanical cooler for the submillimeter limb emission sounding, and ii) global observations of atmospheric minor constituents. JEM/SMILES will allow to observe the atmospheric species such as O3, H35Cl, H37 Cl, ClO, BrO, HOCl, HO2, and HNO3, CH3CN, and Ozone isotope species with the precisions in a few to several tens percents from upper troposphere to the mesosphere. We have estimated the observation capabilities of JEM/SMILES. This new technology may allow us to open new issues in atmospheric science.

  4. Solar mechanics thermal response capabilities.

    Energy Technology Data Exchange (ETDEWEB)

    Dobranich, Dean D.

    2009-07-01

    In many applications, the thermal response of structures exposed to solar heat loads is of interest. Solar mechanics governing equations were developed and integrated with the Calore thermal response code via user subroutines to provide this computational simulation capability. Solar heat loads are estimated based on the latitude and day of the year. Vector algebra is used to determine the solar loading on each face of a finite element model based on its orientation relative to the sun as the earth rotates. Atmospheric attenuation is accounted for as the optical path length varies from sunrise to sunset. Both direct and diffuse components of solar flux are calculated. In addition, shadowing of structures by other structures can be accounted for. User subroutines were also developed to provide convective and radiative boundary conditions for the diurnal variations in air temperature and effective sky temperature. These temperature boundary conditions are based on available local weather data and depend on latitude and day of the year, consistent with the solar mechanics formulation. These user subroutines, coupled with the Calore three-dimensional thermal response code, provide a complete package for addressing complex thermal problems involving solar heating. The governing equations are documented in sufficient detail to facilitate implementation into other heat transfer codes. Suggestions for improvements to the approach are offered.

  5. OPSAID improvements and capabilities report.

    Energy Technology Data Exchange (ETDEWEB)

    Halbgewachs, Ronald D.; Chavez, Adrian R.

    2011-08-01

    Process Control System (PCS) and Industrial Control System (ICS) security is critical to our national security. But there are a number of technological, economic, and educational impediments to PCS owners implementing effective security on their systems. Sandia National Laboratories has performed the research and development of the OPSAID (Open PCS Security Architecture for Interoperable Design), a project sponsored by the US Department of Energy Office of Electricity Delivery and Energy Reliability (DOE/OE), to address this issue. OPSAID is an open-source architecture for PCS/ICS security that provides a design basis for vendors to build add-on security devices for legacy systems, while providing a path forward for the development of inherently-secure PCS elements in the future. Using standardized hardware, a proof-of-concept prototype system was also developed. This report describes the improvements and capabilities that have been added to OPSAID since an initial report was released. Testing and validation of this architecture has been conducted in another project, Lemnos Interoperable Security Project, sponsored by DOE/OE and managed by the National Energy Technology Laboratory (NETL).

  6. Using health information technology to manage a patient population in accountable care organizations.

    Science.gov (United States)

    Wu, Frances M; Rundall, Thomas G; Shortell, Stephen M; Bloom, Joan R

    2016-06-20

    Purpose - The purpose of this paper is to describe the current landscape of health information technology (HIT) in early accountable care organizations (ACOs), the different strategies ACOs are using to develop HIT-based capabilities, and how ACOs are using these capabilities within their care management processes to advance health outcomes for their patient population. Design/methodology/approach - Mixed methods study pairing data from a cross-sectional National Survey of ACOs with in-depth, semi-structured interviews with leaders from 11 ACOs (both completed in 2013). Findings - Early ACOs vary widely in their electronic health record, data integration, and analytic capabilities. The most common HIT capability was drug-drug and drug-allergy interaction checks, with 53.2 percent of respondents reporting that the ACO possessed the capability to a high degree. Outpatient and inpatient data integration was the least common HIT capability (8.1 percent). In the interviews, ACO leaders commented on different HIT development strategies to gain a more comprehensive picture of patient needs and service utilization. ACOs realize the necessity for robust data analytics, and are exploring a variety of approaches to achieve it. Research limitations/implications - Data are self-reported. The qualitative portion was based on interviews with 11 ACOs, limiting generalizability to the universe of ACOs but allowing for a range of responses. Practical implications - ACOs are challenged with the development of sophisticated HIT infrastructure. They may benefit from targeted assistance and incentives to implement health information exchanges with other providers to promote more coordinated care management for their patient population. Originality/value - Using new empirical data, this study increases understanding of the extent of ACOs' current and developing HIT capabilities to support ongoing care management. PMID:27296880

  7. [Undate on Current Care Guideline: Parkinson's disease].

    Science.gov (United States)

    2016-01-01

    The treatment of Parkinson's disease may be initiated with dopamine agonist or MAO-B-inhibitor for people under 60-65 years of age. For older patients, the treatment may also be started with levodopa. If there are motor complications, such as on-off-symptoms, apomorphin injections can be beneficial in addition to other medications. In the case of difficult on-off-symptoms and dyskinesias in spite of optimal treatment, deep brain stimulation, duodenal levodopa infusion and apomorphine infusion should be considered. Rehabilitation can improve gait speed and balance, decrease falls and improve speech. However, with advancing disease the results are not maintained if trainino is discontinued. PMID:27044185

  8. Computer-assisted sperm analysis (CASA): capabilities and potential developments.

    Science.gov (United States)

    Amann, Rupert P; Waberski, Dagmar

    2014-01-01

    Computer-assisted sperm analysis (CASA) systems have evolved over approximately 40 years, through advances in devices to capture the image from a microscope, huge increases in computational power concurrent with amazing reduction in size of computers, new computer languages, and updated/expanded software algorithms. Remarkably, basic concepts for identifying sperm and their motion patterns are little changed. Older and slower systems remain in use. Most major spermatology laboratories and semen processing facilities have a CASA system, but the extent of reliance thereon ranges widely. This review describes capabilities and limitations of present CASA technology used with boar, bull, and stallion sperm, followed by possible future developments. Each marketed system is different. Modern CASA systems can automatically view multiple fields in a shallow specimen chamber to capture strobe-like images of 500 to >2000 sperm, at 50 or 60 frames per second, in clear or complex extenders, and in CASA cannot accurately predict 'fertility' that will be obtained with a semen sample or subject. However, when carefully validated, current CASA systems provide information important for quality assurance of semen planned for marketing, and for the understanding of the diversity of sperm responses to changes in the microenvironment in research. The four take-home messages from this review are: (1) animal species, extender or medium, specimen chamber, intensity of illumination, imaging hardware and software, instrument settings, technician, etc., all affect accuracy and precision of output values; (2) semen production facilities probably do not need a substantially different CASA system whereas biology laboratories would benefit from systems capable of imaging and tracking sperm in deep chambers for a flexible period of time; (3) software should enable grouping of individual sperm based on one or more attributes so outputs reflect subpopulations or clusters of similar sperm with unique

  9. 失能老年人的生活状况和社区照护服务需求研究%Study on Current Life Situation and Community Care Service Demand of Disabled Elders

    Institute of Scientific and Technical Information of China (English)

    姜向群; 刘妮娜; 魏蒙

    2014-01-01

    This paper uses the datum of survey on the basic situation and service demand for the elderly in Xicheng District in Beijing from Gerontology Institute of Renmin University, and analyzes their current life situation and care service demand. The reality reveals that there has been a low degree of utilization of community service facilities for disabled elders. Besides, community service items have been in shortage and had low supply rate. Accordingly, this study recognized that the advancement of social services for disabled elders can be conducted from two aspects: the short-term goals and long-term planning. On one hand, short-term goals include following items: providing corresponding services subsidies for disabled elders, transferring the core of community servicesfrom "entertainment" to "health maintenance" and properly handling the relationship among home-based care, institution care and family support for disabled elders, etc. On the other hand, the long-term planning covers establishment of system and mechanism of social services for disabled elders, furthermore, promotion of the market development of social services for disabled elders etc.%利用中国人民大学老年学研究所2013年对北京市西城区老年人基本情况和服务需求的调查数据,就失能老年人的生活状况和照护服务需求进行分析。失能老年人对社区养老服务设施的利用率低,社区照护服务项目及有效供给不足。可以从短期目标与长期规划两个方面着手推进失能老年人的社会服务发展。短期目标包括给予失能老年人相应服务补贴,社区服务重心由“娱乐型”向“医养型”转变,妥善处理失能老年人居家养老、机构养老与家庭养老的关系等;长期目标包括建立失能老年人社会服务机制、推进失能老年人社会服务市场化发展等。

  10. Investigate on current situation of puerperium health care of women from a village of He'nan province%河南省某村妇女产褥期保健现状调查

    Institute of Scientific and Technical Information of China (English)

    伍东红; 渠利霞; 楚银萍; 高金玲; 潘雪

    2013-01-01

    Objective: To understand the current situation of puerperium health care of women from a village of He'nan province. Methods: Questionnaire investigation and individual interview were adopted to survey 57 mothers whose infants ≤2 years in a village of He'nan province. Results: Fifty - one puerperium women didn't eat fruits (89. 5% ) , 36 puerperium women didn't eat vegetables (63. 2% ) , 49 puerperium women didn't wash hair (86. 0% ) , 49 puerperium women didn't go out (89. 0% ) , 50 puerperium women stayed in a airproof environment (87. 7% ) . The educational levels of parturient women was one of influencing factors of self - health attitude. Conclusion: Misunderstandings exist in self-health of rural women during puerperium period, such as unreasonable dietary structure, bad health status, and less exercises; rural medical health care service is not widespread, maternal and child health care knowledge should be popularized to rural area according to specific circumstance to improve maternal - infantile health level.%目的:了解河南省某村妇女产褥期保健现状.方法:运用问卷调查和个别访谈法对河南省某村57名≤2岁婴幼儿的母亲进行调查.结果:产褥期妇女不吃水果51人,占89.5%;不吃蔬菜36人,占63.2%;不洗发49人,占86.0%;不外出活动49人,占89.0%;不通风50人,占87.7%.产妇的文化程度是自我保健态度的影响因素.结论:农村妇女产褥期自我保健存在误区,饮食结构欠合理、卫生状况欠佳、运动较少.农村医疗卫生保健服务尚未普及,应视具体情况,向农村普及妇幼保健知识,提高母婴健康水平.

  11. OVERVIEW OF DEVELOPMENT OF P-CARES: PROBABILISTIC COMPUTER ANALYSIS FOR RAPID EVALUATION OF STRUCTURES.

    Energy Technology Data Exchange (ETDEWEB)

    NIE,J.; XU, J.; COSTANTINO, C.; THOMAS, V.

    2007-08-01

    Brookhaven National Laboratory (BNL) undertook an effort to revise the CARES (Computer Analysis for Rapid Evaluation of Structures) program under the auspices of the US Nuclear Regulatory Commission (NRC). The CARES program provided the NRC staff a capability to quickly check the validity and/or accuracy of the soil-structure interaction (SSI) models and associated data received from various applicants. The aim of the current revision was to implement various probabilistic simulation algorithms in CARES (referred hereinafter as P-CARES [1]) for performing the probabilistic site response and soil-structure interaction (SSI) analyses. This paper provides an overview of the development process of P-CARES, including the various probabilistic simulation techniques used to incorporate the effect of site soil uncertainties into the seismic site response and SSI analyses and an improved graphical user interface (GUI).

  12. Assessment of NASA's Aircraft Noise Prediction Capability

    Science.gov (United States)

    Dahl, Milo D. (Editor)

    2012-01-01

    A goal of NASA s Fundamental Aeronautics Program is the improvement of aircraft noise prediction. This document provides an assessment, conducted from 2006 to 2009, on the current state of the art for aircraft noise prediction by carefully analyzing the results from prediction tools and from the experimental databases to determine errors and uncertainties and compare results to validate the predictions. The error analysis is included for both the predictions and the experimental data and helps identify where improvements are required. This study is restricted to prediction methods and databases developed or sponsored by NASA, although in many cases they represent the current state of the art for industry. The present document begins with an introduction giving a general background for and a discussion on the process of this assessment followed by eight chapters covering topics at both the system and the component levels. The topic areas, each with multiple contributors, are aircraft system noise, engine system noise, airframe noise, fan noise, liner physics, duct acoustics, jet noise, and propulsion airframe aeroacoustics.

  13. Organizational Economics of Capability and Heterogeneity

    DEFF Research Database (Denmark)

    Argyres, Nicholas S.; Felin, Teppo; Foss, Nicolai Juul;

    2012-01-01

    For decades, the literatures on firm capabilities and organizational economics have been at odds with each other, specifically relative to explaining organizational boundaries and heterogeneity. We briefly trace the history of the relationship between the capabilities literature and organizationa...

  14. Reframing Inclusive Education: Educational Equality as Capability Equality

    Science.gov (United States)

    Terzi, Lorella

    2014-01-01

    In this paper, I argue that rethinking questions of inclusive education in the light of the value of educational equality--specifically conceived as capability equality, or genuine opportunities to achieve educational functionings--adds some important insights to the current debate on inclusive education. First, it provides a cohesive value…

  15. Building capabilities to manage strategic alliances

    OpenAIRE

    SLUYTS, Kim; Matthyssens, Paul; Martens, Rudy; Streukens, Sandra

    2011-01-01

    Recently, academics have attributed a large part of alliance success to a firm's ability to successfully manage its alliances, also called its level of alliance management capability. We contribute to this growing body of literature by (1) verifying the impact of alliance management capability on alliance performance and (2) analyzing the drivers of alliance management capability. We measure this capability through four types of alliance learning processes and study how each of these processe...

  16. A comprehensive estimation method for enterprise capability

    OpenAIRE

    Tetiana Kuzhda; Natalia Kyrych

    2015-01-01

    In today’s highly competitive business world, the need for efficient enterprise capability management is greater than ever. As more enterprises begin to compete on a global scale, the effective use of enterprise capability will become imperative for them to improve their business activities. The definition of socio-economic capability of the enterprise has been given and the main components of enterprise capability have been pointed out. The comprehensive method to estimate enterprise capabil...

  17. Sustainability economics, ontology and the capability approach

    OpenAIRE

    Martins, Nuno O.

    2011-01-01

    Copyright © 2011 Elsevier B.V. All rights reserved. The relationship between sustainability economics and the capability approach has recently been explored. Here I shall discuss this relationship, and argue that a study of the ontology underlying the capability approach can help us to see more clearly the interconnections between sustainability economics and the capability approach. In particular, the interpretations of the capability approach as an ontological exercise, which have recent...

  18. DESIGNING AND MEASURING CAPABILITY. A NEW PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Ovidiu COCENESCU

    2013-01-01

    Full Text Available The concept of capability has long been a topic for debate among planners. The main benefit brought by it is that of ensuring the connection between objectives and necessary financial resources. Thus, capability is a median element within the process of integrated planning. In this context, there are sceptics who consider that capability cannot be measured. However, this article aims at presenting a pattern and a formula for measuring and interpreting the level of capability.

  19. Capability development within the multinational corporation

    OpenAIRE

    Kilpinen, Paula

    2013-01-01

    The operating environment is being shaped by globalization forces, rapid technological change and intensified competition, which call for strategic changes and new capabilities from multinational corporations. Even though the capability-based determinants to firm survival and growth have been recognized, research on capability development has been limited. This study investigates capability dynamics within MNCs and the interactions between strategy and the environments internal and external t...

  20. Dynamic capabilities in small software firms

    OpenAIRE

    Kivelä, Marianne

    2007-01-01

    In this dissertation we study dynamic capabilities in small software firms. Small software firms find themselves in highly complex and turbulent environments that require dynamic capabilities to build, integrate and configure resources. While the literature describes a portfolio of such dynamic capabilities that can help firms to adapt to changing conditions, we could not find many definitions, models and studies on these capabilities suitable with particular focus on small software firms. Fu...

  1. "Uberizing" home care in Ontario.

    Science.gov (United States)

    Wojtak, Anne; Stark, Linda

    2016-07-01

    This article looks at home care in Ontario and its role as a foundation for a sustainable healthcare system in the future. Beginning with the history and evolution of the service delivery model, it examines current challenges and opportunities to unleash the potential of home care within a more integrated model for patient-centred care for the future. An in-depth look at how to better coordinate, integrate, and fund care for patients is highlighted. PMID:27269814

  2. Primary care practice-based care management for chronically ill patients (PraCMan: study protocol for a cluster randomized controlled trial [ISRCTN56104508

    Directory of Open Access Journals (Sweden)

    Baldauf Annika

    2011-06-01

    status and severity (PHQ-9, self-management capabilities and clinical parameters. Data collection will be performed at baseline, 12 and 24 months (12 months post-intervention. Discussion Practice-based care management for high risk individuals involving trained HCAs appears to be a promising approach to face the needs of an aging population with increasing care demands. Trial registration Current Controlled Trials ISRCTN56104508

  3. Selecting Capabilities for Quality of Life Measurement

    Science.gov (United States)

    Robeyns, Ingrid

    2005-01-01

    The capability approach advocates that interpersonal comparisons be made in the space of functionings and capabilities. However, Amartya Sen has not specified which capabilities should be selected as the relevant ones. This has provoked two types of criticism. The stronger critique is Martha Nussbaum's claim that Sen should endorse one specific…

  4. 北京社区失能老年人与照护现状分析%Analysis on disabled elderly and the current status of caring in communities of Beijing

    Institute of Scientific and Technical Information of China (English)

    王建平; 汤哲; 孙菲; 刁丽君; 何士大

    2014-01-01

    目的了解北京社区失能老年人与照护现状。方法采取分层、随机、整群的抽样方法,入户调查西城区(城区)、大兴区(郊区农村)和怀柔区(山区农村)60岁及以上老年人2776例。采用日常生活活动能力量表评估老年人的失能状况。结果调查的老年人中失能老年人为324例,占11.7%,农村失能老年人构成比(16.8%)高于城区(7.4%);随年龄增长失能率增高。10.8%的失能老年人为独居,无照料人同住,尤其农村及女性失能老年人独居比例高。失能老年人的照护人主要是子女(56.6%),其次是配偶(31.1%)。62.7%的失能老年人月均收入在500元以下,农村低收入比例明显高于城区。失能老年人家庭认为目前医药负担较重的占67.6%,其中28.7%的失能老年人家庭认为承受困难。结论老年人失能比例高,家庭与社会照护现状不能满足需求的增长,应探索和建立失能老年人长期照护的有效模式。%Objective To understand the disabled elderly in Beijing and the current status of caring of them. Methods Stratified, random and cluster sampling methods were used, and household surveys were taken among 2776 cases of elderly aged 60 and above in Xicheng District (city), Daxing District (rural outskirts) and Huairou District (moun-tainous countryside). ADL (Activity of Daily Living Scale) was used to assess the elderly disability status. Results In the investigation, 324 elderly were disabled; accounting for 11.7%, the number of disabled elderly in rural areas was signifi-cantly higher than that in urban area, and the disability ratio increaseed along with the age growth. 10.8% of disabled el-derly live alone, not living with caregivers; the ratio was especially higher in rural area and for elderly women. Children of the elderly were mainly the caregivers for the disabled elderly, followed by the spouse. The average monthly income of 67.7% of the

  5. Distinctive Dynamic Capabilities for New Business Creation

    DEFF Research Database (Denmark)

    Rosenø, Axel; Enkel, Ellen; Mezger, Florian

    2013-01-01

    and fast-paced industries, and that similarities exist across industries. Hence, the study contributes to dynamic capabilities literature by: 1) identifying the distinctive dynamic capabilities for new business creation; 2) shifting focus away from dynamic capabilities in environments characterised by high...... clock-speed and uncertainty towards considering dynamic capabilities for the purpose of developing new businesses, which also implies a high degree of uncertainty. Based on interviews with 33 companies, we identify distinctive dynamic capabilities for new business creation, find that dynamic......This study examines the distinctive dynamic capabilities for new business creation in established companies. We argue that these are very different from those for managing incremental innovation within a company's core business. We also propose that such capabilities are needed in both slow...

  6. Activity-based resource capability modeling

    Institute of Scientific and Technical Information of China (English)

    CHENG Shao-wu; XU Xiao-fei; WANG Gang; SUN Xue-dong

    2008-01-01

    To analyse and optimize a enterprise process in a wide scope, an activity-based method of modeling resource capabilities is presented. It models resource capabilities by means of the same structure as an activity, that is, resource capabilities are defined by input objects, actions and output objects. A set of activity-based re-source capability modeling rules and matching rules between an activity and a resource are introduced. This method can not only be used to describe capability of manufacturing tools, but also capability of persons and applications, etc. It unifies methods of modeling capability of all kinds of resources in an enterprise and supports the optimization of the resource allocation of a process.

  7. Power Capability in Low Voltage DC Distribution Systems

    Directory of Open Access Journals (Sweden)

    C.O. Gecan

    2009-12-01

    Full Text Available Recent developments in power electronics components enable the use of power electronics in Low Voltage (LV networks. This development makes the model of a Low Voltage Direct Current (LVDC distribution system possible. The technical and economical benefits of this technology make possible the alternative hypothesis of using DC instead of AC distribution systems. Some aspects, such as increasing the capability of the existing lines, interconnecting distributed generation units and even supplying in DC some loads are creating additional requirements of using a LVDC distribution system. The paper presents some general considerations regarding cables used in a LVAC distribution system and different line reconfigurations witch enable the use of cobles in a LVDC distribution system. The reconfigurations are presented in respect of the DC network topologies: unipolar and bipolar. The central aim of this paper is to investigate capability of power transmission and to calculate the transmission distance for cables used in Low Voltage AC and DC distribution systems. Capability computation is considered in respect of two constrains imposed in the cables cross section selection: cable thermal limit and the maximum allowable voltage drop. Cable thermal limit is represented in calculations by the maximum rated current. The equations used to calculate the power capability are presented for single-phase and threephase AC networks and unipolar and bipolar DC networks. Based on these equations, comparisons between power capability of cables with different cross sections used in Low Voltage DC and AC distribution systems are realized and presented.

  8. Nuclear Research and Development Capabilities Needed to Support Future Growth

    International Nuclear Information System (INIS)

    The energy crisis looming before the United States can be resolved only by an approach that integrates a 'portfolio' of options. Nuclear energy, already an important element in the portfolio, should play an even more significant role in the future as the U.S. strives to attain energy independence and reduce carbon emissions. The DOE Office of Nuclear Energy asked Battelle Memorial Institute to obtain input from the commercial power generation industry on industry's vision for nuclear energy over the next 30-50 years. With this input, Battelle was asked to generate a set of research and development capabilities necessary for DOE to support the anticipated growth in nuclear power generation. This presentation, based on the report generated for the Office of Nuclear Energy, identifies the current and future nuclear research and development capabilities required to make this happen. The capabilities support: (1) continued, safe operation of the current fleet of nuclear plants; (2) the availability of a well qualified and trained workforce; (3) demonstration of the next generation nuclear plants; (4) development of a sustainable fuel cycle; (5) advanced technologies for maximizing resource utilization and minimization of waste and (6) advanced modeling and simulation for rapid and reliable development and deployment of new nuclear technologies. In order to assure these capabilities are made available, a Strategic Nuclear Energy Capability Initiative is proposed to provide the required resources during this critical period of time. (authors)

  9. Post-Irradiation Capabilities at the Idaho National Laboratory

    International Nuclear Information System (INIS)

    The US Department of Energy (DOE), Office of Nuclear Energy (NE) oversees the efforts to ensure nuclear energy remains a viable option for the United States of America. A significant portion of these efforts are related to post-irradiation examinations (PIE) of highly activated fuel and materials that are subject to the extreme environment inside a nuclear reactor. As the lead national laboratory for nuclear energy, Idaho National Laboratory (INL) has a rich history, experience, workforce, and capabilities for performing PIE. However, new advances in tools and techniques for performing PIE now enable understanding the performance of fuels and materials at the nano-scale and smaller level. Examination at this level is critical since this is the scale at which irradiation damage occurs. The INL is on course to adopt advanced tools and techniques to develop a comprehensive nuclear fuels and materials characterization capability that is unique in the world. Because INL has extensive PIE capabilities currently in place, a strong foundation exist to build upon as new capabilities are implemented and workload increases. In the recent past, INL has adopted significant capability to perform advanced PIE characterization. Looking forward, INL is planning for the addition of two facilities that will be built to meet the stringent demands of advanced tools and techniques for highly activated fuels and materials characterization. Dubbed the Irradiated Materials Characterization Laboratory (IMCL) and advanced post- irradiation examination capability, these facilities are next generation PIE laboratories designed to perform the PIE work that cannot be performed in current DOE facilities. In addition to physical capabilities, INL has recently added two significant contributors to the Advanced Test Reactor-National Scientific User Facility (ATR-NSUF), Oak Ridge National Laboratory and University of California Berkeley. (author)

  10. Post Irradiation Capabilities at the Idaho National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    J. L. Schulthess; K. E. Rosenberg

    2011-05-01

    The U.S. Department of Energy (DOE), Office of Nuclear Energy (NE) oversees the efforts to ensure nuclear energy remains a viable option for the United States. A significant portion of these efforts are related to post-irradiation examinations (PIE) of highly activated fuel and materials that are subject to the extreme environment inside a nuclear reactor. As the lead national laboratory, Idaho National Laboratory (INL) has a rich history, experience, workforce and capabilities for performing PIE. However, new advances in tools and techniques for performing PIE now enable understanding the performance of fuels and materials at the nano-scale and smaller level. Examination at this level is critical since this is the scale at which irradiation damage occurs. The INL is on course to adopt these advanced tools and techniques to develop a comprehensive nuclear fuels and materials characterization capability that is unique in the world. Because INL has extensive PIE capabilities currently in place, a strong foundation exist to build upon as new capabilities are implemented and work load increases. In the recent past, INL has adopted significant capability to perform advanced PIE characterization. Looking forward, INL is planning for the addition of two facilities that will be built to meet the stringent demands of advanced tools and techniques for highly activated fuels and materials characterization. Dubbed the Irradiated Materials Characterization Laboratory (IMCL) and Advanced Post Irradiation Examination Capability , these facilities are next generation PIE laboratories designed to perform the work of PIE that cannot be performed in current DOE facilities. In addition to physical capabilities, INL has recently added two significant contributors to the Advanced Test Reactor-National Scientific User Facility (ATR-NSUF), Oak Ridge National Laboratory and University of California, Berkeley.

  11. IAC-1.5 - INTEGRATED ANALYSIS CAPABILITY

    Science.gov (United States)

    Vos, R. G.

    1994-01-01

    , object code, etc. The user can define groups of data and relations between them. A full data manipulation and query system operates with the database. The current interface modules comprise five groups: 1) Structural analysis - IAC contains a NASTRAN interface for standalone analysis or certain structural/control/thermal combinations. IAC provides enhanced structural capabilities for normal modes and static deformation analysis via special DMAP sequences. 2) Thermal analysis - IAC supports finite element and finite difference techniques for steady state or transient analysis. There are interfaces for the NASTRAN thermal analyzer, SINDA/SINFLO, and TRASYS II. 3) System dynamics - A DISCOS interface allows full use of this simulation program for either nonlinear time domain analysis or linear frequency domain analysis. 4) Control analysis - Interfaces for the ORACLS, SAMSAN, NBOD2, and INCA programs allow a wide range of control system analyses and synthesis techniques. 5) Graphics - The graphics packages PLOT and MOSAIC are included in IAC. PLOT generates vector displays of tabular data in the form of curves, charts, correlation tables, etc., while MOSAIC generates color raster displays of either tabular of array type data. Either DI3000 or PLOT-10 graphics software is required for full graphics capability. IAC is available by license for a period of 10 years to approved licensees. The licensed program product includes one complete set of supporting documentation. Additional copies of the documentation may be purchased separately. IAC is written in FORTRAN 77 and has been implemented on a DEC VAX series computer operating under VMS. IAC can be executed by multiple concurrent users in batch or interactive mode. The basic central memory requirement is approximately 750KB. IAC includes the executive system, graphics modules, a database, general utilities, and the interfaces to all analysis and controls programs described above. Source code is provided for the control

  12. Benchmarking HIV health care

    DEFF Research Database (Denmark)

    Podlekareva, Daria; Reekie, Joanne; Mocroft, Amanda;

    2012-01-01

    ABSTRACT: BACKGROUND: State-of-the-art care involving the utilisation of multiple health care interventions is the basis for an optimal long-term clinical prognosis for HIV-patients. We evaluated health care for HIV-patients based on four key indicators. METHODS: Four indicators of health care were...... assessed: Compliance with current guidelines on initiation of 1) combination antiretroviral therapy (cART), 2) chemoprophylaxis, 3) frequency of laboratory monitoring, and 4) virological response to cART (proportion of patients with HIV-RNA 90% of time on cART). RESULTS: 7097 Euro...... to North, patients from other regions had significantly lower odds of virological response; the difference was most pronounced for East and Argentina (adjusted OR 0.16[95%CI 0.11-0.23, p HIV health care utilization...

  13. Transportation capabilities study of DOE-owned spent nuclear fuel

    Energy Technology Data Exchange (ETDEWEB)

    Clark, G.L.; Johnson, R.A.; Smith, R.W. [Packaging Technology, Inc., Tacoma, WA (United States); Abbott, D.G.; Tyacke, M.J. [Lockheed Idaho Technologies Co., Idaho Falls, ID (United States)

    1994-10-01

    This study evaluates current capabilities for transporting spent nuclear fuel owned by the US Department of Energy. Currently licensed irradiated fuel shipping packages that have the potential for shipping the spent nuclear fuel are identified and then matched against the various spent nuclear fuel types. Also included are the results of a limited investigation into other certified packages and new packages currently under development. This study is intended to support top-level planning for the disposition of the Department of Energy`s spent nuclear fuel inventory.

  14. Optical Design Capabilities at Lawrence Livermore National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Lawson, J K

    2002-12-30

    Optical design capabilities continue to play the same strong role at Lawrence Livermore National Laboratory (LLNL) that they have played in the past. From defense applications to the solid-state laser programs to the Atomic Vapor Laser Isotope Separation (AVLIS), members of the optical design group played critical roles in producing effective system designs and are actively continuing this tradition. This talk will explain the role optical design plays at LLNL, outline current capabilities and summarize a few activities in which the optical design team has been recently participating.

  15. PHISICS multi-group transport neutronic capabilities for RELAP5

    Energy Technology Data Exchange (ETDEWEB)

    Epiney, A.; Rabiti, C.; Alfonsi, A.; Wang, Y.; Cogliati, J.; Strydom, G. [Idaho National Laboratory (INL), 2525 N. Fremont Ave., Idaho Falls, ID 83402 (United States)

    2012-07-01

    PHISICS is a neutronic code system currently under development at INL. Its goal is to provide state of the art simulation capability to reactor designers. This paper reports on the effort of coupling this package to the thermal hydraulic system code RELAP5. This will enable full prismatic core and system modeling and the possibility to model coupled (thermal-hydraulics and neutronics) problems with more options for 3D neutron kinetics, compared to the existing diffusion theory neutron kinetics module in RELAP5 (NESTLE). The paper describes the capabilities of the coupling and illustrates them with a set of sample problems. (authors)

  16. Summary of NASA Advanced Telescope and Observatory Capability Roadmap

    Science.gov (United States)

    Stahl, H. Philip; Feinberg, Lee

    2007-01-01

    The NASA Advanced Telescope and Observatory (ATO) Capability Roadmap addresses technologies necessary for NASA to enable future space telescopes and observatories operating in all electromagnetic bands, from x-rays to millimeter waves, and including gravity-waves. It lists capability priorities derived from current and developing Space Missions Directorate (SMD) strategic roadmaps. Technology topics include optics; wavefront sensing and control and interferometry; distributed and advanced spacecraft systems; cryogenic and thermal control systems; large precision structure for observatories; and the infrastructure essential to future space telescopes and observatories.

  17. Tracheostomy care

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000076.htm Tracheostomy care To use the sharing features on this ... through your nose and mouth. Caring for Your Tracheostomy Once the hole in your neck is not ...

  18. Daily Care

    Science.gov (United States)

    ... to Know Online Tools Enhancing Daily Life Daily Plan Activities Communication Food & Eating Music & Art Personal Care Incontinence Bathing ... Tweet Email | Print Create a Daily Routine Daily Plan Activities Communication Food/Eating Get Tips on Personal Care Bathing ...

  19. Continuing Care

    Science.gov (United States)

    ... Care Obesity at Midlife May Speed Alzheimer’s Onset Hello from my mom Easing the Behavior Problems of ... Managers Continuing Care FOR MORE ARTICLES CLICK HERE Hello from my mom Common Estate Planning Errors Alzheimer’s ...

  20. Pin care

    Science.gov (United States)

    ... gov/pubmed/24302374 . Nagy K. Discharge instructions for wound cares. The American Association of the Surgery of Trauma. www.aast.org/discharge-instructions-for-wound-cares . Accessed May 13, 2016.

  1. Status of simulation in health care education: an international survey.

    Science.gov (United States)

    Qayumi, Karim; Pachev, George; Zheng, Bin; Ziv, Amitai; Koval, Valentyna; Badiei, Sadia; Cheng, Adam

    2014-01-01

    Simulation is rapidly penetrating the terrain of health care education and has gained growing acceptance as an educational method and patient safety tool. Despite this, the state of simulation in health care education has not yet been evaluated on a global scale. In this project, we studied the global status of simulation in health care education by determining the degree of financial support, infrastructure, manpower, information technology capabilities, engagement of groups of learners, and research and scholarly activities, as well as the barriers, strengths, opportunities for growth, and other aspects of simulation in health care education. We utilized a two-stage process, including an online survey and a site visit that included interviews and debriefings. Forty-two simulation centers worldwide participated in this study, the results of which show that despite enormous interest and enthusiasm in the health care community, use of simulation in health care education is limited to specific areas and is not a budgeted item in many institutions. Absence of a sustainable business model, as well as sufficient financial support in terms of budget, infrastructure, manpower, research, and scholarly activities, slows down the movement of simulation. Specific recommendations are made based on current findings to support simulation in the next developmental stages. PMID:25489254

  2. A型血友病患儿家庭治疗护理状况回顾性调查分析%Current status of home care for children with hemophilia A

    Institute of Scientific and Technical Information of China (English)

    钟小红

    2011-01-01

    目的 调查中国A型血友病4~18岁患儿家庭治疗和护理状况。方法 2006年、2010年两次对血友病家庭治疗和护理状况进行调查。结果 A型血友病患儿诊断年龄和治疗年龄晚于首次出血年龄;凝血因子用量不足;血友病性骨关节病患病率高;开展了家庭治疗的血友病患儿从55例上升到119例,血友病患儿及家庭对发病原因、遗传规律、出血严重程度的评估和正确服用止痛药物认知率分别从80.8%、78.5%、37.4%和48.4%上升到94.7%、94.1%、52.7%和85.5%;在开展家庭康复训练、保持治疗记录完整两方面没有明显改善。结论 A型血友病患儿诊断治疗延迟,凝血因子用量不足,骨关节病发病率高,家庭护理水平仍然有待于进一步提高。%Objective To investigate the current status of home care for children with hemophilia A. Methods Twice investigation was conducted with a self-designed questionnaire about the status of home care in children with hemophilia A in 2006 and 2010. Results The diagnosis confirming and initial treatment were implemented after initial hemorrhage in children with hemophilia A. Moreover, the dosage of coagulation factor was insufficient and the incidence of joint deformity was high. The number of hemophilia A children received family therapy increased from 55 in 2006 to 119 in 2010. The mastery rates of knowledge on the etiology,inheritance rule,assesment of bleeding and proper use of analgesics were improved from 80.8 percent,78.5 percent,37.4 percent,and 48.4 percent in 2006 to 94.7 percent,94.1 percent,52.7 percent,and 85.5 percent in 2010,respectively. The status of home rehabilitation training and the completeness of medical records was not unproved. Conclusion Delayed diagnosis and treatment,insufficient dosage of coagulation factor,and high incidence of joint deformity are prevalent in the children with hemophilia A. The level of family therapy and home care is still need to

  3. Comparing Care

    NARCIS (Netherlands)

    Evert Pommer; Isolde Woittiez; John Stevens

    2007-01-01

    Home care is one of the most important means of compensating for disabilities and ensuring continuity in people's daily functioning. Home care services in the Netherlands have recently been transferred from a national social security provision for long-term care to a local social service. In most ot

  4. Employer-Supported Child Care in Ontario.

    Science.gov (United States)

    Ontario Ministry of Community and Social Services, Toronto.

    Six case studies describing current employer-supported child care services in Ontario are presented. The studies describe the PLADEC Day Care Center of the Kingston Psychiatric Hospital, the day care center at the Chedoke-McMaster Hospitals in Hamilton, the Early Learning Centre at Durham College in Oshawa, the Hydrokids day care center at the…

  5. Many diseases, one model of care?

    NARCIS (Netherlands)

    Albreht, T.; Dyakova, M.; Schellevis, F.G.; Broucke, S. van den

    2016-01-01

    Patients with multiple chronic conditions (multimorbidity) have complex and extensive health and social care needs that are not well served by current silo-based models of care. A lack of integration between care providers often leads to fragmented, incomplete, and ineffective care, leaving many pat

  6. Compilation of Sandia Laboratories technical capabilities

    Energy Technology Data Exchange (ETDEWEB)

    Lundergan, C. D.; Mead, P. L. [eds.

    1975-11-01

    This report is a compilation of 17 individual documents that together summarize the technical capabilities of Sandia Laboratories. Each document in this compilation contains details about a specific area of capability. Examples of application of the capability to research and development problems are provided. An eighteenth document summarizes the content of the other seventeen. Each of these documents was issued with a separate report number (SAND 74-0073A through SAND 74-0091, except -0078). (RWR)

  7. Compilation of Sandia Laboratories technical capabilities

    International Nuclear Information System (INIS)

    This report is a compilation of 17 individual documents that together summarize the technical capabilities of Sandia Laboratories. Each document in this compilation contains details about a specific area of capability. Examples of application of the capability to research and development problems are provided. An eighteenth document summarizes the content of the other seventeen. Each of these documents was issued with a separate report number (SAND 74-0073A through SAND 74-0091, except -0078)

  8. Understanding dynamic capabilities through knowledge management

    DEFF Research Database (Denmark)

    Nielsen, Anders Paarup

    2006-01-01

    In the paper eight knowledge management activities are identified; knowledge creation, acquisition, capture, assembly, sharing, integration, leverage and exploitation. These activities are assembled into the three dynamic capabilities of knowledge development, knowledge (re......)combination and knowledge use. The dynamic capabilities and the associated knowledge management activities create flows to and from the firm’s stock of knowledge and they support the creation and use of organizational capabilities....

  9. Capabilities, social rights and European market integration

    OpenAIRE

    Jude Browne; Simon Deakin; Frank Wilkinson

    2002-01-01

    This paper explores the links between the economic notion of 'capabilities' and the judicial concept of social rights. We begin by revisiting TH Marshall's classic analysis of social rights and their ambiguous relationship to the market. We then examine how far Amartya Sen's Capabilities Approach provides a framework for locating social rights within a market setting. We argue that Sen's non-dogmatic, context-orientated approach to defining the meaning of capabilities offers a viable way forw...

  10. COMPLEMENTARITY OF INFORMATION TECHNOLOGY AND MARKETING CAPABILITIES

    OpenAIRE

    RAUL ALEXANDRU HUȚU

    2015-01-01

    This paper study the relation between information technology and marketing capabilities. The interface between marketing and information technology forms the subject of numerous empirical and conceptual research. The expanding adoption of information technology in marketing implies the knowledge about the e-marketing capabilities development factors and the potential of these capabilities to generate competitive advantage and to improve firm’s performance. The results of recent st...

  11. An Institutional View of Organizational Capabilities

    OpenAIRE

    Reinert do Nascimento, Mauricio; Bandeira-De-Mello, Rodrigo

    2008-01-01

    The literature of organizational capabilities has overlooked the role of values. We present an institutionalist view of the capability phenomenon accounting for the values occurring in three levels: in the action at routine level, at the organization level and at the institutional environment level. The mutual influences among these three levels are needed to analyze capability dynamics in its entirety. Central to our argument is the Weberian notion of social action and rationality, and the c...

  12. Delirium assessment in Intensive Care Unit in one hospital:current practice and perceived barriers%某医院ICU护士谵妄评估现状及障碍因素调查

    Institute of Scientific and Technical Information of China (English)

    李智; 田永明; 李霞; 唐志红; 胡秀英

    2016-01-01

    Objective: To investigate the current practices of delirium assessment and analyze the perceived barriers among ICU nurses, and to provide reference to improve delirium assessment in ICU. Methods: A questionnaire survey was implemented among 256 ICU nurses in one hospital in Sichuan province. Results: 94.9% nurses had the experiences of caring delirium patients in ICU. Preferred methods for assessing delirium included clinical experience (80.5%), delirium assessment tools (14.5%), and psychiatric consultation (5.0%). The top three perceived barriers were dififculties in assessing intubated patients, assessing sedative patients and lack of delirium assessment knowledge. Nurses who assessed by clinical experience, who had never received related educations and who thought they had insufifcient knowledge, had higher scores of barriers. Conclusion: The current practices of ICU delirium assessment were unsatisfying, and the main barriers were lack of skills and knowledge.%目的:调查ICU护士谵妄评估实施现状,分析影响其评估的障碍因素,为促进ICU谵妄评估实践提供参考依据。方法:采用自行设计的问卷对四川省某医院256位ICU护士进行调查。结果:94.9%的护士护理过谵妄患者,80.5%的护士通过临床经验识别谵妄,14.5%通过评估工具,5.0%则是通过精神科医生会诊意见。插管患者评估困难、镇静患者评估困难及认为自己缺乏ICU谵妄评估相关知识是ICU谵妄评估的三大障碍因素。通过临床经验评估谵妄者、未接受过谵妄评估培训者、自评相关知识不能满足临床工作者的障碍因素得分更高,差异有统计学意义。结论:ICU谵妄评估现状尚须改善,护士缺乏谵妄评估相关技能和知识是主要障碍因素。

  13. Aerodynamics Laboratory Facilities, Equipment, and Capabilities

    Data.gov (United States)

    Federal Laboratory Consortium — The following facilities, equipment, and capabilities are available in the Aerodynamics Laboratory Facilities and Equipment (1) Subsonic, open-jet wind tunnel with...

  14. Esourcing capability model for service providers

    CERN Document Server

    Hefley, Keith M Heston and Bill; Hyder, Elaine

    2010-01-01

    The eSourcing Capability Model for Service Providers (eSCM-SP) is the best practices model that supports sourcing organizations successfully manage and reduce their risks and improve their capabilities across the entire sourcing life-cycle. It addresses the critical issues related to IT-enabled sourcing (eSourcing) for both outsourced and in-sourced (shared services) agreements. Each of the Model's 84 Practice is distributed along three easy to follow dimensions: Sourcing Life-cycle, Capability Area, and Capability Level, and have been applied in IT, BPO, and KPO settings.The eSCM-SP has been

  15. Methods of ecological capability evaluation of forest

    International Nuclear Information System (INIS)

    In this research common methods of ecological capability evaluation of forests were reviewed and limitations for performance were analysed. Ecological capability of forests is an index that show site potential in several role of wood production, soil conservation, flood control, biodiversity, conservation and water supply. This index is related to ecological characteristics of land, such as soil, micro climate, elevation, slope and aspect that affect potential of sites. Suitable method of ecological capability evaluation must be chosen according to the objective of forestry. Common methods for ecological capability evaluation include plant and animal diversity, site index curve, soil and land form, inter branches, index plants, leave analyses, analyses regeneration and ecological mapping

  16. Organizational Capabilities of the Entrepreneurial University

    Directory of Open Access Journals (Sweden)

    Lucian Gramescu

    2015-05-01

    Full Text Available Developing entrepreneurial capabilities has become a key competitiveness strategy in business across the world. Overall, organizational capabilities can provide performance improvements by taking an integrated approach to people, infrastructure and processes as means of codifying organizational learning. The paper proposes “organizational capability” as a valuable tool for universities who seek to develop their competitiveness entrepreneurially, especially across the EU, where higher education is no longer a guarantee for employment and alternatives are sorely needed. For this purpose, we explore conceptualizations of organizational capabilities, propose an integrative model and apply it to learn more about the development of capability from practice at Aalto University in Finland.

  17. Do Acquirer Capabilities Affect Acquisition Performance? Examining Strategic and Effectiveness Capabilities in Acquirers

    OpenAIRE

    Mudde, Paul A.; Brush, Thomas

    2006-01-01

    This paper examines acquisition performance from the perspective of acquirer capabilities. It argues that the strategic capabilities underpinning a firm’s competitive strategy can be utilized to create economic value in acquisitions. Acquirers with strong cost leadership capabilities are expected to leverage these capabilities to reduce post-acquisition costs as they integrate acquisition targets. Acquirers with strong differentiation capabilities are expected to utilize their strategic capab...

  18. Spin current

    CERN Document Server

    Valenzuela, Sergio O; Saitoh, Eiji; Kimura, Takashi

    2012-01-01

    In a new branch of physics and technology called spin-electronics or spintronics, the flow of electrical charge (usual current) as well as the flow of electron spin, the so-called 'spin current', are manipulated and controlled together. This book provides an introduction and guide to the new physics and application of spin current.

  19. Health care supervisors and employee relations success: three C's a day keep the union away.

    Science.gov (United States)

    Bolon, D S

    1995-09-01

    The health care industry is experiencing rapid change and uncertainty. Given the tremendous amount of instability in the industry, many observers are not surprised at the high level of militancy currently being displayed by many health care workers. However, it should not automatically follow that turbulent times will lead to uneasy management-labor relations. Maintaining nonunion status depends largely on the employee relations skills and capabilities of first-line supervisors. The article reviews and discusses three key attributes (communication, consideration, and commitment) that supervisors must display in order to promote employee satisfaction and remain union-free. Practical guidelines and suggestions are provided. PMID:10144616

  20. Advance care directives

    Science.gov (United States)

    ... advance directive; Do-not-resuscitate - advance directive; Durable power of attorney - advance care directive; POA - advance care directive; Health care agent - advance care directive; Health care proxy - ...

  1. Methodological Individualism and the Organizational Capabilities Approach

    DEFF Research Database (Denmark)

    Felin, Teppo; Foss, Nicolai Juul

    2004-01-01

    critical individual-levelconsiderations, including individual action and heterogeneity. In this note we do not denyor reject the notion of routines or capabilities per se, but rather call for an increasedemphasis on how these collective structures originate and change as a result of individualactions.......Key words: Organizational capabilities, methodological individualism, philosophy ofsocial science...

  2. A framework for offshore vendor capability development

    Science.gov (United States)

    Yusuf Wibisono, Yogi; Govindaraju, Rajesri; Irianto, Dradjad; Sudirman, Iman

    2016-02-01

    Offshore outsourcing is a common practice conducted by companies, especially in developed countries, by relocating one or more their business processes to other companies abroad, especially in developing countries. This practice grows rapidly owing to the ease of accessing qualified vendors with a lower cost. Vendors in developing countries compete more intensely to acquire offshore projects. Indonesia is still below India, China, Malaysia as main global offshore destinations. Vendor capability is among other factors that contribute to the inability of Indonesian vendor in competing with other companies in the global market. Therefore, it is essential to study how to increase the vendor's capability in Indonesia, in the context of global offshore outsourcing. Previous studies on the vendor's capability mainly focus on capabilities without considering the dynamic of capabilities due to the environmental changes. In order to be able to compete with competitors and maintain the competitive advantage, it is necessary for vendors to develop their capabilities continuously. The purpose of this study is to develop a framework that describes offshore vendor capability development along the client-vendor relationship stages. The framework consists of three main components, i.e. the stages of client-vendor relationship, the success of each stage, and the capabilities of vendor at each stage.

  3. Knowledge Perspectives on Advancing Dynamic Capability

    NARCIS (Netherlands)

    van Reijsen, J.

    2014-01-01

    Dynamic Capability is the organizational capacity to timely adapt to a changing market environment by reconfiguring resources and routines in order to stay competitive. Although dynamic capability is considered the Holy Grail of strategic management, a connection to the knowledge management domain i

  4. Capability Development in an Offshoring Context

    DEFF Research Database (Denmark)

    Jaura, Manya

    in the offshore unit. Guided by the research question – what drives or impedes capability development in an offshoring context – the purpose of this thesis is to investigate how an idiosyncratic offshoring context affects capability development. The thesis consists of three papers using various datasets...

  5. Marketing capabilities: do they matter in INVs?

    OpenAIRE

    Blesa Pérez, Andreu; Ripollés Meliá, María; Monferrer Tirado, Diego

    2010-01-01

    This paper examines the influence that marketing capabilities developed in international new ventures can have on their international performance and international geographical diversification. Rapid entry in foreign markets is also highlighted as a factor contributing to the development of marketing capabilities in international new ventures. The central concept advanced in the paper is that international new ventures generate competitive advantages associated with early internationalisation...

  6. Cultivating Human Capabilities in Venturesome Learning Environments

    Science.gov (United States)

    Hogan, Padraig

    2013-01-01

    The notion of competencies has been a familiar feature of educational reform policies for decades. In this essay, Padraig Hogan begins by highlighting the contrasting notion of capabilities, pioneered by the research of Amartya Sen and Martha Nussbaum. An educational variant of the notion of capabilities then becomes the basis for exploring…

  7. Organizational Capabilities of the Entrepreneurial University

    OpenAIRE

    Lucian Gramescu; Nicolae Bibu

    2015-01-01

    Developing entrepreneurial capabilities has become a key competitiveness strategy in business across the world. Overall, organizational capabilities can provide performance improvements by taking an integrated approach to people, infrastructure and processes as means of codifying organizational learning. The paper proposes “organizational capability” as a valuable tool for universities who seek to develop their competitiveness entrepreneurially, especially across the EU, where hig...

  8. Developing Technological Capabilities in Agro-Industry

    DEFF Research Database (Denmark)

    Whitfield, Lindsay

    2012-01-01

    This article examines the emergence and trajectory of a new agro-industry in Ghana, the pineapple export industry, using the technological capabilities approach. It explains the limited expansion of the industry and its declining competitiveness in the face of new competition by looking at how Gh...... broader implications for developing new agro-industries in Ghana as well as other African countries.......This article examines the emergence and trajectory of a new agro-industry in Ghana, the pineapple export industry, using the technological capabilities approach. It explains the limited expansion of the industry and its declining competitiveness in the face of new competition by looking at how...... Ghanaian exporters developed technological capabilities initially and the incentives and disincentives to building on those capabilities. The article argues that at the heart of the industry's crisis was an inability to further develop technological capabilities. The crisis had systemic features that have...

  9. Capabilities and Equality of Health II

    DEFF Research Database (Denmark)

    Keiding, Hans

    capability approach to questions of health or equality. In the present paper we extend the notion of rationalizing orderings of capabilities to a dynamical context, in the sense that the utility function is not yet revealed to the individual at the time when the capabilities are ordered. It turns out that......The concept of capabilities, introduced originally by Sen, has inspired many researchers but has not found any simple formal representation which might be instrumental in the construction of a comprehensive theory of equality. In a previous paper (Keiding, 2005), we investigated whether preferences...... over capabilities as sets of functionings can be rationalized by maximization of a suitable utility function over the set of functionings. Such a rationalization turned out to be possible only in cases which must be considered exceptional and which do not allowfor interesting applications of the...

  10. [Current management of epilepsy].

    Science.gov (United States)

    Mizobuchi, Masahiro

    2013-09-01

    Epilepsy is one of the most common neurological disorders. Global neurological knowledge is essential for differential diagnosis of epileptic syndromes due to the diversity of ictal semiology, causes and syndromes. Neurologists play an important role in planning the medical care for patients with epilepsy, as medication is the most fundamental therapeutic strategy. Some patients with early-onset epilepsy require joint care by pediatric neurologists, those with intractable epilepsy by neurosurgeons, and those with psychological comorbidity by psychiatrists, and neurologists should play a coordinating role. While there is a great need for neurologists to participate in epilepsy care, neurologists in Japan currently do not participate substantially in the epilepsy management system. It is necessary to train more neurologists who can provide epilepsy care and conduct basic and clinical research on epilepsy by providing continuous education on epilepsy for general neurologists as well as pre- and post-graduate medical students. Most of the patients who require long-term treatment experience many medical problems and social handicaps, such as adverse effects of medication, social stigma, educational disadvantages and difficulties in obtaining driver's license. To improve the quality of life of patients with epilepsy, it is desirable to build broad medical-social networks participated by patients, doctors, neurological nurses, psychologists, social workers, school teachers, managers of employment support facilities and care givers.

  11. [Current management of epilepsy].

    Science.gov (United States)

    Mizobuchi, Masahiro

    2013-09-01

    Epilepsy is one of the most common neurological disorders. Global neurological knowledge is essential for differential diagnosis of epileptic syndromes due to the diversity of ictal semiology, causes and syndromes. Neurologists play an important role in planning the medical care for patients with epilepsy, as medication is the most fundamental therapeutic strategy. Some patients with early-onset epilepsy require joint care by pediatric neurologists, those with intractable epilepsy by neurosurgeons, and those with psychological comorbidity by psychiatrists, and neurologists should play a coordinating role. While there is a great need for neurologists to participate in epilepsy care, neurologists in Japan currently do not participate substantially in the epilepsy management system. It is necessary to train more neurologists who can provide epilepsy care and conduct basic and clinical research on epilepsy by providing continuous education on epilepsy for general neurologists as well as pre- and post-graduate medical students. Most of the patients who require long-term treatment experience many medical problems and social handicaps, such as adverse effects of medication, social stigma, educational disadvantages and difficulties in obtaining driver's license. To improve the quality of life of patients with epilepsy, it is desirable to build broad medical-social networks participated by patients, doctors, neurological nurses, psychologists, social workers, school teachers, managers of employment support facilities and care givers. PMID:24018740

  12. Enhance End-of-Life Care

    Science.gov (United States)

    ... Home Current Issue Past Issues Enhance End-of-Life Care Past Issues / Spring 2008 Table of Contents ... lead in the efforts to improve end-of-life care for patients and their families. Photo: Corbis ...

  13. Effective health care for older people living and dying in care homes: a realist review

    OpenAIRE

    Goodman, Claire; Dening, Tom; Gordon, Adam L.; Davies, Susan L.; Meyer, Julienne; Martin, Finbarr C; Gladman, John R F; Bowman, Clive; Victor, Christina; Handley, Melanie; Gage, Heather; Iliffe, Steve; ZUBAIR, MARIA

    2016-01-01

    Background Care home residents in England have variable access to health care services. There is currently no coherent policy or consensus about the best arrangements to meet these needs. The purpose of this review was to explore the evidence for how different service delivery models for care home residents support and/or improve wellbeing and health-related outcomes in older people living and dying in care homes. Methods We conceptualised models of health care provision to care homes as comp...

  14. Organizational Fragmentation and Care Quality in the U.S. Health Care System

    OpenAIRE

    Randall D. Cebul; James B. Rebitzer; Taylor, Lowell J.; Mark Votruba

    2008-01-01

    Many goods and services can be readily provided through a series of unconnected transactions, but in health care close coordination over time and within care episodes improves both health outcomes and efficiency. Close coordination is problematic in the US health care system because the financing and delivery of care is distributed across a variety of distinct and often competing entities, each with its own objectives, obligations and capabilities. These fragmented organizational structures l...

  15. 军队离休干部医疗保障现状及对策研究%Current situation of and countermeasure for medical care for retired military officers

    Institute of Scientific and Technical Information of China (English)

    陈琳; 郭雨禾; 张凡; 高嵩; 韩宁; 侯晓敏; 毛常学

    2012-01-01

    Objective To find a solution to rational use of funds for health care and to gain a clear idea of the current situation of medical overall planning for retired military officers in China so as to improve the ability of three levels of medi -cal overall planning. Methods By means of literature research , onsite study and statistical analysis , we analyzed the data on medical expenses , out-patient service, hospital service , types of disease, consumption costs , specific diseases fees and constitutional proportion between 2006 and 2010. Results and Conclusion Based on the real situation and existing problems , countermeasures for medical overall planning for retired military officers are proposed .%目的 探索卫生事业费调整后,我军离休干部医疗统筹中干休所经费结余与不足并存等问题的途径和方法,掌握全军离休干部医疗统筹保障现状,提高总部、军区及干休所三级医疗统筹效能,为下一步加强离休干部医疗统筹管理提供依据.方法 采取文献检索、实地调研和数据分析等方法,对2006~2010年全军离休干部干休所卫生事业费,门诊、住院人次、病种、消耗费用情况,大病与特殊项目费用消耗及其构成比的数据进行汇总分析,对干休所、离休干部的基本情况、存在问题进行梳理和归纳.结果 与结论 从离休干部医疗统筹的基本情况、存在问题和对策3个方面,深入研究了具体措施和建议.

  16. CTH reference manual : composite capability and technologies.

    Energy Technology Data Exchange (ETDEWEB)

    Key, Christopher T.; Schumacher, Shane C.

    2009-02-01

    The composite material research and development performed over the last year has greatly enhanced the capabilities of CTH for non-isotropic materials. The enhancements provide the users and developers with greatly enhanced capabilities to address non-isotropic materials and their constitutive model development. The enhancements to CTH are intended to address various composite material applications such as armor systems, rocket motor cases, etc. A new method for inserting non-isotropic materials was developed using Diatom capabilities. This new insertion method makes it possible to add a layering capability to a shock physics hydrocode. This allows users to explicitly model each lamina of a composite without the overhead of modeling each lamina as a separate material to represent a laminate composite. This capability is designed for computational speed and modeling efficiency when studying composite material applications. In addition, the layering capability also allows a user to model interlaminar mechanisms. Finally, non-isotropic coupling methods have been investigated. The coupling methods are specific to shock physics where the Equation of State (EOS) is used with a nonisotropic constitutive model. This capability elastically corrects the EOS pressure (typically isotropic) for deviatoric pressure coupling for non-isotropic materials.

  17. Community psychology and the capabilities approach.

    Science.gov (United States)

    Shinn, Marybeth

    2015-06-01

    What makes for a good life? The capabilities approach to this question has much to offer community psychology, particularly with respect to marginalized groups. Capabilities are freedoms to engage in valued social activities and roles-what people can do and be given both their capacities, and environmental opportunities and constraints. Economist Amartya Sen's focus on freedoms and agency resonates with psychological calls for empowerment, and philosopher Martha Nussbaum's specification of requirements for a life that is fully human provides an important guide for social programs. Community psychology's focus on mediating structures has much to offer the capabilities approach. Parallels between capabilities, as enumerated by Nussbaum, and settings that foster positive youth development, as described in a National Research Council Report (Eccles and Gootman (Eds) in Community programs to promote youth development. National Academy Press, Washington, 2002) suggest extensions of the approach to children. Community psychologists can contribute to theory about ways to create and modify settings to enhance capabilities as well as empowerment and positive youth development. Finally, capabilities are difficult to measure, because they involve freedoms to choose but only choices actually made or enacted can be observed. The variation in activities or goals across members of a setting provides a measure of the capabilities that the setting fosters.

  18. Towards an Organizational Economics of Heterogeneous Capabilities

    DEFF Research Database (Denmark)

    Foss, Nicolai Juul

    The notion of “capability” has long been influential in management research as an approach to address firm-level heterogeneity and heterogeneity in competitive outcomes. I discuss how recent advances in economics may allow for a more rigorous understanding and measurement of capability that take ...... organizational practices into account. However, economists may also learn from work on capabilities in management research.......The notion of “capability” has long been influential in management research as an approach to address firm-level heterogeneity and heterogeneity in competitive outcomes. I discuss how recent advances in economics may allow for a more rigorous understanding and measurement of capability that take...

  19. A Capability Approach for the European Union

    OpenAIRE

    Eiffe, Franz F.

    2008-01-01

    The aim of this paper is to develop a new concept for the EU in order to define and measure poverty no longer on the basis of income1, but on so called capabilities to argue for a capability oriented social policy. The capability approach (CA) was originally developed by Nobel laureate Amartya Sen2 and can be interpreted as critique of the utilitarian tradition of standard economics. In Sen's view, mainstream economic analysis operates on a very narrow base and does not include central inform...

  20. Prehospital care in Indonesia

    OpenAIRE

    Pitt, E.; Pusponegoro, A

    2005-01-01

    Current system: Hospitals of varying standards are widespread but have no system of emergency ambulance or patient retrieval. Indonesia's only public emergency ambulance service, 118, is based in five of the biggest cities and is leading the way in paramedic training and prehospital care.

  1. Care Ethics in Education.

    Science.gov (United States)

    Shelby, Candice L.

    2003-01-01

    Difficulties with current models of ethics education (correct reasoning, virtue theory, directive moral education) include emphasis on reward/punishment and a presumptive bias toward abstract reasoning. Teaching a care-based ethics would promote a fuller notion of mature moral agents and broaden the school climate beyond compliance. (Contains 19…

  2. Classifying organisational capabilities by their nature and role for technological capability

    OpenAIRE

    Rousseva, R.

    2009-01-01

    Based on critical literature review this research highlights a number of gaps in the existing treatment of technological and organisational capabilities. It has been recognised that organisational capabilities have an important role to play in development of technological capabilities both in latecomer and advanced companies. However, different studies focus on different organisational capabilities and prescribe them different importance. Further, despite the extensive research on organisatio...

  3. Classifying organisational capabilities by their nature and role for technological capability

    NARCIS (Netherlands)

    Rousseva, R.

    2009-01-01

    Based on critical literature review this research highlights a number of gaps in the existing treatment of technological and organisational capabilities. It has been recognised that organisational capabilities have an important role to play in development of technological capabilities both in lateco

  4. The Impact of IT Capability on Employee Capability, Customer Value, Customer Satisfaction, and Business Performance

    Science.gov (United States)

    Chae, Ho-Chang

    2009-01-01

    This study empirically examines the impact of IT capability on firms' performance and evaluates whether firms' IT capabilities play a role in improving employee capability, customer value, customer satisfaction, and ultimately business performance. The results were based on comparing the business performance of the IT leader companies with that of…

  5. Adaptive media content architecture regarding users capabilities

    OpenAIRE

    Cuenca Gil, David

    2009-01-01

    Nowadays, it's common that each user has different capabilities and each media content has different requirements. So, in this project will be studied and implement a first approach how to adapt media content stored in repositories to users capabilities. Different kinds of video content will be studied, and how their requirements can be changed with a good subjective quality for the user. Depending on the kind of content, different types of changes could be done in order to decrease the video...

  6. Descriptors of server capabilities in China

    DEFF Research Database (Denmark)

    Adeyemi, Oluseyi; Slepniov, Dmitrij; Wæhrens, Brian Vejrum;

    2013-01-01

    China with the huge market potential it possesses is an important issue for subsidiaries of western multinational companies. The objective of this paper is therefore to strengthen researchers’ and practitioners’ perspectives on what are the descriptors of server capabilities. The descriptors...... are relevant to determine subsidiary roles and as an indication of the capabilities required. These descriptors are identified through extensive literature review and validated by case studies of two Danish multinational companies subsidiaries operating in China. They provided the empirical basis...

  7. Seeing Market Orientation through a Capabilities Lens

    OpenAIRE

    Foley, Anthony; Fahy, John

    2009-01-01

    Purpose – The purpose of this paper is to examine how conceptualising market orientation within a capabilities framework may assist in developing further understanding of the construct. Design/methodology/approach – Compelling issues in the market orientation literature relating to the nature of the market orientation construct, the relationship of the construct with performance, and identifying antecedents to market orientation are discussed. The capabilities perspective is explored in th...

  8. Porflow Capabilities, Usage, History, and Testing

    International Nuclear Information System (INIS)

    To support closure of the Savannah River Site High Level Waste tanks, the PORFLOW computer program is being applied to predict long term movement of residual contaminants from the tanks. The PORFLOW program has greater capabilities than simpler programs that have been used previously, and PORFLOW results have been accepted by state and federal regulators throughout the United States. This document briefly discusses the PORFLOW capabilities and presents lists of reports showing PORFLOW's usage history and testing

  9. Aging and DNA repair capability. [Review

    Energy Technology Data Exchange (ETDEWEB)

    Tice, R R

    1977-01-01

    A review of the literature on DNA repair processes in relation to aging is presented under the following headings: DNA repair processes; age-related occurrence of unrepaired DNA lesions; DNA repair capability as a function of age; tissue-specific DNA repair capability; acceleration of the aging process by exposure to DNA damaging agents; human genetic syndromes; and longevity and DNA repair processes. (HLW)

  10. Tool for evaluating organizational emergency management capability.

    OpenAIRE

    Ek, Åsa; Borell, Jonas

    2010-01-01

    Crises or emergencies have drawn attention to the need of good emergency management capability in affected organizations or regions. An ongoing subproject in a Swedish multidisciplinary research programme aims at identifying areas or processes that are potentially important to include in the work of developing and improving an organization’s resilience and emergency management capability. This paper presents preliminary findings from interviews conducted to identify such areas or processes an...

  11. A Study Of Manufacturing Competitive Capabilities (...)

    OpenAIRE

    Luis Eduardo Solís

    2002-01-01

    (WP07/02 Clave pdf) One important reason behind total quality management implementation failure has been attributed to the poor understanding of the interdependence between quality management practices and competitive capabilities. Despite, ample literature on total quality management (TQM) techniques, no comprehensive and systematic examination of TQM relating to manufacturing competitive capabilities has been conducted. The purpose of this study is to empirically assess the relationship bet...

  12. Capabilities and The Theory of The Firm

    OpenAIRE

    Nicolai J Foss

    2009-01-01

    The recent decade has witnessed a strong expansion of work on the firm, both from a capabilities perspective and from a contractual perspective. These two bodies of theories are often thought to be fundamentally different, because their domains of applications are different (knowledge-accumulation vs contracts and incentives). However, we need to integrate propositions from capabilities perspectives with ideas about economic organization (markets, hybrids, firms). This is because only a more ...

  13. NASA'S Space Launch System Mission Capabilities for Exploration

    Science.gov (United States)

    Creech, Stephen D.; Crumbly, Christopher M.; Robinson, Kimberly F.

    2015-01-01

    Designed to enable human space exploration missions, including eventual landings on Mars, NASA’s Space Launch System (SLS) represents a unique launch capability with a wide range of utilization opportunities, from delivering habitation systems into the lunar vicinity to high-energy transits through the outer solar system. Developed with the goals of safety, affordability and sustainability in mind, SLS is a foundational capability for NASA’s future plans for exploration, along with the Orion crew vehicle and upgraded ground systems at the agency’s Kennedy Space Center. Substantial progress has been made toward the first launch of the initial configuration of SLS, which will be able to deliver more than 70 metric tons of payload into low Earth orbit (LEO), greater mass-to-orbit capability than any contemporary launch vehicle. The vehicle will then be evolved into more powerful configurations, culminating with the capability to deliver more than 130 metric tons to LEO, greater even than the Saturn V rocket that enabled human landings on the moon. SLS will also be able to carry larger payload fairings than any contemporary launch vehicle, and will offer opportunities for co-manifested and secondary payloads. Because of its substantial mass-lift capability, SLS will also offer unrivaled departure energy, enabling mission profiles currently not possible. Early collaboration with science teams planning future decadal-class missions have contributed to a greater understanding of the vehicle’s potential range of utilization. This presentation will discuss the potential opportunities this vehicle poses for the planetary sciences community, relating the vehicle’s evolution to practical implications for mission capture. As this paper will explain, SLS will be a global launch infrastructure asset, employing sustainable solutions and technological innovations to deliver capabilities for space exploration to power human and robotic systems beyond our Moon and in to

  14. Barriers to Care for Depressed Older People: Perceptions of Aged Care among Medical Professionals

    Science.gov (United States)

    McCabe, Marita P.; Davison, Tanya; Mellor, David; George, Kuruvilla

    2009-01-01

    The current study evaluated barriers to detection of depression among older people. Focus groups were conducted with 21 professional carers, 4 nurses, 10 general practitioners, and 7 aged care managers. The results demonstrated that care for older people is primarily focused on physical care. Further, staff resources, a lack of continuity of care,…

  15. Supportive Care.

    Science.gov (United States)

    Olsen, Pia Riis; Lorenzo, Rosalía

    2016-01-01

    This chapter takes its point of departure in psychosocial aspects of supportive care in adolescent and young adult cancer care. The purpose is to describe some of the challenges that these young people face following a cancer diagnosis and guide healthcare professionals in how to provide care that improves the quality of life. In most hospitals and healthcare systems, adolescents and young adults are cared for and treated in settings for children or adults. Accordingly, healthcare professionals may lack attention to and knowledge about what characterize young peoples' life situation, their special needs and how to meet them. The topics we include in the chapter are the following: the youth friendly environment, social support and social network, parents, information during a psychosocial crisis event, the use of HEADSS, peer support, fertility, body image and self-esteem, after treatment and future challenges and palliative and end of life care. PMID:27595353

  16. TOWARD DIGITAL DYNAMIC CAPABILITIES - A THEORETICAL EXPLORATION

    Directory of Open Access Journals (Sweden)

    Zhenyu Yang

    2011-06-01

    Full Text Available Internet/Management of Information System study is a burgeoning, cross-disciplinary field in business and technology. Its development always accompanies evolving industry change, so it seems that the best strategy is not to use only existing theories for researching on-going phenomena and future evolution of Internet related issues. Alternatively, theorists in this particular field have a strong tradition of drawing from diverse aspects of social science such as human behavior, economics, strategy, and general management to derive rich discussion to address practitioners’ concerns.New theories are continuously brought into this field, particularly those that dominate in other areas with different contexts. The exposure this contributes to theory in the Information System/Internet context could potentially yield critical insights and provide feedback for further refinement of theories.This paper provides a brief review of the dynamic capability framework then incorporates the latest expansion of IT capabilities. This brings the Enterprise 2.0 system architecture into the discussion of popular management frameworks. Such an extension is expected to generate a more detailed categorization of digital dynamic capabilities. First, the key terminology of digital dynamic capabilities is presented. Second, the importance of organizational and environmental factors is emphasized in dynamic capabilities analysis. Finally, future empirical research with digital dynamic capabilities is considered.

  17. Health, vital goals, and central human capabilities.

    Science.gov (United States)

    Venkatapuram, Sridhar

    2013-06-01

    I argue for a conception of health as a person's ability to achieve or exercise a cluster of basic human activities. These basic activities are in turn specified through free-standing ethical reasoning about what constitutes a minimal conception of a human life with equal human dignity in the modern world. I arrive at this conception of health by closely following and modifying Lennart Nordenfelt's theory of health which presents health as the ability to achieve vital goals. Despite its strengths I transform Nordenfelt's argument in order to overcome three significant drawbacks. Nordenfelt makes vital goals relative to each community or context and significantly reflective of personal preferences. By doing so, Nordenfelt's conception of health faces problems with both socially relative concepts of health and subjectively defined wellbeing. Moreover, Nordenfelt does not ever explicitly specify a set of vital goals. The theory of health advanced here replaces Nordenfelt's (seemingly) empty set of preferences and society-relative vital goals with a human species-wide conception of basic vital goals, or 'central human capabilities and functionings'. These central human capabilities come out of the capabilities approach (CA) now familiar in political philosophy and economics, and particularly reflect the work of Martha Nussbaum. As a result, the health of an individual should be understood as the ability to achieve a basic cluster of beings and doings-or having the overarching capability, a meta-capability, to achieve a set of central or vital inter-related capabilities and functionings.

  18. Materials Capability Review Los Alamos National Laboratory April 29-May 2, 2012

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Antoinette J [Los Alamos National Laboratory

    2012-04-20

    Los Alamos National Laboratory (LANL) uses Capability Reviews to assess the quality and institutional integration of science, technology and engineering (STE) and to advise Laboratory Management on the current and future health of LANL STE. The capabilities are deliberately chosen to be crosscutting over the Laboratory and therefore will include experimental, theoretical and simulation disciplines from multiple line organizations. Capability Reviews are designed to provide a more holistic view of the STE quality, integration to achieve mission requirements, and mission relevance. The scope of these capabilities necessitate that there will be significant overlap in technical areas covered by capability reviews (e.g., materials research and weapons science and engineering). In addition, LANL staff may be reviewed in different capability reviews because of their varied assignments and expertise. The principal product of the Capability Review is the report that includes the review committee's assessments, recommendations, and recommendations for STE.

  19. PRODUCTION CAPABILITIES EFFICIENCY PREFABRICATION ERECTION OF BUILDINGS

    Directory of Open Access Journals (Sweden)

    SOKOLOV I. A.

    2015-12-01

    Full Text Available Formulation of the problem. the largest reserves of increase of efficiency of building production concluded in the decision of problems of ensuring compliance with the technological properties of space-planning and constructive decisions of buildings organizational and technological conditions of manufacturing processes. Tendencies of development of the society determined the growth in construction, complexity of design rhenium building and makes it necessary to reduce the time of construction of buildings and reduce the cost of construction and installation works. In recent years, the architectural and compositional solutions constructed buildings are increasingly conflict with organizational, technological and technical capacity building organizations. This problem is solved by the improvement and development of new technologies of building production, the use of more modern construction machines and mechanisms. The implementation of the tasks can be solved by creating a space-planning and constructive decisions of buildings corresponding possibilities of building organizations and the creation of fundamentally new technologies. Currently, there is no single comprehensive approach allows to establish the extent to which space-constructive decisions of buildings technological possibilities of building production. Imbalance intentions and capabilities results in a significant increase in financial expenses for the construction of the building. The purpose of the article. It is necessary to propose a method of assessing the level of technological prefabrication construction of buildings, the application of which will provide an opportunity to improve the full process of erection of the building and, as a consequence, increase its efficiency by increasing the extent to which the technological properties of space-planning and constructive decisions of buildings organizational and technological conditions of manufacturing processes, pogruzki

  20. Physical examinations and laboratory tests in antenatal care visits in Denmark. Do reported practice and current official guidelines concord with results of literature reviews? A nationwide study of the public scheme of shared antenatal care in general practice, centres of midwifery and hospital

    DEFF Research Database (Denmark)

    Kristensen, F B; Andersen, K V; Andersen, A M;

    1995-01-01

    To analyse physical examinations and laboratory tests reported in antenatal care visits in relation to official guidelines and reviews of appropriateness.......To analyse physical examinations and laboratory tests reported in antenatal care visits in relation to official guidelines and reviews of appropriateness....

  1. Palliative care in home care: perceptions of occupational therapists

    Directory of Open Access Journals (Sweden)

    Séfora Gomez Portela

    2015-03-01

    Full Text Available This research aimed at understanding and reflecting on the perceptions of occupational therapists regarding the implementation of palliative care in home care. This is an exploratory, qualitative study, through semi-structured interviews, conducted in the second semester of 2012 with eight occupational therapists with experience in palliative care in the city of São Paulo. Content analysis identified four themes: characterization and professional trajectory in the field, understanding the concepts of palliative care, home care and palliative care, and occupational therapy and palliative care in home care. The results suggest that the role of the occupational therapist in this field has taken place at different levels of health care, being addressed to people with varying needs. The use of the concept of palliative care by the interviewees exceeds the notion of end of life, following the changes in the epidemiological transition. They understand that professional services follow the trend of national palliative care services with focus on specialized levels, but manifest the importance of its implementation in primary and home care. Among the barriers to practice, they identified the complexity of “being at home “, peculiarities of palliative care with high cost demands, lack of infrastructure and implementation of the current policy. Professional training and scientific roduction in the area were viewed as inadequate, although they identified a call for change. The interviewees recognized palliative care in home care as a strong professional field, but one still requiring study and discussions regarding its limits and conditions of implementation, especially in the Unified Health System.

  2. First Materials Science Research Facility Rack Capabilities and Design Features

    Science.gov (United States)

    Cobb, S.; Higgins, D.; Kitchens, L.; Curreri, Peter (Technical Monitor)

    2002-01-01

    The first Materials Science Research Rack (MSRR-1) is the primary facility for U.S. sponsored materials science research on the International Space Station. MSRR-1 is contained in an International Standard Payload Rack (ISPR) equipped with the Active Rack Isolation System (ARIS) for the best possible microgravity environment. MSRR-1 will accommodate dual Experiment Modules and provide simultaneous on-orbit processing operations capability. The first Experiment Module for the MSRR-1, the Materials Science Laboratory (MSL), is an international cooperative activity between NASA's Marshall Space Flight Center (MSFC) and the European Space Agency's (ESA) European Space Research and Technology Center (ESTEC). The MSL Experiment Module will accommodate several on-orbit exchangeable experiment-specific Module Inserts which provide distinct thermal processing capabilities. Module Inserts currently planned for the MSL are a Quench Module Insert, Low Gradient Furnace, and a Solidification with Quench Furnace. The second Experiment Module for the MSRR-1 configuration is a commercial device supplied by MSFC's Space Products Development (SPD) Group. Transparent furnace assemblies include capabilities for vapor transport processes and annealing of glass fiber preforms. This Experiment Module is replaceable on-orbit. This paper will describe facility capabilities, schedule to flight and research opportunities.

  3. Core capabilities and technical enhancement, FY-98 annual report

    Energy Technology Data Exchange (ETDEWEB)

    Miller, D.L.

    1999-04-01

    The Core Capability and Technical Enhancement (CCTE) Program, a part of the Verification, Validation, and Engineering Assessment Program, was implemented to enhance and augment the technical capabilities of the Idaho National Engineering and Environmental Laboratory (INEEL). The purpose for strengthening the technical capabilities of the INEEL is to provide the technical base to serve effectively as the Environmental Management Laboratory for the Department of Energy's Office of Environmental Management (EM). An analysis of EM's science and technology needs as well as the technology investments currently being made by EM across the complex was used to formulate a portfolio of research activities designed to address EM's needs without overlapping work being done elsewhere. An additional purpose is to enhance and maintain the technical capabilities and research infrastructure at the INEEL. This is a progress report for fiscal year 1998 for the five CCTE research investment areas: (a) transport aspects of selective mass transport agents, (b) chemistry of environmental surfaces, (c) materials dynamics, (d) characterization science, and (e) computational simulation of mechanical and chemical systems. In addition to the five purely technical research areas, this report deals with the science and technology foundations element of the CCTE from the standpoint of program management and complex-wide issues. This report also provides details of ongoing and future work in all six areas.

  4. Core Capabilities and Technical Enhancement -- FY-98 Annual Report

    Energy Technology Data Exchange (ETDEWEB)

    Miller, David Lynn

    1999-04-01

    The Core Capability and Technical Enhancement (CC&TE) Program, a part of the Verification, Validation, and Engineering Assessment Program, was implemented to enhance and augment the technical capabilities of the Idaho National Engineering and Environmental Laboratory (INEEL). The purpose for strengthening the technical capabilities of the INEEL is to provide the technical base to serve effectively as the Environmental Management Laboratory for the Office of Environmental Management (EM). An analysis of EM's science and technology needs as well as the technology investments currently being made by EM across the complex was used to formulate a portfolio of research activities designed to address EM's needs without overlapping work being done elsewhere. An additional purpose is to enhance and maintain the technical capabilities and research infrastructure at the INEEL. This is a progress report for fiscal year 1998 for the five CC&TE research investment areas: (a) transport aspects of selective mass transport agents, (b) chemistry of environmental surfaces, (c) materials dynamics, (d) characterization science, and (e) computational simulation of mechanical and chemical systems. In addition to the five purely technical research areas, this report deals with the science and technology foundations element of the CC&TE from the standpoint of program management and complex-wide issues. This report also provides details of ongoing and future work in all six areas.

  5. Childhood socioeconomic position and objectively measured physical capability levels in adulthood

    DEFF Research Database (Denmark)

    Birnie, Kate; Cooper, Rachel; Martin, Richard M;

    2011-01-01

    Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in ...

  6. Fuel Fabrication Capability Research and Development Plan

    Energy Technology Data Exchange (ETDEWEB)

    Senor, David J.; Burkes, Douglas

    2014-04-17

    The purpose of this document is to provide a comprehensive review of the mission of the Fuel Fabrication Capability (FFC) within the Global Threat Reduction Initiative Convert Program, along with research and development (R&D) needs that have been identified as necessary to ensuring mission success. The design and fabrication of successful nuclear fuels must be closely linked endeavors. Therefore, the overriding motivation behind the FFC R&D program described in this plan is to foster closer integration between fuel design and fabrication to reduce programmatic risk. These motivating factors are all interrelated, and progress addressing one will aid understanding of the others. The FFC R&D needs fall into two principal categories, 1) baseline process optimization, to refine the existing fabrication technologies, and 2) manufacturing process alternatives, to evaluate new fabrication technologies that could provide improvements in quality, repeatability, material utilization, or cost. The FFC R&D Plan examines efforts currently under way in regard to coupon, foil, plate, and fuel element manufacturing, and provides recommendations for a number of R&D topics that are of high priority but not currently funded (i.e., knowledge gaps). The plan ties all FFC R&D efforts into a unified vision that supports the overall Convert Program schedule in general, and the fabrication schedule leading up to the MP-1 and FSP-1 irradiation experiments specifically. The fabrication technology decision gates and down-selection logic and schedules are tied to the schedule for fabricating the MP-1 fuel plates, which will provide the necessary data to make a final fuel fabrication process down-selection. Because of the short turnaround between MP-1 and the follow-on FSP-1 and MP-2 experiments, the suite of specimen types that will be available for MP-1 will be the same as those available for FSP-1 and MP-2. Therefore, the only opportunity to explore parameter space and alternative processing

  7. Day Care: A Program in Search of a Policy.

    Science.gov (United States)

    Bikales, Gerda

    This report examines current issues relating to day care and challenges many of the policy assumptions that underlie a major public program of subsidized day care for children. A historical perspective of day care is presented and various types of day care are described. The costs and benefits of day care are examined and the relation of day care…

  8. Machine Process Capability Information Through Six Sigma

    Energy Technology Data Exchange (ETDEWEB)

    Lackner, M.F.

    1998-03-13

    A project investigating details concerning machine process capability information and its accessibility has been conducted. The thesis of the project proposed designing a part (denoted as a machine capability workpiece) based on the major machining features of a given machine. Parts are machined and measured to gather representative production, short-term variation. The information is utilized to predict the expected defect rate, expressed in terms of a composite sigma level process capability index, for a production part. Presently, decisions concerning process planning, particularly what machine will statistically produce the minimum amount of defects based on machined features and associated tolerances, are rarely made. Six sigma tools and methodology were employed to conduct this investigation at AlliedSignal FM and T. Tools such as the thought process map, factor relationship diagrams, and components of variance were used. This study is progressing toward completion. This research study was an example of how machine process capability information may be gathered for milling planar faces (horizontal) and slot features. The planning method used to determine where and how to gather variation for the part to be designed is known as factor relationship diagramming. Components-of-variation is then applied to the gathered data to arrive at the contributing level of variation illustrated within the factor relationship diagram. The idea of using this capability information beyond process planning to the other business enterprise operations is proposed.

  9. A systematic method of accountability. Sound policies allow facilities to account for the level of charity care they provide.

    Science.gov (United States)

    Schmitz, H H; Weiss, S J; Melichar, C

    1992-11-01

    Charity care policies can help hospitals accurately determine, define, and account for the level of charity care they provide. This information will help hospitals budget appropriately and measure trends that will ultimately affect the organization's viability. State governments, the federal government, and the Internal Revenue Service are more closely scrutinizing not-for-profit hospitals' tax-exempt status. As a result, the American Institute of Certified Public Accountants (AICPA) has revised its requirement to report on charity care. To meet the AICPA's requirement, healthcare providers must develop their own definition of charity and determine criteria for providing care free or at a reduced rate. Setting policies to support the organization's definition of charity is necessary for the development of internal systems that promote the early identification of individuals seeking healthcare who will be unable to pay for services. Several policy implications may result from the facility's charity care determination process. For example, patients exhibiting extreme hardship might still be eligible to receive charity care even though their income and assets exceed the hospital's income guidelines. An organization planning to develop a charity care policy must first thoroughly assess its current charity care practices and cost accounting capabilities. Obtaining input from all the departments involved in the development of the charity care policy is necessary to make the transition as smooth as possible. PMID:10122079

  10. The atmospheric release advisory capability (ARAC): A federal emergency response capability

    International Nuclear Information System (INIS)

    The Atmospheric Release Capability (ARAC) is a Department of Energy (DOE)-sponsored emergency-response service set up to provide real-time prediction of the dose levels and the extent of surface contamination resulting from a broad range of possible occurrences (accidents, spills, extortion threats involving nuclear material, reentry of nuclear-powered satellites, and atmospheric nuclear tests) that could involve the release of airborne radioactive material. During the past decade, ARAC has responded to more than 150 real-time situations, including exercises. The most notable responses include the Three Mile Island accident in Pennsylvania, the Titan II missile accident in Arkansas, the reentry of the USSR's COSMOS-954 into the atmosphere over Canada, the accidental release of uranium hexafluoride from the Sequoyah Facility accident in Oklahoma, and, most recently, the Chernobyl reactor accident in the Soviet Union. ARAC currently supports the emergency-preparedness plans at 50 Department of Defense (DOD) and DOE sites within the US and also responds to accidents that happen elsewhere. Our ARAC center serves as the focal point for data acquisition, data analysis and assessments during a response, using a computer-based communication network to acquire real-time weather data from the accident site and the surrounding region, as well as pertinent accident information. Its three-dimensional computer models for atmospheric dispersion, MATHEW and ADPIC, digest all this information and produce the predictions used in accident assessment. 9 refs., 6 figs., 1 tab

  11. Observations of group care worker-child interaction in residential youth care: Pedagogical interventions and child behavior

    NARCIS (Netherlands)

    Bastiaanssen, I.L.W.; Delsing, M.J.M.H.; Geijsen, L.; Kroes, G.; Veerman, J.W.; Engels, R.C.M.E.

    2014-01-01

    The work of group care workers in residential youth care is often described as professional parenting. Pedagogical interventions of group care workers influence the quality of care for looked-after children. The aim of the current study was to observe the pedagogical interventions of group care work

  12. Symptom management in palliative care and end of life care.

    Science.gov (United States)

    Bookbinder, Marilyn; McHugh, Marlene E

    2010-09-01

    There is a need for generalist- and specialist-level palliative care clinicians proficient in symptom management and care coordination. Major factors contributing to this need include changed disease processes and trajectories, improved medical techniques and diagnostic testing, successful screening for chronic conditions, and drugs that often prolong life. The rapid progressive illnesses and deaths that plagued the first half of the twentieth century have been replaced in the twenty-first century by increased survival rates. Conditions that require ongoing medical care beyond a year define the current chronic illness population. Long years of survival are often accompanied by a reduced quality of life that requires more medical and nursing care and longer home care. This article reviews the management of selected symptoms in palliative and end of life care.

  13. Predicting Mortgage Arrears: An Investigation Into the Predictive Capability of Customer Spending Patterns

    OpenAIRE

    Roche, Jamie

    2014-01-01

    The management of credit risk and mortgage arrears has become a very important area in financial services and banking. This dissertation set out to build a statistical model, which incorporates customer spending habits and the current equity value of a property, capable of predicting arrears. Current literature identifies many themes such as negative equity and unemployment that are common occurring factors in mortgage arrears but a multi-faceted approach was required to build a model capable...

  14. Hospice Care

    Science.gov (United States)

    ... your care. Other team members may include a music therapist, physical therapist, speech therapist or occupational therapist. ... to the Terms and Conditions and Privacy Policy Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium ...

  15. Multidisciplinary Care.

    Science.gov (United States)

    Daly, Megan E; Riess, Jonathan W

    2016-01-01

    Optimal multidisciplinary care of the lung cancer patient at all stages should encompass integration of the key relevant medical specialties, including not only medical, surgical, and radiation oncology, but also pulmonology, interventional and diagnostic radiology, pathology, palliative care, and supportive services such as physical therapy, case management, smoking cessation, and nutrition. Multidisciplinary management starts at staging and tissue diagnosis with pathologic and molecular phenotyping, extends through selection of a treatment modality or modalities, management of treatment and cancer-related symptoms, and to survivorship and end-of-life care. Well-integrated multidisciplinary care may reduce treatment delays, improve cancer-specific outcomes, and enhance quality of life. We address key topics and areas of ongoing investigation in multidisciplinary decision making at each stage of the lung cancer treatment course for early-stage, locally advanced, and metastatic lung cancer patients. PMID:27535399

  16. Drift reversal capability in helical systems

    International Nuclear Information System (INIS)

    The maximum-J (J is the second adiabatic invariant) capability, i.e., the drift reversal capability, is examined in quasi-axisymmetric (QAS) stellarators and quasi-poloidally symmetric (QPS) stellarators as a possible mechanism for turbulent transport suppression. Due to the existence of non-axisymmetry of the magnetic field strength in QAS configurations, a local maximum of J is created to cause the drift reversal. The increase of magnetic shear in finite beta equilibria also has favorable effect in realizing the drift reversal. The radial variation of the uniform magnetic field component plays a crucial role for the drift reversal in a QPS configuration. Thus, the drift reversal capability and its external controllability are demonstrated for QAS and QPS stellarators, by which the impact of magnetic configuration on turbulent transport can be studied in experiments. (author)

  17. Cosmopolitan capabilities in the HE classroom

    Directory of Open Access Journals (Sweden)

    Veronica Crosbie

    2014-04-01

    Full Text Available This study, concerning the development of cosmopolitan citizenship, draws on theories of human development and capabilities (Sen 1999; Nussbaum 2000 from a social justice perspective, where individual wellbeing is articulated as having the freedom to live a life of one’s choosing. In the context of an English to Speakers of Other Languages (ESOL classroom this involves paying attention to pedagogical strategies, power dynamics and curriculum content as a means of developing valued beings and doings (or capabilities and functionings as they are described in the literature. Sample activities are presented and evaluated to see to what extent they achieve the desired end. These include critical pedagogical interventions, students’ artefacts and extracts from focus group interviews, class reports and reflective journals.  Results from the textual data offer research evidence of successful curriculum change, demonstrating that the learning that takes place there can make a difference: in terms of the learners’ identity development, capability enhancement and cosmopolitan citizenship.

  18. Stakeholder Alignment and Changing Geospatial Information Capabilities

    Science.gov (United States)

    Winter, S.; Cutcher-Gershenfeld, J.; King, J. L.

    2015-12-01

    Changing geospatial information capabilities can have major economic and social effects on activities such as drought monitoring, weather forecasts, agricultural productivity projections, water and air quality assessments, the effects of forestry practices and so on. Whose interests are served by such changes? Two common mistakes are assuming stability in the community of stakeholders and consistency in stakeholder behavior. Stakeholder communities can reconfigure dramatically as some leave the discussion, others enter, and circumstances shift — all resulting in dynamic points of alignment and misalignment . New stakeholders can bring new interests, and existing stakeholders can change their positions. Stakeholders and their interests need to be be considered as geospatial information capabilities change, but this is easier said than done. New ways of thinking about stakeholder alignment in light of changes in capability are presented.

  19. Capabilitarian Sufficiency: Capabilities and Social Justice

    DEFF Research Database (Denmark)

    Nielsen, Lasse; Axelsen, David Vestergaard

    2016-01-01

    This paper suggests an account of sufficientarianism—i.e. that justice is fulfilled when everyone has enough—laid out within a general framework of the capability approach. In doing so, it seeks to show that sufficiency is especially plausible as an ideal of social justice when constructed around...... key capabilitarian insights such as freedom, pluralism, and attention to empirical interconnections between central capabilities. Correspondingly, we elaborate on how a framework for evaluating social justice would look when constructed in this way and give reasons for why capabilitarians should...... embrace sufficientarianism. We do this by elaborating on how capabilitarian values underpin sufficiency. On this basis, we identify three categories of central capabilities; those related to biological and physical needs, those to fundamental interests of a human agent, and those to fundamental interests...

  20. START Analysis for ESAS Capability Needs Prioritization

    Science.gov (United States)

    Lincoln, William; Mrozinski, Joe; Hua, Hook; Merida, Sofia; Shelton, Kacie; Adumitroaie, Virgil; Weisbin, Charles R.; Derleth, Jason

    2006-01-01

    START is a tool to optimize research and development primarily for NASA missions. It was developed within the Strategic Systems Technology Program Office, a division of the Office of the Chief Technologist at NASA's Jet Propulsion Laboratory. START is capable of quantifying and comparing the risks, costs, and potential returns of technologies that are candidates for funding. START can be enormously helpful both in selecting technologies for development -- within the constraints of budget, schedule, and other resources -- and in monitoring their progress. START's methods are applicable to everything from individual tasks to multiple projects comprising entire programs of investigation. They can address virtually any technology assessment and capability prioritization issue. In this report, START is used to analyze the capability needs using data from NASA's Exploration Systems Architecture Study (ESAS).

  1. Combining advanced imaging processing and low cost remote imaging capabilities

    Science.gov (United States)

    Rohrer, Matthew J.; McQuiddy, Brian

    2008-04-01

    Target images are very important for evaluating the situation when Unattended Ground Sensors (UGS) are deployed. These images add a significant amount of information to determine the difference between hostile and non-hostile activities, the number of targets in an area, the difference between animals and people, the movement dynamics of targets, and when specific activities of interest are taking place. The imaging capabilities of UGS systems need to provide only target activity and not images without targets in the field of view. The current UGS remote imaging systems are not optimized for target processing and are not low cost. McQ describes in this paper an architectural and technologic approach for significantly improving the processing of images to provide target information while reducing the cost of the intelligent remote imaging capability.

  2. NASA ATP Force Measurement Technology Capability Strategic Plan

    Science.gov (United States)

    Rhew, Ray D.

    2008-01-01

    The Aeronautics Test Program (ATP) within the National Aeronautics and Space Administration (NASA) Aeronautics Research Mission Directorate (ARMD) initiated a strategic planning effort to re-vitalize the force measurement capability within NASA. The team responsible for developing the plan included members from three NASA Centers (Langley, Ames and Glenn) as well as members from the Air Force s Arnold Engineering and Development Center (AEDC). After visiting and discussing force measurement needs and current capabilities at each participating facility as well as selected force measurement companies, a strategic plan was developed to guide future NASA investments. This paper will provide the details of the strategic plan and include asset management, organization and technology research and development investment priorities as well as efforts to date.

  3. First Materials Science Research Rack Capabilities and Design Features

    Science.gov (United States)

    Schaefer, D.; King, R.; Cobb, S.; Whitaker, Ann F. (Technical Monitor)

    2001-01-01

    The first Materials Science Research Rack (MSRR-1) will accommodate dual Experiment Modules (EM's) and provide simultaneous on-orbit processing operations capability. The first international Materials Science Experiment Module for the MSRR-1 is an international cooperative research activity between NASA's Marshall Space Flight Center (MSFC) and the European Space Agency's (ESA) European Space Research and Technology Center. (ESTEC). This International Standard Payload Rack (ISPR) will contain the Materials Science Laboratory (MSL) developed by ESA as an Experiment Module. The MSL Experiment Module will accommodate several on-orbit exchangeable experiment-specific Module Inserts. Module Inserts currently planned are a Quench Module Insert, Low Gradient Furnace, Solidification with Quench Furnace, and Diffusion Module Insert. The second Experiment Module for the MSRR-1 configuration is a commercial device supplied by MSFC's Space Products Department (SPD). It includes capabilities for vapor transport processes and liquid metal sintering. This Experiment Module will be replaced on-orbit with other NASA Materials Science EMs.

  4. Identifying management competencies for health care executives: review of a series of Delphi studies.

    Science.gov (United States)

    Hudak, R P; Brooke, P P; Finstuen, K

    2000-01-01

    This analysis reviews a selected body of research that identifies the essential areas of management expertise required of future health care executives. To ensure consistency, six studies are analyzed, utilizing the Delphi technique, to query a broad spectrum of experts in different fields and sites of health care management. The analysis identifies a number of management competencies, i.e., managerial capabilities, which current and aspiring health care executives, in various settings and with differing educational backgrounds, should possess to enhance the probability of their success in current and future positions of responsibility. In addition, this review identifies the skills (technical expertise), knowledge (facts and principles) and abilities (physical, mental or legal power) required to support achievement of these competencies. Leadership and resource management, including cost and finance dimensions, are the highest-rated requisite management competencies. The dominant skills, knowledge and abilities (SKAs) are related to interpersonal skills. The lowest-rated SKAs are related to job-specific, technical skills. Recommendations include the review of this research by formal and continuing education programs to determine the content of their courses and areas for future research. Similarly, current health care executives should assess this research to assist in identifying competency gaps. Lastly, this analysis recommends that the Delphi technique, as a valid and replicable methodology, be applied toward the study of non-executive health care managers, e.g., students, clinicians, mid-level managers and integrated systems administrators, to determine their requisite management competencies and SKAs.

  5. Caring Encounters

    Science.gov (United States)

    Gunn, Alyson

    2012-01-01

    Children with autism may seem to not care about things or have the same range of emotions as those of us who see them and care for them. But they do have empathy and they can be taught how to communicate it, says the author, a teacher of children with autism. We simply need to listen to them, watch them, and be with them in their moment.

  6. ANTECEDENTS OF CUSTOMER RELATIONSHIP MANAGEMENT CAPABILITIES

    Directory of Open Access Journals (Sweden)

    Tuleu Daniela

    2015-07-01

    Full Text Available Customer relationship management, as a process to manage customer relationship initiation, maintenance and termination to maximize the value of the relationship portfolio, is an evolving process. In recent years, the development of interactive technologies (social media have revolutionized the interaction between firms and their customers and between customers. The impact of technology on CRM is improving ways of collecting and processing customer information and transforming communication with customers. In the context of the development of social networks, the introduction of social media applications in customer relationship management activities bring important changes in this area. Thus, managers need to pay attention to the interaction management as an important process of CRM and enhance the customer relationship management capabilities. The study propose a conceptual research model of several antecedents of customer relationship managements capabilities and provide the linkage between this antecedents and CRM capabilities. First, following review of existing research literature related to customer relationship management, there are some conceptual clarification on customer relationship management. Second, are presented the working concepts: the adoption of interactive technologies, customer concept, customer empowerment, customer relationship orientation and customer-centric management system. Then, it is proposed the conceptual model and finally are presented conclusions, managerial implications, limitations and research directions. From a theoretical perspective, this paper highlights the importance of marketing actions at the individual customer level and reveal the impact of adoption by companies of interactive technologies so that organizations have the opportunity to engage in conversations with customers and respond in real time the requirements that they launched the online environment. Nowadays, customers feel empowered and play

  7. Cloud-based Architecture Capabilities Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Vang, Leng [Idaho National Lab. (INL), Idaho Falls, ID (United States); Prescott, Steven R [Idaho National Lab. (INL), Idaho Falls, ID (United States); Smith, Curtis [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-09-01

    In collaborating scientific research arena it is important to have an environment where analysts have access to a shared of information documents, software tools and be able to accurately maintain and track historical changes in models. A new cloud-based environment would be accessible remotely from anywhere regardless of computing platforms given that the platform has available of Internet access and proper browser capabilities. Information stored at this environment would be restricted based on user assigned credentials. This report reviews development of a Cloud-based Architecture Capabilities (CAC) as a web portal for PRA tools.

  8. Organizational capabilities and new market entry processes

    DEFF Research Database (Denmark)

    Nogueira, Leticia Antunes; Andersen, Poul Houman; Drejer, Ina

    This is a conceptual paper that addresses the question of organizational capabilities in the context of firms entering markets that are new to them. The purpose of this work is to outline the theoretical debate on the topic, and propose avenues for empirical investigation.......This is a conceptual paper that addresses the question of organizational capabilities in the context of firms entering markets that are new to them. The purpose of this work is to outline the theoretical debate on the topic, and propose avenues for empirical investigation....

  9. Trends in Microfabrication Capabilities & Device Architectures.

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, Todd [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Jones, Adam [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lentine, Anthony L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mudrick, John [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Okandan, Murat [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Rodrigues, Arun F. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-06-01

    The last two decades have seen an explosion in worldwide R&D, enabling fundamentally new capabilities while at the same time changing the international technology landscape. The advent of technologies for continued miniaturization and electronics feature size reduction, and for architectural innovations, will have many technical, economic, and national security implications. It is important to anticipate possible microelectronics development directions and their implications on US national interests. This report forecasts and assesses trends and directions for several potentially disruptive microfabrication capabilities and device architectures that may emerge in the next 5-10 years.

  10. Esourcing capability model for client organizations

    CERN Document Server

    Hefley, Bill

    2010-01-01

    The eSourcing Capability Model for Client Organizations (eSCM-CL) is the best practices model that enables client organizations to appraise and improve their capability to foster the development of more effective relationships and to better manage these relationships. This title helps readers successfully implement a full range of client-organization tasks, ranging from developing the organization's sourcing strategy, planning for sourcing and service provider selection, initiating an agreement with service providers, managing service delivery, and completing the agreement.The eSCM-CL has been

  11. Analysis and evaluation of enterprise risk management capability elements

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Research on enterprise risk management capability is conducted with a view of discerning and processing risks, in which an evaluation index system and an evaluation model of enterprise risk management capabilities are constructed. The risk management capability consists of four aspects, i.e. risk identification capability, risk assessment capability, risk planning capability and risk control capability. Risk identification and assessment capabilities reflect the level of enterprises on finding and analyzing...

  12. NASA's Space Launch System: Building a New Capability for Discovery

    Science.gov (United States)

    Creech, Stephen D.; Robinson, Kimberly F.

    2015-01-01

    Designed to enable human space exploration missions, including eventually landings on Mars, NASA's Space Launch System (SLS) represents a unique launch capability with a wide range of utilization opportunities, from delivering habitation systems into the lunar vicinity to high-energy transits through the outer solar system. Substantial progress has been made toward the first launch of the initial configuration of SLS, which will be able to deliver more than 70 metric tons of payload into low Earth orbit (LEO). The vehicle will then be evolved into more powerful configurations, culminating with the capability to deliver more than 130 metric tons to LEO. The initial configuration will be able to deliver greater mass to orbit than any contemporary launch vehicle, and the evolved configuration will have greater performance than the Saturn V rocket that enabled human landings on the moon. SLS will also be able to carry larger payload fairings than any contemporary launch vehicle, and will offer opportunities for co-manifested and secondary payloads. Because of its substantial mass-lift capability, SLS will also offer unrivaled departure energy, enabling mission profiles currently not possible. The basic capabilities of SLS have been driven by studies on the requirements of human deep-space exploration missions, and continue to be validated by maturing analysis of Mars mission options. Early collaboration with science teams planning future decadal-class missions have contributed to a greater understanding of the vehicle's potential range of utilization. As this paper will explain, SLS is making measurable progress toward becoming a global infrastructure asset for robotic and human scouts of all nations by providing the robust space launch capability to deliver sustainable solutions for exploration.

  13. Current Titles

    Energy Technology Data Exchange (ETDEWEB)

    Various

    2006-06-01

    This booklet is published for those interested in current research being conducted at the National Center for Electron Microscopy. The NCEM is a DOE-designated national user facility and is available at no charge to qualified researchers. Access is controlled by an external steering committee. Interested researchers may contact Jane Cavlina, Administrator, at 510/486-6036.

  14. Electro-Thermal-Mechanical Simulation Capability Final Report

    Energy Technology Data Exchange (ETDEWEB)

    White, D

    2008-02-06

    This is the Final Report for LDRD 04-ERD-086, 'Electro-Thermal-Mechanical Simulation Capability'. The accomplishments are well documented in five peer-reviewed publications and six conference presentations and hence will not be detailed here. The purpose of this LDRD was to research and develop numerical algorithms for three-dimensional (3D) Electro-Thermal-Mechanical simulations. LLNL has long been a world leader in the area of computational mechanics, and recently several mechanics codes have become 'multiphysics' codes with the addition of fluid dynamics, heat transfer, and chemistry. However, these multiphysics codes do not incorporate the electromagnetics that is required for a coupled Electro-Thermal-Mechanical (ETM) simulation. There are numerous applications for an ETM simulation capability, such as explosively-driven magnetic flux compressors, electromagnetic launchers, inductive heating and mixing of metals, and MEMS. A robust ETM simulation capability will enable LLNL physicists and engineers to better support current DOE programs, and will prepare LLNL for some very exciting long-term DoD opportunities. We define a coupled Electro-Thermal-Mechanical (ETM) simulation as a simulation that solves, in a self-consistent manner, the equations of electromagnetics (primarily statics and diffusion), heat transfer (primarily conduction), and non-linear mechanics (elastic-plastic deformation, and contact with friction). There is no existing parallel 3D code for simulating ETM systems at LLNL or elsewhere. While there are numerous magnetohydrodynamic codes, these codes are designed for astrophysics, magnetic fusion energy, laser-plasma interaction, etc. and do not attempt to accurately model electromagnetically driven solid mechanics. This project responds to the Engineering R&D Focus Areas of Simulation and Energy Manipulation, and addresses the specific problem of Electro-Thermal-Mechanical simulation for design and analysis of energy

  15. Clopidogrel Resistance: Current Issues

    Directory of Open Access Journals (Sweden)

    NS Neki

    2016-05-01

    Full Text Available Antiplatelet agents are mainly used in the prevention and management of atherothrombotic complications. Dual antiplatelet therapy, combining aspirin and clopidogrel, is the standard care for patients having acute coronary syndromes or undergoing percutaneous coronary intervention according to the current ACC/AHA and ESC guidelines. But in spite of administration of dual antiplatelet therapy, some patients develop recurrent cardiovascular ischemic events especially stent thrombosis which is a serious clinical problem. Antiplatelet response to clopidogrel varies widely among patients based on ex vivo platelet function measurements. Clopidogrel is an effective inhibitor of platelet activation and aggregation due to its selective and irreversible blockade of the P2Y12 receptor. Patients who display little attenuation of platelet reactivity with clopidogrel therapy are labeled as low or nonresponders or clopidogrel resistant. The mechanism of clopidogrel resistance remains incompletely defined but there are certain clinical, cellular and genetic factors including polymorphisms responsible for therapeutic failure. Currently there is no standardized or widely accepted definition of clopidogrel resistance. The future may soon be realised in the routine measurement of platelet activity in the same way that blood pressure, cholesterol and blood sugar are followed to help guide the therapy, thus improving the care for millions of people. This review focuses on the methods used to identify patients with clopidogrel resistance, the underlying mechanisms, metabolism, clinical significance and current therapeutic strategies to overcome clopidogrel resistance. J Enam Med Col 2016; 6(1: 38-46

  16. [Quality of health care].

    Science.gov (United States)

    Medina, J L; De Melo, P C

    2000-01-01

    Quality assurance is a relatively recent concern but already plays a major role in health care management and provision. Quality involves the definition of a comprehensive programme tailored by realistic and effective objectives and norms that include the structured review of procedures (namely clinical audits) and the use of up-to-date protocols. The involvement and motivation of health professionals, together with an adequate internal and external communication strategy, play a key role in the planning and application of these programmes. The use of programmed assessment, based on a solid knowledge of current practice, should have practical implications, optimising procedures in order to improve the quality of care. This commitment towards quality in health care should go far beyond governmental policy and should have clear support from health professionals. PMID:11234496

  17. Critical care in India.

    Science.gov (United States)

    Udwadia, F E; Guntupalli, K K; Vidyasagar, D

    1997-04-01

    India is a vast democracy of nearly one billion people. Before the British rule ended in 1947, the life span of an Indian was a mere 21 years. Within a short span of 50 years, it increased to an impressive 63 years, largely due to public health measures initiated by the government. This created a pool of more than 300 million middle class Indians who could afford the benefits of modern and specialized care when needed. Critical care medicine, as practiced in the West, is still confined to large Metropolitan areas. A large pool of expatriate Indian physicians from all over the world are helping bridge the resource gap between the West and India by transfer of technology and providing appropriate training to physicians and paramedical personnel. This article describes the history and current status of development of critical care medicine in India. PMID:9107510

  18. Ethics, Politics, and Religion in Public Health Care: A Manifesto for Health Care Chaplains in Canada.

    Science.gov (United States)

    Lasair, Simon

    2016-03-01

    Health care chaplaincy positions in Canada are significantly threatened due to widespread health care cutbacks. Yet the current time also presents a significant opportunity for spiritual care providers. This article argues that religion and spirituality in Canada are undergoing significant changes. The question for Canadian health care chaplains is, then: how well equipped are they to understand these changes in health care settings and to engage them? This article attempts to go part way toward an answer.

  19. Personalized Primary Care for Older People: An evaluation of a multicomponent nurse-led care program

    OpenAIRE

    Bleijenberg, N.

    2013-01-01

    Providing optimal care for the increasing number of frail older people with complex care needs is a major challenge in primary care. The current approach is reactive and does not meet the needs of older patients, resulting in unnecessary loss of daily functioning, suboptimal quality of life and high health care expenditures. In the Utrecht Proactive Frailty Intervention Trial (U-PROFIT, in Dutch:’ Om U’), we designed and evaluated a strategy for proactive patient-centred primary care of frail...

  20. IAEA inspections and Iraq's nuclear capabilities

    International Nuclear Information System (INIS)

    It is reported that IAEA teams have been investigating Iraq's nuclear capabilities since May 1991 and following the Gulf War under terms of United Nations Security Council Resolution 687 directed at eliminating Iraq's weapons of mass destruction and means to produce and use them. A chronology of the events as well as the IAEA plan of further actions are described