WorldWideScience

Sample records for care trec building

  1. The Lowlands' TREC Experiments 2005 - Notebook paper

    NARCIS (Netherlands)

    Rode, H.; Ramirez, G.; Westerveld, T.H.W.; Hiemstra, D.; Vries, A.P. de

    2005-01-01

    This paper describes our participation to the TREC HARD track (High Accuracy Retrieval of Documents) and the the TREC Enterprise track. The main goal of our HARD participation is the development and evaluation of so-called query profiles: Short summaries of the retrieved results that enable the user

  2. PolarTREC-Teachers and Researchers Exploring and Collaborating: Innovative Science Education from the Poles to the World

    Science.gov (United States)

    Warnick, W. K.; Warburton, J.; Breen, K.; Wiggins, H. V.; Larson, A.; Behr, S.

    2006-12-01

    PolarTREC-Teachers and Researchers Exploring and Collaborating is a three-year (2007-2009) teacher professional development program celebrating the International Polar Year (IPY) that will advance polar science education by bringing K-12 educators and polar researchers together in hands-on field experiences in the Arctic and Antarctic. PolarTREC builds on the strengths of the existing TREC program in the Arctic, an NSF supported program managed by the Arctic Research Consortium of the US (ARCUS), to embrace a wide range of activities occurring at both poles during and after IPY. PolarTREC will foster the integration of research and education to produce a legacy of long-term teacher-researcher collaborations, improved teacher content knowledge through experiences in scientific inquiry, and broad public interest and engagement in polar science and IPY. PolarTREC will enable thirty-six teachers to spend two to six weeks in the Arctic or Antarctic, working closely with researchers investigating a wide range of IPY science themed topics such as sea-ice dynamics, terrestrial ecology, marine biology, atmospheric chemistry, and long-term climate change. While in the field, teachers and researchers will communicate extensively with their colleagues, communities, and hundreds of students of all ages across the globe, using a variety of tools including satellite phones, online journals, podcasts and interactive "Live from IPY" calls and web-based seminars. The online outreach elements of the project convey these experiences to a broad audience far beyond the classrooms of the PolarTREC teachers. In addition to field research experiences, PolarTREC will support teacher professional development and a sustained community of teachers, scientists, and the public through workshops, Internet seminars, an e-mail listserve, and teacher peer groups. For further information on PolarTREC, contact Wendy Warnick, ARCUS Executive Director at warnick@arcus.org or 907-474-1600 or visit www.arcus.org/trec/

  3. PolarTREC-Teachers and Researchers Exploring and Collaborating: Bringing Polar Research to the Classroom

    Science.gov (United States)

    Warnick, W. K.; Warburton, J.; Breen, K.; Wiggins, H. V.; Larson, A.; Behr, S.

    2006-12-01

    PolarTREC-Teachers and Researchers Exploring and Collaborating is a three-year (2007-2009) teacher professional development program that pairs K-12 teachers with researchers to improve science education through authentic polar research experience. PolarTREC builds on the strengths of the existing TREC program in the Arctic, an NSF supported program managed by the Arctic Research Consortium of the US (ARCUS), to embrace a wider range of research activities in the Arctic and Antarctic. PolarTREC uses a Teacher Research Experience (TRE) model to foster the integration of research and education to produce a legacy of long-term teacher-researcher collaborations, improved teacher content knowledge through experiences in scientific inquiry, and broad public interest and engagement in polar science. PolarTREC will enable thirty-six teachers to spend two to six weeks in the Arctic or Antarctic, working closely with researchers investigating a wide range of topics such as sea-ice dynamics, terrestrial ecology, marine biology, atmospheric chemistry, and long-term climate change. With the help of their host researcher and the research team, teachers will develop the experience and tools necessary to teach science through scientific inquiry and investigation based on real-world experiences. While in the field, teachers and researchers will communicate extensively with their colleagues, communities, and hundreds of students of all ages across the globe, using a variety of tools including satellite phones, online journals, podcasts and interactive "Live from IPY" calls and web-based seminars. The online outreach elements of the project convey these experiences to a broad audience far beyond the classrooms of the PolarTREC teachers. In addition to field research experiences, PolarTREC will support teacher professional development and a sustained community of teachers, scientists, and the public through workshops, Internet seminars, an e-mail listserve, and ongoing teacher

  4. University of glasgow at TREC 2006

    DEFF Research Database (Denmark)

    Lioma, Christina; Macdonald, C.; Plachouras, V.;

    2006-01-01

    -independent evidence, in the form of prior probabilities. In the Enterprise track, we test our new voting model for expert search. Our experiments focus on the need for candidate length normalisation, and on how retrieval performance can be enhanced by applying retrieval techniques to the underlying ranking......In TREC 2006, we participate in three tasks of the Terabyte and Enterprise tracks. We continue experiments using Terrier1, our modular and scalable Information Retrieval (IR) platform. Furthering our research into the Divergence From Randomness (DFR) framework of weighting models, we introduce two...

  5. The Building Infrastructure and Home Care

    OpenAIRE

    Lundberg, Stefan

    2007-01-01

    Puropse - To discus the importance of the facilities management in Home Care service. Design/methodology/approach - A case study of a project where new assistive technolgy was used to improve the security for elderly in Home Care service. Findings - The infrastructure of a multi-story building is of vital importance for the delivery chain of Home Care. The care provider is depending on the functionality of the communication network in the home to sustain the care during the time of "care abse...

  6. Building the eye care team

    Directory of Open Access Journals (Sweden)

    Thulasiraj Ravilla

    2014-07-01

    Full Text Available Eye care services are people intensive. They require the right people (competence, in the right numbers (capacity, in the right mix (team with the right resources and processes (enabling conditions to ensure effective and sustainable delivery of patient care.

  7. [The architectural design of psychiatric care buildings].

    Science.gov (United States)

    Dunet, Lionel

    2012-01-01

    The architectural design of psychiatric care buildings. In addition to certain "classic" creations, the Dunet architectural office has designed several units for difficult patients as well as a specially adapted hospitalisation unit. These creations which are demanding in terms of the organisation of care require close consultation with the nursing teams. Testimony of an architect who is particularly engaged in the universe of psychiatry.

  8. Predicting human age with bloodstains by sjTREC quantification.

    Directory of Open Access Journals (Sweden)

    Xue-ling Ou

    Full Text Available The age-related decline of signal joint T-cell receptor rearrangement excision circles (sjTRECs in human peripheral blood has been demonstrated in our previous study and other reports. Until now, only a few studies on sjTREC detection in bloodstain samples were reported, which were based on a small sample of subjects of a limited age range, although bloodstains are much more frequently encountered in forensic practice. In this present study, we adopted the sensitive Taqman real-time quantitative polymerase chain reaction (qPCR method to perform sjTREC quantification in bloodstains from individuals ranging from 0-86 years old (n = 264. The results revealed that sjTREC contents in human bloodstains were declined in an age-dependent manner (r = -0.8712. The formula of age estimation was Age = -7.1815Y-42.458 ± 9.42 (Y dCt(TBP-sjTREC; 9.42 standard error. Furthermore, we tested for the influence of short- or long- storage time by analyzing fresh and stored bloodstains from the same individuals. Remarkably, no statistically significant difference in sjTREC contents was found between the fresh and old DNA samples over a 4-week of storage time. However, significant loss (0.16-1.93 dCt in sjTREC contents was detected after 1.5 years of storage in 31 samples. Moreover, preliminary sjTREC quantification from up to 20-year-old bloodstains showed that though the sjTREC contents were detectable in all samples and highly correlated with donor age, a time-dependent decrease in the correlation coefficient r was found, suggesting the predicting accuracy of this described assay would be deteriorated in aged samples. Our findings show that sjTREC quantification might be also suitable for age prediction in bloodstains, and future researches into the time-dependent or other potential impacts on sjTREC quantification might allow further improvement of the predicting accuracy.

  9. Building a mission for quality care.

    Science.gov (United States)

    Peterson, R

    1999-12-01

    Clearly, there is a benefit to the group process in helping to establish teamwork. Teamwork and cooperation can assist with promoting effective communication, improving work quality, and building a sense of well-being within the group. With this cooperation, setting goals and looking toward the future can become a reality. Once goals are set, then developing a professional image can begin. Developing a mission statement can be an effective means to help create that professional image. Having the opportunity to develop a mission for a patient care area and articulating it through a mission statement coalesces the values, beliefs, and philosophy of a group of neuroscience staff. The following is the mission statement developed by the neurosciences unit at the University of Wisconsin Hospital and Clinics: We, the staff of UWHC Neuroscience unit embrace a vision of excellence in health care for all. Our mission is to deliver consistent quality patient care, while fostering our own professional growth. As caring healers, teachers and patient advocates in an ever-changing health care environment, we are empowered by the code for nurses. Within our scope of practice, we strive to maintain a balance of basic human respect and dignity for patients and their families in their quest for wellness, adaptation, rehabilitation or comfort care. It is our hope that patients and families will work with the health care team to construct a plan of care that best meets the patient's needs and goals. We are committed to accommodate special communication, religious or cultural needs of patients and their families. Our final acknowledgment is to ourselves, as members of the health care team. We celebrate the dignity of the staff by recognizing each individual as a special person capable of making unique and significant contributions to the unit. PMID:10726245

  10. Overview of the TREC 2013 Federated Web Search Track

    NARCIS (Netherlands)

    Demeester, Thomas; Trieschnigg, Dolf; Nguyen, Dong; Hiemstra, Djoerd

    2014-01-01

    The TREC Federated Web Search track is intended to promote research related to federated search in a realistic web setting, and hereto provides a large data collection gathered from a series of online search engines. This overview paper discusses the results of the first edition of the track, FedWeb

  11. Overview of the TREC 2014 Federated Web Search Track

    NARCIS (Netherlands)

    Demeester, Thomas; Trieschnigg, Dolf; Nguyen, Dong-Phuong; Zhou, Ke; Hiemstra, Djoerd

    2014-01-01

    The TREC Federated Web Search track facilitates research in topics related to federated web search, by providing a large realistic data collection sampled from a multitude of online search engines. The FedWeb 2013 challenges of Resource Selection and Results Merging challenges are again included in

  12. Overview of the TREC 2014 Federated Web Search Track

    OpenAIRE

    Demeester, Thomas; Trieschnigg, Dolf; Nguyen, Dong-Phuong; Zhou, Ke; Hiemstra, Djoerd

    2014-01-01

    The TREC Federated Web Search track facilitates research in topics related to federated web search, by providing a large realistic data collection sampled from a multitude of online search engines. The FedWeb 2013 challenges of Resource Selection and Results Merging challenges are again included in FedWeb 2014, and we additionally introduced the task of vertical selection. Other new aspects are the required link between the Resource Selection and Results Merging, and the importance of diversi...

  13. Overview of the TREC 2013 federated web search track

    OpenAIRE

    DEMEESTER, Thomas; Trieschnigg, Dolf; Nguyen, Dong Van; Hiemstra, Djoerd

    2013-01-01

    The TREC Federated Web Search track is intended to promote research related to federated search in a realistic web setting, and hereto provides a large data collection gathered from a series of online search engines. This overview paper discusses the results of the first edition of the track, FedWeb 2013. The focus was on basic challenges in federated search: (1) resource selection, and (2) results merging. After an overview of the provided data collection and the relevance judgments for the ...

  14. The 10 Building Blocks of High-Performing Primary Care

    OpenAIRE

    Bodenheimer, Thomas; Ghorob, Amireh; Willard-Grace, Rachel; Grumbach, Kevin

    2014-01-01

    Our experiences studying exemplar primary care practices, and our work assisting other practices to become more patient centered, led to a formulation of the essential elements of primary care, which we call the 10 building blocks of high-performing primary care. The building blocks include 4 foundational elements—engaged leadership, data-driven improvement, empanelment, and team-based care—that assist the implementation of the other 6 building blocks—patient-team partnership, population mana...

  15. THE TEST OF APPLYING RADAR TREC WIND IN THREE-DIMENSIONAL VARIATIONAL ASSIMILATION

    Institute of Scientific and Technical Information of China (English)

    WAN Qi-lin; XUE Ji-shan; CHEN Zhi-tong; LIU Chun-xia

    2006-01-01

    The application of radar-derived TREC wind to 3DVAR assimilation system of GRAPeS-3DVar developed by Chinese Academy of Meteorological Sciences is introduced. The resulting fundamental feature is estimated when radar TREC wind is assimilated into GRAPeS-3DVar system. It was found that radar TREC wind has better potential of the application in GRAPeS-3DVar system and can effectively improve the analyzed results. Moreover a numerical experiment is performed in which tropical cyclones make landfall and transform;it also showed that the predicted effect can be improved when the radar TREC wind is added into GRAPeS-3DVar system.

  16. TREC Based Newborn Screening for Severe Combined Immunodeficiency Disease : A Systematic Review

    NARCIS (Netherlands)

    van der Spek, Jet; Groenwold, Rolf H. H.; van der Burg, Mirjam; van Montfrans, JM

    2015-01-01

    Background Newborn screening (NBS) by quantifying T cell receptor excision circles (TRECs) in neonatal dried blood spots (DBS) enables early diagnosis of severe combined immunodeficiency disease (SCID). In recent years, different screening algorithms for TREC based SCID screening were reported. Purp

  17. Care platforms: a basic building block for care delivery.

    Science.gov (United States)

    Bohmer, Richard M J; Lawrence, David M

    2008-01-01

    Without significant operational reform within the nation's health care delivery organizations, new financing models, payment systems, or structures are unlikely to realize their promise. Adapting insights from high-performing companies in other high-risk, high-cost, science- and technology-based industries, we propose the "care platform" as an organizing framework for internal operations in diversified provider organizations to increase the quality, reliability, and efficiency of care delivery. A care platform organizes "care production" around similar work, rather than organs or specialties; integrates standard and custom care processes; and surrounds them with specifically configured information and business systems. Such organizational designs imply new roles for physicians. PMID:18780920

  18. Insights into the impact and use of research results in a residential long-term care facility: a case study

    OpenAIRE

    Cranley Lisa A; Birdsell Judy M; Norton Peter G; Morgan Debra G; Estabrooks Carole A

    2012-01-01

    Abstract Background Engaging end-users of research in the process of disseminating findings may increase the relevance of findings and their impact for users. We report findings from a case study that explored how involvement with the Translating Research in Elder Care (TREC) study influenced management and staff at one of 36 TREC facilities. We conducted the study at ‘Restwood’ (pseudonym) nursing home because the Director of Care engaged actively in the study and TREC data showed that this ...

  19. Building collaborative teams in neonatal intensive care.

    Science.gov (United States)

    Brodsky, Dara; Gupta, Munish; Quinn, Mary; Smallcomb, Jane; Mao, Wenyang; Koyama, Nina; May, Virginia; Waldo, Karen; Young, Susan; Pursley, DeWayne M

    2013-05-01

    The complex multidisciplinary nature of neonatal intensive care combined with the numerous hand-offs occurring in this shift-based environment, requires efficient and clear communication and collaboration among staff to provide optimal care. However, the skills required to function as a team are not typically assessed, discussed, or even taught on a regular basis among neonatal personnel. We developed a multidisciplinary, small group, interactive workshop based on Team STEPPS to provide staff with formal teamwork skills, and to introduce new team-based practices; 129 (95%) of the eligible 136 staff were trained. We then compared the results of the pretraining survey (completed by 114 (84%) of staff) with the post-training survey (completed by 104 (81%) of participants) 2 years later. We found an improvement in the overall teamwork score from 7.37 to 8.08 (p=job fulfilment (p=<0.0001), believed that their abilities were being utilised properly (p=0.003), and felt more respected (p=0.0037). 90% of staff found the new practice of team meetings to help increase awareness of unit acuity, and 77% of staff noted that they had asked for help or offered assistance because of information shared during these meetings. In addition to summarising the results of our training programme, this paper also provides practical tools that may be of use in developing team training programmes in other neonatal units. PMID:23396854

  20. University of Twente at the TREC 2008 Enterprise Track: using the Global Web as an expertise evidence source

    NARCIS (Netherlands)

    Serdyukov, Pavel; Aly, Robin; Hiemstra, Djoerd; Voorhees, E.M.; Buckland, Lori P.

    2008-01-01

    This paper describes the details of our participation in expert search task of the TREC 2007 Enterprise track. This is the fourth (and the last) year of TREC 2007 Enterprise Track and the second year the University of Twente (Database group) submitted runs for the expert nding task. In the methods t

  1. Retrospective TREC testing of newborns with Severe Combined Immunodeficiency and other primary immunodeficiency diseases

    Directory of Open Access Journals (Sweden)

    O. Jilkina

    2014-01-01

    Full Text Available In Manitoba, Canada, the overall incidence of Severe Combined Immunodeficiency (SCID is three-fold higher than the national average, with SCID overrepresented in two population groups: Mennonites and First Nations of Northern Cree ancestries. T-cell receptor excision circle (TREC assay is being used increasingly for neonatal screening for SCID in North America. However, the majority of SCID patients in Manitoba are T-cell-positive. Therefore it is likely that the TREC assay will not identify these infants. The goal of this study was to blindly and retrospectively perform TREC analysis in confirmed SCID patients using archived Guthrie cards. Thirteen SCID patients were tested: 5 T-negative SCID (3 with adenosine deaminase deficiency, 1 with CD3δ deficiency, and 1 unclassified and 8 T-positive SCID (5 with zeta chain-associated protein kinase (ZAP70 deficiency and 3 with inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase beta (IKKβ deficiency. As a non-SCID patient group, 5 Primary Immunodeficiency Disease (PID patients were studied: 1 T-negative PID (cartilage-hair hypoplasia and 4 T-positive PID (2 common immune deficiency (CID, 1 Wiskott–Aldrich syndrome, and 1 X-linked lymphoproliferative disease. Both patient groups required hematopoietic stem cell transplantation. In addition, randomly-selected de-identified controls (n = 982 were tested. Results: all T-negative SCID and PID had zero TRECs. Low-TRECs were identified in 2 ZAP70 siblings, 1 CID patient as well as 5 preterm, 1 twin, and 4 de-identified controls. Conclusions: TREC method will identify T-negative SCID and T-negative PID. To identify other SCID babies, newborn screening in Manitoba must include supplemental targeted screening for ethnic-specific mutations.

  2. PolarTREC: Successful Methods and Tools for Attaining Broad Educational Impacts with Interdisciplinary Polar Science

    Science.gov (United States)

    Timm, K. M.; Warburton, J.; Owens, R.; Warnick, W. K.

    2008-12-01

    PolarTREC--Teachers and Researchers Exploring and Collaborating, a program of the Arctic Research Consortium of the U.S. (ARCUS), is a National Science Foundation (NSF)-funded International Polar Year (IPY) project in which K-12 educators participate in hands-on field experiences in the polar regions, working closely with IPY scientists as a pathway to improving science education. Developing long-term teacher- researcher collaborations through PolarTREC ensures up-to-date climate change science content will permeate the K-12 education system long after the IPY. By infusing education with the cutting edge science from the polar regions, PolarTREC has already shown an increase in student and public knowledge of and interest in the polar regions and global climate change. Preliminary evaluations have shown that PolarTREC's program activities have many positive impacts on educators and their ability to teach science concepts and improve their teaching methods. Additionally, K-12 students polled in interest surveys showed significant changes regarding the importance of understanding the polar regions as a person in today's world. Researchers have been overwhelmingly satisfied with PolarTREC and cited several specific strengths, including the program's crucial link between the teachers' field research experiences and their classroom and the extensive training provided to teachers prior to their expedition. This presentation will focus on other successful components of the PolarTREC program and how researchers and organizations might use these tools to reach out to the public for long-term impacts. Best practices include strategies for working with educators and the development of an internet-based platform for teachers and researchers to interact with the public, combining several communication tools such as online journals and forums, real-time Internet seminars, lesson plans, activities, audio, and other educational resources that address a broad range of scientific

  3. CWI and TU Delft at TREC 2013: Contextual Suggestion, Federated Web Search, KBA, and Web Tracks

    NARCIS (Netherlands)

    Bellogín Kouki, A.; Gebremeskel, G.G.; He, J.; Lin, J.J.P.; Said, A.; Samar, T.; Vries, A.P. de; Vuurens, J.B.P.

    2014-01-01

    This paper provides an overview of the work done at the Centrum Wiskunde & Informatica (CWI) and Delft University of Technology (TU Delft) for different tracks of TREC 2013. We participated in the Contextual Suggestion Track, the Federated Web Search Track, the Knowledge Base Acceleration (KBA) Trac

  4. PolarTREC-Celebrating the Legacy of the IPY Through Researcher-Educator Partnerships

    Science.gov (United States)

    Timm, K.; Warburton, J.; Larson, A. M.

    2009-12-01

    Polar TREC-Teachers and Researchers Exploring and Collaborating, a three-year (2007-2009) NSF-funded program, has matched over 40 teachers with polar researchers working in multiple scientific disciplines for 2-8 week Teacher Research Experiences (TRE) in the Arctic and Antarctica during the IPY. PolarTREC contributes to the legacy of the IPY through the creation and dissemination of polar education resources, prolonged teacher-researcher relationships, and contributions to scholarly knowledge on the impacts of TRE's. Products developed during PolarTREC are helping to sustain the widespread interest and enthusiasm in the polar regions generated during the IPY. During their expeditions, participating teachers brought science and information about profound changes at the poles to school, community, and professional audiences through web-based communications, journals, discussion forums, multimedia, and live events. PolarTREC teachers constructed nearly 100 classroom lesson plans and activities as products of their experiences. Live events from the field attracted over 11,000 participants, primarily K-12 students. Although the field experience is central to the PolarTREC TRE Model, many participants cite the relationship they built with their teacher/researcher as one of the best outcomes. Through personal communications, presentations at professional conferences, and continued support of each other’s work through classroom visits or joint proposal development, teachers and researchers have maintained the mutually beneficial relationships established during the IPY. Participating scientists gained access to professional educators with expertise in translating research approaches and results into programs. The need for researchers to explain their research and “boil it down to the raw essence” helped many see how their work fits into a bigger picture, often helping them communicate outside their scientific discipline and to diverse public audiences. Teachers, on

  5. Numerical analysis of pulsed local plane-wave generation in a TREC

    OpenAIRE

    Meton, Philippe; Cozza, Andrea; Monsef, Florian; Lambert, Marc; Joly, Jean-Christophe; Bruguière, Pierre

    2012-01-01

    International audience The feasibility of generating arbitrary wavefronts within a time-reversal electromagnetic chamber (TREC) has been demonstrated both theoretically and experimentally. Though originally motivated for EMC tests, the generation of coherent wavefronts within a reverberating cavity has a potential interest in antenna testing, too. In this paper, the generation of locally planar wavefronts is addressed by means of numerical simulations involving a 2D cavity, for a scalar el...

  6. CWI and TU Delft at TREC 2013: Contextual Suggestion, Federated Web Search, KBA, and Web Tracks

    OpenAIRE

    Bellogín Kouki, Alejandro; Gebremeskel, Gebre; He, Jiyin; Lin, Jimmy; Said, Alan; Samar, Thaer; De, Vries; Vuurens, Jeroen

    2014-01-01

    This paper provides an overview of the work done at the Centrum Wiskunde & Informatica (CWI) and Delft University of Technology (TU Delft) for different tracks of TREC 2013. We participated in the Contextual Suggestion Track, the Federated Web Search Track, the Knowledge Base Acceleration (KBA) Track, and the Web Ad-hoc Track. In the Contextual Suggestion track, we focused on filtering the entire ClueWeb12 collection to generate recommendations according to the provided user profiles and cont...

  7. NASA IceBridge and PolarTREC - Education and Outreach Partnership

    Science.gov (United States)

    Bartholow, S.; Warburton, J.; Beck, J.; Woods, J. E.

    2015-12-01

    PolarTREC-Teachers and Researchers Exploring and Collaborating, a teacher professional development program, began with the International Polar Year in 2004 and continues today in the United States. PolarTREC has worked specifically with OIB for 3 years and looking forward to ongoing collaboration. PolarTREC brings U.S. K­12 educators and polar researchers together through an innovative teacher research experience model. Participating teachers spend 3-6 weeks in the field with research teams conducting surveys and collecting data on various aspects of polar science. During their experience, teachers become research team members filling a variety of roles on the team. They also fulfill a unique role of public outreach officer, conducting live presentations about their field site and research as well as journaling, answering questions, and posting photos. Working with OIB has opened up the nature of science for the participating teachers. In developing the long-term relationship with OIB teams, teachers can now share (1) the diversity of training, backgrounds, and interests of OIB scientists, (2) identify the linkages between Greenlandic culture and community and cryospheric science and evidence of climate change, (3) network with Danish and Greenlandic educators on the mission (4) gain access to the full spectrum of a science project - development, implementation, analysis, networking, and dissemination of information. All aspects help these teachers become champions of NASA science and educational leaders in their communities. Evaluation data shows that PolarTREC has clearly achieved it goals with the OIB partnership and suggests that linking teachers and researchers can have the potential to transform the nature of science education. By giving teachers the content knowledge, pedagogical tools, confidence, understanding of science in the broader society, and experiences with scientific inquiry, participating teachers are using authentic scientific research in their

  8. Building Schools as Caring Communities: Why, What, and How?

    Science.gov (United States)

    Doyle, Lynn H.; Doyle, Patrick M.

    2003-01-01

    Suggests that a caring community has an "ethic of care" that works to develop students who will become empathetic adults and transport a caring mission beyond the walls of the school into their communities. Discusses establishing powerful policies for equity, empowering groups, teaching caring in classrooms, caring for students, and caring by…

  9. Saving energy for ventilation by careful selection of building materials

    DEFF Research Database (Denmark)

    Wargocki, Pawel; Knudsen, Henrik Nellemose

    2008-01-01

    The main objective of the research project described in this paper was to study the potential of reducing energy used for ventilating buildings by using low-polluting building materials without compromising indoor air quality.......The main objective of the research project described in this paper was to study the potential of reducing energy used for ventilating buildings by using low-polluting building materials without compromising indoor air quality....

  10. PolarTREC-Teachers and Researchers Exploring and Collaborating: Science Education from the Poles to the World

    Science.gov (United States)

    Timm, K. M.; Warburton, J.; Owens, R.; Warnick, W. K.

    2008-12-01

    PolarTREC--Teachers and Researchers Exploring and Collaborating, a program of the Arctic Research Consortium of the U.S. (ARCUS), is a National Science Foundation (NSF)--funded International Polar Year (IPY) project in which K-12 educators participate in hands-on field experiences, working closely with IPY scientists as a pathway to improving science education. PolarTREC has developed a successful internet-based platform for teachers and researchers to interact and share their diverse experiences and expertise by creating interdisciplinary educational tools including online journals and forums, real-time Internet seminars, lesson plans, activities, audio, and other educational resources that address a broad range of scientific topics. These highly relevant, adaptable, and accessible resources are available to educators across the globe and have connected thousands of students and citizens to the excitement of polar science. By fostering the integration of research and education and infusing education with the thrill of discovery, PolarTREC will produce a legacy of long-term teacher-researcher collaborations and increased student knowledge of and interest in the polar regions well beyond the IPY time period. Educator and student feedback from preliminary evaluations has shown that PolarTREC's comprehensive program activities have many positive impacts on educators and their ability to teach science concepts and improve their teaching methods. Additionally, K-12 students polled in interest surveys showed significant changes in key areas including amount of time spent in school exploring research activities, importance of understanding science for future work, importance of understanding the polar regions as a person in today's world, as well as increased self-reported knowledge and interest in Science, Technology, Engineering, and Mathematics content areas. PolarTREC provides a tested approach and a clear route for researcher participation in the education community

  11. PolarTREC-Teachers and Researchers Exploring and Collaborating: Science Education from the Poles to the World

    Science.gov (United States)

    Warnick, W. K.; Breen, K.; Warburton, J.; Fischer, K.; Wiggins, H.; Owens, R.; Polly, B.; Wade, B.; Buxbaum, T.

    2007-12-01

    PolarTREC-Teachers and Researchers Exploring and Collaborating is a three-year (2007-2009) teacher professional development program celebrating the International Polar Year (IPY) that advances polar science education by bringing K-12 educators and polar researchers together in hands-on field experiences in the Arctic and Antarctic. Currently in its second year, the program fosters the integration of research and education to produce a legacy of long-term teacher-researcher collaborations, improved teacher content knowledge through experiences in scientific inquiry, and broad public interest and engagement in polar science. Through PolarTREC, over 40 U.S. teachers will spend two to six weeks in the Arctic or Antarctic, working closely with researchers in the field as an integral part of the science team. Research projects focus on a wide range of IPY science themed topics such as sea-ice dynamics, terrestrial ecology, marine biology, atmospheric chemistry, and long-term climate change. While in the field, teachers and researchers will communicate extensively with their colleagues, communities, and hundreds of students of all ages across the globe, using a variety of tools including satellite phones, online journals, podcasts and interactive "Live from IPY" calls and web-based seminars. The online outreach elements of the project convey these experiences to a broad audience far beyond the classrooms of the PolarTREC teachers. In addition to field research experiences, PolarTREC will support teacher professional development and a sustained community of teachers, scientists, and the public through workshops, Internet seminars, an e-mail listserve, and teacher peer groups. To learn more about PolarTREC visit the website at: http://www.polartrec.com or contact info@polartrec.com or 907-474-1600. PolarTREC is funded by NSF and managed by the Arctic Research Consortium of the US (ARCUS).

  12. Organizational Leadership For Building Effective Health Care Teams

    OpenAIRE

    Taplin, Stephen H.; Foster, Mary K.; Shortell, Stephen M.

    2013-01-01

    The movement toward accountable care organizations and patient-centered medical homes will increase with implementation of the Affordable Care Act (ACA). The ACA will therefore give further impetus to the growing importance of teams in health care. Teams typically involve 2 or more people embedded in a larger social system who differentiate their roles, share common goals, interact with each other, and perform tasks affecting others. Multiple team types fit within this definition, and they al...

  13. Terminology extraction from text to build an ontology in surgical intensive care.

    OpenAIRE

    Le Moigno, Sophie; Charlet, Jean; Bourigault, Didier; Degoulet, Patrice; Jaulent, Marie-Christine

    2002-01-01

    In many medical fields, the maintenance of unabiguous terminologies, the comparison and aggregation of different terminologies go through the building of formal specialized clinical terminologies, the ontologies. In this paper, we describe the building of an ontology in the surgical intensive care medical domain. We considered textual reports as the main source of information and a natural language processing tool, the SYNTEX software, is used to build the ontology. We have tested the possibi...

  14. T Cell Receptor Excision Circle (TREC) Monitoring after Allogeneic Stem Cell Transplantation; a Predictive Marker for Complications and Clinical Outcome

    Science.gov (United States)

    Gaballa, Ahmed; Sundin, Mikael; Stikvoort, Arwen; Abumaree, Muhamed; Uzunel, Mehmet; Sairafi, Darius; Uhlin, Michael

    2016-01-01

    Allogeneic hematopoietic stem cell transplantation (HSCT) is a well-established treatment modality for a variety of malignant diseases as well as for inborn errors of the metabolism or immune system. Regardless of disease origin, good clinical effects are dependent on proper immune reconstitution. T cells are responsible for both the beneficial graft-versus-leukemia (GVL) effect against malignant cells and protection against infections. The immune recovery of T cells relies initially on peripheral expansion of mature cells from the graft and later on the differentiation and maturation from donor-derived hematopoietic stem cells. The formation of new T cells occurs in the thymus and as a byproduct, T cell receptor excision circles (TRECs) are released upon rearrangement of the T cell receptor. Detection of TRECs by PCR is a reliable method for estimating the amount of newly formed T cells in the circulation and, indirectly, for estimating thymic function. Here, we discuss the role of TREC analysis in the prediction of clinical outcome after allogeneic HSCT. Due to the pivotal role of T cell reconstitution we propose that TREC analysis should be included as a key indicator in the post-HSCT follow-up. PMID:27727179

  15. University of Twente at the TREC 2007 Enterprise Track : modeling relevance propagation for the expert search task

    NARCIS (Netherlands)

    Serdyukov, Pavel; Rode, Henning; Hiemstra, Djoerd; Voorhees, E.M.; Buckland, Lori P.

    2007-01-01

    This paper describes several approaches which we used for the expert search task of the TREC 2007 Enterprise track. We studied several methods of relevance propagation from documents to related candidate experts. Instead of one-step propagation from documents to directly related candidates, used by

  16. Frequency analysis of TRBV subfamily sjTRECs to characterize T-cell reconstitution in acute leukemia patients after allogeneic hematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Yang Lijian

    2011-04-01

    Full Text Available Abstract Background Allogeneic hematopoietic stem cell transplantation (allo-HSCT leads to a prolonged state of immunodeficiency and requires reconstitution of normal T-cell immunity. Signal joint T-cell receptor excision DNA circles (sjTRECs are markers of developmental proximity to the thymus that have been used to evaluate thymic function related to T-cell immune reconstitution after HSCT. To assess the proliferative history in different T-cell receptor beta variable region (TRBV subfamilies of T cells after HSCT, expansion of TRBV subfamily-naive T cells was determined by analysis of a series of TRBV-BD1 sjTRECs. Methods sjTRECs levels were detected by real-time quantitative polymerase chain reaction (PCR in peripheral blood mononuclear cells (PBMCs from 43 Chinese acute leukemia patients who underwent allo-HSCT. Twenty-three TRBV-BD1 sjTRECs were amplified by semi-nested PCR. Sixteen age-matched healthy volunteers served as normal controls. Results sjTRECs levels were low or undetectable in the first 6 weeks after allo-HSCT and increased after 8 weeks post HSCT; however, sjTRECs levels at week 20 post-HSCT were still less than normal controls. Frequencies of TRBV subfamily sjTRECs in PBMCs from recipients at week 8 post-HSCT (29.17 ± 20.97% or at week 16 post-HSCT (38.33 ± 9.03% were significantly lower than those in donors (47.92 ± 13.82% or recipients at pre-HSCT (45.83 ± 14.03%. However, frequencies of TRBV subfamily sjTRECs in recipients at week 30 post-HSCT (42.71 ± 21.62% were similar to those in donors and recipients at pre-HSCT. sjTRECs levels in donors had a positive linear correlation with sjTRECs levels in recipients within 8-12 weeks post-HSCT. Patients with acute graft-versus-host disease (GVHD or chronic GVHD had profoundly reduced TRECs levels during the first year post-HSCT. Frequencies of BV22-BD1 sjTRECs and BV23-BD1 sjTRECs in patients with GVHD were significantly lower than those in recipients at pre-HSCT, and the

  17. Organizational leadership for building effective health care teams.

    Science.gov (United States)

    Taplin, Stephen H; Foster, Mary K; Shortell, Stephen M

    2013-01-01

    The movement toward accountable care organizations and patient-centered medical homes will increase with implementation of the Affordable Care Act (ACA). The ACA will therefore give further impetus to the growing importance of teams in health care. Teams typically involve 2 or more people embedded in a larger social system who differentiate their roles, share common goals, interact with each other, and perform tasks affecting others. Multiple team types fit within this definition, and they all need support from leadership to succeed. Teams have been invoked as a necessary tool to address the needs of patients with multiple chronic conditions and to address medical workforce shortages. Invoking teams, however, is much easier than making them function effectively, so we need to consider the implications of the growing emphasis on teams. Although the ACA will spur team development, organizational leadership must use what we know now to train, support, and incentivize team function. Meanwhile, we must also advance research regarding teams in health care to give those leaders more evidence to guide their work.

  18. Organizational leadership for building effective health care teams.

    Science.gov (United States)

    Taplin, Stephen H; Foster, Mary K; Shortell, Stephen M

    2013-01-01

    The movement toward accountable care organizations and patient-centered medical homes will increase with implementation of the Affordable Care Act (ACA). The ACA will therefore give further impetus to the growing importance of teams in health care. Teams typically involve 2 or more people embedded in a larger social system who differentiate their roles, share common goals, interact with each other, and perform tasks affecting others. Multiple team types fit within this definition, and they all need support from leadership to succeed. Teams have been invoked as a necessary tool to address the needs of patients with multiple chronic conditions and to address medical workforce shortages. Invoking teams, however, is much easier than making them function effectively, so we need to consider the implications of the growing emphasis on teams. Although the ACA will spur team development, organizational leadership must use what we know now to train, support, and incentivize team function. Meanwhile, we must also advance research regarding teams in health care to give those leaders more evidence to guide their work. PMID:23690329

  19. Utilization review of psychiatric care: building a program that works.

    Science.gov (United States)

    Wilson, P A

    1988-01-01

    Since the early 1970s the federal government, private insurers, and employers have searched for ways to control health care costs. In 1972, Congress, dissatisfied with hospitals' utilization review efforts under the Medicare program created Professional Standards Review Organizations (PSROs). Ten years later when the Medicare reimbursement system underwent radical changes, the utilization review system remained more or less intact but had its name changed to Professional Review Organizations (PROs). The insurance industry has developed and employed, with varying levels of success, several cost-saving tactics, including deductibles and copayments for specialized care, limitation of benefits by diagnosis or facility type, exclusion of specific disorders, inclusion of dollar limits, pre-payment claims review for specific types of service, and post-payment review with retroactive denial of claims. Case management is the latest development in the ever-widening search to put a lid on health care costs. These attempts to measure the effectiveness of care vis a vis the dollar spent for it have been especially difficult for psychiatry, a less measurable science than other fields of medicine. Because psychiatry straddles the disciplines of sociology, psychology, and medicine, it is not easily understood. Inadequate documentation of care, a paucity of outcome studies, and confidentiality issues all combine to make utilization review particularly difficult in psychiatry. This paper will describe a collaboration between Blue Cross and Blue Shield of Maryland and four private psychiatric hospitals in the state that resulted in a workable, effective utilization review program acceptable to providers, payers, and patients. PMID:10318292

  20. Carolinas HealthCare attends to patients, amenities; builds business.

    Science.gov (United States)

    Rees, T

    2000-01-01

    Carolinas HealthCare System has grown into a nearly two billion dollar entity by focusing on patient needs and amenities in its health care facilities. Growth of the system, the largest in North and South Carolina, is due in large part to Harry A. Nurkin, president and CEO, who started out with a run-down hospital for indigents. With the approval of the hospital board, Nurkin launched a marketing effort that included taking a lesson from the founders of the Holiday Inn hotel chain. He remodeled and developed facilities that are pleasing to patients and visitors, moved patient parking closer to the hospitals' front doors, taught key hospital personnel the basics about marketing, aligned the system with ABA and NFL teams and conducted an aggressive advertising program. PMID:11143133

  1. Building A Health Care Data Warehouse for Cancer Diseases

    Directory of Open Access Journals (Sweden)

    Osama E.Sheta

    2012-11-01

    Full Text Available This paper presents architecture for health care data warehouse specific to cancer diseases which could be used by executive managers, doctors, physicians and other health professionals to support the healthcare process. The data today existing in multi sources with different formats makes it necessary to have some techniques for data integration. Executive managers need access to Information so that decision makers can react in real time to changing needs. Information is one of the most factors to an organization success that executive managers or physicians would need to base their decisions on, during decisionmaking. A health care data warehouse is therefore necessary to integrate the different data sources into a central data repository and analysis this data.

  2. A framework to evaluate research capacity building in health care

    Directory of Open Access Journals (Sweden)

    Cooke Jo

    2005-10-01

    Full Text Available Abstract Background Building research capacity in health services has been recognised internationally as important in order to produce a sound evidence base for decision-making in policy and practice. Activities to increase research capacity for, within, and by practice include initiatives to support individuals and teams, organisations and networks. Little has been discussed or concluded about how to measure the effectiveness of research capacity building (RCB Discussion This article attempts to develop the debate on measuring RCB. It highlights that traditional outcomes of publications in peer reviewed journals and successful grant applications may be important outcomes to measure, but they may not address all the relevant issues to highlight progress, especially amongst novice researchers. They do not capture factors that contribute to developing an environment to support capacity development, or on measuring the usefulness or the 'social impact' of research, or on professional outcomes. The paper suggests a framework for planning change and measuring progress, based on six principles of RCB, which have been generated through the analysis of the literature, policy documents, empirical studies, and the experience of one Research and Development Support Unit in the UK. These principles are that RCB should: develop skills and confidence, support linkages and partnerships, ensure the research is 'close to practice', develop appropriate dissemination, invest in infrastructure, and build elements of sustainability and continuity. It is suggested that each principle operates at individual, team, organisation and supra-organisational levels. Some criteria for measuring progress are also given. Summary This paper highlights the need to identify ways of measuring RCB. It points out the limitations of current measurements that exist in the literature, and proposes a framework for measuring progress, which may form the basis of comparison of RCB

  3. Narrative palliative care: a method for building empathy.

    Science.gov (United States)

    Stanley, Patricia; Hurst, Marsha

    2011-01-01

    We make meaning of illness, suffering, and death through narrative, by telling a story. In this article, the authors explore narrative and palliative care: how, at the end of life, narratives of patients, caregivers, and clinicians serve to connect to those still living, and how through each telling and listening, we honor and validate the experience of suffering. A discussion of narrative competence and the skills of attention, representation, and affiliation is followed by an outline of the format for a narrative medicine workshop and a detailed analysis of an experiential exercise in close reading and reflective writing. PMID:21391077

  4. Care of the comatose patient: building mutual staff values.

    Science.gov (United States)

    Hofmann, P B; Smoot, F L

    1985-05-01

    Recognizing individuals' value differences is important to the success of health teams that care for comatose patients, since decisions to withhold or withdraw life-support treatment may lead to conflicts among team members. Such conflicts can adversely affect professional and family relationships. For example, health care personnel cannot work together in harmony or help the family effectively if they disagree about treatment decisions. Although institutional procedures for "do not resuscitate" orders, the treatment of incompetent patients, and other complex issues are helpful, they rarely address value conflicts, which inevitably influence a problem's resolution. Staff members therefore must acknowledge and confront differences they have faced. Such reflection enables catharsis as well as reconciliation of unresolved conflict and permits the group to develop guidelines for future situations. A fictional case also may be used to help work groups gain an understanding of the need for community. Ideally, the team members will sharpen their decision-making skills and gain the confidence to make tough choices in an imperfect, unpredictable world. PMID:10271501

  5. TREC 2010 legal track: method and results of the ELK collaboration

    Energy Technology Data Exchange (ETDEWEB)

    Spearing, Shelly [Los Alamos National Laboratory; Roman, Jorge [Los Alamos National Laboratory; Mc Kay, Bain [KAYVIUM; Lindquist, Eric [EWA-IIT

    2010-10-25

    The ELK team ([E]WA-IIT, [L]os Alamos National laboratory (LANL), and [K]ayvium Corporation (ELK)) used the legal Track task 302 as an opportunity to compare and integrate advanced semantic-automation strategies. The team members believe that enabling parties to discover, consume, analyze, and make decisions in a noisy and information-overloaded environment requires new tools. Together, as well as independently, they are actively developing these tools and view the TREC exercise as an opportunity to test, compare, and complement tools and approaches. Our collaboration is new to TREC, brought together by a shared interest in document relevance, concept-in-context identification and annotation, and the recognition that words out-of-context do not a match make. The team's intent was to lay the foundation for automating the mining and analysis of large volumes of electronic information by litigants and their lawyers, not only in the context of document discovery, but also to support litigation strategy, motion practice, deposition, trial tactics, etc. The premise was that a Subject Matter Expert- (SME-) built model can be automatically mapped onto various search engines for document retrieval, organization, relevance scoring, analysis and decision support. In the end, we ran nearly a dozen models, mostly, but not exclusively, with Kayvium Corporation's knowledge automation technology. The Sal Database Search Engine we used had a bug in its proximity feature, requiring that we develop a workaround. While the work-around was successful, it left us with insufficient time to converge the models to achieve expected quality. However, with optimized proximity processing in place, we would be able to run the model many more times, and believe repeatable quality would be a matter of working through a few requests to get the approach right. We believe that with more time, the results we would achieve might point towards a new way of processing documents for litigation

  6. Abnormal TREC-Based Newborn Screening Test in a Premature Neonate with Massive Perivillous Fibrin Deposition of the Placenta

    Science.gov (United States)

    Kostadinov, Stefan; Robbins, Karen A.; Hayward, Anthony

    2016-01-01

    Severe combined immunodeficiency (SCID), a primary immunodeficiency arising from variable defects in lymphocyte development and survival, is characterized by significant deficiency of thymus derived (T-) lymphocytes and variable defects in the B-lymphocyte population. Newborn screening for SCID is based on detection of low numbers of T-cell receptor excision circles (TRECs) by real time quantitative PCR (RT-qPCR). This screening allows for early identification of individuals with SCID and other disorders characterized by T-lymphopenia. Higher rates of abnormal screens are commonly seen in premature and critically ill neonates, often representing false positives. It is possible that many abnormal screens seen in these populations are result of conditions that are characterized by systemic inflammation or stress, possibly in the context of stress-induced thymic involution. We present a case of a male infant delivered at 27 weeks, 6 days of gestation, with severe intrauterine growth restriction who had an abnormal TREC screen and a massive perivillous fibrin deposition (MPFD) of the placenta. This association has not been reported previously. We are raising the awareness to the fact that conditions, such as MPFD, that can create adverse intrauterine environment are capable of causing severe stress-induced thymic involution of the fetus which can present with abnormal TREC results on newborn screening.

  7. Cancer care coordination: building a platform for the development of care coordinator roles and ongoing evaluation.

    Science.gov (United States)

    Freijser, Louise; Naccarella, Lucio; McKenzie, Rosemary; Krishnasamy, Meinir

    2015-01-01

    Continuity of care is integral to the quality and safety of care provided to people with cancer and their carers. Further evidence is required to examine the contribution Nurse Cancer Care Coordinator (NCCC) roles make in improving the continuity. The aim of the present study was to clarify the assumptions underpinning the NCCC roles and provide a basis for ongoing evaluation. The project comprised a literature review and a qualitative study to develop program logic. The participants who were purposively sampled included policy makers, practitioners, patient advocates, and researchers. Both the literature and participant reports found that NCCC roles are diverse and responsive to contextual influences to coordinate care at the individual (patient), organisational, and systems levels. The application of the program logic for the development of NCCC roles was explored. The conceptualisation of NCCC roles was also examined in relation to Boundary Spanning and Relational Coordination theory. Further research is required to examine how NCCCs contribute to improving equity, safety, quality and coordination of care. The project has implications for research, policy and practice, and makes explicit existing assumptions to provide a platform for further development and evaluation of these roles. PMID:26509202

  8. Teachers, Researchers, and Students Collaborating in Arctic Climate Change Research: The Partnership Between the Svalbard REU and ARCUS PolarTREC programs

    Science.gov (United States)

    Roof, S.; Warburton, J.; Oddo, B.; Kane, M.

    2007-12-01

    Since 2004, the Arctic Research Consortium of the U.S. (ARCUS) "TREC" program (Teachers and Researchers Exploring and Collaborating, now "PolarTREC") has sent four K-12 teachers to Svalbard, Norway to work alongside researchers and undergraduate students conducting climate change research as part of the Svalbard Research Experiences for Undergraduates (REU) Program. The benefits of this scientist/educator/student partnership are many. Researchers benefit from teacher participation as it increases their understanding of student learning and the roles and responsibilities of K-12 teachers. The TREC teacher contributes to the research by making observations, analyzing data, and carrying heavy loads of equipment. In collaborating with K- 12 teachers, undergraduate student participants discover the importance of teamwork in science and the need for effective communication of scientific results to a broad audience. The questions that K-12 teachers ask require the scientists and students in our program to explain their work in terms that non-specialists can understand and appreciate. The K-12 teacher provides a positive career role model and several Svalbard REU undergraduate students have pursued K-12 teaching careers after graduating. TREC teachers benefit from working alongside the researchers and by experiencing the adventures of real scientific research in a remote arctic environment. They return to their schools with a heightened status that allows them to share the excitement and importance of scientific research with their students. Together, all parties contribute to greatly enhance public outreach. With ARCUS logistical support, TREC teachers and researchers do live web conferences from the field, reaching hundreds of students and dozens of school administrators and even local politicians. Teachers maintain web journals, describing the daily activities and progress of the researcher team. Online readers from around the world write in to ask questions, which the

  9. Effects of different temperatures on the performance of seeds germination of Cecropia pachystachya Trec. (Cecropiaceae

    Directory of Open Access Journals (Sweden)

    Rosemari Pilati

    1999-01-01

    Full Text Available Seed germination of Cecropia pachystachya Trec. was investigated at 25, 30, and 35ºC using fluorescent day lights. Ten replicates each of 200 seeds were used in each thermal treatment. Germitest® paper, CEL-065®, and 11x11x5 cm Gerbox® were also used. The frequencies of radicle protrusions were counted at consecutive two hour intervals. The cumulative frequencies were combined with the distribution of Weibull using the following model: Y = M (1 - exp (-(t/bc. The best performance was achieved with the temperature of 30ºC ( M, 95.29%. Time to achieve 60.23% of seed germination (0.6321 x 95.29% was 99.35 h with a spread of 7.19. All model/data set combinations had close to linear.Com o objetivo de avaliar o desempenho germinativo de sementes de Cecropia pachystachya Trec., sob diferentes níveis de temperatura, foi realizado um experimento com sementes coletadas em fragmentos da Floresta Estacional Semidecidual Submontana e Aluvial, localizados na planície de inundação do alto rio Paraná. As sementes foram submetidas a temperaturas constantes de 25ºC, 30ºC e 35ºC. Luzes fluorescentes do tipo "luz do dia" foram mantidas acesas durante todo o período experimental. Cada tratamento consistiu de 10 repetições de 200 sementes distribuídas de maneira uniforme sobre papel especial de germinação, CEL-065, em caixas de plástico transparente do tipo gerbox medindo 11x11x5 cm. As freqüências germinativas foram avaliadas em intervalos consecutivos de duas horas. As freqüências acumuladas foram combinadas com o seguinte modelo da função de Weibull: Y = M ( 1- exp (-(t/bc. Os resultados indicaram que o melhor desempenho germinativo foi alcançado com a temperatura de 30ºC. A porcentagem máxima de germinação (M foi igual a 95,29%, e o tempo (b para a ocorrência de uma porcentagem de germinação igual a 60,23% (0,6321 x 95,29% foi igual a 99,35 horas. A dispersão das germinações (c durante o tempo de avaliação foi igual a 7

  10. Building consensus on key priorities for rural health care in South Africa using the Delphi technique

    Directory of Open Access Journals (Sweden)

    Marije Versteeg

    2013-01-01

    Full Text Available Background: South Africa is currently undergoing major health system restructuring in an attempt to improve health outcomes and reduce inequities in access. Such inequities exist between private and public health care and within the public health system itself. Experience shows that rural health care can be disadvantaged in policy formulation despite good intentions. The objective of this study was to identify the major challenges and priority interventions for rural health care provision in South Africa thereby contributing to pro-rural health policy dialogue. Methods: The Delphi technique was used to develop consensus on a list of statements that was generated through interviews and literature review. A panel of rural health practitioners and other stakeholders was asked to indicate their level of agreement with these statements and to rank the top challenges in and interventions required for rural health care. Results: Response rates ranged from 83% in the first round (n=44 to 64% in the final round (n=34. The top five priorities were aligned to three of the WHO health system building blocks: human resources for health (HRH, governance, and finance. Specifically, the panel identified a need to focus on recruitment and support of rural health professionals, the employment of managers with sufficient and appropriate skills, a rural-friendly national HRH plan, and equitable funding formulae. Conclusion: Specific policies and strategies are required to address the greatest rural health care challenges and to ensure improved access to quality health care in rural South Africa. In addition, a change in organisational climate and a concerted effort to make a career in rural health appealing to health care workers and adequate funding for rural health care provision are essential.

  11. Deficient T Cell Receptor Excision Circles (TRECs) in autosomal recessive hyper IgE syndrome caused by DOCK8 mutation: implications for pathogenesis and potential detection by newborn screening.

    Science.gov (United States)

    Dasouki, Majed; Okonkwo, Kingsley C; Ray, Abhishek; Folmsbeel, Caspian K; Gozales, Diana; Keles, Sevgi; Puck, Jennifer M; Chatila, Talal

    2011-11-01

    Loss of function of DOCK8 is the major cause of autosomal recessive hyper IgE syndrome, a primary immunodeficiency with adaptive and innate immune dysfunction. Patients affected with ARHIES have atopic dermatitis and recurrent, potentially life-threatening viral and bacterial infections. Three consanguineous Pakistani siblings presented with severe atopic dermatitis and superinfection. Direct sequencing of DOCK8 in all three affected siblings demonstrated homozygosity for a deleterious, novel exon 14 frame shift mutation. Current newborn screening for severe combined immunodeficiency syndrome (SCID) and related T cell disorders relies on the quantitation of T Cell Receptor Excision Cells (TRECs) in dried blood spots (DBS). Significantly, both older affected siblings had undetectable TRECs, and TREC copy number was reduced in the youngest sibling. These findings suggest that AR-HIES may be detected by TREC newborn screening, and this diagnosis should be considered in the evaluation of newborns with abnormal TRECs who do not have typical SCID. PMID:21763205

  12. Building social capital in healthcare organizations: thinking ecologically for safer care.

    Science.gov (United States)

    Hofmeyer, Anne; Marck, Patricia B

    2008-01-01

    Research on patient safety and health human resources, 2 critical issues for 21st century healthcare, converges on similar findings. Specifically, it is apparent that along with the patients, families, and communities we serve, nurses and other healthcare professionals navigate a volatile health care system where persistent restructuring, market pressures, and workforce instability present ongoing threats to the delivery of safer care. Drawing from the fields of nursing, healthcare ethics, health systems management, and ecological restoration, we outline the role of social capital for organizational integrity, healthy workplace cultures, sustainable resource management, improved nurse retention, effective knowledge translation, and safer patient care. Nursing leaders can use ecological thinking to build the vital resource of social capital by taking concrete steps to commit the necessary human and material resources to: (1) forge relations to foster bonding, bridging and linking social capital; (2) build solidarity and trust; (3) foster collective action and cooperation; (4) strengthen communication and knowledge exchange; and (5) create capacity for social cohesion and inclusion. PMID:18675014

  13. Building integrated care systems: a case study of Bidasoa Integrated Health Organisation

    Directory of Open Access Journals (Sweden)

    Nuria Toro Polanco

    2015-06-01

    Full Text Available Introduction: This paper analyses the implementation of integrated care policies in the Basque Country through the deployment of an Integrated Health Organisation in Bidasoa area during the period 2011–2014. Structural, functional and clinical integration policies have been employed with the aim to deliver integrated and person-centred care for patients, especially for those living with chronic conditions. Methods: This organisational case study used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the organisational development over a 4-year period. In order to measure the progress of integration three concepts have been measured: (i readiness for chronicity measured with Assessment of Readiness for Chronicity in Healthcare Organisations tool; (ii collaboration between clinicians from different care levels measured with the D'Amour Questionnaire, and (iii overall impact of integration through several indicators based on the Triple Aim Framework. Results: The measurement of organisational readiness for chronicity showed improvements in five of the six areas under evaluation. Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items. Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients’ perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure. Conclusion: There is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes.

  14. Building integrated care systems: a case study of Bidasoa Integrated Health Organisation

    Directory of Open Access Journals (Sweden)

    Nuria Toro Polanco

    2015-06-01

    Full Text Available Introduction: This paper analyses the implementation of integrated care policies in the Basque Country through the deployment of an Integrated Health Organisation in Bidasoa area during the period 2011–2014. Structural, functional and clinical integration policies have been employed with the aim to deliver integrated and person-centred care for patients, especially for those living with chronic conditions.Methods: This organisational case study used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the organisational development over a 4-year period. In order to measure the progress of integration three concepts have been measured: (i readiness for chronicity measured with Assessment of Readiness for Chronicity in Healthcare Organisations tool; (ii collaboration between clinicians from different care levels measured with the D'Amour Questionnaire, and (iii overall impact of integration through several indicators based on the Triple Aim Framework.Results: The measurement of organisational readiness for chronicity showed improvements in five of the six areas under evaluation. Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items. Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients’ perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure.Conclusion: There is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes.

  15. Building Sustainable Capacity for Cardiovascular Care at a Public Hospital in Western Kenya.

    Science.gov (United States)

    Binanay, Cynthia A; Akwanalo, Constantine O; Aruasa, Wilson; Barasa, Felix A; Corey, G Ralph; Crowe, Susie; Esamai, Fabian; Einterz, Robert; Foster, Michael C; Gardner, Adrian; Kibosia, John; Kimaiyo, Sylvester; Koech, Myra; Korir, Belinda; Lawrence, John E; Lukas, Stephanie; Manji, Imran; Maritim, Peris; Ogaro, Francis; Park, Peter; Pastakia, Sonak D; Sugut, Wilson; Vedanthan, Rajesh; Yanoh, Reuben; Velazquez, Eric J; Bloomfield, Gerald S

    2015-12-01

    Cardiovascular disease deaths are increasing in low- and middle-income countries and are exacerbated by health care systems that are ill-equipped to manage chronic diseases. Global health partnerships, which have stemmed the tide of infectious diseases in low- and middle-income countries, can be similarly applied to address cardiovascular diseases. In this review, we present the experiences of an academic partnership between North American and Kenyan medical centers to improve cardiovascular health in a national public referral hospital. We highlight our stepwise approach to developing sustainable cardiovascular services using the health system strengthening World Health Organization Framework for Action. The building blocks of this framework (leadership and governance, health workforce, health service delivery, health financing, access to essential medicines, and health information system) guided our comprehensive and sustainable approach to delivering subspecialty care in a resource-limited setting. Our experiences may guide the development of similar collaborations in other settings.

  16. El enojo en madres y padres de hijas adolescentes: propuesta de orientación desde la TREC y la inteligencia emocional / The anger in parents of teenage daughters: propose of guidance since the TREC and emotional intelligence

    Directory of Open Access Journals (Sweden)

    Murillo Aguilar, Osvaldo

    2008-08-01

    Full Text Available Resumen: Este artículo, basado en la tesis de grado denominada “Expresión del Enojo en Madres y Padres de Hijas Adolescentes: Propuesta de Orientación desde el Enfoque de la TREC”, realizada por Jessie Arroyo Zúñiga y Osvaldo Murillo Aguilar, para optar por el grado de licenciatura en Orientación en el año 2008, ofrece desde esta disciplina, una integración entre la teoría de la Inteligencia Emocional y el enfoque de la Terapia Racional Emotivo – Conductual (TREC, para comprender y abordar la expresión del enojo en estas madres y padres de hijas adolescentes. Por ello, como recomendación, se presenta una propuesta de Orientación que pretende fortalecer los vínculos de las madres y padres con sus hijas adolescentes, por medio de un proceso que propicie formas de expresión emocionalmente saludables del enojo, basado en la integración de la teoría de la inteligencia emocional y el enfoque de la TREC. Para la elaboración del presente trabajo se establecieron los siguientes objetivos: 1. Analizar las formas en las que expresan el enojo las madres y los padres de familia del Liceo María Auxiliadora.2. Elaborar estrategias de Orientación dirigidas a madres y padres de hijas adolescentes que promuevan una expresión saludable del enojo. La metodología se estableció bajo la perspectiva cualitativa, que permitió la comprensión de las experiencias de las madres y los padres, sus emociones, pensamientos y conductas. La principal técnica de recolección de información fueron los grupos focales, y se analizó a partir de la organización y codificación de datos, por medio de categorías de análisis.Abstract: This article, based on the thesis entitled "Expression of Anger in Mothers and Fathers of Daughters Teens: proposed of Guidance since the TREC" performed by Jessie Arroyo Zúñiga and Osvaldo Murillo Aguilar, to graduate in Guidance in the 2008; offers from this discipline, an integration between the theory of Emotional

  17. Interprofessional team building in the palliative home care setting: Use of a conceptual framework to inform a pilot evaluation.

    Science.gov (United States)

    Shaw, James; Kearney, Colleen; Glenns, Brenda; McKay, Sandra

    2016-01-01

    Home-based palliative care is increasingly dependent on interprofessional teams to deliver collaborative care that more adequately meets the needs of clients and families. The purpose of this pilot evaluation was to qualitatively explore the views of an interprofessional group of home care providers (occupational therapists, nurses, personal support work supervisors, community care coordinators, and a team coordinator) regarding a pilot project encouraging teamwork in interprofessional palliative home care services. We used qualitative methods, informed by an interprofessional conceptual framework, to analyse participants' accounts and provide recommendations regarding strategies for interprofessional team building in palliative home health care. Findings suggest that encouraging practitioners to share past experiences and foster common goals for palliative care are important elements of team building in interprofessional palliative care. Also, establishing a team leader who emphasises sharing power among team members and addressing the need for mutual emotional support may help to maximise interprofessional teamwork in palliative home care. These findings may be used to develop and test more comprehensive efforts to promote stronger interprofessional teamwork in palliative home health care delivery. PMID:27026192

  18. Interprofessional team building in the palliative home care setting: Use of a conceptual framework to inform a pilot evaluation.

    Science.gov (United States)

    Shaw, James; Kearney, Colleen; Glenns, Brenda; McKay, Sandra

    2016-01-01

    Home-based palliative care is increasingly dependent on interprofessional teams to deliver collaborative care that more adequately meets the needs of clients and families. The purpose of this pilot evaluation was to qualitatively explore the views of an interprofessional group of home care providers (occupational therapists, nurses, personal support work supervisors, community care coordinators, and a team coordinator) regarding a pilot project encouraging teamwork in interprofessional palliative home care services. We used qualitative methods, informed by an interprofessional conceptual framework, to analyse participants' accounts and provide recommendations regarding strategies for interprofessional team building in palliative home health care. Findings suggest that encouraging practitioners to share past experiences and foster common goals for palliative care are important elements of team building in interprofessional palliative care. Also, establishing a team leader who emphasises sharing power among team members and addressing the need for mutual emotional support may help to maximise interprofessional teamwork in palliative home care. These findings may be used to develop and test more comprehensive efforts to promote stronger interprofessional teamwork in palliative home health care delivery.

  19. Challenges and opportunities in building a sustainable rural primary care workforce in alignment with the Affordable Care Act: the WWAMI program as a case study.

    Science.gov (United States)

    Allen, Suzanne M; Ballweg, Ruth A; Cosgrove, Ellen M; Engle, Kellie A; Robinson, Lawrence R; Rosenblatt, Roger A; Skillman, Susan M; Wenrich, Marjorie D

    2013-12-01

    The authors examine the potential impact of the Patient Protection and Affordable Care Act (ACA) on a large medical education program in the Northwest United States that builds the primary care workforce for its largely rural region. The 42-year-old Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) program, hosted by the University of Washington School of Medicine, is one of the nation's most successful models for rural health training. The program has expanded training and retention of primary care health professionals for the region through medical school education, graduate medical education, a physician assistant training program, and support for practicing health professionals.The ACA and resulting accountable care organizations (ACOs) present potential challenges for rural settings and health training programs like WWAMI that focus on building the health workforce for rural and underserved populations. As more Americans acquire health coverage, more health professionals will be needed, especially in primary care. Rural locations may face increased competition for these professionals. Medical schools are expanding their positions to meet the need, but limits on graduate medical education expansion may result in a bottleneck, with insufficient residency positions for graduating students. The development of ACOs may further challenge building a rural workforce by limiting training opportunities for health professionals because of competing demands and concerns about cost, efficiency, and safety associated with training. Medical education programs like WWAMI will need to increase efforts to train primary care physicians and increase their advocacy for student programs and additional graduate medical education for rural constituents.

  20. Doubling down: Lessons learned from building a new electronic health record as part of primary care practice redesign.

    Science.gov (United States)

    Schutzbank, Andrew; Fernandopulle, Rushika

    2014-03-01

    Iora Health is a primary care delivery company creating de novo primary care practices with the mission of restoring humanity to health care. To support our very different and evolving model of team-based primary care we realized we needed to build our own electronic health record (EHR). This perspective shares four key lessons from the software development process: the tight relationship between delivery innovation and software development, the benefits of Agile development, the value of having the clinicians at all levels as part of the software development team, and different ways to think about clinical information. PMID:26250083

  1. Building the national health information infrastructure for personal health, health care services, public health, and research

    Directory of Open Access Journals (Sweden)

    Detmer Don E

    2003-01-01

    Full Text Available Abstract Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries. The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin

  2. How a Beacon Community Program in New Orleans Helped Create a Better Health Care System By Building Relationships Before Technology

    OpenAIRE

    Khurshid, Anjum; Brown, Lisanne

    2014-01-01

    Introduction: In the aftermath of Hurricane Katrina, much of New Orleans’ healthcare infrastructure was destroyed. Initial federal funding after the storm expanded primary care services and helped set up medical homes for New Orleans’ large uninsured and underinsured population. Following that, the Beacon Community in New Orleans, charged with improving health care through the use of technology, decided the best way to accomplish those goals was to build community partnerships and introduce t...

  3. 3D Sensing Algorithms Towards Building an Intelligent Intensive Care Unit.

    Science.gov (United States)

    Lea, Colin; Facker, James; Hager, Gregory; Taylor, Russell; Saria, Suchi

    2013-01-01

    Intensive Care Units (ICUs) are chaotic places where hundreds of tasks are carried out by many different people. Timely and coordinated execution of these tasks are directly related to quality of patient outcomes. An improved understanding of the current care process can aid in improving quality. Our goal is to build towards a system that automatically catalogs various tasks being performed by the bedside. We propose a set of techniques using computer vision and machine learning to develop a system that passively senses the environment and identifies seven common actions such as documenting, checking up on a patient, and performing a procedure. Preliminary evaluation of our system on 5.5 hours of data from the Pediatric ICU obtains overall task recognition accuracy of 70%. Furthermore, we show how it can be used to summarize and visualize tasks. Our system provides a significant departure from current approaches used for quality improvement. With further improvement, we think that such a system could realistically be deployed in the ICU. PMID:24303253

  4. T-cell Receptor Excision Circles (TREC) in CD4+ and CD8+ T-cell Subpopulations in Atopic Dermatitis and Psoriasis Show Major Differences in the Emission of Recent Thymic Emigrants

    DEFF Research Database (Denmark)

    Just, Helle; Deleuran, Mette; Vestergaard, Christian;

    2008-01-01

    We used T-cell receptor excision circles (TREC) to evaluate thymic function in adult patients with atopic dermatitis and psoriasis. We observed that men, but not women, with atopic dermatitis had a significantly faster decline in TREC content with increasing age compared with healthy men. In cont......-cells, this indicates that atopic dermatitis patients can have compensatory emissions of thymic emigrants, whereas psoriatic patients do not, thus supporting different thymic function in these two diseases....

  5. Supporting Youth Transitioning out of Foster Care. Issue Brief 2: Financial Literacy and Asset Building Programs. OPRE Report No. 2014-69

    Science.gov (United States)

    Edelstein, Sara; Lowenstein, Christopher

    2014-01-01

    This issue brief is one of three that focus on programs providing services to youth transitioning out of foster care in three common service domains: education, employment, and financial literacy and asset building. This brief highlights why financial literacy and asset building services are important to youth currently or formerly in foster care,…

  6. An evaluation of the 'Designated Research Team' approach to building research capacity in primary care

    Directory of Open Access Journals (Sweden)

    Dyas Jane

    2008-06-01

    Full Text Available Abstract Background This paper describes an evaluation of an initiative to increase the research capability of clinical groups in primary and community care settings in a region of the United Kingdom. The 'designated research team' (DRT approach was evaluated using indicators derived from a framework of six principles for research capacity building (RCB which include: building skills and confidence, relevance to practice, dissemination, linkages and collaborations, sustainability and infrastructure development. Methods Information was collated on the context, activities, experiences, outputs and impacts of six clinical research teams supported by Trent Research Development Support Unit (RDSU as DRTs. Process and outcome data from each of the teams was used to evaluate the extent to which the DRT approach was effective in building research capacity in each of the six principles (as evidenced by twenty possible indicators of research capacity development. Results The DRT approach was found to be well aligned to the principles of RCB and generally effective in developing research capabilities. It proved particularly effective in developing linkages, collaborations and skills. Where research capacity was slow to develop, this was reflected in poor alignment between the principles of RCB and the characteristics of the team, their activities or environment. One team was unable to develop a research project and the funding was withdrawn at an early stage. For at least one individual in each of the remaining five teams, research activity was sustained beyond the funding period through research partnerships and funding successes. An enabling infrastructure, including being freed from clinical duties to undertake research, and support from senior management were found to be important determinants of successful DRT development. Research questions of DRTs were derived from practice issues and several projects generated outputs with potential to change daily

  7. Building an Integrative Outpatient Care Program for Breast Cancer Patients in Taiwan.

    Science.gov (United States)

    Lin, Yi-Hsien; Shiu, Jing-Huei; Chen, Fang-Pey; Chiu, Jen-Hwey

    2016-09-01

    Background Breast cancer patients may experience various symptoms that affect the quality of life significantly and they seek complementary and alternative medicine (CAM). To meet the needs of patients, we developed an integrative outpatient care program. Methods This program provided CAM consultation and acupuncture for breast cancer patients at Taipei Veterans General Hospital. The outcome measures included Medical Outcomes Study 12-Item Short-Form Health Survey (SF-12) and patient satisfaction questionnaires on the first visit (baseline) and at 6 months. Results Forty-five breast cancer patients were enrolled. All patients completed the study. The median age was 53.3 (±8.3). The symptoms most often experienced during previous cancer treatments were fatigue (35.6%), arthralgia (20%), nausea (6.7%), and insomnia (6.7%). The symptoms most wished to be diminished by the patients were arthralgia (22.2%), insomnia (17.8%), and fatigue (15.6%). Thirty-four patients (75.6%) had sought CAM therapy to reduce these symptoms. Fifteen patients (33.3%) received CAM consultation only and 30 (66.7%) received acupuncture in addition. Sixteen patients completed at least 6 sessions of acupuncture. No serious adverse effect was reported. In the SF-12 Questionnaire on all the patients, physical component summary (PCS) was 49.6 (±5.6) at baseline and 44.9 (±7.6) at 6 months (P = .001); the mental component summary (MCS) was 44.7 (±6.1) at baseline and 52.3 (±9.3) at 6 months (P research to build a model that integrates CAM with conventional medicine in Taiwan. PMID:26453537

  8. Building capacity for quality and safety in critical care: A roundtable discussion from the second international patient safety conference in April 9-11, 2013, Riyadh, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Yaseen M Arabi

    2013-01-01

    Full Text Available This paper summarizes the roundtable discussion from the Second International Patient Safety Conference held in April 9-11, 2013, Riyadh, Saudi Arabia. The objectives of the roundtable discussion were to: (1 review the conceptual framework for building capacity in quality and safety in critical care. (2 examine examples of leading international experiences in building capacity. (3 review the experience in Saudi Arabia in this area. (4 discuss the role of building capacity in simulation for patient safety in critical care and (5 review the experience in building capacity in an ongoing improvement project for severe sepsis and septic shock.

  9. We can work it out: Group decision-making builds social identity and enhances the cognitive performance of care residents.

    Science.gov (United States)

    Haslam, Catherine; Alexander Haslam, S; Knight, Craig; Gleibs, Ilka; Ysseldyk, Renate; McCloskey, Lauren-Grace

    2014-02-01

    Group-based interventions have been argued to slow the cognitive decline of older people residing in care by building social identification and thereby increasing motivation and engagement. The present study explored the identity-cognition association further by investigating the impact of a group decision-making intervention on cognition. Thirty-six care home residents were assigned to one of three conditions: an Intervention in which they made decisions about lounge refurbishment as a group, a Comparison condition in which staff made these decisions, or a no-treatment Control. Cognitive function, social identification, home satisfaction, and lounge use were measured before and after the intervention. Participants in the Intervention condition showed significant increases on all measures, and greater improvement than participants in both Comparison and Control conditions. Consistent with social identity theorizing, these findings point to the role of group activity and social identification in promoting cognitive integrity and well-being among care residents. PMID:24387094

  10. DEVELOPMENT OF REAL-TIME MULTIPLEX PCR FOR THE QUANTITATIVE DETERMINATION OF TREC'S AND KREC'S IN WHOLE BLOOD AND IN DRIED BLOOD SPOTS

    Directory of Open Access Journals (Sweden)

    M. A. Gordukova

    2015-01-01

    Full Text Available Primary immunodeficiencies (PID such as severe combined immunodeficiency (SCID and X-linked agammaglobulinemia are characterized by the lack of functional Tand B-cells, respectively. Without early diagnosis and prompt treatment children with PID suffer from severe infectious diseases, leading to their death or disability. Our purpose was developing of simple, inexpensive, high throughput technique based on the quantitative determination of TREC and KREC molecules by real-time PCR, and its validation in a group of children with a verified diagnosis of SCID and X-linked agammaglobulinemia.In this study, we developed and validated multiplex real-time PCR for the TREC’s and KREC’s quantitative analysis. We have shown that linear range of Ct changes depending on the concentrations of targets with a correlation coefficient R2 not worse than 0.98 was observed at concentrations from 109 to 5 × 104 copies per ml. The lowest amount of targets reliably detected in a reaction volume was 10 TREC’s copies, 5 KREC ‘s copies and 5 copies of internal control (IL17RA. We determined the age-depended reference values of TRECs and KRECs in whole blood in 29 boys and 27 girls with normal immunological parameters. The normal cut-offs for TRECs and KRECs were defined in dry blood spots depending on the method of extraction.The proposed method showed 100% diagnostic sensitivity and specificity in the studied group. The method can be proposed as a screening tool for the diagnosis of SCID and X-linked agammaglobulinemia both in whole blood and in the dry blood spots. The further investigation is required with larger number of samples. 

  11. Researcher and Educator Long Term Collaboration with NOAA ESRL Regarding Atmospheric Ozone Changes at the South Pole Through the NSF PolarTREC Program

    Science.gov (United States)

    Bergholz, E. H.; Hofmann, D. J.; Johnson, B. J.

    2009-12-01

    The NOAA/ESRL team at South Pole has been monitoring the development of the annual ozone hole over two decades using balloon-borne and ground based instruments. Collaboration with educators has become an important aspect of NOAA/ESRL to educate the public about ozone loss and ozone hole formation. Researcher Bryan Johnson and educator Elke Bergholz worked together at South Pole in 1998/1999 as part of the NSF teacher outreach program called Teachers Experiencing Antarctica (TEA).It has been almost a decade when they collaborated again concerning the ozone changes at South Pole as part of the International Polar Year (IPY) and the PolarTREC ( http://wwpolartrec.com ) teacher outreach program sponsored by NSF. The TEA and PolarTREC programs selected teachers to travel to polar locations to work with research scientists collecting data and running experiments at various Arctic and Antarctic field sites, including Elke Bergholz working at the South Pole with the NOAA/ESRL team. While in the field, daily contact with classrooms and students around the globe was done through the internet journals, answering emails from students, and webinars. This has been followed up with presentations to schools and the public relating Ms. Bergholz’s experience and new “hands-on” understanding of ozone instruments and ozone depletion over Antarctica, and discussing what changes in the ozone we have seen at South Pole since the first outreach program nearly a decade ago. The lesson plans are available through the PolarTREC website or by contacting Elke Bergholz at ebergholz@unis.org.

  12. Building social participation with a support group users: challenges of care qualification in a Psychosocial Care Center (CAPS

    Directory of Open Access Journals (Sweden)

    Vitor Corrêa Detomini

    2015-09-01

    Full Text Available The literature points out a lack of studies describing practical experiences approaching the role of social participation, even though, the subject Brazilian Health System (SUS as a principle is valued by theoretical-conceptual works. The lack of studies is especially observed in mental health care services, where the existing studies focus on the users’ management engagement as part of psychosocial rehabilitation. Thus, this article introduces an experience developed in a Center for Psycho-Social Attention (CAPS, in the state of Mato Grosso do Sul, aiming to address the issue of social participation in care qualification, in accordance to legislation and technical standards. Thisstudy focused on two types of sources. 1 Internship Final Report of a Psycology Student including 54 sessions of a support group, 2 technical and legal documents concerning the SUS and the National Mental Health Policy and Humanization. The service aspects were analyzed through technical and legislative foundations - focusing the needs and claims on group discussions, classified as structure and process, used to assess the health care quality. Most concerns were listed on normative Ordinances and Regulations. Achieving social participation was not an institutional premise and, among the main difficulties was the medical/outpatient centered model and the representation of “crazy”/”CAPS users” as incapable. It requires: i integration of “clinic” and “politics”; ii intensification of interdisciplinary and psychological care; iii respect the citizenship of mental health users, and, finally, iv that the collective participation spaces do not exhaust themselves. Therefore, the collective participation spaces need practical recommendations in order to improve the structures and work processes and meet the users’ needs.

  13. Building social participation with a support group users: challenges of care qualification in a Psychosocial Care Center (CAPS)

    OpenAIRE

    Vitor Corrêa Detomini; Renata Bellenzani

    2015-01-01

    The literature points out a lack of studies describing practical experiences approaching the role of social participation, even though, the subject Brazilian Health System (SUS) as a principle is valued by theoretical-conceptual works. The lack of studies is especially observed in mental health care services, where the existing studies focus on the users’ management engagement as part of psychosocial rehabilitation. Thus, this article introduces an experience developed in a Center for Psycho-...

  14. Building a health care workforce for the future: more physicians, professional reforms, and technological advances.

    Science.gov (United States)

    Grover, Atul; Niecko-Najjum, Lidia M

    2013-11-01

    Traditionally, projections of US health care demand have been based upon a combination of existing trends in usage and idealized or expected delivery system changes. For example, 1990s health care demand projections were based upon an expectation that delivery models would move toward closed, tightly managed care networks and would greatly decrease the demand for subspecialty care. Today, however, a different equation is needed on which to base such projections. Realistic workforce planning must take into account the fact that expanded access to health care, a growing and aging population, increased comorbidity, and longer life expectancy will all increase the use of health care services per capita over the next few decades--at a time when the number of physicians per capita will begin to drop. New technologies and more aggressive screening may also change the equation. Strategies to address these increasing demands on the health system must include expanded physician training.

  15. Building New Teams for Late Life Care: Lessons From LifeCourse.

    Science.gov (United States)

    Schellinger, Sandra; Cain, Cindy L; Shibrowski, Kathleen; Elumba, Deborah; Rosenberg, Erin

    2016-07-01

    This article details team development within a longitudinal cohort study designed to bring team-based, whole person care early in the course of serious illness. The primary innovation of this approach is the use of nonclinically trained care guides who support patients and family members by focusing care around what matters most to patients, linking to resources, collaborating with other providers, and offering continuity through care transitions. By describing the development of this team, we document the kinds of questions others may ask during the process of team creation. PMID:25747670

  16. Opinions on building design for old-aged caring facility%关于养老设施建筑设计的几点看法

    Institute of Scientific and Technical Information of China (English)

    董越秀

    2016-01-01

    根据养老设施的建筑设计理念,介绍了养老设施的建筑内容,从整体规划、居住单元、绿色设计等方面,阐述了养老设施建筑设计的要点,使养老建筑的设计实现全面化、通达化、庭院化、舒适化。%According to building design concept of old-age caring facility,the paper introduces the old-age caring facility building contents. Start-ing from aspects of integral planning,housing unit and green design,it describes the building design points of old-age caring facility,so as to make old-age caring building design comprehensive,smooth,comfortable and garden-like yards.

  17. Embodied Germ Cell at Work: Building an Expansive Concept of Physical Mobility in Home Care

    Science.gov (United States)

    Engestrom, Yrjo; Nummijoki, Jaana; Sannino, Annalisa

    2012-01-01

    This article presents a process of collective formation of a new concept of mobility between home care workers and their elderly clients, who are at risk of losing physical mobility and functional capacity. A new tool called mobility agreement was introduced to facilitate the inclusion of regular mobility exercises in home care visits and in the…

  18. [Palliative care birth plan: a field of perinatal medicine to build].

    Science.gov (United States)

    Tosello, B; Le Coz, P; Payot, A; Gire, C; Einaudi, M-A

    2013-04-01

    Some couples may choose to continue the pregnancy unable to decide for termination of pregnancy. Such situations recently occurred in neonatology units and may lead to neonatal palliative care. Faced with all uncertainties inherent to medicine and the future of the baby, medical teams must inform parents of different possible outcome step by step. Consistency in the reflection and intentionality of the care is essential among all different stakeholders within the same health team to facilitate support of parents up to a possible fatal outcome. This issue in perinatal medicine seems to be to explore how caregivers can contribute in the construction of parenthood in a context of a palliative care birth plan.

  19. Building patient safety in intensive care nursing : Patient safety culture, team performance and simulation-based training

    OpenAIRE

    Ballangrud, Randi

    2013-01-01

    Aim: The overall aim of the thesis was to investigate patient safety culture, team performance and the use of simulation-based team training for building patient safety in intensive care nursing. Methods: Quantitative and qualitative methods were used. In Study I, 220 RNs from ten ICUs responded to a patient safety culture questionnaire analysed with statistics. Studies II-IV were based on an evaluation of a simulation-based team training programme. Studies II-III included 53 RNs from seven I...

  20. A New IL-2RG Gene Mutation in an X-linked SCID Identified through TREC/KREC Screening: a Case Report

    Directory of Open Access Journals (Sweden)

    Maryam Nourizadeh

    2015-10-01

    Full Text Available Severe combined immunodeficiency (SCID represents a rare group of primary immunodeficiency disorders (PIDs, with known or unknown genetic alterations. Here, we report a new interleukin 2 receptor, gamma chain (IL-2RG mutation in an Iranian SCID newborn.The patient was a 6-day old boy with a family history of PID. The child was screened using a molecular-based analysis for the assessment of T cell receptor excision circles (TRECs and kappa-deleting recombination excision circles (KRECs. Moreover, a complete immunological evaluation and gene sequencing was performed.Results showed undetectable TREC but a high level of KREC copy numbers. Flowcytometric data indicated low numbers of T and NK cells, but elevated number of B cells. A novel substitution in IL2RG: c.675 C>A, leading to p.225 Ser>Arg was found. Based on the functional analysis, the mutation is predicted to be damaging. The patient was diagnosed as a T B+ NK X-linked SCID.

  1. Building Trust and Relationships Between Patients and Providers: An Essential Complement to Health Literacy in HIV Care.

    Science.gov (United States)

    Dawson-Rose, Carol; Cuca, Yvette P; Webel, Allison R; Solís Báez, Solymar S; Holzemer, William L; Rivero-Méndez, Marta; Sanzero Eller, Lucille; Reid, Paula; Johnson, Mallory O; Kemppainen, Jeanne; Reyes, Darcel; Nokes, Kathleen; Nicholas, Patrice K; Matshediso, Ellah; Mogobe, Keitshokile Dintle; Sabone, Motshedisi B; Ntsayagae, Esther I; Shaibu, Sheila; Corless, Inge B; Wantland, Dean; Lindgren, Teri

    2016-01-01

    Health literacy is important for access to and quality of HIV care. While most models of health literacy acknowledge the importance of the patient-provider relationship to disease management, a more nuanced understanding of this relationship is needed. Thematic analysis from 28 focus groups with HIV-experienced patients (n = 135) and providers (n = 71) identified a long-term and trusting relationship as an essential part of HIV treatment over the continuum of HIV care. We found that trust and relationship building over time were important for patients with HIV as well as for their providers. An expanded definition of health literacy that includes gaining a patient's trust and engaging in a process of health education and information sharing over time could improve HIV care. Expanding clinical perspectives to include trust and the importance of the patient-provider relationship to a shared understanding of health literacy may improve patient experiences and engagement in care. PMID:27080926

  2. Capacity building in the health sector to improve care for child nutrition and development.

    Science.gov (United States)

    Yousafzai, Aisha K; Rasheed, Muneera A; Daelmans, Bernadette; Manji, Sheila; Arnold, Caroline; Lingam, Raghu; Muskin, Joshua; Lucas, Jane E

    2014-01-01

    The effectiveness of interventions promoting healthy child growth and development depends upon the capacity of the health system to deliver a high-quality intervention. However, few health workers are trained in providing integrated early child-development services. Building capacity entails not only training the frontline worker, but also mobilizing knowledge and support to promote early child development across the health system. In this paper, we present the paradigm shift required to build effective partnerships between health workers and families in order to support children's health, growth, and development, the practical skills frontline health workers require to promote optimal caregiving, and the need for knowledge mobilization across multiple institutional levels to support frontline health workers. We present case studies illustrating challenges and success stories around capacity development. There is a need to galvanize increased commitment and resources to building capacity in health systems to deliver early child-development services.

  3. Building capacity for dementia care in Latin America and the Caribbean

    Science.gov (United States)

    Gonzalez, Francisco J.; Gaona, Ciro; Quintero, Marialcira; Chavez, Carlos A.; Selga, Joyce; Maestre, Gladys E.

    2015-01-01

    Latin America and the Caribbean (LAC) have limited facilities and professionals trained to diagnose, treat, and support people with dementia and other forms of cognitive impairment. The situation for people with dementia is poor, and worsening as the proportion of elderly in the general population is rapidly expanding. We reviewed existing initiatives and provided examples of actions taken to build capacity and improve the effectiveness of individuals, organizations, and national systems that provide treatment and support for people with dementia and their caregivers. Regional barriers to capacity building and the importance of public engagement are highlighted. Existing programs need to disseminate their objectives, accomplishments, limitations, and overall lessons learned in order to gain greater recognition of the need for capacity-building programs. PMID:25932285

  4. Building effective service linkages in primary mental health care: a narrative review part 2

    Directory of Open Access Journals (Sweden)

    Parker Sharon

    2011-03-01

    Full Text Available Abstract Background Primary care services have not generally been effective in meeting mental health care needs. There is evidence that collaboration between primary care and specialist mental health services can improve clinical and organisational outcomes. It is not clear however what factors enable or hinder effective collaboration. The objective of this study was to examine the factors that enable effective collaboration between specialist mental health services and primary mental health care. Methods A narrative and thematic review of English language papers published between 1998 and 2009. An expert reference group helped formulate strategies for policy makers. Studies of descriptive and qualitative design from Australia, New Zealand, UK, Europe, USA and Canada were included. Data were extracted on factors reported as enablers or barriers to development of service linkages. These were tabulated by theme at clinical and organisational levels and the inter-relationship between themes was explored. Results A thematic analysis of 30 papers found the most frequently cited group of factors was "partnership formation", specifically role clarity between health care workers. Other factor groups supporting clinical partnership formation were staff support, clinician attributes, clinic physical features and evaluation and feedback. At the organisational level a supportive institutional environment of leadership and change management was important. The expert reference group then proposed strategies for collaboration that would be seen as important, acceptable and feasible. Because of the variability of study types we did not exclude on quality and findings are weighted by the number of studies. Variability in local service contexts limits the generalisation of findings. Conclusion The findings provide a framework for health planners to develop effective service linkages in primary mental health care. Our expert reference group proposed five areas of

  5. Insights into the impact and use of research results in a residential long-term care facility: a case study

    Directory of Open Access Journals (Sweden)

    Cranley Lisa A

    2012-09-01

    Full Text Available Abstract Background Engaging end-users of research in the process of disseminating findings may increase the relevance of findings and their impact for users. We report findings from a case study that explored how involvement with the Translating Research in Elder Care (TREC study influenced management and staff at one of 36 TREC facilities. We conducted the study at ‘Restwood’ (pseudonym nursing home because the Director of Care engaged actively in the study and TREC data showed that this site differed on some areas from other nursing homes in the province. The aims of the case study were two-fold: to gain a better understanding of how frontline staff engage with the research process, and to gain a better understanding of how to share more detailed research results with management. Methods We developed an Expanded Feedback Report for use during this study. In it, we presented survey results that compared Restwood to the best performing site on all variables and participating sites in the province. Data were collected regarding the Expanded Feedback Report through interviews with management. Data from staff were collected through interviews and observation. We used content analysis to derive themes to describe key aspects related to the study aims. Results We observed the importance of understanding organizational routines and the impact of key events in the facility’s environment. We gleaned additional information that validated findings from prior feedback mechanisms within TREC. Another predominant theme was the sense that the opportunity to engage in a research process was reaffirming for staff (particularly healthcare aides—what they did and said mattered, and TREC provided a means of having one’s voice heard. We gained valuable insight from the Director of Care about how to structure and format more detailed findings to assist with interpretation and use of results. Conclusions Four themes emerged regarding staff engagement with

  6. The ELDER expansion project: building cultural competence among long term home care workers.

    Science.gov (United States)

    Lange, Jean W; Mager, Diana R; Andrews, Nancy

    2013-05-01

    This study aimed to improve communication and care provision in five home or long term care settings by raising staff awareness about health beliefs and patterns among varied cultures. Lack of cultural competence is linked to ethnocentric attitudes that can lead to inappropriate communication and ineffective interventions. Understanding the culturally imbedded belief systems of patients and providers is an integral part of effective communication skills that are foundational to optimal team functioning. Participants included five home or long term care agencies in an underserved region of New England. Seventy-four nurses, aids and allied health professionals participated in 10-12 small group interactive sessions. Comparison of pre and post cultural self efficacy scores revealed that participant confidence regarding their knowledge and skills when interacting with other cultures improved interactions with patients and co-workers. Journal exemplars supported the ability of attendees to apply content to the workplace. PMID:23265680

  7. [Caring for healthy aging: building an educational process with rural women].

    Science.gov (United States)

    Portella, M R

    1999-01-01

    This study analyses a proposal of nursing assistance. The project proposed has as its goal the construction of an educational process aiming a healthy aging among rural women. It is important to emphasize that these women's cultural health practices were taken into consideration in this research. The conceptual milestones adopted were drawn from Madeleine Leninger's concept of "cultural care" and Paulo Freire's pedagogical ideas. The educational process being proposed is based on the idea of caring/educating in which the nursing professional and the group share experiences through reflective dialog, and seek cultural health practices that can contribute on a healthy aging. PMID:12138632

  8. Medical Education Capacity-Building Partnerships for Health Care Systems Development.

    Science.gov (United States)

    Rabin, Tracy L; Mayanja-Kizza, Harriet; Rastegar, Asghar

    2016-01-01

    Health care workforce development is a key pillar of global health systems strengthening that requires investment in health care worker training institutions. This can be achieved by developing partnerships between training institutions in resource-limited and resource-rich areas and leveraging the unique expertise and opportunities both have to offer. To realize their full potential, however, these relationships must be equitable. In this article, we use a previously described global health ethics framework and our ten-year experience with the Makerere University-Yale University (MUYU) Collaboration to provide an example of an equity-focused global health education partnership. PMID:27437821

  9. The HackensackUMC Value-Based Care Model: Building Essentials for Value-Based Purchasing.

    Science.gov (United States)

    Douglas, Claudia; Aroh, Dianne; Colella, Joan; Quadri, Mohammed

    2016-01-01

    The Affordable Care Act, 2010, and the subsequent shift from a quantity-focus to a value-centric reimbursement model led our organization to create the HackensackUMC Value-Based Care Model to improve our process capability and performance to meet and sustain the triple aims of value-based purchasing: higher quality, lower cost, and consumer perception. This article describes the basics of our model and illustrates how we used it to reduce the costs of our patient sitter program.

  10. The Teen Depression Awareness Project: Building an Evidence Base for Improving Teen Depression Care. Research Highlights

    Science.gov (United States)

    Adamson, David M.

    2010-01-01

    Depression's effects on adolescent functioning and family burden are not well understood; there is also limited understanding of teens' and parents' attitudes and knowledge about depression, how these and other factors influence readiness for treatment, and the barriers to care that teens and their parents encounter. To address these knowledge…

  11. What makes a nest-building male successful? Male behavior and female care in penduline tits

    NARCIS (Netherlands)

    Szentirmai, [No Value; Komdeur, J; Szekely, T; Szentirmai, István

    2005-01-01

    Why do females increase parental effort when caring for the offspring of attractive males? First, attractive males may be poor fathers so that their females are compelled to increase their own contribution in order to fledge some young (the partner-compensation hypothesis). Second, females mated to

  12. Building a Culture of Inclusion: Disability as Opportunity for Organizational Growth and Improving Patient Care.

    Science.gov (United States)

    Ailey, Sarah H; Brown, Paula; Friese, Tanya R; Dugan, Shelia

    2016-01-01

    Administrators at Rush University Medical Center have made a commitment to diversity, including accommodating disabilities in the workplace and for students. This article explains extensive multilevel accommodations instituted by Rush University Medical Center that promote organizational growth and a healthier work environment and improve patient care.

  13. Building Teams in Primary Care: What Do Nonlicensed Allied Health Workers Want?

    OpenAIRE

    Saba, George W.; Taché, Stephanie; Ward, Lisa; Chen, Ellen H.; Hammer, Hali

    2011-01-01

    Introduction: Nonlicensed allied health workers are becoming increasingly important in collaborative team care, yet we know little about their experiences while filling these roles. To explore their perceptions of working as health coaches in a chronic-disease collaborative team, the teamlet model, we conducted a qualitative study to understand the nature and dynamics of this emerging role.

  14. Building the Diversity Bridge Abroad: The Journey to Implement Cultural Competent Health Care in Lausanne, Switzerland

    Science.gov (United States)

    Casillas, Alejandra; Paroz, Sophie; Dory, Elody; Green, Alexander; Vu, Francis; Bodenmann, Patrick

    2016-01-01

    Introduction: Although the United States has been central in bringing cultural competency into the discussion of high-quality care, health systems all over the world are faced with the effects of global immigration and the widening disparities gap between socioeconomic classes. Lausanne University Hospital is one of five Swiss academic medical…

  15. A chance for change : building an outcome monitoring feedback system for outpatient mental health care

    NARCIS (Netherlands)

    Jong, Kim de

    2012-01-01

    The principal aim of this thesis was to develop an outcome monitoring feedback model for Dutch outpatient mental health care in the Netherlands and to test whether providing feedback to therapists and patients can improve treatment outcomes. Data on patient progress collected in outpatient centers i

  16. Building a high quality medical data architecture for multiple uses in an integrated health care environment

    NARCIS (Netherlands)

    Boterenbrood, Frank; Krediet, Irene; Goossen, William

    2014-01-01

    Objective: The aim was to create a reliable information provisioning system in healthcare for both care and research processes, based on existing data standards and standardized electronic messages. The research question is: How can a Clinical Data Ware House (CDWH) be developed for standardized bas

  17. Building a Culture of Inclusion: Disability as Opportunity for Organizational Growth and Improving Patient Care.

    Science.gov (United States)

    Ailey, Sarah H; Brown, Paula; Friese, Tanya R; Dugan, Shelia

    2016-01-01

    Administrators at Rush University Medical Center have made a commitment to diversity, including accommodating disabilities in the workplace and for students. This article explains extensive multilevel accommodations instituted by Rush University Medical Center that promote organizational growth and a healthier work environment and improve patient care. PMID:26641467

  18. [Building competences in the care, according to Boff: a new perspective of nurse's ethical conduct].

    Science.gov (United States)

    Trevizan, Maria Auxiliadora; Mendes, Isabel Amélia Costa; Lourenço, Maria Regina; Melo, Marcia Regina Antonietto da Costa

    2003-01-01

    In this study, authors characterize nurse's managerial conduct in the perspective of the work, illustrated through the analysis of three investigations. Understanding the fragility of managerial nurse's situation, considering the commitment with the users and with the ones who provide the services, authors advocate in favor of an intervention to change this situation. Therefore, they propose an alternative of reflection about the changes that are necessary. They defend a new ethics articulating a new sense of providing care proposed by Boff, in which the relationship is based on the companionship, interaction and sharing. According to this way of being, nurse's care is an attitude of concern, responsibility and affective commitment with the other. Thus, the instrumental reasoning is substituted by the sensible reasoning and the spirit of deep feelings. Considering these new values, nurses understand better the other's dimension, the respect, reciprocity, and complementarity in the managerial relationship.

  19. A cooperative building up of care security: patient participation to risk management in radiotherapy

    International Nuclear Information System (INIS)

    Based on observations of radiotherapy consultations, interviews of professionals (physicians and operators), of ex-patients and patients under treatment, and on analysis of questionnaires sent to patients, this study aimed at understanding how, and to which levels, participation of patients can optimize risk management. It outlines the major role of therapeutic information and education of patients, but also of health professionals, in order to reach a shared cooperative management of cares. Short communication

  20. Building a high quality medical data architecture for multiple uses in an integrated health care environment

    OpenAIRE

    Boterenbrood, Frank; Krediet, Irene; Goossen, William

    2014-01-01

    Objective: The aim was to create a reliable information provisioning system in healthcare for both care and research processes, based on existing data standards and standardized electronic messages. The research question is: How can a Clinical Data Ware House (CDWH) be developed for standardized basic patient data, generic nursing data and data about oncology nursing, allowing management of Electronic Health Record data, electronic data exchange and data analytics? Materials and methods: The ...

  1. Building a culture of health: A new framework and measures for health and health care in America.

    Science.gov (United States)

    Trujillo, Matthew D; Plough, Alonzo

    2016-09-01

    For generations, Americans' health has been unequally influenced by income, education, ethnicity, and geography. Health care systems have operated largely apart from each other and from community life. The definition of health has been the "absence of illness," rather than the recognition that all aspects of our lives should support health. Today, a growing number of communities, regions, and states are working to redefine what it means to get and stay healthy by addressing the multiple determinants of health. The requirements of federal health care reform are changing who has access to care, how care is paid for and delivered, and how patients and providers interact. Coordinated efforts to promote wellness and prevent diseases are proliferating among a diverse set of stakeholders. These developments in health and in society present a window of opportunity for real societal transformation-a chance to catalyze a national movement that demands and supports a widely shared, multifaceted vision for a Culture of Health. To address this challenge, the Robert Wood Johnson Foundation has embarked on a strategic direction to use the tools of a large national philanthropy to catalyze a social movement which we are calling Building a Culture of Health. This article presents the Foundation's new model for a Culture of Health, the trans-disciplinary research that developed a set of metrics that tie to the model, and the community engagement activities undertaken in the development of both the model and metrics. The model and associated metrics and extensive communication, in addition to partnership, and grant funding strategies, represent a culture change strategy being implemented over 20 years. Addressing underlying inequities in health affirming life conditions and improving social cohesion across diverse groups to take action to improve theses condition lay at the heart of this strategy. PMID:27405727

  2. Building a culture of health: A new framework and measures for health and health care in America.

    Science.gov (United States)

    Trujillo, Matthew D; Plough, Alonzo

    2016-09-01

    For generations, Americans' health has been unequally influenced by income, education, ethnicity, and geography. Health care systems have operated largely apart from each other and from community life. The definition of health has been the "absence of illness," rather than the recognition that all aspects of our lives should support health. Today, a growing number of communities, regions, and states are working to redefine what it means to get and stay healthy by addressing the multiple determinants of health. The requirements of federal health care reform are changing who has access to care, how care is paid for and delivered, and how patients and providers interact. Coordinated efforts to promote wellness and prevent diseases are proliferating among a diverse set of stakeholders. These developments in health and in society present a window of opportunity for real societal transformation-a chance to catalyze a national movement that demands and supports a widely shared, multifaceted vision for a Culture of Health. To address this challenge, the Robert Wood Johnson Foundation has embarked on a strategic direction to use the tools of a large national philanthropy to catalyze a social movement which we are calling Building a Culture of Health. This article presents the Foundation's new model for a Culture of Health, the trans-disciplinary research that developed a set of metrics that tie to the model, and the community engagement activities undertaken in the development of both the model and metrics. The model and associated metrics and extensive communication, in addition to partnership, and grant funding strategies, represent a culture change strategy being implemented over 20 years. Addressing underlying inequities in health affirming life conditions and improving social cohesion across diverse groups to take action to improve theses condition lay at the heart of this strategy.

  3. Building laboratory capacity to support HIV care in Nigeria: Harvard/APIN PEPFAR, 2004–2012

    Science.gov (United States)

    Hamel, Donald J.; Sankalé, Jean-Louis; Samuels, Jay Osi; Sarr, Abdoulaye D.; Chaplin, Beth; Ofuche, Eke; Meloni, Seema T.; Okonkwo, Prosper; Kanki, Phyllis J.

    2015-01-01

    Introduction From 2004–2012, the Harvard/AIDS Prevention Initiative in Nigeria, funded through the US President’s Emergency Plan for AIDS Relief programme, scaled up HIV care and treatment services in Nigeria. We describe the methodologies and collaborative processes developed to improve laboratory capacity significantly in a resource-limited setting. These methods were implemented at 35 clinic and laboratory locations. Methods Systems were established and modified to optimise numerous laboratory processes. These included strategies for clinic selection and management, equipment and reagent procurement, supply chains, laboratory renovations, equipment maintenance, electronic data management, quality development programmes and trainings. Results Over the eight-year programme, laboratories supported 160 000 patients receiving HIV care in Nigeria, delivering over 2.5 million test results, including regular viral load quantitation. External quality assurance systems were established for CD4+ cell count enumeration, blood chemistries and viral load monitoring. Laboratory equipment platforms were improved and standardised and use of point-of-care analysers was expanded. Laboratory training workshops supported laboratories toward increasing staff skills and improving overall quality. Participation in a World Health Organisation-led African laboratory quality improvement system resulted in significant gains in quality measures at five laboratories. Conclusions Targeted implementation of laboratory development processes, during simultaneous scale-up of HIV treatment programmes in a resource-limited setting, can elicit meaningful gains in laboratory quality and capacity. Systems to improve the physical laboratory environment, develop laboratory staff, create improvements to reduce costs and increase quality are available for future health and laboratory strengthening programmes. We hope that the strategies employed may inform and encourage the development of other

  4. Building laboratory capacity to support HIV care in Nigeria: Harvard/APIN PEPFAR, 2004–2012

    Directory of Open Access Journals (Sweden)

    Donald J. Hamel

    2015-05-01

    Full Text Available Introduction: From 2004–2012, the Harvard/AIDS Prevention Initiative in Nigeria, funded through the US President’s Emergency Plan for AIDS Relief programme, scaled up HIV care and treatment services in Nigeria. We describe the methodologies and collaborative processes developed to improve laboratory capacity significantly in a resource-limited setting. These methods were implemented at 35 clinic and laboratory locations.Methods: Systems were established and modified to optimise numerous laboratory processes. These included strategies for clinic selection and management, equipment and reagent procurement, supply chains, laboratory renovations, equipment maintenance, electronic data management, quality development programmes and trainings.Results: Over the eight-year programme, laboratories supported 160 000 patients receiving HIV care in Nigeria, delivering over 2.5 million test results, including regular viral load quantitation. External quality assurance systems were established for CD4+ cell count enumeration, blood chemistries and viral load monitoring. Laboratory equipment platforms were improved and standardised and use of point-of-care analysers was expanded. Laboratory training workshops supported laboratories toward increasing staff skills and improving overall quality. Participation in a World Health Organisation-led African laboratory quality improvement system resulted in significant gains in quality measures at five laboratories.Conclusions: Targeted implementation of laboratory development processes, during simultaneous scale-up of HIV treatment programmes in a resource-limited setting, can elicit meaningful gains in laboratory quality and capacity. Systems to improve the physical laboratory environment, develop laboratory staff, create improvements to reduce costs and increase quality are available for future health and laboratory strengthening programmes. We hope that the strategies employed may inform and

  5. Building Resilience for Palliative Care Clinicians: An Approach to Burnout Prevention Based on Individual Skills and Workplace Factors.

    Science.gov (United States)

    Back, Anthony L; Steinhauser, Karen E; Kamal, Arif H; Jackson, Vicki A

    2016-08-01

    For palliative care (PC) clinicians, the work of caring for patients with serious illness can put their own well-being at risk. What they often do not learn in training, because of the relative paucity of evidence-based programs, are practical ways to mitigate this risk. Because a new study indicates that burnout in PC clinicians is increasing, we sought to design an acceptable, scalable, and testable intervention tailored to the needs of PC clinicians. In this article, we describe our paradigm for approaching clinician resilience, our conceptual model, and curriculum for a workplace resilience intervention for hospital-based PC teams. Our paradigm for approaching resilience is based on upstream, early intervention. Our conceptual model posits that clinician well-being is influenced by personal resources and work demands. Our curriculum for increasing clinician resilience is based on training in eight resilience skills that are useful for common challenges faced by clinicians. To address workplace issues, our intervention also includes material for the team leader and a clinician perception survey of work demands and workplace engagement factors. The intervention will focus on individual skill building and will be evaluated with measures of resilience, coping, and affect. For PC clinicians, resilience skills are likely as important as communication skills and symptom management as foundations of expertise. Future work to strengthen clinician resilience will likely need to address system issues more directly. PMID:26921494

  6. Could the ethics of institutionalized health care be anything but Kantian? Collecting building blocks for a unifying metaethics.

    Science.gov (United States)

    Kaldis, Byron

    2005-01-01

    Is a Health Care Ethics possible? Against sceptical and relativist doubts Kantian deontology may advance a challenging alternative affirming the possibility of such an ethics on the condition that deontology be adopted as a total programme or complete vision. Kantian deontology is enlisted to move us from an ethics of two-person informal care to one of institutions. It justifies this affirmative answer by occupying a commanding meta-ethical stand. Such a total programme comprises, on the one hand, a dual-aspect strategy incorporating the macro- (institutional) and micro- (person-to-person) levels while, on the other, it integrates consistently within moral epistemology a meta-ethics with lower-ground moral theories. The article describes the issues to be dealt with and the problems which have to be solved on the way to a unifying theory of that kind (Sections I-III) and indicates elements of Kantian moral philosophy which may serve as building blocks (Section IV). Among these are not only Kant's ideas concerning the moral acting of persons and his ideas concerning civil society and state but also his ideas concerning morality, schematism and religion. PMID:15906938

  7. Towards building the oral health care workforce: who are the new dental therapists?

    Science.gov (United States)

    Blue, Christine M; Lopez, Naty

    2011-01-01

    In 2009, Minnesota Governor Pawlenty signed into law a bill approving the creation of a new dental team member: the dental therapist. The intent of this legislation was to address oral health disparities by creating a dental professional who would expand access to dental care in Minnesota. This study aimed to describe the characteristics of the first class of dental therapy students at the University of Minnesota and to ascertain the values and motivations that led them to choose a career in dental therapy. Four surveys were used to create the composite profile of the ten students in this first dental therapy class: 1) the California Critical Thinking Skills Test, 2) the Learning Type Measure, 3) the Attitudes Toward Healthcare Survey, and 4) a values and motivation survey that included demographic data. The results of the surveys revealed interacting influences of the students' background, personal self-concept, and environment leading to a career decision to pursue dental therapy. PMID:21205726

  8. Careful modernisation of historical buildings. Wall-mounted multiple high-efficiency boiler systems; Sanierung mit Fingerspitzengefuehl. Brennwertwandgeraete als Mehrkesselanlage

    Energy Technology Data Exchange (ETDEWEB)

    Rieke, M. [Broetje (A.) Werke fuer Heizungstechnik GmbH und Co. KG, Rastede (Germany)

    2006-11-15

    The Offenburg townhall building is a historical monument of the baroque era which is still used as an office building. The technical facilities were checked and modernisation measures were planned and executed in 2005 so as to ensure high thermal comfort without interfering with the character of the building. (orig.)

  9. Building the capacity of family day care educators to promote children's social and emotional wellbeing: an exploratory cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Sims Margaret

    2011-11-01

    Full Text Available Abstract Background Childhood mental health problems are highly prevalent, experienced by one in five children living in socioeconomically disadvantaged families. Although childcare settings, including family day care are ideal to promote children's social and emotional wellbeing at a population level in a sustainable way, family day care educators receive limited training in promoting children's mental health. This study is an exploratory wait-list control cluster randomised controlled trial to test the appropriateness, acceptability, cost, and effectiveness of "Thrive," an intervention program to build the capacity of family day care educators to promote children's social and emotional wellbeing. Thrive aims to increase educators' knowledge, confidence and skills in promoting children's social and emotional wellbeing. Methods/Design This study involves one family day care organisation based in a low socioeconomic area of Melbourne. All family day care educators (term used for registered carers who provide care for children for financial reimbursement in the carers own home are eligible to participate in the study. The clusters for randomisation will be the fieldworkers (n = 5 who each supervise 10-15 educators. The intervention group (field workers and educators will participate in a variety of intervention activities over 12 months, including workshops; activity exchanges with other educators; and focused discussion about children's social and emotional wellbeing during field worker visits. The control group will continue with their normal work practice. The intervention will be delivered to the intervention group and then to the control group after a time delay of 15 months post intervention commencement. A baseline survey will be conducted with all consenting educators and field workers (n = ~70 assessing outcomes at the cluster and individual level. The survey will also be administered at one month, six months and 12 months post

  10. Bringing Experience from the Field into the Classroom with the NOAA Teacher at Sea and PolarTREC Teacher Research Experience Programs

    Science.gov (United States)

    Eubanks, E. D.; Kohin, S.; Oberbauer, S.

    2008-12-01

    As a participant of the National Oceanic and Atmospheric Administration (NOAA), Teacher at Sea (2007) and the Arctic Research Consortium of the U.S., PolarTREC (2008) programs, I have had the opportunity to participate in hands-on research with leading scientific researchers from the tropics to the Arctic. These Teacher Researcher Experiences (TRE's) and the resulting relationships that have developed with the scientific community have been an asset to my professional development and have greatly enhanced my students' learning. The opportunity to participate in data collection and hands-on research with a NOAA researcher, Dr. Kohin, helped me bring shark, ocean, and ship science from my expedition onboard the NOAA Ship David Starr Jordan in the Channel Island region into my classroom. The new knowledge, experiences, and resources that I brought back allowed me to create lesson plans and host Shark Month--an activity that involved all 300 students in my school. My students were able to link real data regarding the location of sharks to practical application and still meet state standards. Likewise, the scientist from my PolarTREC expedition, Dr. Oberbauer, is assisting me in a long-term plan to incorporate his data into my classroom curricula. Already, my experiences from Barrow, Alaska, have been shared through webinars with my community and as a keynote speaker to over 600 Palm Beach County science teachers. We are also working together to develop a yearlong curriculum, in which my entire school of 300 students will discover interdisciplinary polar science. Participation in TRE's has been beneficial for my students and my community, but what is the return on the investment for the scientists who invited me to participate in their research? Both scientists have transferred their knowledge out of the laboratory and made a link between their research and a different generation--our future scientists. They become instrumental science leaders in a community of young

  11. The Global Role of Health Care Delivery Science: Learning from Variation to Build Health Systems that Avoid Waste and Harm

    OpenAIRE

    Mulley, Albert G.

    2013-01-01

    This paper addresses the fourth theme of the Indiana Global Health Research Working Conference, Clinical Effectiveness and Health Systems Research. It explores geographic variation in health care delivery and health outcomes as a source of learning how to achieve better health outcomes at lower cost. It focuses particularly on the relationship between investments made in capacities to deliver different health care services to a population and the value thereby created by that care for individ...

  12. Mental health promotion in the health care setting: collaboration and engagement in the development of a mental health promotion capacity-building initiative.

    Science.gov (United States)

    Horn, Michelle A; Rauscher, Alana B; Ardiles, Paola A; Griffin, Shannon L

    2014-01-01

    Health Compass is an innovative, multiphased project that aims to transform health care practice and shift organizational culture by building the capacity of Provincial Health Services Authority (PHSA) health care providers to further promote the mental health and well-being of patients and families accessing PHSA's health care services. Health Compass was developed within a health promotion framework, which involved collaboration and engagement with stakeholders across all partnering PHSA agencies. This approach led to the development of an educational and training resource that contributes to increased capacity for mental health promotion within the health care setting. Based on interviews with Health Compass' internal Project Team and findings from a Stakeholder Engagement Evaluation Report, this article outlines the participatory approach taken to develop the Health Compass Mental Health Promotion Resource and E-Learning Tool. A number of key facilitators for collaboration and engagement are discussed, which may be particularly applicable to the implementation of a mental health promotion program or initiative within a complex health care setting.

  13. Building Learning Health Systems to Accelerate Research and Improve Outcomes of Clinical Care in Low- and Middle-Income Countries.

    Science.gov (United States)

    English, Mike; Irimu, Grace; Agweyu, Ambrose; Gathara, David; Oliwa, Jacquie; Ayieko, Philip; Were, Fred; Paton, Chris; Tunis, Sean; Forrest, Christopher B

    2016-04-01

    Mike English and colleagues argue that as efforts are made towards achieving universal health coverage it is also important to build capacity to develop regionally relevant evidence to improve healthcare. PMID:27070913

  14. Capacity building of nurses providing neonatal care in Rio de Janeiro, Brazil: methods for the POINTS of care project to enhance nursing education and reduce adverse neonatal outcomes

    Directory of Open Access Journals (Sweden)

    Darlow Brian A

    2012-03-01

    Full Text Available Abstract Background Increased survival of preterm infants in developing countries has often been accompanied by increased morbidity. A previous study found rates of severe retinopathy of prematurity varied widely between different neonatal units in Rio de Janeiro. Nurses have a key role in the care of high-risk infants but often do not have access to ongoing education programmes. We set out to design a quality improvement project that would provide nurses with the training and tools to decrease neonatal mortality and morbidity. The purpose of this report is to describe the methods and make the teaching package (POINTS of care--six modules addressing Pain control; optimal Oxygenation; Infection control; Nutrition interventions; Temperature control; Supportive care available to others. Methods/Design Six neonatal units, caring for 40% of preterm infants in Rio de Janeiro were invited to participate. In Phase 1 of the study multidisciplinary workshops were held in each neonatal unit to identify the neonatal morbidities of interest and to plan for data collection. In Phase 2 the teaching package was developed and tested. Phase 3 consisted of 12 months data collection utilizing a simple tick-sheet for recording. In Phase 4 (the Intervention all nurses were asked to complete all six modules of the POINTS of care package, which was supplemented by practical demonstrations. Phase 5 consisted of a further 12 months data collection. In Phase 1 it was agreed to include inborn infants with birthweight ≤ 1500 g or gestational age of ≤ 34 weeks. The primary outcome was death before discharge and secondary outcomes included retinopathy of prematurity and bronchopulmonary dysplasia. Assuming 400-450 infants in both pre- and post-intervention periods the study had 80% power at p = Discussion The results of the POINTS of Care intervention will be presented in a separate publication. Trial registration Current Controlled Trials: ISRCTN83110114

  15. Lessons Learned From Transitioning PEPFAR Track 1.0 Care and Treatment Programs: Case Studies in Financial Management Capacity Building in Zambia and Botswana.

    Science.gov (United States)

    Kuehn, Chuck; Tidwell, George; Vhugen, Jann; Sharma, Anjali

    2015-01-01

    In 2008, the United States government mandated transition of internationally managed HIV care and treatment programs to local country ownership. Three case studies illustrate the US Health Resources Services Administration's fiscal assessment and technical assistance (TA) processes to strengthen local organizations' capabilities to absorb and manage United States government funding. Review of initial, TA and follow-up reports reveal that the 1 Botswanan and 2 Zambian organizations closed 10 of 17 financial capacity gaps, with Health Resources Services Administration assisting on 2. Zambian organizations requested and absorbed targeted TA on the basis of the consultant's desk review, their finance staff revised fiscal policies and procedures, and accordingly trained other staff. In Botswana, delays in integrating recommendations necessitated on-site TA for knowledge building and role modeling. Organizational maturity may explain differences in responsiveness, ownership, and required TA approaches. Clarifying expectations of capacity building, funding agreement, and nonmonetary donor involvement can help new organizations determine and act on intervening actions. PMID:25514757

  16. Building relationships with physicians. Internal marketing efforts help strengthen organizational bonds at a rural health care clinic.

    Science.gov (United States)

    Peltier, J W; Boyt, T; Westfall, J E

    1997-01-01

    Physician turnover is costly for health care organizations, especially for rural organizations. One approach management can take to reduce turnover is to promote physician loyalty by treating them as an important customer segment. The authors develop an information--oriented framework for generating physician loyalty and illustrate how this framework has helped to eliminate physician turnover at a rural health care clinic. Rural health care organizations must develop a more internal marketing orientation in their approach to establishing strong relationship bonds with physicians. PMID:10173904

  17. Building better systems of care for Aboriginal and Torres Strait Islander people: findings from the Kanyini health systems assessment

    Directory of Open Access Journals (Sweden)

    Peiris David

    2012-10-01

    Full Text Available Abstract Background Australian federal and jurisdictional governments are implementing ambitious policy initiatives intended to improve health care access and outcomes for Aboriginal and Torres Strait Islander people. In this qualitative study we explored Aboriginal Medical Service (AMS staff views on factors needed to improve chronic care systems and assessed their relevance to the new policy environment. Methods Two theories informed the study: (1 ‘candidacy’, which explores “the ways in which people’s eligibility for care is jointly negotiated between individuals and health services”; and (2 kanyini or ‘holding’, a Central Australian philosophy which describes the principle and obligations of nurturing and protecting others. A structured health systems assessment, locally adapted from Chronic Care Model domains, was administered via group interviews with 37 health staff in six AMSs and one government Indigenous-led health service. Data were thematically analysed. Results Staff emphasised AMS health care was different to private general practices. Consistent with kanyini, community governance and leadership, community representation among staff, and commitment to community development were important organisational features to retain and nurture both staff and patients. This was undermined, however, by constant fear of government funding for AMSs being withheld. Staff resourcing, information systems and high-level leadership were perceived to be key drivers of health care quality. On-site specialist services, managed by AMS staff, were considered an enabling strategy to increase specialist access. Candidacy theory suggests the above factors influence whether a service is ‘tractable’ and ‘navigable’ to its users. Staff also described entrenched patient discrimination in hospitals and the need to expend considerable effort to reinstate care. This suggests that Aboriginal and Torres Strait Islander people are still

  18. A road map to building ethics capacity in the home and community care and support services sector.

    Science.gov (United States)

    Boulanger, Renaud F; Ibarra, Kimberley; Wagner, Frank

    2014-01-01

    There are unique ethical issues that arise in home and community care because of its locus and range of service. However, the academic literature on ethical issues in the sector of home and community care and support remains minimal. Opportunities for education, collaboration and exchange among professionals and care providers are also severely limited. Although the proposed solution of developing ethics capacity in the home care setting is over 20 years old, only modest progress had been made until recently. This article introduces the Community Ethics Network (CEN), a replicable network of home and community care agencies in the Greater Toronto Area. Its achievements can be attributed to a commitment to work toward a common approach to ethical decision-making and to a focus on education, case reviews and policy development. CEN has produced numerous positive outcomes; key among these is the development and delivery of standardized training on ethics to more than 2,000 front-line staff of diverse backgrounds/professions and representing over 40 different organizations.

  19. The global role of health care delivery science: learning from variation to build health systems that avoid waste and harm.

    Science.gov (United States)

    Mulley, Albert G

    2013-09-01

    This paper addresses the fourth theme of the Indiana Global Health Research Working Conference, Clinical Effectiveness and Health Systems Research. It explores geographic variation in health care delivery and health outcomes as a source of learning how to achieve better health outcomes at lower cost. It focuses particularly on the relationship between investments made in capacities to deliver different health care services to a population and the value thereby created by that care for individual patients. The framing begins with the dramatic variation in per capita health care expenditures across the nations of the world, which is largely explained by variations in national wealth. The 1978 Declaration of Alma Ata is briefly noted as a response to such inequities with great promise that has not as yet been realized. This failure to realize the promise of Alma Ata grows in significance with the increasing momentum for universal health coverage that is emerging in the current global debate about post-2015 development goals. Drawing upon work done at Dartmouth over more than three decades, the framing then turns to within-country variations in per capita expenditures, utilization of different services, and health outcomes. A case is made for greater attention to the question of value by bringing better information to bear at both the population and individual levels. Specific opportunities to identify and reduce waste in health care, and the harm that is so often associated with it, are identified by learning from outcome variations and practice variations. PMID:23797914

  20. The global role of health care delivery science: learning from variation to build health systems that avoid waste and harm.

    Science.gov (United States)

    Mulley, Albert G

    2013-09-01

    This paper addresses the fourth theme of the Indiana Global Health Research Working Conference, Clinical Effectiveness and Health Systems Research. It explores geographic variation in health care delivery and health outcomes as a source of learning how to achieve better health outcomes at lower cost. It focuses particularly on the relationship between investments made in capacities to deliver different health care services to a population and the value thereby created by that care for individual patients. The framing begins with the dramatic variation in per capita health care expenditures across the nations of the world, which is largely explained by variations in national wealth. The 1978 Declaration of Alma Ata is briefly noted as a response to such inequities with great promise that has not as yet been realized. This failure to realize the promise of Alma Ata grows in significance with the increasing momentum for universal health coverage that is emerging in the current global debate about post-2015 development goals. Drawing upon work done at Dartmouth over more than three decades, the framing then turns to within-country variations in per capita expenditures, utilization of different services, and health outcomes. A case is made for greater attention to the question of value by bringing better information to bear at both the population and individual levels. Specific opportunities to identify and reduce waste in health care, and the harm that is so often associated with it, are identified by learning from outcome variations and practice variations.

  1. Standing on the toes of pygmies:. Why econophysics must be careful of the economic foundations on which it builds

    Science.gov (United States)

    Keen, Steve

    2003-06-01

    Modern economic theory does not provide a sound foundation on which to build econophysics. Pivotal concepts like utility maximization, perfect competition, and diminishing marginal productivity are empirically and logically flawed. Physicists should not use any of these in econophysics, and should be wary of many other models accepted by economists.

  2. Discipline Policies in Early Childhood Care and Education Programs: Building an Infrastructure for Social and Academic Success

    Science.gov (United States)

    Longstreth, Sascha; Brady, Sharon; Kay, Adam

    2013-01-01

    Research Findings: Preventing challenging behavior in young children is a national priority. The number of young children with behavioral problems is on the rise. Discipline policies can help early childhood programs build an infrastructure that promotes social and academic success. This study sought to document the extent to which existing early…

  3. 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.

  4. 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

  5. Overcoming barriers to effectiveness in a health care operational environment: building on the lessons of American industry.

    Science.gov (United States)

    Zimmerer, L W; Zimmerer, T W; Yasin, M M

    1999-01-01

    Several of the manufacturing-based philosophies, techniques and tools, such as Total Quality Management (TQM), Continuous Improvement (CI), Business Process Reengineering (BPR) and Time-based Competition (TBC) have been successfully adapted for use within the service sector. Diverse service industries including airlines, insurance, food services and hospitality have increased customer satisfaction and performance through the use of the quality driven, manufacturing-based philosophies. This article explores the reasons for the limited success of TQM/CI, BPR, TBC and benchmarking within the health care industry. Sixteen barriers to change are identified, possible counter-measures to these barriers are outlined and two conceptual frameworks are offered as possible facilitators of change for the health care industry. PMID:11066723

  6. Overcoming barriers to effectiveness in a health care operational environment: building on the lessons of American industry.

    Science.gov (United States)

    Zimmerer, L W; Zimmerer, T W; Yasin, M M

    1999-01-01

    Several of the manufacturing-based philosophies, techniques and tools, such as Total Quality Management (TQM), Continuous Improvement (CI), Business Process Reengineering (BPR) and Time-based Competition (TBC) have been successfully adapted for use within the service sector. Diverse service industries including airlines, insurance, food services and hospitality have increased customer satisfaction and performance through the use of the quality driven, manufacturing-based philosophies. This article explores the reasons for the limited success of TQM/CI, BPR, TBC and benchmarking within the health care industry. Sixteen barriers to change are identified, possible counter-measures to these barriers are outlined and two conceptual frameworks are offered as possible facilitators of change for the health care industry.

  7. Proceedings of the AMCP Partnership Forum: NCPDP Electronic Prior Authorization Standards-Building a Managed Care Implementation Plan.

    Science.gov (United States)

    2015-07-01

    Today's manual prior authorization (PA) process is often viewed by providers, payers, pharmacists, and patients as cumbersome, costly, and inefficient. The recent approval by the National Council for Prescription Drug Programs of a standard transaction for electronic prior authorization (e-PA) has paved the way for more rapid and efficient processing of PA requests. On April 23, 2014, the Academy of Managed Care Pharmacy (AMCP) convened a meeting of key stakeholders to explore how to support the process of implementing the new standard transactions for e-PA and to recommend activities and programs that AMCP can promote to speed the adoption of e-PA. This Partnership Forum included individuals from managed care organizations, the pharmaceutical industry, pharmacy benefit managers, electronic prescription hubs or networks, and health information technology vendors. The speakers and panelists recommended that AMCP should develop measurable goals for staged and full implementation of e-PA. To accomplish this, it was recommended that AMCP work to collaborate with organizations representing these stakeholders. Additionally, it was recommended that AMCP develop managed care e-PA implementation and e-PA criteria guides, as well as an e-PA scorecard. PMID:26108378

  8. Building positive self-image in adolescents in foster care: the use of role models in an interactive group approach.

    Science.gov (United States)

    Yancey, A K

    1998-01-01

    In a previous article (Yancey, 1992), the literature on identity development in individuals from socially devalued racial and ethnic groups was summarized. It was postulated that the social maladaptation of adolescents in residential group foster care is reflective of identity disturbances created by the negative images of African-Americans and Latinos perpetuated by the dominant society and unfiltered by optimal parental racial/ethnic socialization. The present article describes the development of a pilot preventive mental health intervention, the PRIDE (Personal and Racial/ethnic Identity Development and Enhancement) program, designed to provide components of parenting that are necessary for promoting positive self-image in ethnically marginalized adolescents and that are typically lacking in the group foster care milieu. PRIDE utilizes successful, ethnically relevant role models in interactive group sessions to create a significant cognitive and emotional experience for teens. While the utility of role modeling for at-risk youth is widely accepted, there is little research on the packaging, delivery, and influence of this intervention modality. This study demonstrates the feasibility of a "hybrid" role-modeling approach (intermediate in intensity of exposure and cost between one-to-one mentoring and career-day programs). Implications for further research on this type of intervention are discussed.

  9. Building equity in chronic disease management in Thailand: a whole-system provincial trial of systematic, pro-active chronic illness care.

    Science.gov (United States)

    Wanitkun, N; Batterham, R; Vichathai, C; Leetongin, G; Osborne, R H

    2011-03-01

    Thailand has a history of implementing innovative and proactive policies to address the health needs of its population. Since 1962 Thailand has implemented initiatives that led to it having a health system characterized by a primary care focus, decentralization and mechanisms to maximize equity and universal access to basic care at the local level. Thai health structures initially evolved to meet challenges including infectious and developmental diseases and later HIV. Early in the 21st century chronic illness rapidly became the greatest cause of morbidity and mortality and the question has arisen how Thailand can adapt its strong health system to deal with the new epidemics. This article describes an effort to reorient provincial health services to meet the needs of the increasing number of people with diabetes and heart disease. It describes measures taken to build on the equity-promoting elements of the Thai health system. The project included; a situational analysis, development and implementation of a chronic disease self-management intervention implemented by nurses and alignment of provincial health services. The self-management intervention is currently being evaluated within a clustered randomized control trial. The evaluation has been developed to fit with the focus on equity in relation to both selection criteria and the outcomes that are being assessed.

  10. Front-line worker engagement: greening health care, improving worker and patient health, and building better jobs.

    Science.gov (United States)

    Chenven, Laura; Copeland, Danielle

    2013-01-01

    Frontline workers have a great deal to contribute to improving environmental sustainability of their employers and the health of workers and patients. This article discusses a national project of the Healthcare Career Advancement Program, funded by the U.S. Department of Labor to support green jobs development. Implementation was accomplished through a labor/management collaboration between union locals and 11 employers in four regions throughout the United States. The project developed and implemented a model of training and education for environmental service workers and other frontline health-care workers in hospital settings that supported systems change and built new roles for these workers. It empowered them to contribute to triple bottom line outcomes in support of People (patients, workers, the community), Planet (environmental sustainability and a lower carbon footprint), and Profit (cost savings for the institutions). In the process workers more clearly articulated their important role as a part of the healthcare team and learned how they could contribute to improved patient and worker health and safety.

  11. Controlling the intelligent building

    Energy Technology Data Exchange (ETDEWEB)

    LeBlanc, R.J.

    1985-08-01

    Companies will be able to locate in intelligent buildings that offer access to a variety of sophisticated communications equipment, at the heart of which are building controls that ensure a comfortable and safe working environment for the occupants. Future buildings will include advanced telephones or workstations with built-in building control sensors for temperature, light level, and security. Advanced telecommunication systems may have telephone cabinets with built-in control functions which eliminate the need for discrete control systems. The owners and tenants will both enjoy benefits if the controls are carefully selected and designed so that they integrate into a single building package.

  12. Team-building through sailing: effects on health status, job satisfaction and work performance of health care professionals involved in organ and tissue donation.

    Science.gov (United States)

    Ponzin, Diego; Fasolo, Adriano; Vidale, Enrico; Pozzi, Annalaura; Bottignolo, Elisa; Calabrò, Francesco; Rupolo, Giampietro

    2015-01-01

    The aim of this study was to evaluate the effects of a team-building learning project on job satisfaction, psychological wellbeing, and performance of health care workers involved in the process of organ and tissue donation. The project was conducted between June and September 2011 and consisted of two one-day meetings and a one week sailing, involving 20 staff members. GHQ-12, MBI-HSS, and 25 items taken from the Multidimensional Organizational Health Questionnaire (MOHQ) were used to assess health status, burnout, and job satisfaction. Results of the descriptive analyses were expressed as mean ± SD and as counts and percentages; Chi-square test was used to evaluate statistical significance of differences before and after the initiative. 6 (30,0%) participants showed the likelihood to suffering from anxiety and depression (i.e. recognized as 'cases' by the GHQ-12), 3 (15.0%) of them at baseline and 3 (15.0%), different from the previous ones, in the post-intervention. The presence of stress was revealed in 9 (45.0%) and 12 subjects (60.0%) before and after the experience, respectively (6 subjects showed the presence of stress in both circumstances). We documented 4 burnout cases, 3 (15.0%) at baseline and 1 (5.0%) after the experience. Nevertheless, about 80% of the participants showed a high degree ofjob satisfaction, in terms of positive influence of job in the professional satisfaction and of clear satisfaction for the organization, during both evaluation. In respect to 2010, the number of organ donors and that of ocular tissue donors improved of about 16% and 10%, respectively, during the year of the project and in the following year (mean value). We recognize that our team-building project for personnel involved in the stressful and demanding setting of organ and tissue donation, worthwhile and recompensing at the same time, possibly influenced the personal commitment and the quality of job provided. The high level of stress showed by participants should be

  13. Team-building through sailing: effects on health status, job satisfaction and work performance of health care professionals involved in organ and tissue donation.

    Science.gov (United States)

    Ponzin, Diego; Fasolo, Adriano; Vidale, Enrico; Pozzi, Annalaura; Bottignolo, Elisa; Calabrò, Francesco; Rupolo, Giampietro

    2015-01-01

    The aim of this study was to evaluate the effects of a team-building learning project on job satisfaction, psychological wellbeing, and performance of health care workers involved in the process of organ and tissue donation. The project was conducted between June and September 2011 and consisted of two one-day meetings and a one week sailing, involving 20 staff members. GHQ-12, MBI-HSS, and 25 items taken from the Multidimensional Organizational Health Questionnaire (MOHQ) were used to assess health status, burnout, and job satisfaction. Results of the descriptive analyses were expressed as mean ± SD and as counts and percentages; Chi-square test was used to evaluate statistical significance of differences before and after the initiative. 6 (30,0%) participants showed the likelihood to suffering from anxiety and depression (i.e. recognized as 'cases' by the GHQ-12), 3 (15.0%) of them at baseline and 3 (15.0%), different from the previous ones, in the post-intervention. The presence of stress was revealed in 9 (45.0%) and 12 subjects (60.0%) before and after the experience, respectively (6 subjects showed the presence of stress in both circumstances). We documented 4 burnout cases, 3 (15.0%) at baseline and 1 (5.0%) after the experience. Nevertheless, about 80% of the participants showed a high degree ofjob satisfaction, in terms of positive influence of job in the professional satisfaction and of clear satisfaction for the organization, during both evaluation. In respect to 2010, the number of organ donors and that of ocular tissue donors improved of about 16% and 10%, respectively, during the year of the project and in the following year (mean value). We recognize that our team-building project for personnel involved in the stressful and demanding setting of organ and tissue donation, worthwhile and recompensing at the same time, possibly influenced the personal commitment and the quality of job provided. The high level of stress showed by participants should be

  14. TREC-SAVE: a randomised trial comparing mechanical restraints with use of seclusion for aggressive or violent seriously mentally ill people: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Ferreira Marco AV

    2011-07-01

    Full Text Available Abstract Background Thousands of people whose aggression is thought due to serious mental illness are secluded or restrained every day. Without fair testing these techniques will continue to be used outside of a rigorous evidence base. With such coercive treatment this leaves all concerned vulnerable to abuse and criticism. This paper presents the protocol for a randomised trial comparing seclusion with restraints for people with serious mental illnesses. Methods/Design Setting-General psychiatric wards of a large psychiatric hospital in Rio de Janeiro, Brazil. Participants-Anyone aggressive or violent suspected or known to have serious mental illness for whom restriction is felt to be indicated by nursing and medical staff, but also for whom they are unsure whether seclusion or restraint would be indicated. Interventions-The standard care of either strong cotton banding to edge of bed with medications as indicated and close observation or the other standard care of use of a minimally furnished seclusion room but with open but barred windows onto the nursing station. Outcomes-time to restrictions lifted, early change of treatment, additional episodes, adverse effects/events, satisfaction with care during episode. Duration-2 weeks. Identifier: ISRCTN 49454276 http://www.controlled-trials.com/ISRCTN49454276

  15. Building Social Web Applications

    CERN Document Server

    Bell, Gavin

    2009-01-01

    Building a web application that attracts and retains regular visitors is tricky enough, but creating a social application that encourages visitors to interact with one another requires careful planning. This book provides practical solutions to the tough questions you'll face when building an effective community site -- one that makes visitors feel like they've found a new home on the Web. If your company is ready to take part in the social web, this book will help you get started. Whether you're creating a new site from scratch or reworking an existing site, Building Social Web Applications

  16. 关于“社区化”城市养老建筑空间研究%Research on space of Urban community buildings for old-age care

    Institute of Scientific and Technical Information of China (English)

    石英

    2014-01-01

    To solve the arising problems of construction sites "suburban", we find the new direction what Urban community facilities for old-age care is. Through the investigation of Beijing urban endowment facilities, the writer analysis and expounds influences that the old behavior over their’s living space. The writer want to seek some design methods from the indoor and outdoor space environment of buildings for old-age care had constructed, and the writer expect it can provide Suggestions for the future Urban community buildings for old-age.%针对建设场所“郊区化”所产生的问题,提出养老建筑建设“社区化”的新方向。通过对北京城市养老建筑的实地调查,分析与阐述老年人行为对空间使用的影响。从养老建筑室内外空间环境等方面寻求一些设计手法,并期望对今后社区养老建筑建设提供建议。

  17. 构建长期照护体系是解决养老问题的根本途径%Building Long-Term Care System is the Essential Way to Resolve the Aging Problem

    Institute of Scientific and Technical Information of China (English)

    宋惠平; 陈峥

    2015-01-01

    With the continuous development of an aging population, pension problems especially the disability of the elderly pension problem becomes more prominent. At the same time, families or general pension institutions is difficult to solve the medical care problem of old people; the increasing cost of elderly care and beds makes the hospital operation cost increase. Long-term care service system is the fundamental way for dealing with disability elderly care crisis in the future. In some developed countries, the long-term care and acute medical are combined together; the medical institutions, families and personal are linked together through the case management and social workers. In short, in view of China's aging population trends and China’s population policy, we should establish the countermeasures: people-oriented, comprehensive integration, building long-term care security system including long-term care constituted by medical professionals and the general long-term life care.%随着人口老龄化的不断发展,养老问题尤其是失能老年人的养老问题变得更为突出。与此同时,家庭或一般养老机构难以解决老年人的医疗照护问题;老年人医疗费用、占床日的增加,导致医院运行成本加大。长期照护服务体系是未来应对失能老年人照护危机的根本出路。在一些发达国家,长期照护与急性医疗、急性后期医疗有机整合在一起,通过个案管理和社会工作者把医疗机构与家庭、个人联系在一起。针对中国人口老龄化的趋势和中国特有的人口政策,我们应当建立的对策是:以人为本,全面整合,构建包括由专业医护人员实施的长期医疗护理和一般性长期生活照料在内的长期照护保障体系。

  18. Building the Partners HealthCare Biobank at Partners Personalized Medicine: Informed Consent, Return of Research Results, Recruitment Lessons and Operational Considerations.

    Science.gov (United States)

    Karlson, Elizabeth W; Boutin, Natalie T; Hoffnagle, Alison G; Allen, Nicole L

    2016-01-01

    The Partners HealthCare Biobank is a Partners HealthCare enterprise-wide initiative whose goal is to provide a foundation for the next generation of translational research studies of genotype, environment, gene-environment interaction, biomarker and family history associations with disease phenotypes. The Biobank has leveraged in-person and electronic recruitment methods to enroll >30,000 subjects as of October 2015 at two academic medical centers in Partners HealthCare since launching in 2010. Through a close collaboration with the Partners Human Research Committee, the Biobank has developed a comprehensive informed consent process that addresses key patient concerns, including privacy and the return of research results. Lessons learned include the need for careful consideration of ethical issues, attention to the educational content of electronic media, the importance of patient authentication in electronic informed consent, the need for highly secure IT infrastructure and management of communications and the importance of flexible recruitment modalities and processes dependent on the clinical setting for recruitment. PMID:26784234

  19. Building the Partners HealthCare Biobank at Partners Personalized Medicine: Informed Consent, Return of Research Results, Recruitment Lessons and Operational Considerations.

    Science.gov (United States)

    Karlson, Elizabeth W; Boutin, Natalie T; Hoffnagle, Alison G; Allen, Nicole L

    2016-01-01

    The Partners HealthCare Biobank is a Partners HealthCare enterprise-wide initiative whose goal is to provide a foundation for the next generation of translational research studies of genotype, environment, gene-environment interaction, biomarker and family history associations with disease phenotypes. The Biobank has leveraged in-person and electronic recruitment methods to enroll >30,000 subjects as of October 2015 at two academic medical centers in Partners HealthCare since launching in 2010. Through a close collaboration with the Partners Human Research Committee, the Biobank has developed a comprehensive informed consent process that addresses key patient concerns, including privacy and the return of research results. Lessons learned include the need for careful consideration of ethical issues, attention to the educational content of electronic media, the importance of patient authentication in electronic informed consent, the need for highly secure IT infrastructure and management of communications and the importance of flexible recruitment modalities and processes dependent on the clinical setting for recruitment.

  20. Building the Partners HealthCare Biobank at Partners Personalized Medicine: Informed Consent, Return of Research Results, Recruitment Lessons and Operational Considerations

    Directory of Open Access Journals (Sweden)

    Elizabeth W. Karlson

    2016-01-01

    Full Text Available The Partners HealthCare Biobank is a Partners HealthCare enterprise-wide initiative whose goal is to provide a foundation for the next generation of translational research studies of genotype, environment, gene-environment interaction, biomarker and family history associations with disease phenotypes. The Biobank has leveraged in-person and electronic recruitment methods to enroll >30,000 subjects as of October 2015 at two academic medical centers in Partners HealthCare since launching in 2010. Through a close collaboration with the Partners Human Research Committee, the Biobank has developed a comprehensive informed consent process that addresses key patient concerns, including privacy and the return of research results. Lessons learned include the need for careful consideration of ethical issues, attention to the educational content of electronic media, the importance of patient authentication in electronic informed consent, the need for highly secure IT infrastructure and management of communications and the importance of flexible recruitment modalities and processes dependent on the clinical setting for recruitment.

  1. Building the Community-based Long-term Care System%以社区为基础的老年人长期照护体系构建

    Institute of Scientific and Technical Information of China (English)

    陈雪萍

    2014-01-01

    综合近年对杭州市老年人、老年人照护及照护机构、照护队伍的现状研究,分析老年人长期照护存在的主要问题,提出以社区为基础的老年人长期照护构建的主要内涵,为相关制度建设提供依据。并提出了促进社区日间照料中心、以社区卫生服务中心为依托的社区老年护理院及其他老年护理机构的规范建设;加强服务队伍培训;设立转介制度和转介标准,建立老年人长期照护转介体系;建立评估标准、第三方评估运作方式及公众监督机制,逐步完善评估制度;加强风险管理;规范社区长期照护体系运作。%By synthesizing various researches on current situations of the elderly ,the elderly care ,the care facilities and the caregiver team in recent years ,we completed analysis on major issues of long-term care for the elderly ,proposed principal implications for the constitution of community-based long-term elderly care system and provided reference for relevant institutional improvement . Simultaneously , we also presented specific suggestions in the following fields :accelerate standardized construction of day care center ,community-based nursing homes ,and other nursing institutions for the elderly ;strengthen the training of service team ;establish the referral regimes and referral standards ,building long-term caring referral system for the elderly ;set up evaluative criteria ,the third party evaluating methods and public supervisory mechanism in order to achieve progressive elaboration on evaluation scheme ;enhance risk management ;Standardize the operation of long-term care system in the community .

  2. How to build and evaluate an integrated health care system for chronic patients: study design of a clustered randomised controlled trial in rural China

    Directory of Open Access Journals (Sweden)

    Wenxi Tang

    2015-03-01

    Full Text Available Background: While integrated health care system has been proved an effective way to help improving patient health and system efficiency, the exact behaviour model and motivation approach are not so clear in poor rural areas where health human resources and continuous service provision are urgently needed. To gather solid evidence, we initiated a comprehensive intervention project in Qianjiang District, southwest part of rural China in 2012. And after one-year's pilot, we developed an intervention package of team service, comprehensive pathway and prospective- and performance-based payment system. Methods: To testify the potential influence of payment interventions, we use clustered randomised controlled trial, 60 clusters are grouped into two treatment groups and one control group to compare the time and group differences. Difference-in-differences model and structural equation modelling will be used to analyse the intervention effects and pathway. The outcomes are: quality of care, disease burden, supplier cooperative behaviour and patient utilisation behaviour and system efficiency. Repeated multivariate variance analysis will be used to statistically examine the outcome differences. Discussion: This is the first trial of its kind to prove the effects and efficiency of integrated care. Though we adopted randomised controlled trial to gather the highest rank of evidence, still the fully randomisation was hard to realise in health policy reform experiment. To compensate, the designer should take efforts on control for the potential confounders as much as possible. With this trial, we assume the effects will come from: (1 improvement on the quality of life through risk factors control and lifestyles change on patient's behaviours; (2 improvement on quality of care through continuous care and coordinated supplier behaviours; (3 improvement on the system efficiency through active interaction between suppliers and patients. Conclusion

  3. How to build and evaluate an integrated health care system for chronic patients: study design of a clustered randomised controlled trial in rural China

    Directory of Open Access Journals (Sweden)

    Wenxi Tang

    2015-03-01

    Full Text Available Background: While integrated health care system has been proved an effective way to help improving patient health and system efficiency, the exact behaviour model and motivation approach are not so clear in poor rural areas where health human resources and continuous service provision are urgently needed. To gather solid evidence, we initiated a comprehensive intervention project in Qianjiang District, southwest part of rural China in 2012. And after one-year's pilot, we developed an intervention package of team service, comprehensive pathway and prospective- and performance-based payment system.Methods: To testify the potential influence of payment interventions, we use clustered randomised controlled trial, 60 clusters are grouped into two treatment groups and one control group to compare the time and group differences. Difference-in-differences model and structural equation modelling will be used to analyse the intervention effects and pathway. The outcomes are: quality of care, disease burden, supplier cooperative behaviour and patient utilisation behaviour and system efficiency. Repeated multivariate variance analysis will be used to statistically examine the outcome differences.Discussion: This is the first trial of its kind to prove the effects and efficiency of integrated care. Though we adopted randomised controlled trial to gather the highest rank of evidence, still the fully randomisation was hard to realise in health policy reform experiment. To compensate, the designer should take efforts on control for the potential confounders as much as possible. With this trial, we assume the effects will come from: (1 improvement on the quality of life through risk factors control and lifestyles change on patient's behaviours; (2 improvement on quality of care through continuous care and coordinated supplier behaviours; (3 improvement on the system efficiency through active interaction between suppliers and patients

  4. Patterns and expenditures of multi-morbidity in an insured working population in the United States: insights for a sustainable health care system and building healthier lives.

    Science.gov (United States)

    Greene, Robert; Dasso, Edwin; Ho, Sam; Frank, Jerry; Scandrett, Graeme; Genaidy, Ash

    2013-12-01

    The U.S. health care system is currently heading toward unsustainable health care expenditures and increased dissatisfaction with health outcomes. The objective of this population-based study is to uncover practical insights regarding patients with 1 or more chronic illnesses. A cross-sectional investigation was designed to gather data from health records drawn from diverse US geographic markets. A database of 9.74 million fully-insured, working individuals was used, together with members in the same households. Among nearly 3.43 million patients with claims, 2.22 million had chronic conditions. About 24.3% had 1 chronic condition and 40.4% had multi-morbidity. Health care expenditures for chronic conditions accounted for 92% of all costs (52% for chronic costs and 40% for nonchronic costs). Psychiatry, orthopedics-rheumatology, endocrinology, and cardiology areas accounted for two thirds of these chronic condition costs; nonchronic condition costs were dominated by otolaryngology, gastroenterology, dermatology, orthopedics-rheumatology conditions, and preventive services. About 50.1% of all households had 2 or more members with chronic conditions. In summary, multi-morbidity is prevalent not only among those older than age 65 years but also in younger and working individuals, and commonly occurs among several members of a household. The authors suggest that the disease-focused model of medicine should change to a more holistic illness-wellness model, emphasizing not only the physical but also the mental and social elements that can influence individual health. In that way the chronic care model could be broadened in context and content to improve the health of patients and households.

  5. What Is Best for Esther? Building Improvement Coaching Capacity With and for Users in Health and Social Care--A Case Study.

    Science.gov (United States)

    Vackerberg, Nicoline; Levander, Märta Sund; Thor, Johan

    2016-01-01

    While coaching and customer involvement can enhance the improvement of health and social care, many organizations struggle to develop their improvement capability; it is unclear how best to accomplish this. We examined one attempt at training improvement coaches. The program, set in the Esther Network for integrated care in rural Jönköping County, Sweden, included eight 1-day sessions spanning 7 months in 2011. A senior citizen joined the faculty in all training sessions. Aiming to discern which elements in the program were essential for assuming the role of improvement coach, we used a case-study design with a qualitative approach. Our focus group interviews included 17 informants: 11 coaches, 3 faculty members, and 3 senior citizens. We performed manifest content analysis of the interview data. Creating will, ideas, execution, and sustainability emerged as crucial elements. These elements were promoted by customer focus--embodied by the senior citizen trainer--shared values and a solution-focused approach, by the supportive coach network and by participants' expanded systems understanding. These elements emerged as more important than specific improvement tools and are worth considering also elsewhere when seeking to develop improvement capability in health and social care organizations. PMID:26783868

  6. Energy Conservation in Buildings--A Human Factors/Systems Viewpoint. NBS Building Science Series 88.

    Science.gov (United States)

    Rubin, Arthur I.

    The current emphasis on energy conservation in buildings must be balanced by a careful consideration of how proposed approaches affect building occupants. A headlong rush toward building designs that conserve energy at the expense of the quality of buildings as judged by occupants would be a very shortsighted approach. There must be a continual…

  7. Developing Integrated Care: Towards a development model for integrated care

    OpenAIRE

    Minkman, Mirella M.N

    2012-01-01

    textabstractThe thesis adresses the phenomenon of integrated care. The implementation of integrated care for patients with a stroke or dementia is studied. Because a generic quality management model for integrated care is lacking, the study works towards building a development model for integrated care. Based on a systematic approach in which a literature study, a delphi study, a concept mapping study and questionnaire research are combined, a development model for integrated care is created....

  8. Building TQM into nursing management.

    Science.gov (United States)

    Masters, M L; Masters, R J

    1993-01-01

    Total quality management (TQM) is a management philosophy that addresses problems currently faced by health care, specifically reducing costs while improving quality of services. As hospital administrators embrace this new management style, nurse executives and managers will be challenged to implement TQM. Building TQM into nursing management will improve quality and reduce costs while meeting the needs of health care customers.

  9. Reactor building

    International Nuclear Information System (INIS)

    The whole reactor building is accommodated in a shaft and is sealed level with the earth's surface by a building ceiling, which provides protection against penetration due to external effects. The building ceiling is supported on walls of the reactor building, which line the shaft and transfer the vertical components of forces to the foundations. The thickness of the walls is designed to withstand horizontal pressure waves in the floor. The building ceiling has an opening above the reactor, which must be closed by cover plates. Operating equipment for the reactor can be situated above the building ceiling. (orig./HP)

  10. Capacity building for primary health care reform and its effectiveness in Feixi county, Anhui province%安徽省肥西县基层卫生服务能力提升改革及其成效

    Institute of Scientific and Technical Information of China (English)

    金音子; 何莉; 岳大海; 朱炜明; 张鲁豫; 马慧芬; 孟庆跃

    2015-01-01

    Objective:To analyze the implementation and effectiveness of primary health care reform in Feixi county, Anhui province. Methods: This paper uses data analysis of interviews with key insiders, policy documents and archives, as well as institutional questionnaire survey and other methods to collect information, and then it com-bines qualitative and quantitative research to arrive at research findings through cross-analysis and interpretation. Re-sults:From 2010 to 2014, the reform enhanced the capacity of primary health care in four main aspects, including capacity building of primary health care personnel, network construction of primary health care system, improvement of working conditions, and system construction of institutional management. Accordingly, the human capacity of pri-mary health care personnel was improved, their enthusiasm for work increased, their income was raised, the working conditions were improved, the cooperation mechanism for vertical and horizontal health care services was established, and the consultation rate and primary health care utilization in Feixi county increased. Conclusion:Both the“bottom-up” exploration approach and “from point to area” implementation strategy adopted by Feixi county have not only been the core content of primary health care system’s comprehensive reform, but also effectively leveraged the other aspects of the reform. They have played an important role in deepening medical reform and establishing institutional mechanism of health care system.%目的::分析安徽省肥西县基层卫生服务能力提升改革措施及成效,为深化基层医疗卫生服务体系改革提供参考。方法:采用关键知情人访谈、政策文件和档案资料分析以及机构问卷调查等方法收集资料,定性和定量研究结合,通过交叉分析和解释得出研究发现。结果:2010—2014年,肥西县从基层卫生人员能力、卫生服务体系网络建设、工作条件改善、

  11. Building America

    Energy Technology Data Exchange (ETDEWEB)

    Brad Oberg

    2010-12-31

    IBACOS researched the constructability and viability issues of using high performance windows as one component of a larger approach to building houses that achieve the Building America 70% energy savings target.

  12. Solar building

    OpenAIRE

    Zhang, Luxin

    2014-01-01

    In my thesis I describe the utilization of solar energy and solar energy with building integration. In introduction it is also mentioned how the solar building works, trying to make more people understand and accept the solar building. The thesis introduces different types of solar heat collectors. I compared the difference two operation modes of solar water heating system and created examples of solar water system selection. I also introduced other solar building applications. It is conv...

  13. Tecendo a rede assistencial em saúde mental com a ferramenta matricial Building the mental health care network with the matrix support tool

    Directory of Open Access Journals (Sweden)

    Fernando Sérgio Pereira de Sousa

    2011-12-01

    Full Text Available Objetivou-se analisar o matriciamento como ferramenta articuladora da rede de atenção em saúde mental. Trata-se de uma pesquisa de natureza qualitativa, realizada no Nordeste brasileiro, no período de março a abril de 2010. Utilizaram-se para a coleta das informações a entrevista semiestruturada e a observação sistemática. Como participantes da pesquisa, incluíram-se 47 profissionais de saúde da Estratégia Saúde da Família e dos Centros de Atenção Psicossocial, distribuídos em dois grupos. Os dados foram organizados e analisados pelos pressupostos da análise de conteúdo articulando o teórico com o empírico. Em cumprimento ao exigido, o estudo foi submetido à análise do Comitê de Ética em Pesquisa adequando-se às normas da pesquisa envolvendo seres humanos. Segundo os resultados evidenciaram, o apoio matricial é uma estratégia potente, pois possibilita a construção de um sistema articulado em rede no SUS, não limitado às fronteiras de um dado serviço. Interconectado por uma equipe de referência, que mobiliza diversos atores para lidar com o andamento do caso, o apoio matricial sinaliza os caminhos que viabilizam a conexão de redes de cuidados em saúde mental.This study aimed to analyze the matrix support as an organizer tool of mental health care network. This is a qualitative survey, conducted in Brazilian Northeast, from March to April 2010. Systematic observations and semi-structured interviews were conducted with 47 health professionals from the Family Health Strategy and Psychosocial Care Centers. The collected information was organized and analyzed by content analysis. Pursuant to the requirements, the study was submitted to the Research Ethics Committee for adapting to the standards of research involving human beings. The results showed the matrix support as a powerful strategy since it enables the construction of a linkage in SUS network services, not limited to the borders of a specific service. Also

  14. Developing Integrated Care: Towards a development model for integrated care

    NARCIS (Netherlands)

    M.M.N. Minkman (Mirella)

    2012-01-01

    textabstractThe thesis adresses the phenomenon of integrated care. The implementation of integrated care for patients with a stroke or dementia is studied. Because a generic quality management model for integrated care is lacking, the study works towards building a development model for integrated c

  15. From the description of activities to the identification of risks for clinical management: a proposal of building, merging and sharing knowledge representations of care processes.

    Science.gov (United States)

    Staccini, Pascal; Joubert, Michel; Collomp, Rémy; Quaranta, Jean-François; Fieschi, Marius

    2007-01-01

    Management of clinical processes and hospital activities takes advantage of business process reengineering methodology. It is now recognized that care process modeling must integrate the definition of goals and the assessment of risk. Two kinds of issues have been outlined: 1) the lack of an integrated model to identify and describe processes and their components according to a functional point of view; and 2) an increasing amount of documents that hospital staff members have to create, collect, index and maintain. As initial models focused only on a structural view of activities, we reviewed different sources of standards and norms to extract and classify a set of metadata aimed at describing any activity and its outcomes. The model includes links to structured terminologies to name attributes or value them. An object-oriented information model has been created and implemented to test the relevance and the feasibility of the modeling approach. Conceptually speaking, this model gives opportunity to bridge tacit and explicit knowledge. Practically speaking, limits to generalization remain partly due to the lack of a template processes database.

  16. From the description of activities to the identification of risks for clinical management: a proposal of building, merging and sharing knowledge representations of care processes.

    Science.gov (United States)

    Staccini, Pascal; Joubert, Michel; Collomp, Rémy; Quaranta, Jean-François; Fieschi, Marius

    2007-01-01

    Management of clinical processes and hospital activities takes advantage of business process reengineering methodology. It is now recognized that care process modeling must integrate the definition of goals and the assessment of risk. Two kinds of issues have been outlined: 1) the lack of an integrated model to identify and describe processes and their components according to a functional point of view; and 2) an increasing amount of documents that hospital staff members have to create, collect, index and maintain. As initial models focused only on a structural view of activities, we reviewed different sources of standards and norms to extract and classify a set of metadata aimed at describing any activity and its outcomes. The model includes links to structured terminologies to name attributes or value them. An object-oriented information model has been created and implemented to test the relevance and the feasibility of the modeling approach. Conceptually speaking, this model gives opportunity to bridge tacit and explicit knowledge. Practically speaking, limits to generalization remain partly due to the lack of a template processes database. PMID:17911723

  17. Development and Implementation of a Child Welfare Workforce Strategy to Build a Trauma-Informed System of Support for Foster Care.

    Science.gov (United States)

    Kerns, Suzanne E U; Pullmann, Michael D; Negrete, Andrea; Uomoto, Jacqueline A; Berliner, Lucy; Shogren, Dae; Silverman, Ellen; Putnam, Barbara

    2016-05-01

    Effective strategies that increase the extent to which child welfare professionals engage in trauma-informed case planning are needed. This study evaluated two approaches to increase trauma symptom identification and use of screening results to inform case planning. The first study evaluated the impact of training on trauma-informed screening tools for 44 child welfare professionals who screen all children upon placement into foster care. The second study evaluated a two-stage approach to training child welfare workers on case planning for children's mental health. Participants included (a) 71 newly hired child welfare professionals who received a 3-hr training and (b) 55 child welfare professionals who participated in a full-day training. Results from the first study indicate that training effectively increased knowledge and skills in administering screening tools, though there was variability in comfort with screening. In the second study, participants self-reported significant gains in their competency in identifying mental health needs (including traumatic stress) and linking children with evidence-based services. These findings provide preliminary evidence for the viability of this approach to increase the extent to which child welfare professionals are trauma informed, aware of symptoms, and able to link children and youth with effective services designed to meet their specific needs. PMID:26928411

  18. Laboratory Building.

    Energy Technology Data Exchange (ETDEWEB)

    Herrera, Joshua M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-03-01

    This report is an analysis of the means of egress and life safety requirements for the laboratory building. The building is located at Sandia National Laboratories (SNL) in Albuquerque, NM. The report includes a prescriptive-based analysis as well as a performance-based analysis. Following the analysis are appendices which contain maps of the laboratory building used throughout the analysis. The top of all the maps is assumed to be north.

  19. Be More Involved in Your Health Care: Tips for Patients

    Science.gov (United States)

    ... Task Force Improving Primary Care Practice Health IT Integration Health Care/System Redesign Clinical-Community Linkages Care Coordination Capacity Building Behavioral and Mental Health Self-Management Support Resources Clinical Community Relationships ...

  20. Teamwork for eye care

    Directory of Open Access Journals (Sweden)

    M Babar Qureshi

    2014-04-01

    Full Text Available Human resource development (HRD – the development of the people who deliver health care – has been identified as one of the key pillars of eye health delivery. HRD is one of the essential building blocks of the World Health Organization (WHO Global Action Plan: ‘Towards universal eye health’. The importance of HRD is also recognised beyond eye care, as can be seen in the WHO Health Systems approach.

  1. Teamwork for eye care

    OpenAIRE

    M Babar Qureshi

    2014-01-01

    Human resource development (HRD) – the development of the people who deliver health care – has been identified as one of the key pillars of eye health delivery. HRD is one of the essential building blocks of the World Health Organization (WHO) Global Action Plan: ‘Towards universal eye health’. The importance of HRD is also recognised beyond eye care, as can be seen in the WHO Health Systems approach.

  2. Building Inclusion

    NARCIS (Netherlands)

    Jeanet Kullberg; Isik Kulu-Glasgow

    2009-01-01

    The social inclusion of immigrants and ethnic minorities is a central issue in many European countries. Governments face challenges in ensuring housing for immigrants, delivering public services, promoting neighbourhood coexistence and addressing residential segregation. The Building Inclusion proje

  3. Building Languages

    Science.gov (United States)

    ... family's native language) is taught as the child's second language through reading, writing, speech, and use of residual ... that parents can use to help their child learn language. There are many types of building blocks, and ...

  4. Hair care and dyeing.

    Science.gov (United States)

    Draelos, Zoe Diana

    2015-01-01

    Alopecia can be effectively camouflaged or worsened through the use of hair care techniques and dyeing. Proper hair care, involving hair styling and the use of mild shampoos and body-building conditioners, can amplify thinning scalp hair; however, chemical processing, including hair dyeing, permanent waving, and hair straightening, can encourage further hair loss through breakage. Many patients suffering from alopecia attempt to improve their hair through extensive manipulation, which only increases problems. Frequent haircuts to minimize split ends, accompanied by gentle handling of the fragile fibers, is best. This chapter offers the dermatologist insight into hair care recommendations for the alopecia patient.

  5. Hair care and dyeing.

    Science.gov (United States)

    Draelos, Zoe Diana

    2015-01-01

    Alopecia can be effectively camouflaged or worsened through the use of hair care techniques and dyeing. Proper hair care, involving hair styling and the use of mild shampoos and body-building conditioners, can amplify thinning scalp hair; however, chemical processing, including hair dyeing, permanent waving, and hair straightening, can encourage further hair loss through breakage. Many patients suffering from alopecia attempt to improve their hair through extensive manipulation, which only increases problems. Frequent haircuts to minimize split ends, accompanied by gentle handling of the fragile fibers, is best. This chapter offers the dermatologist insight into hair care recommendations for the alopecia patient. PMID:26370650

  6. Building Bridges through an Ethic of Caring.

    Science.gov (United States)

    Stine, Deborah E.; Louque, Angela C.

    This study addresses the question of what principles need to be incorporated into the daily life of women in leadership positions to assist in their success. It is framed around the work of Carlos Castaneda, who describes the path of a warrior in metaphorical terms through seven principles of power: (1) knowing the battleground; (2) discarding the…

  7. Study of the effect of humanistic nursing care model wards in Children Caring Ward School on the nurses' caring ability

    Institute of Scientific and Technical Information of China (English)

    Jiao He; De-Ying Hu; Yi-Lan Liu; Li-Fen Wu; Lian Liu

    2016-01-01

    Objective: To understand the effect of humanistic nursing care model wards in Children Caring Ward School (CCWS) on the nurses' caring ability. Methods: Questionnaire 25 nurses of humanistic nursing care model wards in CCWS using the Nkongho Caring Ability Inventory (CAI) before and after implement the humanistic nursing care model, including reform the systems of nursing care, introduce humanistic care model, implement the humanistic care, to measure the nurses' caring ability. Results: The nurses' caring ability had significantly developed on total, cognition dimension, courage dimension and patience dimension after all measures considered (p Conclusions: The humanistic nursing care model wards in CCWS has a positive effect on the nurses' caring ability, not only to help build great relationships between nurses and patients but also to enhance the patients' satisfaction.

  8. Competence Building

    DEFF Research Database (Denmark)

    Borrás, Susana; Edquist, Charles

    The main question that guides this paper is how governments are focusing (and must focus) on competence building (education and training) when designing and implementing innovation policies. With this approach, the paper aims at filling the gap between the existing literature on competences...... on the one hand, and the real world of innovation policy-making on the other, typically not speaking to each other. With this purpose in mind, this paper discusses the role of competences and competence-building in the innovation process from a perspective of innovation systems; it examines how governments...... and public agencies in different countries and different times have actually approached the issue of building, maintaining and using competences in their innovation systems; it examines what are the critical and most important issues at stake from the point of view of innovation policy, looking particularly...

  9. Building Procurement

    DEFF Research Database (Denmark)

    Andersson, Niclas

    2007-01-01

    ‘The procurement of construction work is complex, and a successful outcome frequently elusive’. With this opening phrase of the book, the authors take on the challenging job of explaining the complexity of building procurement. Even though building procurement systems are, and will remain, complex...... despite this excellent book, the knowledge, expertise, well-articulated argument and collection of recent research efforts that are provided by the three authors will help to make project success less elusive. The book constitutes a thorough and comprehensive investigation of building procurement, which...... evolves from a simple establishment of a contractual relationship to a central and strategic part of construction. The authors relate to cultural, ethical and social and behavioural sciences as the fundamental basis for analysis and understanding of the complexity and dynamics of the procurement system...

  10. Building Bridges

    DEFF Research Database (Denmark)

    The report Building Bridges adresses the questions why, how and for whom academic audience research has public value, from the different points of view of the four working groups in the COST Action IS0906 Transforming Audiences, Transforming Societies – “New Media Genres, Media Literacy and Trust...... in the Media”, “Audience Interactivity and Participation”, “The Role of Media and ICT Use for Evolving Social Relationships” and “Audience Transformations and Social Integration”. Building Bridges is the result of an ongoing dialogue between the Action and non-academic stakeholders in the field of audience...

  11. Building Systems: Passing Fad or Basic Tool?

    Science.gov (United States)

    Rezab, Donald

    Building systems can be traced back to a 1516 A.D. project by Leonardo da Vinci and to a variety of prefabrication projects in every succeeding century. When integrated into large and repetitive spatial units through careful design, building systems can produce an architecture of the first order, as evidenced in the award winning design of…

  12. Building Bridges

    DEFF Research Database (Denmark)

    The report Building Bridges adresses the questions why, how and for whom academic audience research has public value, from the different points of view of the four working groups in the COST Action IS0906 Transforming Audiences, Transforming Societies – “New Media Genres, Media Literacy and Trust...

  13. Sustainable Buildings

    DEFF Research Database (Denmark)

    Tommerup, Henrik M.; Elle, Morten

    The scientific community agrees that: all countries must drastically and rapidly reduce their CO2 emissions and that energy efficient houses play a decisive role in this. The general attitude at the workshop on Sustainable Buildings was that we face large and serious climate change problems...

  14. Adaptive fuzzy logic control for solar buildings

    OpenAIRE

    El-Deen, M. M. G. Naser

    2002-01-01

    Significant progress has been made on maximising passive solar heating loads through the careful selection of glazing, orientation and internal mass within building spaces. Control of space heating in buildings of this type has become a complex problem. Additionally, and in common with most building control applications, there is a need to develop control solutions that permit simple and transparent set up and commissioning procedures. This work concerns the development and testing of an adap...

  15. Building Letters

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Cabinet是种十分吸引人却很简单的衬线字体,是由一名匿名字体设计师专门为Building Letters最新的资金筹集活动所设计的。这个Building Letters包中包含一个CDROM,有32种字体,以及一本专门设计的杂志和两张由Eboy和Emigre所设计的海报。字体光盘样例是由世界顶级的字体设计师们设计的.

  16. Building capacity for evidence generation, synthesis and implementation to improve the care of mothers and babies in South East Asia: methods and design of the SEA-ORCHID Project using a logical framework approach

    Directory of Open Access Journals (Sweden)

    Short Jacki

    2010-07-01

    Full Text Available Abstract Background Rates of maternal and perinatal mortality remain high in developing countries despite the existence of effective interventions. Efforts to strengthen evidence-based approaches to improve health in these settings are partly hindered by restricted access to the best available evidence, limited training in evidence-based practice and concerns about the relevance of existing evidence. South East Asia - Optimising Reproductive and Child Health in Developing Countries (SEA-ORCHID was a five-year project that aimed to determine whether a multifaceted intervention designed to strengthen the capacity for research synthesis, evidence-based care and knowledge implementation improved clinical practice and led to better health outcomes for mothers and babies. This paper describes the development and design of the SEA-ORCHID intervention plan using a logical framework approach. Methods SEA-ORCHID used a before-and-after design to evaluate the impact of a multifaceted tailored intervention at nine sites across Thailand, Malaysia, Philippines and Indonesia, supported by three centres in Australia. We used a logical framework approach to systematically prepare and summarise the project plan in a clear and logical way. The development and design of the SEA-ORCHID project was based around the three components of a logical framework (problem analysis, project plan and evaluation strategy. Results The SEA-ORCHID logical framework defined the project's goal and purpose (To improve the health of mothers and babies in South East Asia and To improve clinical practice in reproductive health in South East Asia, and outlined a series of project objectives and activities designed to achieve these. The logical framework also established outcome and process measures appropriate to each level of the project plan, and guided project work in each of the participating countries and hospitals. Conclusions Development of a logical framework in the SEA

  17. Model Building

    OpenAIRE

    Frampton, Paul H.

    1997-01-01

    In this talk I begin with some general discussion of model building in particle theory, emphasizing the need for motivation and testability. Three illustrative examples are then described. The first is the Left-Right model which provides an explanation for the chirality of quarks and leptons. The second is the 331-model which offers a first step to understanding the three generations of quarks and leptons. Third and last is the SU(15) model which can accommodate the light leptoquarks possibly...

  18. Building economics

    DEFF Research Database (Denmark)

    Pedersen, D.O.(red.)

    Publikationen er på engelsk. Den omfatter alle indlæg på det fjerde internationale symposium om byggeøkonomi, der blev arrangeret af SBI for det internationale byggeforskningsråd CIB. De fem bind omhandler: Methods of Economic Evaluation, Design Optimization, Ressource Utilization, The Building...... Market og Economics and Technological Forecasting in Construction. Et indledende bind bringer statusrapporter for de fem forskningsområder, og det sidste bind sammenfatter debatten på symposiet....

  19. 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 ...

  20. 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 ...

  1. 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 ...

  2. 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 ...

  3. Child Day Care Centers, Part of our City of Hutchinson polygon building footprint layer and the list was/is derived from the fire department, Published in 2006, 1:600 (1in=50ft) scale, City of Hutchinson.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Child Day Care Centers dataset, published at 1:600 (1in=50ft) scale, was produced all or in part from Orthoimagery information as of 2006. It is described as...

  4. Health Care Professionals Devise Ways to Get Around Using Electronic Health Record Systems

    Science.gov (United States)

    ... Task Force Improving Primary Care Practice Health IT Integration Health Care/System Redesign Clinical-Community Linkages Care Coordination Capacity Building Behavioral and Mental Health Self-Management Support Resources Clinical Community Relationships ...

  5. Building energy analysis tool

    Science.gov (United States)

    Brackney, Larry; Parker, Andrew; Long, Nicholas; Metzger, Ian; Dean, Jesse; Lisell, Lars

    2016-04-12

    A building energy analysis system includes a building component library configured to store a plurality of building components, a modeling tool configured to access the building component library and create a building model of a building under analysis using building spatial data and using selected building components of the plurality of building components stored in the building component library, a building analysis engine configured to operate the building model and generate a baseline energy model of the building under analysis and further configured to apply one or more energy conservation measures to the baseline energy model in order to generate one or more corresponding optimized energy models, and a recommendation tool configured to assess the one or more optimized energy models against the baseline energy model and generate recommendations for substitute building components or modifications.

  6. Building America

    Energy Technology Data Exchange (ETDEWEB)

    Brad Oberg

    2010-12-31

    Builders generally use a 'spec and purchase' business management system (BMS) when implementing energy efficiency. A BMS is the overall operational and organizational systems and strategies that a builder uses to set up and run its company. This type of BMS treats building performance as a simple technology swap (e.g. a tank water heater to a tankless water heater) and typically compartmentalizes energy efficiency within one or two groups in the organization (e.g. purchasing and construction). While certain tools, such as details, checklists, and scopes of work, can assist builders in managing the quality of the construction of higher performance homes, they do nothing to address the underlying operational strategies and issues related to change management that builders face when they make high performance homes a core part of their mission. To achieve the systems integration necessary for attaining 40% + levels of energy efficiency, while capturing the cost tradeoffs, builders must use a 'systems approach' BMS, rather than a 'spec and purchase' BMS. The following attributes are inherent in a systems approach BMS; they are also generally seen in quality management systems (QMS), such as the National Housing Quality Certification program: Cultural and corporate alignment, Clear intent for quality and performance, Increased collaboration across internal and external teams, Better communication practices and systems, Disciplined approach to quality control, Measurement and verification of performance, Continuous feedback and improvement, and Whole house integrated design and specification.

  7. 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 ...

  8. 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 ...

  9. 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 ...

  10. 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.

  11. Building a leadership brand.

    Science.gov (United States)

    Ulrich, Dave; Smallwood, Norm

    2007-01-01

    How do some firms produce a pipeline of consistently excellent managers? Instead of concentrating merely on strengthening the skills of individuals, these companies focus on building a broad organizational leadership capability. It's what Ulrich and Smallwood--cofounders of the RBL Group, a leadership development consultancy--call a leadership brand. Organizations with leadership brands take an "outside-in" approach to executive development. They begin with a clear statement of what they want to be known for by customers and then link it with a required set of management skills. The Lexus division of Toyota, for instance, translates its tagline--"The pursuit of perfection"--into an expectation that its leaders excel at managing quality processes. The slogan of Bon Secours Health System is "Good help to those in need." It demands that its managers balance business skills with compassion and caring. The outside-in approach helps firms build a reputation for high-quality leaders whom customers trust to deliver on the company's promises. In examining 150 companies with strong leadership capabilities, the authors found that the organizations follow five strategies. First, make sure managers master the basics of leadership--for example, setting strategy and grooming talent. Second, ensure that leaders internalize customers' high expectations. Third, incorporate customer feedback into evaluations of executives. Fourth, invest in programs that help managers hone the right skills, by tapping customers to participate in such programs. Finally, track the success of efforts to build leadership bench strength over the long-term. The result is outstanding management that persists even when individual executives leave. In fact, companies with the strongest leadership brands often become "leader feeders"--firms that regularly graduate leaders who go on to head other companies. PMID:17642128

  12. Does informal care from children to their elderly parents substitute for formal care in Europe?

    Science.gov (United States)

    Bonsang, Eric

    2009-01-01

    This paper analyzes the impact of informal care by adult children on the use of long-term care among the elderly in Europe and the effect of the level of the parent's disability on this relationship. We focus on two types of formal home care that are the most likely to interact with informal care: paid domestic help and nursing care. Using recent European data emerging from the Survey on Health, Ageing and Retirement in Europe (SHARE), we build a two-part utilization model analyzing both the decision to use each type of formal care or not and the amount of formal care received by the elderly. Instrumental variables estimations are used to control for the potential endogeneity existing between formal and informal care. We find endogeneity of informal care in the decision to receive paid domestic help. Estimation results indicate that informal care substitutes for this type of formal home care. However, we find that this substitution effect tends to disappear as the level of disability of the elderly person increases. Finally, informal care is a weak complement to nursing care, independently of the level of disability. These results highlight the heterogeneous effects of informal care on formal care use and suggest that informal care is an effective substitute for long-term care as long as the needs of the elderly are low and require unskilled type of care. Any policy encouraging informal care to decrease long-term care expenditures should take it into account to assess its effectiveness. PMID:18950879

  13. 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

  14. Building trust

    International Nuclear Information System (INIS)

    'Activate' is the energy magazine for secondary schools and is part of the Education Programme which is managed on behalf of the British Nuclear Industry Forum by AEA Technology. activate is the flagship communication device between the British Nuclear Industry Forum's Education Programme and secondary schools in the UK. It was developed from a previous publication, Nuclear Bulletin. There is a need for the nuclear industry to build trust with teachers and students in the UK, where for a long time, everything that the industry has said, written or printed has been disregarded by school teachers as propaganda. Over the last few years the industry has put in a great deal of effort to position itself as a provider of educationally sound and socially acceptable information. 'Activate' was an evolution of this idea and there was a hole in the market for a lively, activity and article based magazine that could be used in the classroom. The target audience is principally teachers of science, mathematics and geography, but also includes teachers of art,, English and history with students of between 11 and 18. The results were very positive in that teachers appreciated the colourful and lively nature of activate and they felt that it provided information and opinions in an un biased and non-propagandist way. Their comments about layout, number of activities style of presentation were taken into account and during the summer of 1994 activate was remodelled ready for re launch in September. The feedback so far is good with more teachers signing up every week to receive their own free copy

  15. Primary care research in Denmark

    DEFF Research Database (Denmark)

    Vedsted, Peter; Kallestrup, Per

    2016-01-01

    the inter-professional nature of the discipline, the book also features a section on cross-nation organisations and primary care networks supporting research. National perspectives are offered from researchers in 20 countries that form part of the World Organization of Family Doctors, providing case...... histories from research-rich to resource-poor nations that illustrate the range of research development and capacity building. This book argues the importance of primary care research, especially to policy makers, decision makers and funders in informing best practice, training primary health care providers...

  16. BUILDING 341 Seismic Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Halle, J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-06-15

    The Seismic Evaluation of Building 341 located at Lawrence Livermore National Laboratory in Livermore, California has been completed. The subject building consists of a main building, Increment 1, and two smaller additions; Increments 2 and 3.

  17. 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 - ...

  18. Danish building typologies

    DEFF Research Database (Denmark)

    Wittchen, Kim Bjarne; Kragh, Jesper

    The objective of TABULA is to develop a harmonised building typology for European countries. Each national building typology will consist of a set of residential model buildings with characteristic energy-related properties (element areas of the thermal building envelope, U-values, supply system...... efficiencies). The model buildings will each represent a specific construction period of the country in question and a specific building size. Furthermore the number of buildings, flats and the overall floor areas will be given, which are represented by the different building types of the national typologies....

  19. Integrating Responsive Building Elements in Buildings

    DEFF Research Database (Denmark)

    Haase, Matthias; Amato, Alex; Heiselberg, Per

    2006-01-01

    energy strategies to develop guidelines and procedures for estimation of environmental performance of responsive building elements and integrated building concepts This paper introduces the ideas of this collaborative work and discusses its usefulness for Hong Kong and China. Special focus was put......There is a global need for a more sustainable building development. About 50% of energy is used in buildings indicating that buildings provide a considerable potential for operational energy savings. Studies were conducted with the following objectives: to perform a state-of-the-art review...

  20. Building an international network for a primary care research program: reflections on challenges and solutions in the set-up and delivery of a prospective observational study of acute cough in 13 European countries

    Directory of Open Access Journals (Sweden)

    Veen Robert ER

    2011-07-01

    Full Text Available Abstract Background Implementing a primary care clinical research study in several countries can make it possible to recruit sufficient patients in a short period of time that allows important clinical questions to be answered. Large multi-country studies in primary care are unusual and are typically associated with challenges requiring innovative solutions. We conducted a multi-country study and through this paper, we share reflections on the challenges we faced and some of the solutions we developed with a special focus on the study set up, structure and development of Primary Care Networks (PCNs. Method GRACE-01 was a multi-European country, investigator-driven prospective observational study implemented by 14 Primary Care Networks (PCNs within 13 European Countries. General Practitioners (GPs recruited consecutive patients with an acute cough. GPs completed a case report form (CRF and the patient completed a daily symptom diary. After study completion, the coordinating team discussed the phases of the study and identified challenges and solutions that they considered might be interesting and helpful to researchers setting up a comparable study. Results The main challenges fell within three domains as follows: i selecting, setting up and maintaining PCNs; ii designing local context-appropriate data collection tools and efficient data management systems; and iii gaining commitment and trust from all involved and maintaining enthusiasm. The main solutions for each domain were: i appointing key individuals (National Network Facilitator and Coordinator with clearly defined tasks, involving PCNs early in the development of study materials and procedures. ii rigorous back translations of all study materials and the use of information systems to closely monitor each PCNs progress; iii providing strong central leadership with high level commitment to the value of the study, frequent multi-method communication, establishing a coherent ethos

  1. Health care consumerism movement takes a step forward.

    Science.gov (United States)

    Thompson, Michael; Cutler, Charles M

    2010-01-01

    One of the contributing factors to both the increase in health care costs and the backlash to managed care was the lack of consumer awareness of the cost of health care service, the effect of health care costs on profits and wages, and the need to engage consumers more actively as consumers in health care decisions. This article reviews the birth of the health care consumerism movement and identifies gaps in health care consumerism today. The authors reveal some of the keys to building a sustainable health care consumerism framework, which involves enlisting consumers as well as other stakeholders.

  2. Advance care planning: thinking ahead to achieve our patients' goals.

    Science.gov (United States)

    Cairns, Rosemary

    2011-09-01

    The End of Life Care Strategy for England describes advance care planning (ACP) as a 'voluntary process of discussion about future care...concerns and wishes...values or personal goals for care, their understanding of their illness and prognosis...wishes for types of care or treatment and the availability of these' (Department of Health (DH), 2008). In Scotland, Living and Dying Well: Building on Progress (Scottish Government (SG), 2011) referred to adopting a 'thinking ahead' philosophy.

  3. The Building Commissioning Handbook.

    Science.gov (United States)

    Heinz, John A.; Casault, Rick

    This book discusses building commissioning, which is the process of certifying that a new facility meets the required specifications. As buildings have become more complex, the traditional methods for building start-up and final acceptance have been proven inadequate, and building commissioning has been developed, which often necessitates the use…

  4. BUILDING AN EFFECTIVE SALES FORCE

    Directory of Open Access Journals (Sweden)

    Ioana Olariu

    2016-07-01

    Full Text Available Building an effective sales force starts with selecting good salespeople, but good salespeople are very difficult to find. The reason for this is that most sales jobs are very demanding and require a great deal from the salesperson. There are many different types of sales jobs. Before it can hire salespeople, each company must do a careful job analysis to see what particular types of selling and other skills are necessary for each sales job. One task of the market planner is to establish clear objectives each year for the entire sales force, for each region, each sales office, and each salesperson. Sales jobs are different from in-house jobs in some significant ways. Nevertheless, each company must continually work on building and maintaining an effective sales force using the following steps: recruitment, selection, training, compensation and evaluation of each salesperson.

  5. Global building physics

    DEFF Research Database (Denmark)

    Rode, Carsten

    2013-01-01

    High ambitions are set for the building physics performance of buildings today. No single technology can achieve fulfilment of these ambitions alone. Integrated, multi-facetted solutions and optimization are necessary. A holistic, or ‘global’, technological perspective is needed, which includes all...... aspects of the building as defined in building engineering. We live in an international society and building solutions are developed across country borders. Building physics is a global theme. The International Association of Building Physics has global appeal. This brief article reports the keynote...

  6. Global Building Physics

    DEFF Research Database (Denmark)

    Rode, Carsten

    2012-01-01

    High ambitions are set for the building physics performance of buildings today. No single technology can achieve fulfilment of these ambitions alone. Integrated, multi-facetted solutions and optimization are necessary. A holistic, or “global”, technological perspective is needed, which includes all...... aspects of the building as defined in building engineering. We live in an international society and building solutions are developed across country borders. Building physics is a global theme. The International Association of Building Physics has global appeal. The keynote lecture and this brief paper...

  7. 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

  8. Retrofitting Listed Buildings

    DEFF Research Database (Denmark)

    Rasmussen, Torben Valdbjørn

    2011-01-01

    The paper presents a case study where the energy demand for a listed building constructed in 1900 is reduced. Many older buildings are listed and have restrictions that include the entire building or that include only its exterior. For the building presented, only its exterior facade is listed...... of the local urban environment and therefore listed. The reduced energy demand, related to individual measures, is estimated and building physics requirements are addressed together with the economic options for evaluating the profitability....

  9. ANALYSES AND INFLUENCES OF GLAZED BUILDING ENVELOPES

    Directory of Open Access Journals (Sweden)

    Sabina Jordan

    2011-01-01

    Full Text Available The article presents the results of an analytical study of the functioning of glazing at two different yet interacting levels: at the level of the building as a whole, and at that of glazing as a building element. At the building level, analyses were performed on a sample of high-rise business buildings in Slovenia, where the glazing"s share of the building envelope was calculated, and estimates of the proportion of shade provided by external blinds were made. It is shown that, especially in the case of modern buildings with large proportions of glazing and buildings with no shading devices, careful glazing design is needed, together with a sound knowledge of energy performance. In the second part of the article, the energy balance values relating to selected types of glazing are presented, including solar control glazing. The paper demonstrates the need for a holistic energy approach to glazing problems, as well as how different types of glazing can be methodically compared, thus improving the design of sustainability-orientated buildings.

  10. Building Community: It Starts in Your Own Backyard!

    Science.gov (United States)

    Kane, Cindy; Croft, Lucy

    2000-01-01

    Refers to Ernest Boyer' work, Campus Life: In Search of Community, to discuss six principles of building campus community. Boyer's principles guide community building initiatives on a campus-wide level. This paper highlights the six principles, which emphasize the creation of a purposeful, just, open, disciplined, caring, and celebrative…

  11. Key Elements of Building Coordinated Health Care Delivery System in China%我国目前分级诊疗工作中的几个关键环节探讨

    Institute of Scientific and Technical Information of China (English)

    周瑞; 赵琨; 齐雪然

    2016-01-01

    本文依据“知信行”行为改变理论,探讨分级诊疗体系建设中政府管医、医生行医、患者就医行为改变的关键要素,并探讨实现“大医院愿意放、基层愿意接、患者愿意去”的政策支撑和制度环境。本文提出:在认知上,分级诊疗是区域医疗服务体系规划的核心,是医改工作的风向标,是一项复杂的长期任务。在意愿上,若要大医院愿意放,需同步推进传统的财政补助方式、当前医疗服务定价机制的改革;若要基层愿意接,应设立财政专项补助、拉大绩效工资差;若要患者愿意去,应鼓励大医院专科医生坐诊基层、正确宣传基层首诊内涵、完善医保管理方式。在行动上,实行机构差异化考核、设立大医院基层部、打通药物目录等管理措施必须兼顾,协同推进分级诊疗体系建设。%According to the behavior changing theory of knowledge - attitude - practice,we explored the key elements regarding how government manages medical services,how doctors practice medicine,and how patients have medical services in the coordinated health care delivery system in China,and also explored the supporting polices and institutional environment to encourage major hospitals to make patient referral down to primary - level medical settings,primary - level medical settings to receive referral patients,and patients to have medical services in primary - level medical settings. This paper came up with following suggestions. In terms of cognition,we should realize that the coordinated health care delivery system is the core of planning for regional health care delivery system and benchmark of health care system reform,and is a complex long - term task. In terms of willingness,given the willingness of major hospitals to make patient referral down to primary - level medical settings,the reform of traditional financial aid mode and the current pricing mechanism of medical services

  12. Building Performance Simulation tools for planning of energy efficiency retrofits

    OpenAIRE

    Mondrup, Thomas Fænø; Karlshøj, Jan; Vestergaard, Flemming

    2014-01-01

    Designing energy efficiency retrofits for existing buildings will bring environmental, economic, social, and health benefits. However, selecting specific retrofit strategies is complex and requires careful planning. In this study, we describe a methodology for adopting Building Performance Simulation (BPS) tools as energy and environmentally conscious decision-making aids. The methodology has been developed to screen buildings for potential improvements and to support the development of retro...

  13. ICT Enhanced Buildings Potentials

    DEFF Research Database (Denmark)

    Christiansson, Per

    2007-01-01

    The paper describes and gives example on how Information and Communication, ICT, can and will enhance and support the building functional systems defined from client and end-user needs and requirements. The building systems may be derived from functional requirements on buildings such as usability...... and security on highest level with sub-systems definitions on lever levels. Building functional sub-systems may be defined for user comfort, indoor-climate, evacuation, space configuration, aesthetics, O&M etc. These building systems are supported by Information and Communication Technology, ICT, and building...... with focus on virtual building models support, new services and user environment definitions and development, virtual spaces and augmented reality, intelligent building components, application ontologies, and ICT systems integration to illustrate ICT enhanced buildings potentials and R&D needs.  ...

  14. Sustainable Buildings in Interaction

    DEFF Research Database (Denmark)

    Elle, Morten

    2007-01-01

    The first attempts to build sustainable buildings in Denmark were typically located on the countryside. The basic idea was to create buildings that were independent of the technical infrastructure. District heating has, however, been the dominating solution to heating in buildings in Denmark......, and the focus on sustainable building have gradually turned from special houses on the countryside to normally looking houses in the urban fabric, integrated in the technical infrastructure. Some new built urban areas in Denmark will, however, not have to be supplied with district heating – these developments...... are going to consist of passive houses. The first sustainable buildings were built by their users, and the user – building interaction still play a decisive role for the performance of the present sustainable buildings. The users have to understand how the building functions. Urban design is essential...

  15. CWI at TREC 2012, KBA track and Session Track

    NARCIS (Netherlands)

    Araújo, S.; Boscarino, C.; Gebremeskel, G.G.; He, J.; Vries, A.P. de; Voorhees, E.M.; Buckland, L. P.

    2013-01-01

    We participated in two tracks: Knowledge Base Acceleration (KBA) Track and Session Track. In the KBA track, we focused on experi- menting with different approaches as it is the first time the track is launched. We experimented with supervised and unsupervised re- trieval models. Our supervised appro

  16. Investing in Our Future: A Guide to Child Care Financing.

    Science.gov (United States)

    Stoney, Louise; Groginsky, Scott; Poppe, Julie

    This book investigates the innovative ways being used to ensure and finance high quality care for children. Chapter 1, "Introduction," discusses the government's role in helping to structure, build, and finance the system, as well as financing strategies. Chapter 2, "Financing Child Care Supply," addresses center-based child care, supports for…

  17. 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 ...

  18. 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

  19. Applied building physics

    CERN Document Server

    Hens, Hugo S L C

    2012-01-01

    The energy crises of the 1970s, persisting moisture problems, complaints about sick buildings, thermal, visual and olfactory discomfort, and the move towards more sustainability in building construction have pushed Building Physics to the forefront of building innovation. The societal pressure to diminish energy consumption in buildings without impairing usability acted as a trigger to activate the whole notion of performance based design and construction. As with all engineering sciences, Building Physics is oriented towards application, which is why, after a first book on fundamentals this s

  20. 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.

  1. The Building of Government Responsibility System of Our Country in Home-based Care Services under the Welfare Pluralism Perspective%福利多元主义视角下我国居家养老服务的政府责任体系构建

    Institute of Scientific and Technical Information of China (English)

    同春芬; 汪连杰

    2015-01-01

    Under the background of the aging population , our country has faced with the huge pressure of pension. Based on the welfare pluralism theory,this paper build a four dimensional framework for responsibility,which treat family,community,country and society,as the main bodies in the Home-based care services. From their own attribute and the social security point of view ,the government as a part of it, should undertake certain responsibility. At present,there are four main types of Home-based care services mode,namely “relying on third party organization”,“marketing operation”,“community dominance”pattern and the dominance of "family" pattern. Different service modes have different government's responsibilities , but there are a lot of advantages and disadvantages. Finally this paper build up the government responsibility in the field of Home-based care services , which including overall responsibility and four policy specific respon-sibilities,there are supervision and management,capital investment and policy implementation of four specific responsibilities.%在人口老龄化的背景下,我国面临着巨大的养老压力。基于福利多元主义理论,本文构建一个以家庭、社区、国家和社会为主体的居家养老的四维责任框架。从自身属性和社会保障的角度来说,政府作为其中的一部分,应该承担相应的责任。目前我国居家养老服务主要存在着四种模式,即“依托第三方组织”模式、“市场化运作”模式、“社区主导”模式和“家庭主导”模式,不同的服务模式,政府的责任的体现也不尽相同。文章最后构建出我国政府在居家养老服务领域的责任体系,主要包括总体责任和政策制定、监督管理、资金投入、政策实施四个具体责任。

  2. Does Informal Care from Children to their Elderly Parents Substitute for Formal Care in Europe?

    OpenAIRE

    Eric Bonsang

    2008-01-01

    This paper analyzes the impact of informal care by adult children on the use of long-term care among the elderly in Europe and the effect of the level of the parent’s disability on this relationship. We focus on two types of formal home care that are the most likely to interact with informal care: paid domestic help and nursing care. Using the most recent European data emerging from the Survey on Health, Ageing and Retirement in Europe (SHARE), we build a two-part utilization model analyzing ...

  3. Comfort control in buildings

    CERN Document Server

    Castilla, Maria del Mar; Rodriguez, Francisco de Asis

    2014-01-01

    This book describes both concepts and development of advanced comfort control systems in buildings, with significant energy saving, and attention to thermal, visual and indoor air quality. The concepts are proven through real tests in a bioclimatic building.

  4. Building the Korogwe Laboratory

    DEFF Research Database (Denmark)

    Knudsen, Jakob; von Seidlein, Lorenz; Richard, Jean Pierre

    2011-01-01

    An illustrated description of the building of a biomedical research laboratory in Korogwe, Tanzania.......An illustrated description of the building of a biomedical research laboratory in Korogwe, Tanzania....

  5. Building Design & Construction - Sustainability

    Energy Technology Data Exchange (ETDEWEB)

    None

    2003-11-01

    Offers a brief history of green building; presents the results of a specially commissioned survey; and analyzes the chief trends, issues, and published research, based on interviews with dozens of experts and participants in green building.

  6. Robotic buildings(s)

    NARCIS (Netherlands)

    Bier, H.H.

    2014-01-01

    Technological and conceptual advances in fields such as artificial intelligence, robotics, and material science have enabled robotic building to be in the last decade prototypically implemented. In this context, robotic building implies both physically built robotic environments and robotically supp

  7. Better Buildings Challenge Overview

    Energy Technology Data Exchange (ETDEWEB)

    None

    2011-06-01

    The Better Buildings Challenge is a national leadership initiative calling on corporate chief executive officers, university presidents, and state and local leaders to make a significant commitment to building energy efficiency.

  8. Requirements for existing buildings

    DEFF Research Database (Denmark)

    Thomsen, Kirsten Engelund; Wittchen, Kim Bjarne

    2012-01-01

    This report collects energy performance requirements for existing buildings in European member states by June 2012.......This report collects energy performance requirements for existing buildings in European member states by June 2012....

  9. Integrated Building Health Management

    Data.gov (United States)

    National Aeronautics and Space Administration — Abstract: Building health management is an important part in running an efficient and cost-effective building. Many problems in a building’s system can go...

  10. Allegheny County Building Footprints

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset contains photogrammetrically compiled roof outlines of buildings. All near orthogonal corners are square. Buildings that are less than 400 square feet...

  11. Buildings interoperability landscape - Draft

    Energy Technology Data Exchange (ETDEWEB)

    Hardin, Dave B. [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Stephan, Eric G. [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Wang, Weimin [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Corbin, Charles D. [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Widergren, Steven E. [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States)

    2015-02-01

    Buildings are an integral part of our nation’s energy economy. The advancement in information and communications technology (ICT) has revolutionized energy management in industrial facilities and large commercial buildings. As ICT costs decrease and capabilities increase, buildings automation and energy management features are transforming the small-medium commercial and residential buildings sectors. A vision of a connected world in which equipment and systems within buildings coordinate with each other to efficiently meet their owners’ and occupants’ needs, and where buildings regularly transact business with other buildings and service providers (such as gas and electric service providers) is emerging. However, while the technology to support this collaboration has been demonstrated at various degrees of maturity, the integration frameworks and ecosystems of products that support the ability to easily install, maintain, and evolve building systems and their equipment components are struggling to nurture the fledging business propositions of their proponents.

  12. Building Materials Property Table

    Energy Technology Data Exchange (ETDEWEB)

    None

    2010-04-16

    This information sheet describes a table of some of the key technical properties of many of the most common building materials taken from ASHRAE Fundamentals - 2001, Moisture Control in Buildings, CMHC, NRC/IRC, IEA Annex 24, and manufacturer data.

  13. Valuing Equality in Irish Social Care

    Directory of Open Access Journals (Sweden)

    Niall Hanlon

    2009-01-01

    Full Text Available In this article the author critiques Irish social care by presenting an equality perspective on practice. An equality perspective involves developing emancipatory practices, that is, ways of helping that provide egalitarian solutions and outcomes. Although emancipatory values are often contrasted with traditional social care values, the author seeks a pragmatic and integrated approach to emancipatory practices rather than a restatement of traditional dichotomies. Emancipatory practice begins with an appreciation of the nature and relevance of inequalities on the lives of diverse social care users. Building a commitment to equality within social care education and practice is an important step in altering many individual and institutional social care practices by focussing on equality processes and outcomes as central social care objectives. Using a well credited framework that outlines five dimensions of inequality (Baker, Lynch, Cantillon and Walsh, 2004, the author argues that social care educators and practitioners need to debate the issues raised and develop emancipatory practices.

  14. 品牌建设视野下本土护肤品牌的发展策略研究%Research on the Development Strategy of the Local Skin-care Brand in the Brand Building Perspective

    Institute of Scientific and Technical Information of China (English)

    陈桃红

    2012-01-01

    Brand building is an important way of brand growing and development.This paper discusses the development strategy of the local brand building: position differentia strategy to create the Chinese herbal medicine brands of national characteristics;inject traditional culture and design brand system well;increase efforts on research and development and innovate product categories and functions;establish the concept of quality and safety and a high-quality image of national brand;promote brand with multi-angle range through online advertising and microblogging;maintain brand equity and innovate the form of brand performance.%品牌建设是品牌培育和发展的重要途径。本文探讨了本土品牌建设的发展策略:差异化定位,打造民族特色的中草药品牌;注入传统文化,精心设计品牌识别系统;加大研发力度,创新产品类别和功能;树立质量安全观念,树立民族品牌高品质形象;借助网络广告和微博营销,多角度全方位进行品牌推广;维护品牌权益,创新品牌表现形式。

  15. Integrating Palliative Care into Primary Care.

    Science.gov (United States)

    Gorman, Rosemary D

    2016-09-01

    Improved quality of life, care consistent with patient goals of care, and decreased health care spending are benefits of palliative care. Palliative care is appropriate for anyone with a serious illness. Advances in technology and pharmaceuticals have resulted in increasing numbers of seriously ill individuals, many with a high symptom burden. The numbers of individuals who could benefit from palliative care far outweighs the number of palliative care specialists. To integrate palliative care into primary care it is essential that resources are available to improve generalist palliative care skills, identify appropriate patients and refer complex patients to specialist palliative care providers.

  16. Construção de descritores para o processo de educação permanente em atenção básica Building descriptors for the permanent basic care education process

    Directory of Open Access Journals (Sweden)

    Rosita Saupe

    2007-11-01

    Full Text Available Educação permanente e atenção básica fazem parte do sistema de saúde brasileiro desde suas origens. Recentemente estas políticas públicas foram atualizadas, gerando um movimento inovador de construção de conhecimento visando apoiar sua implementação e consolidação. Este estudo, através de uma metodologia quantitativa, procurou evidenciar os principais descritores que devem orientar os processos de educação permanente em atenção básica. O método é originário da Universidade da Carolina do Norte. É desenvolvido em duas etapas. Os dados apresentados neste artigo dizem respeito à primeira etapa, que inclui as seguintes fases: elaboração de um diagrama com todos os componentes a serem avaliados; sua análise por um grupo de especialistas, indicando o que deve ser mantido, retirado ou incluído; avaliação por juízes, utilizando escala Likert de 1 a 5; verificação da concordância entre os juízes. O diagrama foi decomposto em quatro dimensões, procurando responder as seguintes questões: para quem? - audiências ou população alvo; o quê? - módulos de conteúdos e experiências de aprendizagem; para quê? - competências a serem desenvolvidas; e como? - metodologia a ser priorizada. Os resultados evidenciaram a procedência dos descritores propostos e avaliados, constituindo em material que pode contribuir para a tomada de decisão sobre educação permanente em atenção básica.Permanent education and basic care have been part of the Brazilian health system from the beginning. These public policies were recently updated, leading to an innovative knowledge construction movement to support their implementation and consolidation. This study, which used a quantitative approach, attempted to single-out the main descriptors that must guide the permanent basic care education processes. The method originated at the University of North Carolina and is carried out in two stages. The data shown in this article concern the

  17. Wound Care in Primary Health Care

    OpenAIRE

    Nail Ersoz; Ismail Hakki Ozerhan; Fatih Zor

    2008-01-01

    Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull 2008; 7(1.000): 71-74

  18. Wound Care in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Nail Ersoz

    2008-02-01

    Full Text Available Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull. 2008; 7(1: 71-74

  19. Wound Care in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Nail Ersoz

    2008-02-01

    Full Text Available Wound care starts with occuring of wound. Primary health care wound care important as to affect on quality of healing. It is given information about the types of wounds, brief wound physiopathology and presented the options of wound care to primary health care wound care proffessionals in this article. Wound care must be done in a systematic process by health care professionals. [TAF Prev Med Bull 2008; 7(1.000: 71-74

  20. Capacity building for HIA

    Directory of Open Access Journals (Sweden)

    Gabriel Gulis PhD

    2007-09-01

    Full Text Available

    Background: To integrate health impact assessment (HIA into existing decision-making processes requires not only methods and procedures but also well-trained experts, aware policy makers and appropriate institutions. Capacity building is the assistance which is provided to entities, which have a need to develop a certain skill or competence, or for general upgrading of performance ability. If a new technique is planned to be introduced there is a need for capacity building with no respect to levels (local, regional, national, international or sectors (health, environment, finance, social care, education, etc.. As such, HIA is a new technique for most of the new Member States and accession countries of the European Union.

    Methods: To equip individuals with the understanding and skills needed to launch a HIA or be aware of the availability of this methodology and to access information, knowledge and training, we focused on the organization of workshops in participating countries. The workshops served also as pilot events to test a “curriculum” for HIA; a set of basic topics and presentations had been developed to be tested during workshops. In spite of classical in-class workshops we aimed to organize e-learning events as a way to over come the “busyness” problem of decision makers.

    Results: Throughout March – October 2006 we organized and ran 7 workshops in Denmark, Turkey, Lithuania, Poland, Bulgaria, Slovak Republic and Hungary. Participants came from the public health sector (141, non-public health decision makers (113 and public health students (100. A concise curriculum was developed and tested during these workshops. Participants developed a basic understanding of HIA, skills to develop and use their own screening tools as well as scoping.Within the workshop in Denmark we tested an online, real-time Internet based training method; participants highly welcomed this

  1. Building the ISS

    Institute of Scientific and Technical Information of China (English)

    石继忠; 李秀霞

    2007-01-01

    Have you seen people building houses?To build a house,you need workers.They use their hands,tools and machines to put everything together. Building the ISS is almost the same.The difference is that the workers are astronauts.They

  2. Future Green Buildings

    DEFF Research Database (Denmark)

    Mathiesen, Brian Vad; Drysdale, David; Lund, Henrik;

    Efficient buildings are essential for an affordable Danish energy supply in 2050. The purpose of this report is to describe the contribution and role of the building sector in a 100% renewable energy future, as well as the transitions that are necessary in the building sector to support this chan...

  3. Marine Building Technology

    OpenAIRE

    Westby, Ola

    2006-01-01

    This textbook is all about building of ships, platforms and other offshore installations. The geometry and functions of systems and structures are explained as an introduction to management and technology at shipyards and building sites. Both loadbearing structures, outfitting and installation of accommodation are included. Project management, production planning, cost calculations, building methods, discipline knowledge (welding, painting, insulation, mechanical, piping etc.), fabrication te...

  4. Building with History

    DEFF Research Database (Denmark)

    Douglas-Jones, Rachel; Adams, Charlotte; Green, Adrian;

    2014-01-01

    on the thermal and energetic properties of historic buildings, as distinct from their social meaning and use. A similar separation between the physi- cal building and its social use is inherent in methodologies such as energy audits that constitute key devices through which buildings are institution- ally...

  5. The Relevance of the Affordable Care Act for Improving Mental Health Care.

    Science.gov (United States)

    Mechanic, David; Olfson, Mark

    2016-03-28

    Provisions of the Affordable Care Act provide unprecedented opportunities for expanded access to behavioral health care and for redesigning the provision of services. Key to these reforms is establishing mental and substance abuse care as essential coverage, extending Medicaid eligibility and insurance parity, and protecting insurance coverage for persons with preexisting conditions and disabilities. Many provisions, including Accountable Care Organizations, health homes, and other structures, provide incentives for integrating primary care and behavioral health services and coordinating the range of services often required by persons with severe and persistent mental health conditions. Careful research and experience are required to establish the services most appropriate for primary care and effective linkage to specialty mental health services. Research providing guidance on present evidence and uncertainties is reviewed. Success in redesign will follow progress building on collaborative care and other evidence-based practices, reshaping professional incentives and practices, and reinvigorating the behavioral health workforce. PMID:26666969

  6. Building Order in the Building Company Organization

    OpenAIRE

    Krivdová, Magdaléna

    2013-01-01

    The aim of the thesis is to describe an organization of a building order, and to show its key phases. The individual phases of how a order is completed in a company are shown on practical examples. The first two chapters deal with the current situation of today's construction industry; consequently, the reasons for introducing the principles of project management into the construction business practice are mentioned. The third chapter is devoted to the description of a building order. It...

  7. Wound Care.

    Science.gov (United States)

    Balsa, Ingrid M; Culp, William T N

    2015-09-01

    Wound care requires an understanding of normal wound healing, causes of delays of wound healing, and the management of wounds. Every wound must be treated as an individual with regard to cause, chronicity, location, and level of microbial contamination, as well as patient factors that affect wound healing. Knowledge of wound care products available and when negative pressure wound therapy and drain placement is appropriate can improve outcomes with wound healing. Inappropriate product use can cause delays in healing. As a wound healing progresses, management of a wound and the bandage material used must evolve. PMID:26022525

  8. Wound Care.

    Science.gov (United States)

    Balsa, Ingrid M; Culp, William T N

    2015-09-01

    Wound care requires an understanding of normal wound healing, causes of delays of wound healing, and the management of wounds. Every wound must be treated as an individual with regard to cause, chronicity, location, and level of microbial contamination, as well as patient factors that affect wound healing. Knowledge of wound care products available and when negative pressure wound therapy and drain placement is appropriate can improve outcomes with wound healing. Inappropriate product use can cause delays in healing. As a wound healing progresses, management of a wound and the bandage material used must evolve.

  9. Team Building e a enfermagem Team Building e enfermería Team Building and nursing

    Directory of Open Access Journals (Sweden)

    Filipa Homem

    2012-07-01

    : profundizar los conocimientos sobre Team Building, contextualizar el Team Building y reflexionar sobre su utilidad del Team Building en su contexto dentro de las prestaciones de atención de enfermería. De este modo, se realizaron búsquedas en la base de datos electrónica EBSCO, y se consultó la literatura relacionada con la psicología organizacional. Con esta investigación se concluyó que la estrategia de dinamización de equipo es útil aplicada a la enfermería, puede incluso mejorar la comunicación y las relaciones interpersonales, identificar fortalezas y debilidades de los equipos, proporcionar una mayor satisfacción en el trabajo y así, mejorar la calidad la atención sanitaria prestada.In this environment of growing dissatisfaction and unpredictability in nursing, it is increasingly important to motivate teams, giving them personal, relational, and communicative competencies and, above all, to build team working and thus improve productivity. Team Building emerges as an effective strategy to achieve positive results within organizations. Because it is a strategy not yet widely used in Portugal, we decided to look into the issue and reflect on its relevance and potential in nursing teams with the following objectives: to deepen knowledge about Team Building, to frame Team Building within the context of organizational theories, to describe different models of Team Building and to reflect on the usefulness of Team Building for the quality of nursing care. Articles were searched in EBSCO electronic databases, and organizational psychology literature was consulted. With this research, we conclude that Team Building applied to nursing can improve communication and interpersonal relationships, identify strengths and weaknesses of teams, provide greater job satisfaction and thus enhance the quality of health care provided.

  10. Building an ethical organizational culture.

    Science.gov (United States)

    Nelson, William A; Taylor, Emily; Walsh, Thom

    2014-01-01

    The success of a health care institution-as defined by delivering high-quality, high-value care, positive patient outcomes, and financial solvency-is inextricably tied to the culture within that organization. The ability to achieve and sustain alignment between its mission, values, and everyday practices defines a positive organizational culture. An institution that has a diminished organizational culture, reflected in the failure to consistently align management and clinical decisions and practices with its mission and values, will struggle. The presence of misalignment or of ethics gaps affects the quality of care being delivered, the morale of the staff, and the organization's image in the community. Transforming an organizational culture will provide a foundation for success and a framework for daily ethics-grounded operations in any organization. However, building an ethics-grounded organization is a challenging process requiring strong organization leadership and planning. Using a case study, the authors provide a multiyear, continuous step-by-step strategy consisting of identifying ethics culture gaps, establishing an ethics taskforce, clarifying and prioritizing the problems, developing strategy for change, implementing the strategy, and evaluating outcomes. This process will assist organizations in aligning its actions with its mission and values, to find success on all fronts.

  11. Net zero energy buildings

    Energy Technology Data Exchange (ETDEWEB)

    Nieminen, J., Email: jyri.nieminen@vtt.fi

    2012-06-15

    Two net zero apartment buildings with basically similar architecture have been built in Finland, in Kuopio (latitude 62.90) and in Jaervenpaeae (latitude 60.50). The aim was to test the possibilities to build zero energy buildings at high latitudes. The Kuopio case is a student hostel and the Jaervenpaeae case a home for elderly people. The total energy demand in the buildings are 102 MWh for Kuopio and 94.3 for Jaervenpaeae corresponding to 48 and 45 and kWh/gross-m2. The buildings utilise district heat and are connected to the local grid. The renewable energy production bases in the Kuopio case on solar heat and photovoltaics. The Kuopio building has been finished in 2010 and the Jaervenpaeae building in 2011. (orig.)

  12. Commercial Buildings Characteristics, 1992

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-29

    Commercial Buildings Characteristics 1992 presents statistics about the number, type, and size of commercial buildings in the United States as well as their energy-related characteristics. These data are collected in the Commercial Buildings Energy Consumption Survey (CBECS), a national survey of buildings in the commercial sector. The 1992 CBECS is the fifth in a series conducted since 1979 by the Energy Information Administration. Approximately 6,600 commercial buildings were surveyed, representing the characteristics and energy consumption of 4.8 million commercial buildings and 67.9 billion square feet of commercial floorspace nationwide. Overall, the amount of commercial floorspace in the United States increased an average of 2.4 percent annually between 1989 and 1992, while the number of commercial buildings increased an average of 2.0 percent annually.

  13. Strengthening of primary health care: Key to deliver inclusive health care

    Directory of Open Access Journals (Sweden)

    Rajiv Yeravdekar

    2013-01-01

    Full Text Available Inequity and poverty are the root causes of ill health. Access to quality health services on an affordable and equitable basis in many parts of the country remains an unfulfilled aspiration. Disparity in health care is interpreted as compromise in ′Right to Life.′ It is imperative to define ′essential health care,′ which should be made available to all citizens to facilitate inclusivity in health care. The suggested methods for this include optimal utilization of public resources and increasing public spending on health care. Capacity building through training, especially training of paramedical personnel, is proposed as an essential ingredient, to reduce cost, especially in tertiary care. Another aspect which is considered very important is improvement in delivery system of health care. Increasing the role of ′family physician′ in health care delivery system will improve preventive care and reduce cost of tertiary care. These observations underlie the relevance and role of Primary health care as a key to deliver inclusive health care. The advantages of a primary health care model for health service delivery are greater access to needed services; better quality of care; a greater focus on prevention; early management of health problems; and cumulative improvements in health and lower morbidity as a result of primary health care delivery.

  14. Revealing tact within postnatal care.

    Science.gov (United States)

    Smythe, Elizabeth; Payne, Deborah; Wilson, Sally; Paddy, Ann; Heard, Kate

    2014-02-01

    In this article, we explore the nature of good postnatal care through a hermeneutic unpacking of the notion of tact, drawing on the philosophical writings of Heidegger, Gadamer, and van Manen. The tactful encounters considered were from a hermeneutic research study within a small, rural birthing center in New Zealand. Insights drawn from the analysis were as follows: the openness of listening, watching and being attuned that builds a positive mode of engagement, recognizing that the distance the woman needs from her nurse/midwife is a call of tact, that tact is underpinned by a spirit of care, within tact there are moods and tact might require firmness, and that all of these factors come together to build trust. We conclude that the attunement of tact requires that the staff member has time to spend with a woman, enough energy to engage, and a spirit of care. Women know that tactful practice builds their confidence and affects their mothering experience. Tact cannot be assumed; it needs to be nurtured and sheltered.

  15. Home Care

    Science.gov (United States)

    ... care is especially useful for persons who need nursing, therapy, or aide services. You may need help if you are dealing with one or more of the following: You have trouble getting around (for example, after a hospital stay or an accident) You have wounds that need to be cleaned, ...

  16. Just caring.

    Science.gov (United States)

    Hussey, Trevor

    2012-01-01

    Social justice is concerned with fair distribution of the benefits and burdens of living together in society. Regarding nursing care, social justice is concerned with who should receive its benefits, how much they should receive, and who should take up the burden of providing and paying for it. A specific thesis is offered: 'Health care, including nursing care, should be distributed on the basis of need, free at the point of use, the cost being born by the community involved.' This thesis is shown to be incompatible with consequentialist (utilitarian) and libertarian approaches to social justice, but reasons are given for rejecting these theories. It is shown that it may be compatible with Rawl's liberal theory of justice and definitely compatible with a version of the teleological (Aristotelian) theory. The thesis is then defended against criticisms concerned with desert and responsibility: that the provident ought not to pay for the improvident, and that those who are responsible for their health do not deserve free care. There are answered by an epistemological argument concerning what we need to know before we can decide what people deserve, and an argument about social cohesion. The conclusion is that the thesis can be offered as a moral principle for a fair society. PMID:22176544

  17. Building for animal production

    International Nuclear Information System (INIS)

    In order to limit the radiation dose to persons working with animal husbandry in severe fallout situations, it was considered necessary to make an inventory of the Swedish livestock buildings as to number, location, use and size. These data as well as data on geometry of buildings, building material and thickness of the material in walls and roofs are given in the present work. On the basis of the mentioned data, calculations were made of the shielding factors of different types of livestock buildings. The collected data can also be used in preparedness planning in relation to housing facilities for livestock and location and size of animal production in situations of crises or war. The calculations show shielding factors for different types of livestock buildings of normal ground area within the range of 0.18-0.71. The higher value indicates a fairly poor shielding effect. The inventory and the calculations show that in those regions in Sweden where the main part of the livestock is managed, the types of buildings are, however, characterized by radiation shielding factors of 0.3-0.4. Calculation were also made of the radiation level inside the buildings following decontamination of roofs or of surrounding ground. Ground decontamination only, i.e., removal of the upper contaminated surface layer, will reduce the radiation level inside the building. For most buildings the radius of the surrounding area to be decontaminated has to be 15-30 times larger than the width of the building in order to achieve a 50 percentage reduction of the radiation level inside the building. For buildings of medium or large size and with thick walls the radiation contribution from the roof is greater than the radiation from the ground, and regardless of the size of the ground areas decontaminated the radiation level inside these buildings will only be reduced by 20-30%. 15 refs, 11 figs, 14 tabs

  18. "Who Says What Is Quality?": Setting Quality Standards for Family Child Care

    Science.gov (United States)

    Modigliani, Kathy

    2011-01-01

    This article tells the story of the 4-year consensus-building process to design quality standards for the field of family child care. Working with the National Association for Family Child Care, the Family Child Care Project at Wheelock College was funded to create an accreditation system for home-based child care programs using innovative methods…

  19. Building perservation practice

    DEFF Research Database (Denmark)

    Pilegaard, Marie Kirstine

    of architects and planners is primarily to reconcile the conservation prospects with the future use of buildings and sites. They intermediary the site through selections of the narratives, and in practice the restoration or transformation projects becomes a communication of the selected story, utilized...... planning? In this paper I will focus on the communication of the architects working with building preservation and planning, how they communicate the building, the interventions and the storytelling in practice. The methods used by the architects are based on a practice, where some skills are learned...... through education, such as documentation of buildings and the restoration as a way of communicating the architect's intervention on the building, meanwhile the communication of the buildings history is seen as a "natural" skill and the methods are not questioned in the practice. The storytelling has today...

  20. Sustainable Building Operation

    DEFF Research Database (Denmark)

    Jensen, Jesper Ole

    2009-01-01

    Energy-savings in the existing building stock have becomes a main goal in national and international policies. Often focus is on building-renovations, whereas the potential of sustainable building operation to a large extent has been neglected. Nevertheless, international research as well...... as practical experiences from Danish housing estates indicates that there are large potentials for energy savings by focusing on the operation of the buildings. We suggest that in order to achieve sustainability in the existing housing, renovation and operations should be seen as integrated parts...... building operation as an 'umbrella' for various ways of reducing flows of energy, water and waste in the daily operation of the buildings, for instance by regular monitoring the consumption, by using 'green accounting', by applying policies for sustainability etc. The paper is based on case studies...

  1. 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

  2. Spirituality, religion and palliative care.

    Science.gov (United States)

    Richardson, Patrice

    2014-07-01

    As medical science has evolved, many conditions that once were thought to be "death sentences" have become chronic illness. In some ways, this makes death and dying more complicated, fraught with decisions about what care is appropriate and when to withhold or withdraw care. Studies have shown that most patients faced with life-threatening illness have spiritual needs that are not adequately addressed by their health care providers. The philosophy and practice of palliative care operates upon an understanding of whole person care, reflected in the muli-dimensional approach of the biopsychosocial model. One cannot provide whole-person care without giving consideration to the relevant spiritual needs held by patients with serious illness. As palliative care clinicians, we are uniquely positioned to work with teams/patients/families to explore the many variables that individuals and their families use as the guiding principles when making difficult decisions around end of life. While we are often consulted to manage physical symptoms, that is only part of our work. As we work on building relationships, both with our patients and their care team, we are often able to help facilitate communication that allows for mutually satisfactory goal setting. We are equipped to work with patients within their cultural contexts of which spirituality is a part. It is important to recognize the barriers to providing adequate spiritual care. The National Consensus Project has created clinical practice guidelines to provide a road map for the provision of quality palliative care. These guidelines delineate eight domains that are addressed through the provision of palliative care; the fifth domain gives attention to spiritual, religious and existential aspects of care. Guidelines recommend the use of standardized tools wherever possible to assess spiritual needs; referral to members of the interdisciplinary team who have specialized skills in addressing existential and spiritual

  3. Capacity Building in Vietnam

    OpenAIRE

    Adam McCarty

    2001-01-01

    This report is the outcome of a study commissioned to examine the capacity building needs in Vietnam, and is a supplementary document to the Asian Development Bank's Country Operational Strategy for Vietnam. Vietnam's needs in terms of capacity building are particularly important given that is it a transitional economy and also one with little institutional experience in dealing with the international donor community. This paper examines the international awareness of capacity building and ca...

  4. Development of Ecological Buildings

    Directory of Open Access Journals (Sweden)

    Andrius Keizikas

    2011-04-01

    Full Text Available The article presents research on ecological buildings and their influence on the constructional sphere. The aim of the paper is to reveal the essence of ecological architecture showing substantial progress and its potential to stimulate architectural and technological growth. The article also describes relations between the ideas of ecological buildings and the ‘passive house’ concepts and aspects of development as well as describes the possibilities of improving building sustainability and energy efficiency. Article in Lithuanian

  5. Maternal care

    OpenAIRE

    2001-01-01

    In June 2000 a distinguished group of obstetricians, midwives, general practitioners, and medical statisticians came together to discuss maternal care. Chaired by Professor James Drife from Leeds, discussion ranged over many topics, including: the changing role of the obstetrician, general practitioners, and the increasing status and responsibility of midwives. Other subjects include the induction of labour, obstetric analgesia and anaesthesia, and debates about the place and kind of delivery...

  6. Building valve amplifiers

    CERN Document Server

    Jones, Morgan

    2013-01-01

    Building Valve Amplifiers is a unique hands-on guide for anyone working with tube audio equipment--as an electronics hobbyist, audiophile or audio engineer. This 2nd Edition builds on the success of the first with technology and technique revisions throughout and, significantly, a major new self-build project, worked through step-by-step, which puts into practice the principles and techniques introduced throughout the book. Particular attention has been paid to answering questions commonly asked by newcomers to the world of the valve, whether audio enthusiasts tackling their first build or

  7. Healthy Buildings '88

    International Nuclear Information System (INIS)

    The Healthy Buildings '88 Conference focuses on the technical solutions and functional requirements contributing to Healthy Buildings for people to live and work in. The main object of the Conference is to give architects, consultants, real-estate owners and manufacturers of building materials recommendations on choice of materials and choice of systems and on how to combine materials and systems. The program includes overview lectures, plenary symposia with invited speakers, workshops, poster presentations and an exhibition of scientific, educational and technical material. One part of the conference is devoted to the problem of radon in residential buildings

  8. Sick building syndrome

    Directory of Open Access Journals (Sweden)

    Tjandra Y. Aditama

    2002-06-01

    Full Text Available Sick building syndrome describes a number of mostly unspesific complaints of some occupants of the building. The exact pathophysiological mechanism remains elusive. It is a multi factorial event which may include physical, chemical, biological as well as psycological factors. In many cases it is due to insufficient maintenance of the HVAC (heating, ventilation, air conditioning system in the building. Sign and symptoms can be uncomfortable and even disabling, which may include mucus membrane irritation, neurotoxic symptoms, asthma like symptoms, skin complaints, gastrointestinal symptoms and other related symptoms. There are various investigation methods to diagnose sick building syndrome, and on site assessment of the building is extremely useful. Prevention through a proactive air quality monitoring program is far more desirable than dealing with an actual sick building. Indoor air and the sick building symdrome serves as a paradigm of modern occupational and environmental medicine. (Med J Indones 2002; 11:124-31Keywords: indoor air pollution, sick building syndrome, building related illness

  9. Buildings' integral role in good health.

    Science.gov (United States)

    Hall, Chris

    2014-05-01

    As reported in last month's HEJ, the new Sustainable Development Strategy for the Health, Public Health and Social Care System for 2014-20 rightly emphasises the importance of the built environment to health and well-being. Chris Hall, the BRE's health sector lead, says this message 'stretches far beyond hospitals and healthcare buildings into the communities and homes that people live in'. Here he highlights some of the key elements relating to the current carbon efficiency of healthcare buildings, considers the impact of 'good' housing on health and preventing illness, and looks forward to a series of joint IHEEM and BRE 'Building Sustainable Development' mini-conference events planned in the run-up to October's Healthcare Estates 2014 event in response to the new Strategy, designed to share ideas and good practice on sustainable estates issues. The first takes place in London later this month (see panel below).

  10. Better team management--better team care?

    Science.gov (United States)

    Shelley, P; Powney, B

    1994-01-01

    Team building should not be a 'bolt-on' extra, it should be a well planned, integrated part of developing teams and assisting their leaders. When asked to facilitate team building by a group of NHS managers we developed a framework which enabled individual members of staff to become more effective in the way they communicated with each other, their teams and in turn within the organization. Facing the challenge posed by complex organizational changes, staff were able to use 3 training days to increase and develop their awareness of the principles of teamwork, better team management, and how a process of leadership and team building could help yield better patient care.

  11. Sustainable building and local resources

    Directory of Open Access Journals (Sweden)

    Maria Cristina Forlani

    2014-05-01

    Full Text Available The research comes from the deepest reasons of the crisis, in order to recognize in such reasons themselves the direction to come out, the new needs and the new challenges. The local resources (material and immaterial were reconsidered as patrimony, precious but limited, of each specific area to trace out a path of supportability able to rebuild new relations between project/production and environmental culture. The industrial production becomes a driving force for the economic renewal through an iterative cycle between research/science and economics aiming to smart building, meant as practice in evolution. This practise is careful to the local, environmental, cultural and economic situation, whose parameters are identity, energy, environment, mobility and economics that give back different scale answers.

  12. Continuous Briefing and User Participation in Building Projects

    DEFF Research Database (Denmark)

    Jensen, Per Anker

    2006-01-01

    into the building is required. A building project is often part of a change process of the organisation that is going to occupy the building, and this change process should be management carefully to reach a successful result. An important aspect of briefing is to manage the par-ticipation of the coming users......Briefing is not just about specifying needs as requirements but also about evaluating how well design pro-posals fulfill the needs and aspirations. Furthermore, briefing is not only about building design. Briefing starts at the pre-project stage to create a basis for the project decision...... in the process. This paper includes a literature study on briefing and user participation in building projects and presents a case study of a major ongoing building project DR Byen - a new headquarters for DR (Danish Broadcasting Corporation) in Copenhagen. The paper describes the briefing processes...

  13. Promoting Patient- and Family-Centered Care Through Personal Stories.

    Science.gov (United States)

    Johnson, Beverley H

    2016-03-01

    Patient- and family-centered care is an approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among patients, their families, and health care professionals. It redefines the relationships in health care by placing an emphasis on collaborating with patients of all ages, and their families, at all levels of care, in all health care settings, and in organizational change and improvement. This collaboration ensures that health care is responsive to an individual's priorities, preferences, and values. In patient- and family-centered care, patients define their "family" and determine how they and their family will participate in care and decision making. While patient- and family-centered care can improve the experience of care, safety, and quality, it also can improve the learning environment for students and trainees. The author shares personal stories to illustrate the core concepts of patient- and family-centered care, when they are present in health care interactions, and when they are not. Drawing from these stories and the author's experience in working with academic medical centers and other health care organizations over many decades, recommendations for changes in medical education are suggested that can contribute to the development of a health care workforce with the skills and commitment to partner respectfully, effectively, and authentically with patients and families. The implementation of the Affordable Care Act gives new impetus for building a health care delivery system and related educational programs to support patient- and family-centered practice. PMID:26796094

  14. O grupo pesquisador construindo ações de autocuidado para o envelhecimento saudável: pesquisa sociopoética El grupo investigador construyendo acciones de cuidar de si para el envejecimiento saludable: abordaje sociopoética The research group building self-care actions for the healthy aging process: sociopoetic research

    Directory of Open Access Journals (Sweden)

    Iraci dos Santos

    2011-12-01

    adversidades que el envejecimiento pueda provocar, utilizando su potencial humano. Una contribución es valorar el autocuidado como estrategia para el crecimiento personal y el inicio de cambios significativos.The aim of this study was to analyze the feelings of aged people regarding the self-care, accordingly to Nola Pender's Theory. This theory takes in consideration cognitive experiences, beliefs, habits and practices, in order to characterize the group's culture and lifestyle. The subjects were a group of participants from the Third Age Open University Program of Rio de Janeiro State University. The Data was collected through Art techniques and the data production was submitted to Sociopoetics thematic analysis. As results emerged the following categories: Collective face of the aging process - the group members do not see themselves as old, as represented by the cultural and social discrimination; The comprehensiveness of self-care - the image of the nurse attributed only to physical care was deconstructed, thus building the "conffect" (concept/affection self-care/aging is the quest for another living dimension. To conclude, being old involves adopting positive solutions to face the difficulties regarding the aging process, using people's own human potential. A contribution may be to promote the self-care as a strategy for personal growth and as a start point for substantial changes.

  15. Processo de trabalho na Unidade de Terapia Intensiva Neonatal: construção de uma atenção orientada pela integralidade Proceso de trabajo en la Unidad de Terapia Intensiva Neonatal: construcción de una atención integral Work process in the neonatal intensive care unit: building a holistic-oriented care

    Directory of Open Access Journals (Sweden)

    Elysângela Dittz Duarte

    2009-09-01

    organización del proceso de trabajo inscribe el quehacer del colectivo de los trabajadores.This is a qualitative study aimed at analyzing the performance of healthcare professionals, as well as their contribution to a holistic-oriented care towards newborn babies in a Neonatal Intensive Care Unit (NICU. The study was carried out in the Sofia Feldman Hospital, in Belo Horizonte, State of Minas Gerais, Brazil. The study's subjects were ten healthcare professionals who cared for newborns in the NICU, and seven parents of admitted newborns. Data was collected by means of workshops and participant observation processes. Data were treated and analyzed by means of discourse analysis concepts. The resulting data highlighted the following aspects: the potential and holistic-oriented practices of healthcare professionals; the presence or absence of healthcare actions that materialized the holistic care; the different perceptions of the participants about the work carried out by the team; and in what sense the rationale of the work organization encompassed the workers' collective performance.

  16. Buildings for Education.

    Science.gov (United States)

    Asian Regional Inst. for School Building Research, Colombo (Sri Lanka).

    The quarterly review for October and December 1967 of the Asian Regional Institute for School Building Research at Colombo, Ceylon--(1) reviews two main activities of a cost and space utilization study and a report of the workshop of the directors and UNESCO experts on regional educational buildings, (2) describes a method for determining teacher…

  17. Building a Better Robot

    Science.gov (United States)

    Navah, Jan

    2012-01-01

    Kids love to build robots, letting their imaginations run wild with thoughts of what they might look like and what they could be programmed to do. Yet when students use cereal boxes and found objects to make robots, often the projects look too similar and tend to fall apart. This alternative allows students to "build" robots in a different way,…

  18. Building: Food for thought

    Directory of Open Access Journals (Sweden)

    Efraïm Rodríguez

    2011-05-01

    Full Text Available The sculpture presented by Efraïm Rodríguez for the conference is titled “pequeño arquitecto” (The Little Architect, a figure which represents a child building a tower with pieces of classical children’s block building toys; the child itself is built out of the same sculpted materials.

  19. Building Numbers from Primes

    Science.gov (United States)

    Burkhart, Jerry

    2009-01-01

    Prime numbers are often described as the "building blocks" of natural numbers. This article shows how the author and his students took this idea literally by using prime factorizations to build numbers with blocks. In this activity, students explore many concepts of number theory, including the relationship between greatest common factors and…

  20. Electromagnetically shielded building

    International Nuclear Information System (INIS)

    This invention relates to a building having an electromagnetic shield structure well-suited for application to an information network system utilizing electromagnetic waves, and more particularly to an electromagnetically shielded building for enhancing the electromagnetic shielding performance of an external wall. 6 figs

  1. School Building Defect Pattern

    Directory of Open Access Journals (Sweden)

    Mahli M.

    2014-01-01

    Full Text Available In providing a conducive learning environment for the student, the school building must be in good condition. This paper is evaluating the existing condition of primary school building in Sarawak, Malaysia. It focuses on building defects pattern for school building. The primary data collection is from the school building condition survey with involvement of 24 primary schools. The schools have been selected using simple random sampling and stratified sampling (of school age as the variable of selection. The reporting method is based on Condition Survey Protocol (CSP 1 Matrix. Data analysis covers descriptive and inferential statistics. The analysis carried out found that the overall 4,725 defects have been identified. The building defect pattern is mainly on Ground Level of 3,176 defects, the highest number of defects components found on walls (798. 16.2% defects are cracks from 11 common defects and most of all the highest score of defects based on age of the building were the building in the range of 11 to 20 years.

  2. Integrated Building Design

    DEFF Research Database (Denmark)

    Heiselberg, Per

    In the first half of the 20th century, HVAC systems and artificial lighting were developed to meet indoor comfort needs. Before the introduction of mechanical systems, climate - not building style or appearance - was the major determinant of building form. Comfort was achieved through passive means...

  3. Heat loss from Buildings

    DEFF Research Database (Denmark)

    Karlsson, Kenneth; Næraa, Rikke

    1997-01-01

    Determination of heat loss coefficients for buildings in Denmark. The coefficient are determined for 15 building groups and 3 year intervals. They are based on the BBR-registre and assumptions of U-values(W/K*m2)and computed in a simple spreed sheet model.The results are used in the REVEILLE...... project for calculations in the SESAM model....

  4. Body-building

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    正In recent years, more and more people spare no pains to join in the body-building group. People begin to take part in various fitness clubs or fitness centers in their spare time. This shows body-building has become an indispensable part of many people’s life.

  5. Building a Data Warehouse.

    Science.gov (United States)

    Levine, Elliott

    2002-01-01

    Describes how to build a data warehouse, using the Schools Interoperability Framework (www.sifinfo.org), that supports data-driven decision making and complies with the Freedom of Information Act. Provides several suggestions for building and maintaining a data warehouse. (PKP)

  6. LARGE BUILDING RADON MANUAL

    Science.gov (United States)

    The report summarizes information on how bilding systems -- especially the heating, ventilating, and air-conditioning (HVAC) system -- inclurence radon entry into large buildings and can be used to mitigate radon problems. It addresses the fundamentals of large building HVAC syst...

  7. Dancing building prevents collapse

    NARCIS (Netherlands)

    Visscher, R.

    2007-01-01

    In future, anybody caught inside a building during an earthquake need no longer fear the roof collapsing on them. Thanks to the use of composite materials, all the building will do is dance along, riding the waves of the earthquake. At least, according to Professor Ir. Adriaan Beukers of the Aerospa

  8. Energy Performance of Buildings

    DEFF Research Database (Denmark)

    Heiselberg, Per

    2007-01-01

    emissions in the coming years. By approving the Energy Performance in Buildings Directive the European Union has taken a strong leadership role in promoting energy efficiency in buildings in Europe, and the Directive will be the most powerful instrument developed to date for the building sector in Europe...... programme (ECCP) was established in June 2000 to help identify the most environmentally cost-effective measures enabling the EU to meet its target under the Kyoto Protocol, namely an 8% reduction in greenhouse gas emissions from 1990 levels by 2012. Energy use in buildings accounts for almost half of all CO......-effective energy saving potential of between 22% and 40% of the energy consumption in the sector by the year 2020. The paper presents the European approach to improve sustainability in the building sector, which has a very high potential for considerable reduction of energy consumption and green house gas...

  9. CERN's newest building

    CERN Multimedia

    Anaïs Vernède

    2011-01-01

    With a growing number of users looking for offices, the shortage of space has become acute, particularly for physicists. Building 42, inaugurated on Friday 11 February, offers almost 300 new work-spaces and a particularly pleasant working environment.   Mauro Dell’Ambrogio, the Swiss State Secretary for Education and Research (left), Rolf Heuer , CERN Director-General (centre), and Mark Muller, President of the Government of the Republic and Canton of Geneva and Head of the Department of Construction and Information Technology (right) at the opening of Building 42 on 11 February, 2011.   Construction work for the new Building 42 began in January 2009, thanks to support from the Swiss foundation FIPOI (Fondation des immeubles pour les organisations internationales). After two years of work, the building, an extension of Building 40, is ready to accommodate physicists from around the world who have come to work on the LHC. "We had more than 25 external contractors working...

  10. Managing acute care.

    Science.gov (United States)

    Russell, J S

    1993-02-01

    In the last few years, much medical-facility construction has been driven by what insurers want. Hospitals have built facilities for well-reimbursed procedures and closed money-losing ones. Health-maintenance organizations increasingly expect to hold down costs by making prepayment arrangements with doctors and their hospitals. President Clinton has pledged early action on health-care reform, which will likely change planners' priorities. Whether the nation goes to Clintonian "managed competition" or a Canadian-style nationwide single-payer system (the two most likely options), the projects on these pages reflect two large-scale trends that are likely to continue: the movement of more procedures from inpatient to outpatient facilities and the separation of treatment functions from ordinary office and administrative tasks so that the latter are not performed in the same high-cost buildings as technology-intensive procedures. Various schemes that make care more "patient-centered" have been tried and been shown to speed healing, even for outpatients, but such hard-to-quantify issues get short shrift in an era of knee-jerk cost containment. The challenge in tomorrow's healthcare universe--whatever it becomes--will be to keep these issues on the table.

  11. Modern community care program

    International Nuclear Information System (INIS)

    Going into the next millennium do we see nuclear energy? Yes we will see an expanding nuclear sector in the modem community. he modem community that cares for people, health and environment needs nuclear. Energy saves lives. Electricity is efficient use of energy. Energy will be the key to a sustainable society, energy is life. Nuclear energy protects the environment. Nuclear is an integral part of the modern community caring for people, health and environment. The dynamics of the public opinion-forming process and its effects on the nuclear industry are a challenge of the global nuclear industry. Current communications strategy and its consequences are on of the key issues. The nuclear industry must be perceived in certain ways in order to move towards achieving the vision and avoiding the harassment scenario. Each perception goal does not bear the same function within the communications process. As the nuclear industry is oe of the keys to a sustainable society, it must achieve legitimacy in its capacity as an interesting agenda-setter for tackling problems and as an expert. We have to build our communication activities on an open and honest attitude and we have to establish trust and confidence. The nuclear industry must also prove its ability and performance. If this could be achieved there will be an option for the future

  12. Caring for Multiples

    Science.gov (United States)

    ... labor & premature birth The newborn intensive care unit (NICU) Birth defects & other health conditions Loss & grief Tools & ... Home > Complications & Loss > The newborn intensive care unit (NICU) > Caring for multiples Caring for multiples E-mail ...

  13. Home Care Services

    Science.gov (United States)

    Home care is care that allows a person with special needs stay in their home. It might be for people who are getting ... chronically ill, recovering from surgery, or disabled. Home care services include Personal care, such as help with ...

  14. Analysis of energy use at US institutional buildings

    Science.gov (United States)

    Hirst, E.; Trimble, J.; Goelitz, R.

    1981-11-01

    The Federal Institutional Conservation Program includes collection of energy use and energy related data from individual institutional buildings. Data were obtained from ten states (Massachusetts, New Hampshire, Vermont, New Jersey, Florida, Minnesota, Wisconsin, Texas, Kansas, and Oregon) on almost fifteen thousand schools, hospitals, local government buildings, and public care institutions. After the data were carefully examined, organized, and validated (i.e., outliers that might be errors were deleted), regression equations were developed for each of the four institutional building types. Because so many of the data elements were either missing or outliers, techniques were applied that allow incorporation of observations with missing data in the regression analysis. These equations explain annual energy use as functions of average energy price, floor area, year of construction, occupancy, air conditioning, primary heating fuel, owner, location, and building function.

  15. The Road to Excellence for Primary Care Resident Teaching Clinics.

    Science.gov (United States)

    Gupta, Reena; Dubé, Kate; Bodenheimer, Thomas

    2016-04-01

    Primary care residency programs and their associated primary care clinics face challenges in their goal to simultaneously provide a good education for tomorrow's doctors and excellent care for today's patients. A team from the Center for Excellence in Primary Care at the University of California, San Francisco, conducted site visits to 23 family medicine, internal medicine, and pediatric residency teaching clinics. The authors found that a number of programs have transformed themselves with respect to engaged leadership, resident scheduling, continuity of care for patients and residents, team-based care, and resident engagement in practice improvement. In this Commentary, the authors highlight the features of transforming programs that are melding inspiring resident education with excellent patient care. The authors propose a model, the 10 + 3 Building Blocks of Primary Care Teaching Clinics, to illustrate the themes that characterize transforming primary care residency programs. PMID:26826073

  16. Constructing a conflict resolution program for health care.

    Science.gov (United States)

    Porter-O'Grady, Tim

    2004-01-01

    Resolving conflict throughout organizations requires a programmatic infrastructure and a committed management team. Leaders must recognize the need to approach conflict by building a format for learning, creating and managing an effective conflict management program. Careful attention to the elements of design and the stages of development can make all the difference in building a sustainable and useful conflict management approach. PMID:15600105

  17. Who cares!

    Institute of Scientific and Technical Information of China (English)

    老晃

    2013-01-01

    1有人再三怂恿,希望我能吐槽《富春山居图》,务求鞭辟入里,揭露丑恶真相。我舍不得,舍不得浪费纸。好吧,小吐一下。传说,在《富春山居图》开拍之前有心人提醒导演孙健君,剧本有硬伤,得改,例举一三三四……话没说完,孙勃然大怒,"Who cares!"这位目空一切的君王,他什么都不care,所以他花钱砸的那堆玩意儿,根本也不是电影。这就是真相。值得一说的,是此刻红得发紫,摸都摸不得的《小时代》。

  18. Knowledge formalization of intelligent building

    Science.gov (United States)

    Žáček, Martin

    2016-06-01

    This article aim is understanding the basic knowledge about an intelligent building. The notion of the intelligent building can be called any building equipped with computer and communication technology, which can automatically respond to internal or external stimuli. The result of the intelligent building is an automated and foreseeing of activities that enable to reduce operating costs and increase comfort. The best way to use the intelligent building is for a low-energy building, a passive building, or for building with high savings. The output of this article is the formalization of basic knowledge of the intelligent building by RDF graph.

  19. Energy management systems in buildings

    Energy Technology Data Exchange (ETDEWEB)

    Lush, D.M.

    1979-07-01

    An investigation is made of the range of possibilities available from three types of systems (automatic control devices, building envelope, and the occupants) in buildings. The following subjects are discussed: general (buildings, design and personnel); new buildings (envelope, designers, energy and load calculations, plant design, general design parameters); existing buildings (conservation measures, general energy management, air conditioned buildings, industrial buildings); man and motivation (general, energy management and documentation, maintenance, motivation); automatic energy management systems (thermostatic controls, optimized plant start up, air conditioned and industrial buildings, building automatic systems). (MCW)

  20. Building Software with Gradle

    CERN Document Server

    CERN. Geneva; Studer, Etienne

    2014-01-01

    In this presentation, we will give an overview of the key concepts and main features of Gradle, the innovative build system that has become the de-facto standard in the enterprise. We will cover task declaration and task graph execution, incremental builds, multi-project builds, dependency management, applying plugins, extracting reusable build logic, bootstrapping a build, and using the Gradle daemon. By the end of this talk, you will have a good understanding of what makes Gradle so powerful yet easy to use. You will also understand why companies like Pivotal, LinkedIn, Google, and other giants with complex builds count on Gradle. About the speakers Etienne is leading the Tooling Team at Gradleware. He has been working as a developer, architect, project manager, and CTO over the past 15 years. He has spent most of his time building software products from the ground up and successfully shipping them to happy customers. He had ...

  1. Building Sustainability Assessment

    Directory of Open Access Journals (Sweden)

    Heli Koukkari

    2010-07-01

    Full Text Available Although social, economic, and cultural indicators are of substantial importance to the concept of sustainable building, this concept is usually related to environmental characteristics. Any building level assessment method is complex and involves contradictory aspects. Moreover, emphasizing qualitative criteria only increases confusion. R&D and standardization are thus concentrated to transparency and usability of the environmental methods. Other directions of research aim at performance-based design and methods to take regional and cultural aspects into account. In this paper, the perspectives of the sustainability assessment of a whole building are presented, based on a state of the art, feasibility study on performance analysis and the development of an extended life-cycle assessment for buildings. Using various tools, and based on the case studies of building sustainability assessment, environmental indicators were often shown to be of lesser importance than the other, soft ones. The first steps in the development of a building sustainability assessment method for Portuguese residential buildings will be presented and discussed in the end.

  2. Buildings Interoperability Landscape

    Energy Technology Data Exchange (ETDEWEB)

    Hardin, Dave [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stephan, Eric G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wang, Weimin [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Corbin, Charles D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Widergren, Steven E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-12-31

    Through its Building Technologies Office (BTO), the United States Department of Energy’s Office of Energy Efficiency and Renewable Energy (DOE-EERE) is sponsoring an effort to advance interoperability for the integration of intelligent buildings equipment and automation systems, understanding the importance of integration frameworks and product ecosystems to this cause. This is important to BTO’s mission to enhance energy efficiency and save energy for economic and environmental purposes. For connected buildings ecosystems of products and services from various manufacturers to flourish, the ICT aspects of the equipment need to integrate and operate simply and reliably. Within the concepts of interoperability lie the specification, development, and certification of equipment with standards-based interfaces that connect and work. Beyond this, a healthy community of stakeholders that contribute to and use interoperability work products must be developed. On May 1, 2014, the DOE convened a technical meeting to take stock of the current state of interoperability of connected equipment and systems in buildings. Several insights from that meeting helped facilitate a draft description of the landscape of interoperability for connected buildings, which focuses mainly on small and medium commercial buildings. This document revises the February 2015 landscape document to address reviewer comments, incorporate important insights from the Buildings Interoperability Vision technical meeting, and capture thoughts from that meeting about the topics to be addressed in a buildings interoperability vision. In particular, greater attention is paid to the state of information modeling in buildings and the great potential for near-term benefits in this area from progress and community alignment.

  3. [Care between ethics, work and political].

    Science.gov (United States)

    Svandra, Philippe

    2015-09-01

    Down to the roots, the ethics of care have stood up a "different voice". Building on Carol Gilligan's works, the concept was developed widely in opposition with the rational and universalist aspect of Kant's moral philosophy. However, it also appears that this vision of care runs counter sets the three other main dominant moral theories, ie, utilitarism, John Rawls' procedural ethics and the Aristotelian virtue ethics. We may assert that the care theory presents itself as a contextualized moral theory aiming at taking into account others' vulnerability, in a practical way. Hence, the general term of "care" may encompass the notions of "help", "support" and "healing process", which, in France, for have often been opposed for varied reasons--historical, economical, psychological, professional etc... Switching from a moral position to a professional and practical activity, the concept of care has now undeniably taken on now a social and political dimension.

  4. The infant caring process among Cherokee mothers.

    Science.gov (United States)

    Nichols, Lee Anne

    2004-09-01

    The purpose of this study was to identify the social process of infant care among Cherokee mothers. Nineteen informants, who had an infant less than 2 years of age, were interviewed. The data were analyzed using the technique of constant comparative analysis. A social process of Indian infant care among Cherokee mothers was identified. Eight concepts emerged from data analysis. The first and principal concept, being a Cherokee mother, describes the functions of being an Indian mother in Cherokee society. The other seven concepts describe the patterns of cultural care the mothers provided to their infants. These included accommodating everyday infant care, accommodating health perspectives, building a care-providing consortium, living spiritually, merging the infant into Indian culture, using noncoercive discipline techniques, and vigilantly watching for the natural unfolding of the infant. Trustworthiness and credibility of the generated theory were evaluated through multiple measures. PMID:15296577

  5. INL Green Building Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Jennifer Dalton

    2005-05-01

    Green buildings, also known as sustainable buildings, resource efficient buildings, and high performance buildings, are structures that minimize the impact on the environment by using less energy and water, reducing solid waste and pollutants, and limiting the depletion of natural resources. As Idaho National Laboratory (INL) becomes the nation’s premier nuclear energy research laboratory, the physical infrastructure will be established to help accomplish the mission. This infrastructure, particularly the buildings, should incorporate green design features in order to be environmentally responsible and reflect an image of progressiveness and innovation to the public and prospective employees. With this in mind, the recommendations described in this strategy are intended to form the INL foundation for green building standards. The recommendations in this strategy are broken down into three levels: Baseline Minimum, Leadership in Energy and Environmental Design (LEED)Certification, and Innovative. Baseline Minimum features should be included in all new occupied buildings no matter what the purpose or size. These features do not require significant research, design, or capital costs and yet they can reduce Operation and Maintenance (O&M) costs and produce more environmentally friendly buildings. LEED Certification features are more aggressive than the Baseline Minimums in that they require documentation, studies, and/or additional funding. Combined with the Baseline Minimums, many of the features in this level will need to be implemented to achieve the goal of LEED certification. LEED Silver certification should be the minimum goal for all new buildings (including office buildings, laboratories, cafeterias, and visitor centers) greater than 25,000 square feet or a total cost of $10 million. Innovative features can also contribute to LEED certification, but are less mainstream than those listed in the previous two levels. These features are identified as areas where

  6. Environmental indicators for buildings

    DEFF Research Database (Denmark)

    Dammann, Sven

    Environmental Indicators for Buildings are studied using two different perspectives: with a technological, environmental scientific departing point and with a social scientific departing point. Different relevant groups in the building sector are identified and analysed, using the Social...... Construction Of Technology theory as a frame for the studies. It is concluded that it is not possible to develop a common set of indicators that all the central actors in the building sector find acceptable - at least not in a near future. Different sets of solutions are, however, outlined in the thesis...

  7. Mycotoxins in building materials

    DEFF Research Database (Denmark)

    Nielsen, Kristian Fog; Frisvad, Jens Christian

    2011-01-01

    as in future energy efficient buildings. It brings together different disciplinary points of view on indoor mold, ranging from physics and material science to microbiology and health sciences. The contents have been outlined according to three main issues: Fundamentals, particularly addressing the crucial...... for avoiding adverse health effects is the prevention (or minimization) of persistent dampness and microbial growth on interior surfaces and in building structures. This book aims to describe the fundamentals of indoor mold growth as a prerequisite to tackle mold growth in the existing building stock as well...

  8. The corporate brand building

    OpenAIRE

    Wisterová, Veronika

    2011-01-01

    The target of this master's thesis is to follow the process of corporate brand building of the company Starkl zahradník, to analyse it and to suggest possible improvements. The thesis is divided into four main sections. The first section deals with the theoretical aspects of the corporate brand building. The second section observes the process of brand building of the brand Starkl zahradník. The third section deals with the survey that was carried out and analyse its results. This survey was ...

  9. Palliative wound care: principles of care.

    Science.gov (United States)

    Dale, Barbara; Emmons, Kevin R

    2014-01-01

    Home care nursing occurs in a complex care environment. Nurses working in this setting care for a wide array of individuals who often are sicker and more complex than ever before. The high prevalence of wounds among these individuals requires that home care nurses have a certain level of knowledge to provide excellent care. Many times, individuals with wounds do not have the capacity to heal or are burdened with numerous symptoms affecting quality of life. In these cases, the home care nurse must understand concepts of palliative wound care to alleviate symptoms with the goal of improving quality of life.

  10. Teaching Reflective Care in Japanese Early Childhood Settings

    Science.gov (United States)

    Hellman, Anette

    2016-01-01

    The purpose of this article is to explore the way preschool teachers teach reflective care in Japan. The article builds on a two-month ethnographic study conducted in Japanese kindergartens and nurseries among children aged 3-6 years. The data were analysed using concepts of age and gender. The results show that care in Japan, in contrast to…

  11. Careful science?

    DEFF Research Database (Denmark)

    Jespersen, Astrid P; Bønnelycke, Julie; Eriksen, Hanne Hellerup

    2014-01-01

    Concern about obesity has prompted numerous public health campaigns that urge people to be more physically active. The campaigns often include normative statements and attempt to impose restrictions on individuals' lives without considering the complexities of daily life. We suggest that broadening...... the focus to reflect everyday practices would foster better targeted public health campaigns. This article is based on our participation in FINE, a multidisciplinary Danish research project. The core methodology of FINE was a randomised controlled trial in which 61 moderately overweight men were put...... into different exercise groups. In this article we analyse the scientific work of the trial as representing entangled processes of bodywork, where data are extracted and objectified bodies are manipulated and care practices address the emotional, social and mundane aspects of the participants' everyday lives...

  12. Edmonton, Canada: a regional model of palliative care development.

    Science.gov (United States)

    Fainsinger, Robin L; Brenneis, Carleen; Fassbender, Konrad

    2007-05-01

    Palliative care developed unevenly in Edmonton in the 1980s and early 1990s. Health care budget cuts created an opportunity for innovative redesign of palliative care service delivery. This report describes the components that were developed to build an integrated comprehensive palliative care program, the use of common clinical assessments and outcome evaluation that has been key to establishing credibility and ongoing support. Our program has continued to develop and grow with an ongoing focus on the core areas of clinical care, education, and research. PMID:17482060

  13. Building Technologies Program Key Activities

    Energy Technology Data Exchange (ETDEWEB)

    None

    2011-12-15

    The Building Technologies Program (BTP) employs a balanced approach to making buildings more energy efficient. The three pillars of our program, research and development (R&D), market stimulation, and building and equipment standards, help meet our strategic vision.

  14. Green buildings pay

    DEFF Research Database (Denmark)

    Naboni, Emanuele; Edwards, Brian

    2012-01-01

    The new edition of ‘Green Buildings Pay’ authored by Brian Edwards and Emanuele Naboni explores the business and professional benefits which derive from architectural design driven by sustainability. With a new sub-title ‘Green Buildings Pay: design, productivity and ecology’ the book argues...... or environmental thinking and this finds expression in new approaches to the design of building facades, roofs, atria. Another is that new software simulation tools have changed energy assumptions and hence building forms. In a fast evolving arena, the book shows how architects are reshaping their practices....... Branding via LEED and BREEAM has taken green ideas to China and other emerging economies. The globalization of sustainability and of architectural practice is an important strand of the new edition....

  15. Helping clients build credit

    OpenAIRE

    Vikki Frank

    2007-01-01

    Until now people who repaid loans from community groups had not been on credit bureaus’ radar. Now Credit Builders Alliance is partnering with Experian to help clients of community lenders build strong credit histories.

  16. Municipal Building Energy Usage

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data set contains energy use data from 2009-2014 for 139 municipally operated buildings. Metrics include: Site & Source EUI, annual electricity, natural...

  17. Buildings Sector Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hostick, Donna J.; Nicholls, Andrew K.; McDonald, Sean C.; Hollomon, Jonathan B.

    2005-08-01

    A joint NREL, ORNL, and PNNL team conducted market analysis to help inform DOE/EERE's Weatherization and Intergovernmental Program planning and management decisions. This chapter presents the results of the market analysis for the Buildings sector.

  18. Building Services Systems

    DEFF Research Database (Denmark)

    Zinzi, Michele; Romeo, Carlo; Thomsen, Kirsten Engelund;

    2015-01-01

    of the description of 5 main technologies: condensing boilers, heat pumps, ventilation systems, lighting and photovoltaic systems. For each technology chapter there is the same content list: an introduction, a brief technology description, some advantages and disadvantages, market penetration and utilisation, energy......This guideline on Building Services Systems is one of four guidelines produced by the School of the Future project. The other three guidelines cover: Building Construction Elements, Improved Indoor Environmental Quality and Concepts for Zero Emission Schools. This guideline consists...

  19. Building Peaceful Borders

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    China's efforts to build a harmonious world begin with establishing peaceful borders with its neighbors China's recent contribution to the world of international relations is the promotion of "building a harmonious world together," put forward by President Hu Jintao at the 60th anniversary of the UN in September 2005. As the core of the country's peaceful foreign policy in the new era, this approach has been well received and widely discussed in the international community. Meanwhile, Chinese foreign pol...

  20. Building Materials in Arctic Climate

    DEFF Research Database (Denmark)

    Jensen, Ole Mejlhede

    2005-01-01

    Building in the artic requires special attention on the appropriateness of building materials. The harsh climate makes execution difficult and sets unusual requirements for the pure material properties. In addition, there is a lack of choice of good, natural building materials in the arctic....... This results in high transport costs. The building materials situation in Greenland may potentially be improved by intensifying the reuse of building materials or by promoting the local production of building materials....

  1. Improving organizational climate for excellence in patient care.

    Science.gov (United States)

    Arnold, Edwin

    2013-01-01

    Managers in health care organizations today are expected to achieve higher-quality patient care at a lower cost. Developing and maintaining a positive organizational climate can help improve motivation and foster higher employee performance. In turn, this will help the organization deliver better patient care at a lower cost. This article offers metrics for assessing organizational climate, analyzes barriers to a positive climate, and explores strategies that managers can use to build the type of climate that fosters high performance. PMID:23903945

  2. Improving organizational climate for excellence in patient care.

    Science.gov (United States)

    Arnold, Edwin

    2013-01-01

    Managers in health care organizations today are expected to achieve higher-quality patient care at a lower cost. Developing and maintaining a positive organizational climate can help improve motivation and foster higher employee performance. In turn, this will help the organization deliver better patient care at a lower cost. This article offers metrics for assessing organizational climate, analyzes barriers to a positive climate, and explores strategies that managers can use to build the type of climate that fosters high performance.

  3. Building Services Requests Subsystem (BSRS)

    Data.gov (United States)

    Department of Transportation — Lotus Notes workflow application used for the submission, processing, tracking and reporting of building service related requiests. Enables regional office building...

  4. Building the chronic kidney disease management team.

    Science.gov (United States)

    Spry, Leslie

    2008-01-01

    The need to be efficient and the demands for performance-based service are changing how nephrologists deliver care. Chronic kidney disease (CKD) occurs in patients with complex medical and social problems. CKD management requires that multidisciplinary professionals provide patient education, disease management, and psychosocial support. To remain cost-efficient, many physicians are training and supervising midlevel practitioners in the delivery of specialized health care. Specialized care that meets present CKD patient needs is best delivered in a CKD clinic. Three models of CKD clinic are identified: (1) anemia management CKD clinic, (2) the basic CKD clinic, and (3) the comprehensive CKD clinic. Each clinic model is based on critical elements of staffing, billable services, and patient-focused health care. Billable services are anemia-management services, physician services that may be provided by midlevel practitioners, and medical nutrition therapy. In some cases, social worker services may be billable. Building a patient-focused clinic that offers CKD management requires planning, familiarity with federal regulations and statutes, and skillful practitioners. Making services cost-efficient and outcome oriented requires careful physician leadership, talented midlevel practitioners, and billing professionals who understand the goals of the CKD clinic. As Medicare payment reforms evolve, a well-organized CKD program can be well poised to meet the requirements of payers and congressional mandates for performance-based purchasing.

  5. Building Performance Simulation tools for planning of energy efficiency retrofits

    DEFF Research Database (Denmark)

    Mondrup, Thomas Fænø; Karlshøj, Jan; Vestergaard, Flemming

    2014-01-01

    Designing energy efficiency retrofits for existing buildings will bring environmental, economic, social, and health benefits. However, selecting specific retrofit strategies is complex and requires careful planning. In this study, we describe a methodology for adopting Building Performance...... to energy efficiency retrofits in social housing. To generate energy savings, we focus on optimizing the building envelope. We evaluate alternative building envelope actions using procedural solar radiation and daylight simulations. In addition, we identify the digital information flow and the information...... Simulation (BPS) tools as energy and environmentally conscious decision-making aids. The methodology has been developed to screen buildings for potential improvements and to support the development of retrofit strategies. We present a case study of a Danish renovation project, implementing BPS approaches...

  6. Perioperative Care of Prisoners: Providing Safe Care.

    Science.gov (United States)

    Smith, Francis Duval

    2016-03-01

    Correctional nurses are trained to care for prisoners in a controlled security environment; however, when a convict is transferred to a noncorrectional health care facility, the nurses there are often unfamiliar with custody requirements or how to safely care for these patients. The care of prisoners outside of prison has not been adequately investigated, and a gap exists between research and nursing education and practice. Nurses rarely have to consider how providing care for a prisoner in custody affects their practice, the potential dissonance between routine nursing care and the requirements to maintain security, or that care of prisoners in unsecured clinical areas places the nurse and other personnel at risk for physical assault or prisoner escape. Educating perioperative nurses in the care of prisoners in a public hospital environment is important for the provision of safe care and prevention of physical and emotional repercussions to personnel.

  7. Building Better Buildings: Sustainable Building Activities in California Higher Education Systems.

    Science.gov (United States)

    Sowell, Arnold; Eichel, Amanda; Alevantis, Leon; Lovegreen, Maureen

    2003-01-01

    This article outlines the activities and recommendations of California's sustainable building task force, discusses sustainable building activities in California's higher education systems, and highlights key issues that California is grappling with in its implementation of sustainable building practices. (EV)

  8. Providing for energy efficiency in homes and small buildings. Part I. Understanding and practicing energy conservation in buildings

    Energy Technology Data Exchange (ETDEWEB)

    Parady, W. Harold; Turner, J. Howard

    1980-06-01

    This is a training program to educate students and individuals in the importance of conserving energy and to provide for developing skills needed in the application of energy-saving techniques that result in energy-efficient buildings. A teacher guide and student workbook are available to supplement the basic guide, which contains three parts. Part I considers the following: understanding the importance of energy; developing a concern for conserving energy; understanding the use of energy in buildings; care and maintenance of energy-efficient buildings; and developing energy-saving habits. A bibliography is presented.

  9. Training a system-literate care coordination workforce.

    Science.gov (United States)

    Naccarella, Lucio; Osborne, Richard H; Brooks, Peter M

    2016-04-01

    People with chronic complex conditions continue to experience increasing health system fragmentation and poor coordination. To reverse these trends, one solution has been an investment in effective models of care coordination that use a care coordinator workforce. Care coordinators are not a homogenous workforce - but an applied professional role, providing direct and indirect care, and is often undertaken by nurses, allied health professionals, social workers or general practitioners. In Australia, there is no training curriculum nor courses, nor nationally recognised professional quality standards for the care coordinator workforce. With the growing complexity and fragmentation of the health care system, health system literacy - shared understanding of the roles and contributions of the different workforce professions, organisations and systems, among patients and indeed the health workforce is required. Efforts to improve health system literacy among the health workforce are increasing at a policy, practice and research level. However, insufficient evidence exists about what are the health system literacy needs of care coordinators, and what is required for them to be most effective. Key areas to build a health system literate care coordination workforce are presented. Care coordination is more than an optional extra, but one of the only ways we are going to be able to provide equitable health services for people with chronic complex conditions. People with low health literacy require more support with the coordination of their care, therefore we need to build a high performing care coordinator workforce that upholds professional quality standards, and is health literacy responsive.

  10. Care coordination between specialty care and primary care: a focus group study of provider perspectives on strong practices and improvement opportunities

    Directory of Open Access Journals (Sweden)

    Kim B

    2015-01-01

    Full Text Available Bo Kim,1,2 Michelle A Lucatorto,3 Kara Hawthorne,4 Janis Hersh,5 Raquel Myers,6 A Rani Elwy,1,7 Glenn D Graham81Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial VA Hospital, Bedford, 2Department of Psychiatry, Harvard Medical School, Boston, MA, 3Office of Nursing Services, Department of Veterans Affairs, 4Chief Business Office, Purchased Care, Washington, DC, 5New England Veterans Engineering Resource Center, Boston, MA, 6SJ Quinney College of Law, University of Utah, Salt Lake City, UT, 7Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, 8Specialty Care Services (10P4E, Department of Veterans Affairs, Washington, DC, USAAbstract: Care coordination between the specialty care provider (SCP and the primary care provider (PCP is a critical component of safe, efficient, and patient-centered care. Veterans Health Administration conducted a series of focus groups of providers, from specialty care and primary care clinics at VA Medical Centers nationally, to assess 1 what SCPs and PCPs perceive to be current practices that enable or hinder effective care coordination with one another and 2 how these perceptions differ between the two groups of providers. A qualitative thematic analysis of the gathered data validates previous studies that identify communication as being an important enabler of coordination, and uncovers relationship building between specialty care and primary care (particularly through both formal and informal relationship-building opportunities such as collaborative seminars and shared lunch space, respectively to be the most notable facilitator of effective communication between the two sides. Results from this study suggest concrete next steps that medical facilities can take to improve care coordination, using as their basis the mutual understanding and respect developed between SCPs and PCPs through relationship-building efforts

  11. Health care operations management

    OpenAIRE

    Carter, M W; Hans, E.W.; Kolisch, R.

    2012-01-01

    Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully selected papers dealing with optimization and decision analysis problems in the field of health care operations management.

  12. Development of two Danish building typologies for residential buildings

    DEFF Research Database (Denmark)

    Kragh, Jesper; Wittchen, Kim Bjarne

    2014-01-01

    performance of the residential building stock. Overall, the typologies consist of two types of building models—real example models and average designed models. The main purpose of developing the building typologies was to establish a tool able to calculate different energy-saving scenarios for the entire...... residential building stock. To make such calculations of scenarios, similar average designed building models were established based on extracted average values from the Danish Energy Performance Certification Scheme database. The two building typologies had the same overall composition, i.e., three main...... building types: single-family houses, terraced houses and blocks of flats. Each main building type is presented for nine periods representing age, typical building tradition and insulation levels. Finally, an energy balance model of the residential building stock was devised to validate the average...

  13. The Living, Dynamic and Complex Environment Care in Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Marli Terezinha Stein Backes

    2015-06-01

    Full Text Available OBJECTIVE: to understand the meaning of the Adult Intensive Care Unit environment of care, experienced by professionals working in this unit, managers, patients, families and professional support services, as well as build a theoretical model about the Adult Intensive Care Unit environment of care.METHOD: Grounded Theory, both for the collection and for data analysis. Based on theoretical sampling, we carried out 39 in-depth interviews semi-structured from three different Adult Intensive Care Units.RESULTS: built up the so-called substantive theory "Sustaining life in the complex environment of care in the Intensive Care Unit". It was bounded by eight categories: "caring and continuously monitoring the patient" and "using appropriate and differentiated technology" (causal conditions; "Providing a suitable environment" and "having relatives with concern" (context; "Mediating facilities and difficulties" (intervenienting conditions; "Organizing the environment and managing the dynamics of the unit" (strategy and "finding it difficult to accept and deal with death" (consequences.CONCLUSION: confirmed the thesis that "the care environment in the Intensive Care Unit is a living environment, dynamic and complex that sustains the life of her hospitalized patients".

  14. SOLAR EFFECTS ON BUILDING DESIGN.

    Science.gov (United States)

    Building Research Inst., Inc., Washington, DC.

    A REPORT OF A PROGRAM HELD AS PART OF THE BUILDING RESEARCH INSTITUTE 1962 SPRING CONFERENCE ON THE SOLAR EFFECTS ON BUILDING DESIGN. TOPICS DISCUSSED ARE--(1) SOLAR ENERGY DATA APPLICABLE TO BUILDING DESIGN, (2) THERMAL EFFECTS OF SOLAR RADIATION ON MAN, (3) SOLAR EFFECTS ON ARCHITECTURE, (4) SOLAR EFFECTS ON BUILDING COSTS, (5) SELECTION OF…

  15. Being the Change: An Inner City School Builds Peace

    Science.gov (United States)

    Curry, Marnie W.

    2014-01-01

    This article describes an urban high school's response to gun violence, chronicling how the school's mission, full-service community orientation, and commitment to authentic cariño (caring) allowed students to respond to grief and tragedy and develop an ongoing peace building movement that seeks to transform students' lives and the…

  16. Building work in nuclear power plant construction in France

    International Nuclear Information System (INIS)

    A survey is given of the methods of forming and reinforcing concrete structures, concrete laying jobs, instrumentation and transport on the building sites, occupational safety, care of labour, and work quality testing used in the construction of nuclear power plants in France. (J.B.)

  17. Buildings for advanced technology

    CERN Document Server

    Teague, E; Murday, James

    2015-01-01

    This book deals with the design and construction of buildings for nanoscale science and engineering research. The information provided in this book is useful for designing and constructing buildings for such advanced technologies as nanotechnology, nanoelectronics and biotechnology. The book outlines the technology challenges unique to each of the building environmental challenges outlined below and provides best practices and examples of engineering approaches to address them: • Establishing and maintaining critical environments: temperature, humidity, and pressure • Structural vibration isolation • Airborne vibration isolation (acoustic noise) • Isolation of mechanical equipment-generated vibration/acoustic noise • Cost-effective power conditioning • Grounding facilities for low electrical interference • Electromagnetic interference (EMI)/Radio frequency interference (RFI) isolation • Airborne particulate contamination • Airborne organic and chemical contamination • Environment, safety a...

  18. On building Information Warehouses

    CERN Document Server

    Laha, Arijit

    2009-01-01

    One of the most important goals of information management (IM) is supporting the knowledge workers in performing their works. In this paper we examine issues of relevance, linkage and provenance of information, as accessed and used by the knowledge workers. These are usually not adequately addressed in most of the IT based solutions for IM. Here we propose a non-conventional approach for building information systems for supporting the knowledge workers which addresses these issues. The approach leads to the ideas of building Information Warehouses (IW) and Knowledge work Support Systems (KwSS). Such systems can open up potential for building innovative applications of significant impact, including those capable of helping organizations in implementing processes for double-loop learning.

  19. Automated model building

    CERN Document Server

    Caferra, Ricardo; Peltier, Nicholas

    2004-01-01

    This is the first book on automated model building, a discipline of automated deduction that is of growing importance Although models and their construction are important per se, automated model building has appeared as a natural enrichment of automated deduction, especially in the attempt to capture the human way of reasoning The book provides an historical overview of the field of automated deduction, and presents the foundations of different existing approaches to model construction, in particular those developed by the authors Finite and infinite model building techniques are presented The main emphasis is on calculi-based methods, and relevant practical results are provided The book is of interest to researchers and graduate students in computer science, computational logic and artificial intelligence It can also be used as a textbook in advanced undergraduate courses

  20. Building information deduced

    DEFF Research Database (Denmark)

    Tamke, Martin; Myrup Jensen, Morten; Beetz, Jakob;

    2014-01-01

    In recent years, Building Information Models have become commonplace in building profession. The extensive use and increasing experience with BIM models offers new perspectives and potentials for design and planning. A recent stakeholder study conducted by the authors of this paper show...... of a model, differences in separate models or models from different point of time. Current BIM tools support both modes only in a rudimentary form. This paper discusses current modes of information query within and across BIM models, shows beneficial scenarios for building and planning practice through...... that in practice models are no longer solely observed as culmination of knowledge in a 3d representation of future built structures, but as a source of information in itself. Experienced users of BIM want to Find Information within a model or across a set of these and Compare models in order to evaluate states...

  1. Zero Energy Building

    DEFF Research Database (Denmark)

    Marszal, Anna Joanna; Heiselberg, Per; Bourrelle, J.S.;

    2011-01-01

    , (4) the type of energy balance, (5) the accepted renewable energy supply options, (6) the connection to the energy infrastructure and (7) the requirements for the energy efficiency, the indoor climate and in case of gird connected ZEB for the building–grid interaction. This paper focuses......The concept of Zero Energy Building (ZEB) has gained wide international attention during last few years and is now seen as the future target for the design of buildings. However, before being fully implemented in the national building codes and international standards, the ZEB concept requires...... clear and consistent definition and a commonly agreed energy calculation methodology. The most important issues that should be given special attention before developing a new ZEB definition are: (1) the metric of the balance, (2) the balancing period, (3) the type of energy use included in the balance...

  2. Adoption & Foster Care

    Science.gov (United States)

    ... Children > Family Life > Family Dynamics > Adoption & Foster Care Adoption & Foster Care Article Body ​Each year, many children join families through adoption and foster care. These families may face unique ...

  3. About Critical Care Nursing

    Science.gov (United States)

    ... requiring intense and vigilant nursing care. Number of Critical Care Nurses in the United States According to "The Registered ... nurses who work in a hospital setting. Where Critical Care Nurses Work According to "The Registered Nurse Population" study, ...

  4. Carbon Efficient Building Solutions

    Directory of Open Access Journals (Sweden)

    Pellervo Matilainen

    2010-03-01

    Full Text Available Traditionally, the Finnish legislation have focused on energy use and especially on energy used for heating space in buildings. However, in many cases this does not lead to the optimal concept in respect to minimizing green house gases. This paper studies how CO2 emission levels are affected by different measures to reduce energy use in buildings. This paper presents two real apartment buildings with different options of energy efficiency and power sources. The calculations clearly show that in the future electricity and domestic hot water use will have high importance in respect to energy efficiency, and therefore also CO2 equivalent (eq emissions. The importance increases when the energy efficiency of the building increases. There are big differences between average Finnish production and individual power plants; CO2 eq emissions might nearly double depending on the energy source and the power plant type. Both a building with an efficient district heating as a power source, and a building with ground heat in addition to nuclear power electricity as a complimentary electricity source performed very similarly to each other in respect to CO2 eq emissions. However, it is dangerous to conclude that it is not important which energy source is chosen. If hypothetically, the use of district heating would dramatically drop, the primary energy factor and CO2 eq emissions from electricity would rise, which in turn would lead to the increase of the ground heat systems emissions. A problem in the yearly calculations is that the fact that it is very important, sometimes even crucial, when energy is needed, is always excluded.

  5. Climate Responsive Buildings in China

    DEFF Research Database (Denmark)

    Haase, M.; Amato, A.; Heiselberg, Per

    2006-01-01

    There is a global need for a more sustainable building development. About 50% of energy is used in buildings indicating that buildings provide a considerable potential for operational energy savings. Studies were conducted with the following objectives: to perform a state-of-the-art review...... of responsive building elements, of integrated building concepts and of environmental performance assessment methods to improve and optimize responsive building elements to develop and optimize new building concepts with integration of responsive building elements, HVAC-systems as well as natural and renewable...... energy strategies to develop guidelines and procedures for estimation of environmental performance of responsive building elements and integrated building concepts This paper introduces the ideas of this collaborative work within the framework of the Annex44 of the International Energy Agency (IEA...

  6. Towards a taxonomy for integrated care: A mixed-methods study

    NARCIS (Netherlands)

    Valentijn, P.P.; Boesveld, I.C.; Klauw, D.M. van der; Ruwaard, D.; Struijs, J.N.; Molema, J.J.W.; Bruijnzeels, M.A.; Vrijhoef, H.J.M.

    2015-01-01

    Introduction: Building integrated services in a primary care setting is considered an essential important strategy for establishing a highquality and affordable health care system. The theoretical foundations of such integrated service models are described by the Rainbow Model of Integrated Care, wh

  7. Commitment, Community, and Passion: Dimensions of a Care-Centered Approach to Teacher Education.

    Science.gov (United States)

    Goldstein, Lisa S.

    2002-01-01

    Builds on Nel Noddings' work on caring encounters to develop a care-centered approach to teacher education. This model emphasizes the important contributions to the process of preparing caring teachers made by enhanced interpersonal commitment, membership in a community of learners, and passion for the creative, intellectual aspects of teaching.…

  8. Applying Lean Six Sigma for innovative change to the post-anesthesia care unit.

    Science.gov (United States)

    Haenke, Roger; Stichler, Jaynelle F

    2015-04-01

    Many healthcare organizations are building or renovating patient care facilities. Using Lean Six Sigma methods, nurse leaders can eliminate unnecessary waste and improve work and patient care environments. Starting with a key department like the post-anesthesia care unit is a good way to expose staff and leaders to the potential of Lean.

  9. CTEPP DATA COLLECTION FORM 05: CHILD DAY CARE CENTER PRE-MONITORING QUESTIONNAIRE

    Science.gov (United States)

    This data collection form is used to identify the potential sources of pollutants at the day care center. The day care teacher is asked questions related to the age of their day care building; age and frequency of cleaning carpets or rugs; types of heating and air conditioning de...

  10. Architecture Building Sustainability

    Institute of Scientific and Technical Information of China (English)

    DAVID HENDRICKSON

    2006-01-01

    @@ Leading architectural design and engineering firm, Skidmore,Owings, & Merrill (SOM), is renowned for pushing the envelope, masterminding some of the world's most cutting edge and enduring structural masterpieces - America's tallest building, the Sears Tower,in the firm's home city of Chicago, the 88-story Jinmao Tower in Shanghai, and the Freedom Tower in New York City, successor to the fallen World Trade Center complex,are among the well known projects in its building portfolio. SOM's next high profile assignment, the Pearl River Tower, in Guangzhou is one no less worthy of this tradition.

  11. PV cool-build

    Energy Technology Data Exchange (ETDEWEB)

    Cross, B.; Nuh, D.

    2004-07-01

    This report summarises the findings of a project to develop a method for calculating the operating temperature of building integrated photovoltaic (BIPV) modules/laminates which are estimated to operate above ambient temperature. The aim of the study was to minimise the temperature of the BIPV in order to increase the production of clean electricity. Details are given of a series of indoor experiments, computer modelling, and outdoor measurements. The production of a readily available, user-friendly design guide for architects and building designers is discussed.

  12. Building global learning communities

    Directory of Open Access Journals (Sweden)

    Averill Gordon

    2013-09-01

    Full Text Available Within the background where education is increasingly driven by the economies of scale and research funding, we propose an alternative online open and connected framework (OOC for building global learning communities using mobile social media. We critique a three year action research case study involving building collaborative global learning communities around a community of practice of learning researchers and practitioners. The results include the development of a framework for utilising mobile social media to support collaborative curriculum development across international boundaries. We conclude that this framework is potentially transferrable to a range of educational contexts where the focus is upon student-generated mobile social media projects.

  13. Ecology Beyond Building

    DEFF Research Database (Denmark)

    Peters, Terri

    2011-01-01

    As the designers of the WWf building in Zeist, The Netherslands a CO2-neutral, self-sufficient office complex, RAU has set the bar for sustainable research and design. Guesteditor Terri Peters visited the firm's studio in Amsterdam to talk to principal Thomas Rau. As Peters relates, Rau prefers t...... to put on the dwindling supply of raw materials rather than the immidiate problems of energy consumption for which there are solutions within reach. With the emphasis on a more far-reaching approach, he places buildings in a wider context of ecological thinking and systems....

  14. Building the perfect PC

    CERN Document Server

    Thompson, Robert Bruce

    2006-01-01

    This popular Build-It-Yourself (BIY) PC book covers everything you want to know about building your own system: Planning and picking out the right components, step-by-step instructions for assembling your perfect PC, and an insightful discussion of why you'd want to do it in the first place. Most big brand computers from HP, Dell and others use lower-quality components so they can meet their aggressive pricing targets. But component manufacturers also make high-quality parts that you can either purchase directly, or obtain through distributors and resellers. Consumers and corporations

  15. Oncology and palliative care

    OpenAIRE

    Bausewein, Claudia; Hartenstein, R.

    2000-01-01

    Oncology developed as a discipline over the last decades. Treatment is concentrated on cure or palliation of the illness with the help of chemotherapy, radiotherapy or surgery. Palliative care has its origin in the hospice movement that started around 1960 in the UK. Centre of care is the patient and his family. Focus of care has moved from quantity to quality of life. Symptom control, communication, rehabilitation and care for the dying are main areas of palliative care. Palliative care and ...

  16. Critical care during epidemics

    OpenAIRE

    Rubinson, Lewis; O'Toole, Tara

    2005-01-01

    We recommend several actions that could improve hospitals' abilities to deliver critical care during epidemics involving large numbers of victims. In the absence of careful pre-event planning, demand for critical care services may quickly exceed available intensive care unit (ICU) staff, beds and equipment, leaving the bulk of the infected populace without benefit of potentially lifesaving critical care. The toll of death may be inversely proportional to the ability to augment critical care c...

  17. The business case for better buildings.

    Science.gov (United States)

    Berry, Leonard L; Parker, Derek; Coile, Russell C; Hamilton, D Kirk; O'Neill, David D; Sadler, Blair L

    2004-01-01

    The buildings in which customers receive services are inherently part of the service experience. Given the high stress of illness, healthcare facility designs are especially likely to have a meaningful impact on customers. In the past, a handful of visionary "healing environments" such as the Lucille Packard Children's Hospital at Stanford University in Palo Alto, California; Griffin Hospital in Derby, Connecticut; Woodwinds Health Campus in St. Paul, Minnesota; and San Diego Children's Hospital were built by values-driven chief executive officers and boards and aided by philanthropy when costs per square foot exceeded typical construction costs. Designers theorized that such facilities might have a positive impact on patients' health outcomes and satisfaction. But limited evidence existed to show that such exemplary health facilities were superior to conventional designs in actually improving patient outcomes and experiences and the organization's bottom line. More evidence was needed to assess the impact of innovative health facility designs. Beginning in 2ooo, a research collaborative of progressive healthcare organizations voluntarily came together with The Center for Health Design to evaluate their new buildings. Various "Pebble Projects" are now engaged in three-year programs of evaluation, using comparative research instruments and outcome measures. Pebble Projects include hospital replacements, critical care units, cancer units, nursing stations, and ambulatory care centers. The Pebble experiences are synthesized here in a composite 3oo-bed "Fable Hospital" to present evidence in support of the business case for better buildings as a key component of better, safer, and less wasteful healthcare. The evidence indicates that the one-time incremental costs of designing and building optimal facilities can be quickly repaid through operational savings and increased revenue and result in substantial, measurable, and sustainable financial benefits. PMID:15469120

  18. GP and nurses' perceptions of how after hours care for people receiving palliative care at home could be improved: a mixed methods study

    OpenAIRE

    Miles Gail; O'Connor Margaret M; Tan Heather M; Klein Britt; Schattner Peter

    2009-01-01

    Abstract Background Primary health care providers play a dominant role in the provision of palliative care (PC) in Australia but many gaps in after hours service remain. In some rural areas only 19% of people receiving palliative care achieve their goal of dying at home. This study, which builds on an earlier qualitative phase of the project, investigates the gaps in care from the perspective of general practitioners (GPs) and PC nurses. Methods Questionnaires, developed from the outcomes of ...

  19. Education for Care and Sustainable Life

    Directory of Open Access Journals (Sweden)

    Victoria Vásquez Verdera

    2014-07-01

    Full Text Available Reflective paper that presents results of research conducted from the perspective of the ethic of care. To board the issue of what do educational organizations do when they care; a methodology for critical-hermeneutic character is followed. Different texts are selected and interpreted with the intention to argue a speech that is considered not univocal. It draws on original sources to address the topic of how to put into action the philosophy of care education. Challenges arise as the need to: (1 seek collaboration in interpersonal and institutional relations, (2 include plural perspectives to build a public speech that doesn´t obscure the diversity of human experience, and (3 analyze critically and honest our daily practices so as not to legitimize the use of violence. Ways to promote the development from the perspective of the ethic of care and concludes by identifying the key elements of this educational perspective are presented.

  20. Many diseases, one model of care?

    Directory of Open Access Journals (Sweden)

    Tit Albreht

    2016-02-01

    Full Text Available Abstract This article has been corrected. See J Comorbidity 2016;6(1:33. http://dx.doi.org/joc.2016.6.78. 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 patients overwhelmed and unable to navigate their way towards better health outcomes. In planning for the future, healthcare policies and models of care are required that cater for the complex needs of patients with multimorbidity and that deliver coordinated care that is patient-centred and focused on disease prevention, multidisciplinary teamwork and shared decision-making, and on empowering patients to self-manage. Salient lessons can be learnt from the work undertaken at a European and national level to develop care models in cancer and diabetes – two complex and often co-occurring conditions requiring coordinated long-term care. Innovative work is also underway in many European countries aimed at improving the integration of care for people with multimorbidity, resulting in more efficient and cost-effective health outcomes. This article reviews some of the most innovative programmes that have been initiated across and within Europe with the aim of improving the way care is delivered to people with complex and multiple long-term conditions. This work provides a foundation upon which to build better, more effective models of care for people with multimorbidity. Journal of Comorbidity 2016;6(1:12–20

  1. Integrating palliative care into comprehensive cancer care.

    Science.gov (United States)

    Abrahm, Janet L

    2012-10-01

    While there are operational, financial, and workforce barriers to integrating oncology with palliative care, part of the problem lies in ourselves, not in our systems. First, there is oncologists' "learned helplessness" from years of practice without effective medications to manage symptoms or training in how to handle the tough communication challenges every oncologist faces. Unless they and the fellows they train have had the opportunity to work with a palliative care team, they are unlikely to be fully aware of what palliative care has to offer to their patients at the time of diagnosis, during active therapy, or after developing advanced disease, or may believe that, "I already do that." The second barrier to better integration is the compassion fatigue many oncologists develop from caring for so many years for patients who, despite the oncologists' best efforts, suffer and die. The cumulative grief oncologists experience may go unnamed and unacknowledged, contributing to this compassion fatigue and burnout, both of which inhibit the integration of oncology and palliative care. Solutions include training fellows and practicing oncologists in palliative care skills (eg, in symptom management, psychological disorders, communication), preventing and treating compassion fatigue, and enhancing collaboration with palliative care specialists in caring for patients with refractory distress at any stage of disease. As more oncologists develop these skills, process their grief, and recognize the breadth of additional expertise offered by their palliative care colleagues, palliative care will become integrated into comprehensive cancer care. PMID:23054873

  2. Building the quantum network

    International Nuclear Information System (INIS)

    We show how quantum key distribution (QKD) techniques can be employed within realistic, highly secure communications systems, using the internet architecture for a specific example. We also discuss how certain drawbacks in existing QKD point-to-point links can be mitigated by building QKD networks, where such networks can be composed of trusted relays or untrusted photonic switches. (author)

  3. Moisture conditions in buildings

    DEFF Research Database (Denmark)

    Rode, Carsten

    2012-01-01

    Growth of mould requires the presence of moisture at a certain high level. In a heated indoor environment such moisture levels occur only if there is a reason for the moisture supply. Such moisture can come from the use of the building, because of malfunctioning constructions, or it can be the...

  4. Customer loyalty building

    OpenAIRE

    Nováková, Veronika

    2012-01-01

    This bachelor thesis focuses on the customer loyalty. It gives an example of CRM project which aims to build the loyalty of customers to some brand or product so the customer would return to the company and would be satisfied with all products and services he get.

  5. Building Project Competence

    DEFF Research Database (Denmark)

    Pemsel, Sofia; Wiewiora, Anna

    This research investigates the development of project competence, and particularly, three related dynamic capabilities (shifting, adapting, leveraging) that contribute to project competence development. In doing so, we make use of the emerging literature on knowledge governance and theorize how...... of dynamic capability building promoting project competence development....

  6. Building for International Business

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    When completed next August, the LG Beijing Tower project is sureto be one of the most high-end buildings in Beijing. With a meticulous attention to detail, planners know the ins and outs of the city's business momentum.The LG Beijing Tower will utilize an integrated networking system to ensure safety,efficiency and comfort.

  7. Ecology Beyond Building

    DEFF Research Database (Denmark)

    Peters, Terri

    2011-01-01

    As the designers of the WWf building in Zeist, The Netherslands a CO2-neutral, self-sufficient office complex, RAU has set the bar for sustainable research and design. Guesteditor Terri Peters visited the firm's studio in Amsterdam to talk to principal Thomas Rau. As Peters relates, Rau prefers...

  8. Radioactivity in building materials

    International Nuclear Information System (INIS)

    The present report, drawn up at the request of the former Minister of Public Health and Environmental Affairs of the Netherlands, discusses the potential radiological consequences for the population of the Netherlands of using waste materials as building materials in housing construction. (Auth.)

  9. Building a Twig Phylogeny

    Science.gov (United States)

    Flinn, Kathryn M.

    2015-01-01

    In this classroom activity, students build a phylogeny for woody plant species based on the morphology of their twigs. Using any available twigs, students can practice the process of cladistics to test evolutionary hypotheses for real organisms. They identify homologous characters, determine polarity through outgroup comparison, and construct a…

  10. Building Automation Systems.

    Science.gov (United States)

    Honeywell, Inc., Minneapolis, Minn.

    A number of different automation systems for use in monitoring and controlling building equipment are described in this brochure. The system functions include--(1) collection of information, (2) processing and display of data at a central panel, and (3) taking corrective action by sounding alarms, making adjustments, or automatically starting and…

  11. Life between buildings

    DEFF Research Database (Denmark)

    Gehl, Jan

    2001-01-01

    A classic is republished. Life between Buildings was first published in 1971. This book - frequently revised over the years - is still the best source for understanding how people use public spaces in our cities. Published in many languages, it is a standard textbook in Architecture and Planning...

  12. Gaze Interactive Building Instructions

    DEFF Research Database (Denmark)

    Hansen, John Paulin; Ahmed, Zaheer; Mardanbeigi, Diako

    We combine eye tracking technology and mobile tablets to support hands-free interaction with digital building instructions. As a proof-of-concept we have developed a small interactive 3D environment where one can interact with digital blocks by gaze, keystroke and head gestures. Blocks may be moved...

  13. Checklist for Physics Buildings.

    Science.gov (United States)

    American Inst. of Physics, New York, NY.

    This booklet was written to encourage close communication between architect and client and to assist planners of physics facilities in providing important features of building design. Some 300 items considered important are listed Also included is a list of 17 references related to facility construction (many available free of charge. A companion…

  14. Vedr.: Military capacity building

    DEFF Research Database (Denmark)

    Larsen, Josefine Kühnel; Struwe, Lars Bangert

    2013-01-01

    Kühnel Larsen and researcher Lars Bangert Struwe of CMS had organized a seminar in collaboration with Royal Danish Defense Colleg and the East African Security Governance Network. The seminar focused on some of the risks involved in Military capacity building and how these risks are dealt with from...

  15. Fire Protection for Buildings

    Science.gov (United States)

    Edmunds, Jane

    1972-01-01

    Reviews attack on fire safety in high rise buildings made by a group of experts representing the iron and steel industry at a recent conference. According to one expert, fire problems are people oriented, which calls for emphasis on fire prevention rather than reliance on fire suppression and for fire pretection to be built into a structure.…

  16. Building a Better CTO

    Science.gov (United States)

    Fletcher, Geoffrey H.

    2010-01-01

    This article features the new Framework of Essential Skills of the K-12 CTO of the Consortium for School Networking (CoSN). This latest, version 2.0 iteration of the skills framework builds upon work the organization did earlier this decade. This time CoSN, a professional association for district technology leaders, reached out to a variety of…

  17. Building Satellites is Easier

    Science.gov (United States)

    Marsh, Phyllis Nimmo

    1996-01-01

    'Building Satellites' is a story about Jim Marsh's recovery from a severe head injury told by his wife Phyllis from the moment she learned of its happening, through the ups and downs of a lengthy rehabilitation, until his return to work and daily living. It continues on, however, and narrates his battle with the more insidious Grave's disease. Told in the first person, 'Building Satellites' vividly portrays Phyllis's thoughts and feelings throughout this experience with scrupulous honestly. This is a story worth reading for many reasons. First of all, Jim was an accomplished scientist, respected by his colleagues both in this country and abroad. Secondly, it narrates the many stages of his recovery from head injury with detailed readable accuracy; it informs us as well as inspires. Finally, 'Building Satellites" also tells us the story of Phyllis Marsh's remarkable creative response to this crisis. It narrates her personal experiences as she progresses through the strange and somewhat bizarre world of medicine and rehabilitation, guided by a few basic beliefs, which she learned as a child in Iowa, that provided her with the strength to endure. 'Building Satellites' seems to reaffirm our unconscious, but settled conviction, that when confornted overnight with adversity, we are somehow given the means for coping, supported by our basic beliefs, strengthened by family and friends, and eventually learning to accept any outcome.

  18. Building Bridges to China.

    Science.gov (United States)

    Wasta, Stephanie; Scott, Margaret

    1998-01-01

    Describes a theme cycle called "Building Bridges to China" developed for third grade students that focuses on the similarities between the lives of children and families in China and the United States. Explains that the theme cycle addresses the National Geography Standards and three of the National Council for the Social Studies standards. (CMK)

  19. Building Background Knowledge

    Science.gov (United States)

    Neuman, Susan B.; Kaefer, Tanya; Pinkham, Ashley

    2014-01-01

    This article make a case for the importance of background knowledge in children's comprehension. It suggests that differences in background knowledge may account for differences in understanding text for low- and middle-income children. It then describes strategies for building background knowledge in the age of common core standards.

  20. Dynamic Soil-Structure Interaction of Instrumented Buildings and Test Structures

    OpenAIRE

    Givens, Michael James

    2013-01-01

    The effects of soil-structure interaction (SSI) are investigated through careful interpretation of available data from instrumented buildings and recently performed forced vibration experiments on instrumented buildings and test structures. Conventional engineering practice typically ignores soil-structure interaction (SSI) during evaluation of the seismic demand on buildings based on the perception that consideration of SSI will reduce demands on structures and ignoring SSI effects will caus...

  1. Deactivation of Building 7602

    International Nuclear Information System (INIS)

    The Department of Energy (DOE) has sponsored research and development programs in Building 7602 at Oak Ridge National Laboratory (ORNL) since 1984. This work focused on development of advanced technology for processing nuclear fuels. Building 7602 was used for engineering-scale tests using depleted and natural uranium to simulate the nuclear fuel. In April 1994 the DOE Office of Nuclear Energy (NE) sent supplemental FY 1994 guidance to ORNL stating that in FY 1995 and beyond, Building 7602 is considered surplus to NE programs and missions and shall be shut down (deactivated) and maintained in a radiologically and industrially safe condition with minimal surveillance and maintenance (S ampersand M). DOE-NE subsequently provided FY 1995 funding to support the deactivation activities. Deactivation of Building 7602 was initiated on October 1, 1994. The principal activity during the first quarter of FY 1995 was removal of process materials (chemicals and uranium) from the systems. The process systems were operated to achieve chemical solution concentrations needed for reuse or disposal of the solutions prior to removal of the materials from the systems. During this phase of deactivation the process materials processed and removed were: (1) Uranyl nitrate solution 30,178 L containing 4490 kg of uranium; (2) Nitric acid (neutralized) 9850 L containing less than 0.013 kg of uranium; (3) Organic solution 3346 L containing 265 kg of uranium; (4) Uranium oxide powder 95 kg; and (5) Miscellaneous chemicals. At the end of December 1994, the process systems and control systems were shut down and deactivated. Disposition of the process materials removed from the process systems in Building 7602 proved to be the most difficult part of the deactivation. An operational stand down and funding reductions at Y-12 prevented planned conversion of the uranyl nitrate solution to depleted uranium oxide powder. This led to disposal of the uranyl nitrate solution as waste

  2. PROGRESS IN ENERGY EFFICIENT BUILDINGS

    Energy Technology Data Exchange (ETDEWEB)

    Wall, L.W.; Rosenfeld, A.H.

    1982-12-01

    Recent accomplishments in buildings energy research by the diverse groups in the Energy Efficient Buildings Program at Lawrence Berkeley Laboratory (LBL) are summarized. We review technological progress in the areas of ventilation and indoor air quality, buildings energy performance, computer modeling, windows, and artificial lighting. The need for actual consumption data to track accurately the improving energy efficiency of buildings is being addressed by the Buildings Energy Data (BED) Group at LBL. We summarize results to date from our Building Energy Use Compilation and Analysis (BECA) studies, which include time trends in the energy consumption of new commercial and new residential buildings, the measured savings being attained by both commercial and residential retrofits, and the cost-effectiveness of buildings energy conservation measures. We also examine recent comparisons of predicted vs. actual energy usage/savings, and present the case for building energy use labels.

  3. Model development for international nurse educator partnerships: relationship-building process and strategies

    OpenAIRE

    Sandra Cadena

    2012-01-01

    Cultural diversity and its impact on patient care contribute to persistent health care disparities. In attempts to enhance nursing student cultural awareness and sensitivity, nurse educators seek international opportunities, often times in low resource countries, as ways to expand upon culturally diverse experiences. A model that addresses relationship-building among faculty from different countries and cultures contributes to enhanced professional relationships, minimizes colla...

  4. Models of Comprehensive Care

    Science.gov (United States)

    The second plenary of the EPEC-O (Education in Palliative and End-of-Life Care for Oncology) Self-Study: Cultural Considerations When Caring for African Americans reviews the various models for integration of hospice and palliative care into traditional cancer care that have been shown to improve outcomes.

  5. Building codes: An often overlooked determinant of health.

    Science.gov (United States)

    Chauvin, James; Pauls, Jake; Strobl, Linda

    2016-05-01

    Although the vast majority of the world's population spends most of their time in buildings, building codes are not often thought of as 'determinants of health'. The standards that govern the design, construction, and use of buildings affect our health, security, safety, and well-being. This is true for dwellings, schools, and universities, shopping centers, places of recreation, places of worship, health-care facilities, and workplaces. We urge proactive engagement by the global public health community in developing these codes, and in the design and implementation of health protection and health promotion activities intended to reduce the risk of injury, disability, and death, particularly when due to poor building code adoption/adaption, application, and enforcement. PMID:26935404

  6. Pediatric Palliative Care

    OpenAIRE

    Johnston, Donna L.; Hentz, Tracy A.; Friedman, Debra L.

    2005-01-01

    Pediatric palliative care provides benefit to children living with life-threatening or terminal conditions. Palliative care should be available to all seriously ill children. Palliative care includes the treatment of symptoms such as pain, nausea, dyspnea, constipation, anorexia, and sialorrhea. This care can occur in a variety of settings, from home to hospice to hospital, and must include bereavement care and follow up after the death of a child. There are many challenges in pediatric palli...

  7. Building a Model Astrolabe

    CERN Document Server

    Ford, Dominic

    2012-01-01

    This paper presents a hands-on introduction to the medieval astrolabe, based around a working model which can be constructed from photocopies of the supplied figures. As well as describing how to assemble the model, I also provide a brief explanation of how each of its various parts might be used. The printed version of this paper includes only the parts needed to build a single model prepared for use at latitudes around 52{\\deg}N, but an accompanying electronic file archive includes equivalent images which can be used to build models prepared for use at any other latitude. The vector graphics scripts used to generate the models are also available for download, allowing customised astrolabes to be made.

  8. Net Zero Energy Buildings

    DEFF Research Database (Denmark)

    Marszal, Anna Joanna; Bourrelle, Julien S.; Musall, Eike;

    2010-01-01

    The international cooperation project IEA SHC Task 40 / ECBCS Annex 52 “Towards Net Zero Energy Solar Buildings”, attempts to develop a common understanding and to set up the basis for an international definition framework of Net Zero Energy Buildings (Net ZEBs). The understanding of such buildings...... and how the Net ZEB status should be calculated differs in most countries. This paper presents an overview of Net ZEBs energy calculation methodologies proposed by organisations representing eight different countries: Austria, Canada, Denmark, Germany, Italy, Norway, Switzerland and the USA. The different...... parameters used in the calculations are discussed and the various renewable supply options considered in the methodologies are summarised graphically. Thus, the paper helps to understand different existing approaches to calculate energy balance in Net ZEBs, highlights the importance of variables selection...

  9. Building and using binoscopes

    CERN Document Server

    Butler, Norman

    2015-01-01

    Focusing on both homemade and commercial products, this book provides the reader with simple and straightforward information about the modelling and building of binoscopes. Binoscopes can be thought of as binoculars enlarged to the size of telescopes: essentially, a combination of the two. Constructing a binoscope is easier than most people think, but it still demands attention to detail and proper background knowledge. The author goes on to provide additional information about how to understand the products currently on the market, should the reader choose to purchase a binoscope instead of building one. Lastly, the book also compares binoscopes with telescopes in great detail, outlining the differences the reader can expect to see in the night sky from using both. The celestial views obtained with a binoscope, compared to a single telescope of the same aperture, are a very different experience and well worth the effort.

  10. Building synthetic memory

    OpenAIRE

    Inniss, Mara C.; Silver, Pamela A.

    2013-01-01

    Cellular memory – conversion of a transient signal into a sustained response – is a common feature of biological systems. Synthetic biologists aim to understand and reengineer such systems in a reliable and predictable manner. Synthetic memory circuits have been designed and built in vitro and in vivo based on diverse mechanisms such as oligonucleotide hybridization, recombination, transcription, phosphorylation, and RNA editing. Thus far, building these circuits has helped us explore the bas...

  11. BUILD UP Skills Danmark

    DEFF Research Database (Denmark)

    Forsingdal, Charlotte Vartou; Lauridsen, Vagn Holk; Hougaard, Karsten Frøhlich;

    opfyldelsen af 2020-målene, skal de rette kompetencer inden for energief-fektivitet og brug af vedvarende energi være til stede blandt de udførende i bygge- og an-lægsbranchen. Det er på denne baggrund, at Europa-Kommissionen har igangsat Build Up Skills projektet på tværs af Europa. Formålet med denne...

  12. Building a professional portfolio.

    OpenAIRE

    Arhippainen, Mikko

    2016-01-01

    Building a professional portfolio is a thesis report with buiding a professional portfolio for the author with a background in graphic design and event management with main interest on aesthetics side. This report describes the main process of selecting materials, planning and actually producing the portfolio. In addition to the portfolio there is a chapter with inspection on LinkedIn and other social medias when planning for jobsearch. Altogether it is many channels and a combination of ...

  13. Work at Building 513

    CERN Multimedia

    IT Department

    2006-01-01

    As part of IT's preparations to meet the challenge of LHC computing, a new chilled water production unit is being constructed for the Computer Centre. The air conditioning work will start in mid-January and last until June 2006. During this period, access to the car park of Building 513 will be restricted. Please consult the plan for details of the area affected by the work. With apologies for the inconvenience. IT Department

  14. Work at Building 513

    CERN Multimedia

    IT Department

    2006-01-01

    As part of IT's preparations to meet the challenge of LHC computing, a new chilled water production unit is being constructed for the Computer Centre. The air conditioning work will start in mid-January and last until June 2006. During this period access to the car park of Building 513 will be restricted. Please consult the plan for details of the area affected by the work. With apologies for the inconvenience, IT Department

  15. NRC new sustainable building

    International Nuclear Information System (INIS)

    'Full text:' The National Research Council Institute For Fuel Cell Innovation is relocating to a purpose-built 71,343 sq. Ft. (6598 sq. M) Research, Testing, Evaluation, and Industry Incubation Facility in the spring of 2006. The new facility will contain Hydrogen-ready laboratories, the existing relocated Hydrogen Safe Environmental Test Chamber, a hydrogen vehicle maintenance bay, a hydrogen vehicle refuelling station, and the following demonstration projects and features: 1. A Ground Source Heat Pump: This long-proven natural-source heating and cooling technology to provide climate control for the new IFCI's atrium and galleria. It is being designed by Keen Engineering of North Vancouver, BC. 2. 5 KW Solid Oxide Fuel Cell System: Fuelled by natural gas and in the future, from biomass, the fuel cell will also produce approximately 15 kW of waste heat, which will be captured and used to supply heat for the building. The Solid Oxide Fuel Cell will be supplied by Fuel Cell Technologies in Kingston, ON. 3. LEED Building certification: Attaining LEED 'green building' certification is considered an important complement to the plans for the new NRC-IFCI, because it will provide respected third-party verification of government's commitment to efficient building design and construction. Project architects Bunting Coady of Vancouver, BC believe the IFCI has strong potential to earn gold LEED certification. 4. Photovoltaic hydrogen source for back-up power fuel cell system: A photovoltaic array will capture energy from sunlight to power an electrolyzer that will produce and store hydrogen for a PEM fuel cell emergency backup power system. The electrolyzer will be provided by Hydrogenics of Mississauga, ON. Photovoltaics are being designed and installed by the British Columbia Institute of Technology. (author)

  16. Thermal evaluation of buildings

    OpenAIRE

    Barajas, Luís M; Roset Calzada, Jaime; La Ferla, Giuseppe

    2015-01-01

    To COST ACTION TU 1104 "Smart Energy Regions" Prof. Aleksandra Djukic and Prof. Aleksandra Krstic-Furundzic of the Faculty of Architecture of the University of Belgrade, Serbia, that gave us the opportunity of be part of the training school imparted from Monday 20th to Thursday 23rd April 2015, where we can teach the topic. The convenience of the use of environmental building evaluation tools, to know design conditions and thermal behavior, by using bioclimatic strategies fo...

  17. Building retrofit for cities

    Energy Technology Data Exchange (ETDEWEB)

    Heinrich, H.

    1979-11-01

    The impact of high fuel prices on retrofit in the urban sector is discussed. Then, the benefits of a strong urban retrofit program are enumerated. Institutional, financial, informational, and attitudinal barriers that stand in the way of widespread implementation of energy conservation retrofit are discussed. Policy tools which can be used to implement a retrofit program consist of tax breaks, financing arrangements, mandatory building efficiency standards, and education programs.

  18. Building for energy conservation

    Energy Technology Data Exchange (ETDEWEB)

    Burberry, P.

    1978-01-01

    Ways in which buildings may be designed to increase thermal efficiency are discussed, giving first of all examples of thermal design in relation to climate. How the building itself may be designed to take advantage of solar energy and the ways in which heat loss takes place are described; the effect of design variables such as siting, volume, and insulation is shown. The book also reviews the development of thermal regulations for health and comfort and, more recently, energy conservation. It discusses the possitilities and difficulties of legislation for energy saving. The UK regulations are given in detail together with descriptions of the FHA and ASHRAE recommendations for the USA and the lastest Scandinavian norms. The author argues that no significant cost need be involved in many of the aspects of thermal design, e.g., shape and fenestration; and that these factors should automatically be taken into account by designers. Even existing buildings can be adapted in various respects to save energy consumption. The book concludes with an explanation of calculation methods for U-values, heat loss, plant sizing, seasonal heat requirements, and other procedures, amply illustrated with tables and graphs.

  19. Allegheny County Building Footprint Locations

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset contains photogrammetrically compiled roof outlines of buildings. All near orthogonal corners are square. Buildings that are less than 400 square feet...

  20. Care for the Health Care Provider.

    Science.gov (United States)

    Kunin, Sharon Brown; Kanze, David Mitchell

    2016-03-01

    Pretravel care for the health care provider begins with an inventory, including the destination, length of stay, logistical arrangements, type of lodging, food and water supply, team members, personal medical needs, and the needs of the community to be treated. This inventory should be created and processed well in advance of the planned medical excursion. The key thing to remember in one's planning is to be a health care provider during one's global health care travel and not to become a patient oneself. This article will help demonstrate the medical requirements and recommendations for such planning. PMID:26900113

  1. Kidney stones - self-care

    Science.gov (United States)

    Renal calculi - self-care; Nephrolithiasis - self-care; Stones - kidney - self-care ... You visited your health care provider or the hospital because you have a kidney stone. You will need to take self-care steps. Which steps ...

  2. ENERGY EFFICIENCY OF THE BUILDING

    OpenAIRE

    Bocharnikov, Dmitry

    2011-01-01

    The subject of bachelor’s thesis is about energy efficiency of the building. Much attention is being paid to energy saving problems all over the world. In the first part it theoretic base for thermal performance requirements of buildings. It includes main positions of Russian requirements for thermal performance. Also it is about general types of building envelope. The second part is about energy audit of buildings. In this part there is an energy efficiency assessment methodology. Energy eff...

  3. Upcoming renovations in Building 63

    CERN Multimedia

    2014-01-01

    La Poste will close its doors in Building 63 on Friday, 28 November. It moves to Building 510 and where it will open on 1 December (see picture).   UNIQA will close its HelpDesk in Building 63 on Wednesday, 26 November and will re-open the next day in Building 510. La Poste and UNIQA are expected to return to their renovated office space between April and May 2015.

  4. Hawaii-Okinawa Building Evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Metzger, I.; Salasovich, J.

    2013-05-01

    NREL conducted energy evaluations at the Itoman City Hall building in Itoman, Okinawa Prefecture, Japan, and the Hawaii State Capitol building in Honolulu, Hawaii. This report summarizes the findings from the evaluations, including the best practices identified at each site and opportunities for improving energy efficiency and renewable energy. The findings from this evaluation are intended to inform energy efficient building design, energy efficiency technology, and management protocols for buildings in subtropical climates.

  5. Extensive Renovation of Heritage Buildings

    DEFF Research Database (Denmark)

    Rasmussen, Torben Valdbjørn; Møller, Eva B.; Buch-Hansen, Thomas Cornelius

    2015-01-01

    In the debate on whether or not heritage buildings should be included in work to mitigate climate change impacts, it is important to assess the impact of these buildings. Therefore the results of an extensive energy upgrading of a listed complex was studied. Climate change and measures to mitigat...... a far more vulnerable building and change its robustness to withstand moisture and user behaviour....

  6. Classification of Building Object Types

    DEFF Research Database (Denmark)

    Jørgensen, Kaj Asbjørn

    2011-01-01

    be managed by software applications and on the basis of building models. Classification systems with taxonomies of building object types have many application opportunities but can still be beneficial in data exchange between building construction partners. However, this will be performed by new methods...... and in strong connection with databases holding a wide range of object types....

  7. Building our future: a plea for leadership.

    Science.gov (United States)

    Souba, Wiley W

    2004-05-01

    In recent years the spastic nature of the health care marketplace has continued to increase, which has greatly escalated the demands of leadership in academic medical centers. The expectations of leaders, including surgery chairs, have increased considerably, whereas their capacity for independent action has undeniably diminished. In such a predicament, it is useful to revisit fundamentals, using them as a guide to build a sound future. Five leadership principles are critical to building a better future: (1) recognizing that the work of leadership involves an inward journey of self-discovery and self-development; (2) establishing clarity around a set of core values that guide the organization as it pursues its goals; (3) communicating a clear sense of purpose and vision that inspires widespread commitment to a shared sense of destiny; (4) building a culture of excellence and accountability throughout the entire organization; and (5) creating a culture that emphasizes the development of leaders and leadership as an organizational capacity. Leadership and learning are inextricably linked. We must change the perception that learning in academic surgery is about correcting a deficit rather than a natural part of human growth and development. Our ability to learn, grow, and contribute to an organization is what provides each of us with meaning and identity. This feeling of being part of something special that is larger than ourselves is a powerful force and an important dividend of great leadership. PMID:15085387

  8. Indirect building localization based on a prominent solid landmark from a forward-looking infrared imagery

    Institute of Scientific and Technical Information of China (English)

    Xiaoping Wang; Tianxu Zhang; Xiaoyu Yang

    2011-01-01

    A novel indirect building localization technique based on a prominent solid landmark from a forwardlooking infrared imagery is proposed to localize low, deeply buried, or carefully camouflaged buildings in dense urban areas.First, the widely used effective methods are applied to detect and localize the solid landmark.The building target is then precisely indirectly localized by perspective transformation according to the imaging parameters and the space constraint relations between the building target and the solid landmark.Experimental results demonstrate this technique can indirectly localize buildings in dense urban areas effectively.%@@ A novel indirect building localization technique based on a prominent solid landmark from a forward-looking infrared imagery is proposed to localize low, deeply buried, or carefully camouflaged buildings in dense urban areas.First, the widely used effective methods are applied to detect and localize the solid landmark.The building target is then precisely indirectly localized by perspective transformation according to the imaging parameters and the space constraint relations between the building target and the solid landmark.Experimental results demonstrate this technique can indirectly localize buildings in dense urban areas effectively.

  9. Towards an empirical ethics in care: relations with technologies in health care.

    Science.gov (United States)

    Pols, Jeannette

    2015-02-01

    This paper describes the approach of empirical ethics, a form of ethics that integrates non-positivist ethnographic empirical research and philosophy. Empirical ethics as it is discussed here builds on the 'empirical turn' in epistemology. It radicalizes the relational approach that care ethics introduced to think about care between people by drawing in relations between people and technologies as things people relate to. Empirical ethics studies care practices by analysing their intra-normativity, or the ways of living together the actors within these practices strive for or bring about as good practices. Different from care ethics, what care is and if it is good is not defined beforehand. A care practice may be contested by comparing it to alternative practices with different notions of good care. By contrasting practices as different ways of living together that are normatively oriented, suggestions for the best possible care may be argued for. Whether these suggestions will actually be put to practice is, however, again a relational question; new actors need to re-localize suggestions, to make them work in new practices and fit them in with local intra-normativities with their particular routines, material infrastructures, know-how and strivings.

  10. 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....

  11. Optimization of preventive health care facility locations

    Directory of Open Access Journals (Sweden)

    McGregor S

    2010-03-01

    Full Text Available Abstract Background Preventive health care programs can save lives and contribute to a better quality of life by diagnosing serious medical conditions early. The Preventive Health Care Facility Location (PHCFL problem is to identify optimal locations for preventive health care facilities so as to maximize participation. When identifying locations for preventive health care facilities, we need to consider the characteristics of the preventive health care services. First, people should have more flexibility to select service locations. Second, each preventive health care facility needs to have a minimum number of clients in order to retain accreditation. Results This paper presents a new methodology for solving the PHCFL problem. In order to capture the characteristics of preventive health care services, we define a new accessibility measurement that combines the two-step floating catchment area method, distance factor, and the Huff-based competitive model. We assume that the accessibility of preventive health care services is a major determinant for participation in the service. Based on the new accessibility measurement, the PHCFL problem is formalized as a bi-objective model based on efficiency and coverage. The bi-objective model is solved using the Interchange algorithm. In order to accelerate the solving process, we implement the Interchange algorithm by building two new data structures, which captures the spatial structure of the PHCFL problem. In addition, in order to measure the spatial barrier between clients and preventive health care facilities accurately and dynamically, this paper estimates travelling distance and travelling time by calling the Google Maps Application Programming Interface (API. Conclusions Experiments based on a real application for the Alberta breast cancer screening program show that our work can increase the accessibility of breast cancer screening services in the province.

  12. care about还是care for?

    Institute of Scientific and Technical Information of China (English)

    曾克辉

    2015-01-01

    1问care about和care for可以相互替换使用吗?答:有时可以。但在不同情况下,它们在较确切的含义上还是有区别的。1在表示"喜欢,关心,担心"时,意思一样,常可以互换使用。如:I care about/for your integrity and honesty.我喜欢你的正直和诚实。She doesn’t care about/for politics.她不关心政治。You needn't care about/for his safety.你不必为他的安全担心。2在表示"介意,计较,在乎"等意思时,

  13. How to Build Better Friendships

    Institute of Scientific and Technical Information of China (English)

    Sue; Browder; 王燕平; 王莺平

    1998-01-01

    没有“朋友”这盏明灯,人生道路将变得黯然无光;没有“朋友”这个音符,生命乐曲将失去动人的华章。 国人有首世代传唱的儿歌:找呀找呀找呀找,找到一个好朋友,敬个礼呀…… 然而,找朋友,交朋友也是一门艺术。 本文认为,友谊并非一种简单的自然发生而又自然消亡的现象: But friendshipes don’t just happen.They have to be created(缔造)and nurtured(培养).Like any other skill,building friendship has to be practiced. 如何create和nurture友谊,文章主要观点如下: a.“友谊第一”: 交友需要时间,但值得! Making time for friends may mean leaving the house a bit messier,letting the grassgrow higher or skipping your favorite TV sitcom(系列喜剧).But aren’t these smallprices to pay for the pleasures of companionship? b.“问寒问暖”: But the seemingly trivial acts of caring are what keep friendships going: thebirthday call,the note scrawled in a greeting card to ask,"How’s your back?" 三言两语,一声问候,暖人心怀: He found the talks that matter most tend to last only two or three minutes. It’s not the long meaning-of-life conversations that remind old

  14. Using DOE Commercial Reference Buildings for Simulation Studies: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Field, K.; Deru, M.; Studer, D.

    2010-08-01

    The U.S. Department of Energy developed 256 EnergyPlus models for use in studies that aim to characterize about 70% of the U.S. commercial building stock. Sixteen building types - including restaurants, health care, schools, offices, supermarkets, retail, lodging, and warehouses - are modeled across 16 cities to represent the diversity of U.S. climate zones. Weighting factors have been developed to combine the models in proportions similar to those of the McGraw-Hill Construction Projects Starts Database for 2003-2007. This paper reviews the development and contents of these models and their applications in simulation studies.

  15. On a computational model of building thermal dynamic response

    Science.gov (United States)

    Jarošová, Petra; Vala, Jiří

    2016-07-01

    Development and exploitation of advanced materials, structures and technologies in civil engineering, both for buildings with carefully controlled interior temperature and for common residential houses, together with new European and national directives and technical standards, stimulate the development of rather complex and robust, but sufficiently simple and inexpensive computational tools, supporting their design and optimization of energy consumption. This paper demonstrates the possibility of consideration of such seemingly contradictory requirements, using the simplified non-stationary thermal model of a building, motivated by the analogy with the analysis of electric circuits; certain semi-analytical forms of solutions come from the method of lines.

  16. Sustainable Development and Green Buildings

    Directory of Open Access Journals (Sweden)

    Arijit Sinha

    2013-03-01

    Full Text Available Global sustainability goals have led to the development of the green building movement. The Green Building Program, stemming from the movement, has had unprecedented success as it provides a quantifiable metric to people’s efforts towards sustainable development. Sustainable development and green buildings are often used interchangeably. Although, sustainable development and green buildings are related, they are not the same. This paper provides an overview of how green building relates to sustainable development practices. Sustainability also governs decisions concerning building materials. A comprehensive explanation of what constitutes a green building material is discussed and how renewable material like wood fare in the deciding criteria. There are many green building rating systems in place. United States Green Building Council administered Leadership in Energy and Environment Design (LEED is the global market leader in the rating systems. LEED is a commendable and grand effort in moving towards sustainable development by converting the built environment green. However, it does have certain pitfalls and challenges. Some of these challenges are with respect to policies on material selection and performance monitoring. The materials used in a project are considered at a common starting point and no consideration is given to the life cycle performance of the material. Statements concerning sustainability require validation, and Life Cycle Analysis (LCA is a tool that can provide such validity. This paper presents how beneficial it can be, when included, in the bigger scheme of green building rating systems and introduces an integrated design concept for green buildings.

  17. Building Web Reputation Systems

    CERN Document Server

    Farmer, Randy

    2010-01-01

    What do Amazon's product reviews, eBay's feedback score system, Slashdot's Karma System, and Xbox Live's Achievements have in common? They're all examples of successful reputation systems that enable consumer websites to manage and present user contributions most effectively. This book shows you how to design and develop reputation systems for your own sites or web applications, written by experts who have designed web communities for Yahoo! and other prominent sites. Building Web Reputation Systems helps you ask the hard questions about these underlying mechanisms, and why they're critical

  18. Building Transdisciplinary Environmental Studies

    DEFF Research Database (Denmark)

    Holm, Jesper

    department (Dept. of Environment, Technology and Social Studies, Roskilde University), and has originally in another version been presented in the book “Miljøregulering - tværvidenskabelige studier (Environmental Regulation. Interdisciplinary Studies)” (Holm, Kjærgård & Pedersen eds. 1997, in Danish) written......We will in this paper approach the challenge of building integrated environmental studies by presenting a crude frame of analysis which take into account both the physical aspects and the social-discursive articulations of environmental problems. This framework partly mirrors the approach of our...

  19. Building Regional Competencies

    DEFF Research Database (Denmark)

    Norus, Jesper

    2004-01-01

    a dominating position in the global marketfor industrial enzymes from 1870-2004. The case of industrial enzymes shows how aregion has been able to build sustainable competitive advantages from its distinctivecompetencies. This is done through a mixture of outsourcing and in sourcing ofcompetencies, knowledge......This paper analyzes the foundations of regional knowledge and its long-term impact onthe region's companies' and how a particular knowledge has developed an ability tostay competitive within a specific technological field. The case illustrates how theCopenhagen region has been able to develop...

  20. Homelessness: a problem for primary care?

    Science.gov (United States)

    Riley, Anthony J; Harding, Geoffrey; Underwood, Martin R; Carter, Yvonne H

    2003-06-01

    Homelessness is a social problem that affects all facets of contemporary society. This paper discusses the concept of homelessness in terms of its historical context and the dominance of the pervasive 'victim blaming' ideologies, which, together with the worldwide economic changes that have contributed to a fiscal crisis of the state, and the resultant policies and circumstances, have led to an increase in the number of 'new homeless' people. This paper attempts to challenge the dominant political discourse on homelessness. The widespread healthcare problems and heterogeneity of homeless people have a particular impact on health services, with many homeless people inappropriately accessing local accident and emergency (A&E) departments because of barriers inhibiting adequate access to primary care. A number of primary care schemes have been successfully implemented to enable the homeless to have better access to appropriate care. However, there is no consistency in the level of services around the United Kingdom (UK), and innovations in service are not widespread and by their nature they are ad hoc. Despite the successes of such schemes, many homeless people still access health care inappropriately. Until homeless people are fully integrated into primary care the situation will not change. The question remains, how can appropriate access be established? A start can be made by building on some of the positive work that is already being done in primary care, but in reality general practitioners (GPs) will be 'swimming against the tide' unless a more integrated policy approach is adopted to tackle homelessness. PMID:12939894

  1. Problems of building social and production bases for the construction of the Temelin nuclear power plant

    International Nuclear Information System (INIS)

    A survey is given of capital costs of building parts and the concept is presented of the equipment of a building site. The social basis consists of accommodation units, cloakrooms, catering units, utility units, a health care centre and a shopping centre. The production base consists of a central concrete plant, cement plant, central armour unit, forming hall, storage area, buildings for pre-assembly, fleet of trucks and other machines, maintenance and repair shops. The network infrastructure and the mains connections are designed and the procedure of the build up of the site is described. The experience is summed up and recommendations made for future nuclear power plant projects. (E.S.)

  2. Elder care - resources

    Science.gov (United States)

    Resources - elder care ... The following organizations are good resources for information on aging and elder care: Administration on Aging -- www.aoa.gov Eldercare Locator -- www.eldercare.gov National Institute on ...

  3. Day Care Centers

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of day care centers for 50 states and Washington D.C. and Puerto Rico. The dataset only includes center based day care locations...

  4. Palliative Care in Cancer

    Science.gov (United States)

    ... care that is given to a person when cancer therapies are no longer controlling the disease. It focuses on caring, not curing. When a person has a terminal diagnosis (usually defined as having a life expectancy ...

  5. US EPA CARE Grants

    Data.gov (United States)

    U.S. Environmental Protection Agency — This is a provisional dataset that contains point locations for the subset of Community Action for a Renewed Environment (CARE) grants given out by the US EPA. CARE...

  6. Critical Care Team

    Science.gov (United States)

    ... of these areas: Surgery Internal medicine Pediatrics Anesthesiology Critical care nurse: A highly skilled nurse who provides all aspects ... and can often uphold the patient's wishes. The critical care nurse becomes an important part of decision-making with ...

  7. Wound Care: Preventing Infection

    Science.gov (United States)

    ... happening, the better you’ll be prepared to take care of yourself once you leave the hospital. You ... skin. If you catch a problem early and take care, you will often be able to continue to ...

  8. Caring for the Caregiver

    Science.gov (United States)

    ... But during this time, it’s important that caregivers take care of themselves too. PDF Kindle ePub This booklet ... cancer This booklet is not about how to take care of a patient. Instead, it mainly provides ways ...

  9. Children's hospice care.

    Science.gov (United States)

    Armstrong-Dailey, A

    1990-01-01

    Facing the inevitable death of a child is a difficult reality for many parents and health care providers as well. Children's Hospice International offers a variety of information and education services to support the provision of children's hospice care.

  10. National Health Care Survey

    Science.gov (United States)

    This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.

  11. What is palliative care?

    Science.gov (United States)

    ... Living Wills: A Guide to Advance Directives, the Health Care Power of Attorney, and Other Key Documents . Cambridge, MA: Harvard Health Publications. 2013. Oxenham D. Palliative care and pain. ...

  12. Preeclampsia - self-care

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000606.htm Preeclampsia - self-care To use the sharing features on this ... have frequent checkups and tests. Bed Rest and Self-care at Home When you are at home, ...

  13. Diabetes - eye care

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000078.htm Diabetes - eye care To use the sharing features on this ... enable JavaScript. Diabetic retinopathy - care Diabetes and your eyes Diabetes can harm your eyes. It can damage ...

  14. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  15. Managed care demands flexibility, creativity.

    Science.gov (United States)

    1996-05-01

    The definition of hospice care is changing as home care providers come under managed care regulations. Hospice care for AIDS patients is demanding, requiring extra time from home care providers. The managed care cost-cutting measures require creativitity and patience. The Visiting Nurses and Hospice of San Francisco (VNH) has held seminars to help providers adapt to managed care.

  16. The role of programmed and emergent mechanisms of coordination: How standardized care pathways contribute to coordinate care tasks in hospitals

    DEFF Research Database (Denmark)

    Prætorius, Thim

    Hospitals face substantial coordination challenges. To meet this hospitals more and more use standardized work processes such as care pathways. By drawing on recent coordination theory that increasingly emphasizes the role of lateral and emergent interactions alongside traditional, programmed...... mechanisms of coordination, this paper finds that standardized work processes such as care pathways should be considered as a bundle of coordination mechanisms—plans and rules, objects, routines, roles and proximity—rather than a mechanism of its own. The bundle builds the accountability, predictability...... and common understanding needed to coordinate standardized care tasks. The analysis lends theoretical insights to the traditional view that see standardized work processes as programmed processes. For health care workers who design, implement and use care pathways to solve care tasks, the analysis calls...

  17. ECOLOGICAL BUILDING DESIGN DETERMINANTS

    Directory of Open Access Journals (Sweden)

    Ali Vakili-Ardebili

    2010-11-01

    Full Text Available The sustainable building design process is driven on the basis of a range of design eco-indicators. Consideration of a multitude of eco-determinants, such as environment, economy, resources, energy consumption and society values in addition to design characteristics and contexts, makes the process of ecological design even more complex. A large number of eco-drivers are extracted from the literature and current design practices. To gain a better insight on eco-design determinants, a survey focusing on the use of eco-design drivers has been conducted with various architects in the UK. The factor analysis method was used to remove redundant data from the survey. Through the factor analysis approach, 115 eco-determinants are grouped into six main clusters. This article presents the process, analysis and findings of this work. The extracted eco-indicators and their associated clusters can be used to improve the process of ecological building design. DOI: 10.3763/aedm.2008.0096 Source: Architectural Engineering and Design Management, Volume 6, Number 2, 2010 , pp. 111-131(21

  18. Revisiting Balint's innovation: enhancing capacity in collaborative mental health care.

    Science.gov (United States)

    Lee, Eunjung; Kealy, David

    2014-09-01

    Interprofessional collaboration is increasingly recognized as a key response to the challenges associated with complex mental health issues in community primary-care settings. Relatively few practice models, however, provide an orientation and a structure that combines quality patient care, professional development, and the building of community capacity. A psychodynamic tradition of supervision and collaboration, an approach known as the Balint model, holds considerable potential to bring this orientation to collaborative primary care and mental health teams. As a consultation group, the Balint approach brings participants' attention to subtle emotional-interpersonal phenomena such as the provider-patient relationship, the presentation of illness, and the experiences of patients and team members. We introduce and provide an overview of the Balint group model, including several concepts proposed by Balint to illuminate the emotional and relational complexities of providing mental health care in a collaborative primary-care setting. The context of our discussion is the implementation of a modified Balint group approach within a Canadian collaborative mental health Care (CMHC) program. We also discuss how an interprofessional application of this approach can enhance patient care, contribute to care providers' professional development, and build community capacity.

  19. Parental Care and Investment

    OpenAIRE

    González-Voyer, Alejandro; Kolm, N.

    2010-01-01

    Parental care is common throughout the animal kingdom and among caring species there is a bewildering variation in how parents care for offspring, as well as in the amount of resources parents invest in care. For instance, there is considerable variation in the relative parental investment by the sexes – in some species females invest more, in others males invest more, and in some investment is more or less equally shared. Different hypotheses have been proposed to explain patterns of parenta...

  20. Strengthening competence building for preventing and controlling health-care-associated infection, improving healthcare-associated infection management level%加强医院感染防控能力建设,提升医院感染管理水平

    Institute of Scientific and Technical Information of China (English)

    李六亿; 李洪山; 郭燕红; 樊静; 孟莉; 姚洪; 胡必杰; 吴安华; 徐英春

    2015-01-01

    目的:通过医院感染预防与控制能力建设项目的实施,加强我国医院感染的预防与控制能力,加大医院感染防控措施的落实力度,提升医院感染管理工作水平。方法整个项目包括呼吸机相关肺炎(VAP)、中央静脉插管相关血流感染(CLABSI)、导尿管相关尿路感染(CAUTI)、手术部位感染(SSI)、新生儿病房和新生儿重症监护室(NICU)、血液透析中心(室)、多重耐药菌(MDRO)医院感染防控7个子项目,通过召开项目启动会、基线调查、统一培训,参与项目的医院按照统一的要求、方法与内容进行调查。2013年10月项目正式实施;2013年10月—2014年3月:进行医院感染流行病学及防控措施实施情况的调查;2014年4—9月:实施各项干预防控措施,并监测干预措施的依从性。结果全国共有52所医院参与该项目,49所医院上报数据。重症监护病房(ICU)器械插管相关感染,VAP、CLABSI 和 CAUTI 发病率分别为8.89‰、1.32‰和2.02‰;综合 ICU VAP、CLABSI 和CAUTI 发病率分别为9.6‰、1.4‰和2.2‰。干预前后 ICU VAP、CAUTI 发病率比较,差异均有统计学意义(均P <0.05)。ICU 手卫生依从率为76.73%(29361/38267),通过采取干预措施,总依从性和各类医务人员的手卫生依从性均有提升,干预前后比较,差异均有统计学意义(均 P <0.05)。结论该项目加大了医院感染各项防控措施的落实力度,降低了相关医院感染发病率,提升了医院感染预防与控制能力,是一种值得推广的模式。%Objective Through the implementation of competence building project of healthcare-associated infec-tion(HAI)prevention and control,strengthen the competence for HAI prevention and control in China,promote the implementation of HAI prevention and control measures,and improve HAI management level.Methods The whole

  1. Value of care - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Value of care displays – national data. This data set includes national-level data for the value of care displays associated with a 30-day episode of care for...

  2. Enlarged prostate - after care

    Science.gov (United States)

    ... self-care; Benign prostatic hypertrophy - self-care; Benign prostatic hyperplasia - self-care ... Kaplan SA. Benign prostatic hyperplasia and prostatis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap ...

  3. Irregular Shaped Building Design Optimization with Building Information Modelling

    Directory of Open Access Journals (Sweden)

    Lee Xia Sheng

    2016-01-01

    Full Text Available This research is to recognise the function of Building Information Modelling (BIM in design optimization for irregular shaped buildings. The study focuses on a conceptual irregular shaped “twisted” building design similar to some existing sculpture-like architectures. Form and function are the two most important aspects of new buildings, which are becoming more sophisticated as parts of equally sophisticated “systems” that we are living in. Nowadays, it is common to have irregular shaped or sculpture-like buildings which are very different when compared to regular buildings. Construction industry stakeholders are facing stiff challenges in many aspects such as buildability, cost effectiveness, delivery time and facility management when dealing with irregular shaped building projects. Building Information Modelling (BIM is being utilized to enable architects, engineers and constructors to gain improved visualization for irregular shaped buildings; this has a purpose of identifying critical issues before initiating physical construction work. In this study, three variations of design options differing in rotating angle: 30 degrees, 60 degrees and 90 degrees are created to conduct quantifiable comparisons. Discussions are focused on three major aspects including structural planning, usable building space, and structural constructability. This research concludes that Building Information Modelling is instrumental in facilitating design optimization for irregular shaped building. In the process of comparing different design variations, instead of just giving “yes or no” type of response, stakeholders can now easily visualize, evaluate and decide to achieve the right balance based on their own criteria. Therefore, construction project stakeholders are empowered with superior evaluation and decision making capability.

  4. Parameters of Upgrading Existing Building into a Green Building

    OpenAIRE

    Mrs. Rupali Kapure; Dr.R.K.Jain

    2014-01-01

    Before turning to specific programs for upgrading buildings, it’s important to understand the market dynamics of greening existing buildings. From a macroeconomic perspective, energy efficiency upgrades represent the most cost-effective way to meet growing energy demands. From a microeconomic perspective, recent studies have shown that energy-efficient and certified green buildings merit higher market values, greater rents, and higher occupancies. From a corporate sustainabili...

  5. Towards more Manageable Coastal Building; Initial Coastal Building Construction Guidelines

    OpenAIRE

    Roslan Talib; Mohd Z. Sulieman

    2011-01-01

    Problem statement: As we may not be aware that the coastal construction is different from inland construction. Building in a coastal environment is different from building in an inland area. In general, buildings in coastal areas must be designed and built to withstand higher loads due to its more extreme conditions. Nowadays, the issue of global warming, uncertainty of global weather and the climate change effect indirectly creating the coastal area with much more expose to extreme condition...

  6. Parameters of Upgrading Existing Building into a Green Building

    Directory of Open Access Journals (Sweden)

    Mrs. Rupali Kapure

    2014-02-01

    Full Text Available Before turning to specific programs for upgrading buildings, it’s important to understand the market dynamics of greening existing buildings. From a macroeconomic perspective, energy efficiency upgrades represent the most cost-effective way to meet growing energy demands. From a microeconomic perspective, recent studies have shown that energy-efficient and certified green buildings merit higher market values, greater rents, and higher occupancies. From a corporate sustainability viewpoint, greening existing buildings is a direct way to reduce a company’s carbon footprint. As a result, corporate real estate managers in the United States have begun to decide in favour of greening both owned and leased buildings, seeing many economic benefits from this switch. Green buildings offer many marketing benefits for building owners and tenants, including opportunities for creating new green “brands” and also “future-proofing” their real estate against both future energy price increases and also value erosion as the trend toward green buildings continues to grow. Marketing benefits will vary by geographic location, building and tenant type, and other factors, but they are present in all privately owned real estate.

  7. Building America Case Study: Solar Water Heating in Multifamily Buildings

    Energy Technology Data Exchange (ETDEWEB)

    R. Aldrich and J. Williamson

    2016-05-01

    Solar domestic hot water (SDHW) systems have been installed on buildings for decades, but because of relatively high costs they have not achieved significant market penetration in most of the country. As more buildings move towards zero net energy consumption, however, many designers and developers are looking more closely at SDHW. In multifamily buildings especially, SDHW may be more practical for several reasons: (1) When designing for zero net energy consumption, solar water heating may be part of the lowest cost approach to meet water heating loads. (2.) Because of better scale, SDHW systems in multifamily buildings cost significantly less per dwelling than in single-family homes. (3) Many low-load buildings are moving away from fossil fuels entirely. SDHW savings are substantially greater when displacing electric resistance water heating. (4) In addition to federal tax incentives, some states have substantial financial incentives that dramatically reduce the costs (or increase the benefits) of SDHW systems in multifamily buildings. With support form the U.S. DOE Building America program, the Consortium for Advanced Residential Buildings (CARB) worked with a developer in western Massachusetts to evaluate a SDHW system on a 12-unit apartment building. Olive Street Development completed construction in spring of 2014, and CARB has been monitoring performance of the water heating systems since May 2014.

  8. Energy Efficiency, Building Productivity and the Commercial Buildings Market

    Energy Technology Data Exchange (ETDEWEB)

    Jones, D.W.

    2002-05-16

    The energy-efficiency gap literature suggests that building buyers are often short-sighted in their failure to apply life-cycle costing principles to energy efficient building technologies, with the result that under investment in these advanced technology occurs. This study examines the reasons this behavior may occur, by analyzing the pressures that market forces place on purchasers of buildings. Our basic conclusion is that the fundamental manner in which the buildings sector does business creates pressures to reduce initial capital outlays and to hedge against a variety of risks, including the ability of building owners to capture benefits from energy efficiency. Starting from the position that building buyers' willingness to pay drives choices over building attributes, we examine basic market principles, the structure of the buildings market, including the role of lenders, and policies that promote penetration of energy efficient technologies. We conclude that greater attention to buyers, and to the incentives and constraints they face, would promote a better understanding of building investment choices and contribute to better policies to promote the penetration of these technologies into markets.

  9. Preservation in New Buildings

    Directory of Open Access Journals (Sweden)

    Christopher Kitching

    2000-06-01

    Full Text Available In the United Kingdom (as in many other countries increasing attention is being paid to the importance of each library and archive having a written preservation strategy endorsed by its governing body. So increasingly we are asking: where does „preservation“ begin and what are its top priorities? Some would say preservation begins with the definition of collecting policies to ensure that only relevant items are acquired in the first place, and therefore that no unnecessary costs are incurred on the long-term care of unwanted and unconsulted items. Others might argue that the first priority must be the careful appraisal of existing holdings to determine their preservation and conservation requirements and to prioritise their treatment. Or should preservation begin with damage-limitation: restricting the physical handling of books and documents, on the one hand by providing whenever possible surrogate copies in digital formats or microform, and on the other hand by offering at least basic protection through appropriate boxing and packaging? This, surely, goes hand-in-hand with the education of staff and readers about the importance of treating rare or unique materials with proper respect.

  10. Speak Up: Help Prevent Errors in Your Care: Ambulatory Care

    Science.gov (United States)

    ... role in making health care safe. That includes doctors, nurses and other health care professionals. Health care organizations ... embarrassed if you don't understand what your doctor, nurse or other health care professional tells you. • Don’ ...

  11. Guidelines for Building Science Education

    Energy Technology Data Exchange (ETDEWEB)

    Metzger, Cheryn E.; Rashkin, Samuel; Huelman, Pat

    2015-03-11

    The U.S. Department of Energy’s (DOE) residential research and demonstration program, Building America, has triumphed through 20 years of innovation. Partnering with researchers, builders, remodelers, and manufacturers to develop innovative processes like advanced framing and ventilation standards, Building America has proven an energy efficient design can be more cost effective, healthy, and durable than a standard house. As Building America partners continue to achieve their stretch goals, they have found that the barrier to true market transformation for high performance homes is the limited knowledge-base of the professionals working in the building industry. With dozens of professionals taking part in the design and execution of building and selling homes, each person should have basic building science knowledge relevant to their role, and an understanding of how various home components interface with each other. Instead, our industry typically experiences a fragmented approach to home building and design. After obtaining important input from stakeholders at the Building Science Education Kick-Off Meeting, DOE created a building science education strategy addressing education issues preventing the widespread adoption of high performance homes. This strategy targets the next generation and provides valuable guidance for the current workforce. The initiative includes: • Race to Zero Student Design Competition: Engages universities and provides students who will be the next generation of architects, engineers, construction managers and entrepreneurs with the necessary skills and experience they need to begin careers in clean energy and generate creative solutions to real world problems. • Building Science to Sales Translator: Simplifies building science into compelling sales language and tools to sell high performance homes to their customers. • Building Science Education Guidance: Brings together industry and academia to solve problems related to

  12. Finnish care integrated?

    Directory of Open Access Journals (Sweden)

    Jouni Niskanen

    2002-06-01

    Full Text Available The public Finnish social and health care system has been challenged by the economic crisis, administrative reforms and increased demands. Better integration as a solution includes many examples, which have been taken to use. The most important are the rewritten national and municipals strategies and quality recommendations, where the different sectors and the levels of care are seen as one entity. Many reorganisations have taken place, both nationally and locally, and welfare clusters have been established. The best examples of integrated care are the forms of teamwork, care management, emphasis on non-institutional care and the information technology.

  13. The Application Trend of Smart Sensing Technology in Home of Building: An Example of a Green and Smart Building for the Seniors Citizens Offered by Farglory Land Development

    Directory of Open Access Journals (Sweden)

    Meng-Hsien Hsieh

    2011-09-01

    Full Text Available The living space of smart buildings requires three major applications: energy-saving and comfort, security and hazard prevention, and health care. These applications not only give rise to a market opportunity for advanced sensor fusion technologies including comfort sensing, infrared sensing, inertial sensing, and voice recognition, but also make proactive sensing, smart determination, and automatic control possible. The smart building project by Farglory Land Development, where senior citizens are able to live comfortably and be well taken care of, is presented here. The current trends visible from this project are also discussed.

  14. Development of hazard-compatible building fragility and vulnerability models

    Science.gov (United States)

    Karaca, E.; Luco, N.

    2008-01-01

    We present a methodology for transforming the structural and non-structural fragility functions in HAZUS into a format that is compatible with conventional seismic hazard analysis information. The methodology makes use of the building capacity (or pushover) curves and related building parameters provided in HAZUS. Instead of the capacity spectrum method applied in HAZUS, building response is estimated by inelastic response history analysis of corresponding single-degree-of-freedom systems under a large number of earthquake records. Statistics of the building response are used with the damage state definitions from HAZUS to derive fragility models conditioned on spectral acceleration values. Using the developed fragility models for structural and nonstructural building components, with corresponding damage state loss ratios from HAZUS, we also derive building vulnerability models relating spectral acceleration to repair costs. Whereas in HAZUS the structural and nonstructural damage states are treated as if they are independent, our vulnerability models are derived assuming "complete" nonstructural damage whenever the structural damage state is complete. We show the effects of considering this dependence on the final vulnerability models. The use of spectral acceleration (at selected vibration periods) as the ground motion intensity parameter, coupled with the careful treatment of uncertainty, makes the new fragility and vulnerability models compatible with conventional seismic hazard curves and hence useful for extensions to probabilistic damage and loss assessment.

  15. Environmental site assessments and audits: Building inspection requirements

    Science.gov (United States)

    Lange, John H.; Kaiser, Genevieve; Thomulka, Kenneth W.

    1994-01-01

    Environmental site assessment criteria were originally developed by organizations that focused, almost exclusively, on surface, subsurface, and pollution source contamination. Many of the hazards associated with indoor environments and building structures were traditionally not considered when evaluating sources and entities of environmental pollution. Since a large number of building materials are potentially hazardous, careful evaluation is necessary. Until recently, little information on building inspection requirements of environmental problems has been published. Traditionally, asbestos has been the main component of concern. The ever-changing environmental standards have dramatically expanded the scope of building surveys. Indoor environmental concerns, for example, currently include formaldehyde, lead-based paint, polychlorinated biphenyls, radon, and indoor air pollution. Environmental regulations are being expanded and developed that specifically include building structures. These regulatory standards are being triggered by an increased awareness of health effects from indoor exposure, fires, spills, and other accidents that have resulted in injury, death, and financial loss. This article discusses various aspects of assessments for building structures.

  16. Building design: sustainability and some energetic and ecological aspects

    Energy Technology Data Exchange (ETDEWEB)

    Abruzzese, D.; Ascolani, F.; Strollo, R.M. [University of Rome Tor Vergata (Italy). Dept. of Civil Engineering

    1998-07-01

    In the paper a general overview of the connections between architecture and the field of environmental care is presented. Sustainability is related with the system of human activities, thought as a holistic one: among these, architecture represents a holistic complex itself. Energy consumption reduction and pollutant emissions cut down are seen in the light of the maintenance of our health. Building plays an important role in the environmental impact of human acting, therefore it takes many responsibilities on its back. Building impacts on nature in ways and some data about environmental burdens deriving from activities related to building are given, with a certain stress laid on the Italian state. An overview of the green building philosophy, pointing out the importance of renovation of existing building estate, and so me basic aspects of green building design are presented; some examples illustrate the realization of bioarchitecture's principles. The acknowledgement by technical standards and rules has been dealt with through short account to give an idea that things are getting going. (author)

  17. Spintronics: Conceptual Building Blocks

    Science.gov (United States)

    Ansermet, J.-Ph.

    The purpose of this introduction to spintronics is to provide some elementary description of its conceptual building blocks. Thus, it is intended for a newcomer to the field. After recalling rudimentary descriptions of spin precession and spin relaxation, spin-dependent transport is treated within the Boltzmann formalism. This suffices to introduce key notions such as the spin asymmetry of the conductivities in the two-current model, the spin diffusion length, and spin accumulation. Two basic mechanisms of spin relaxation are then presented, one arising from spin-orbit scattering and the other from electron-magnon collisions. Finally, the action of a spin-polarized current on magnetization is presented in a thermodynamics framework. This introduces the notion of spin torque and the characteristic length scale over which the transverse spin polarization of conduction electron decays as it is injected into a magnet.

  18. Renovating the Main Building

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    CERN's "Main Building" is exactly that. The Organization's central hub, with hundreds of staff and visitors passing through its doors every day, will soon be getting a well-earned facelift. Refurbishment work will proceed in phases, starting with the Salle des Pas Perdus, the concourse between the Council Chamber and the Main Auditorium. By the end of August, informal seating areas will be installed, electronic display panels will provide practical information and improved sound insulation will enhance conditions in the auditoria and surrounding meeting rooms.   In light green the area that will undergo the facelift. Work will start in July. The ground floor is home to the entrance to Restaurant No. 1, the bank, the post office, the travel agent, the Users Office, the Staff Association, the notice boards etc. Step up to the first floor to access CERN's largest lecture theatre, the Council Chamber and its "Pas Perdus" lobby. Everyone who works at or visits CERN i...

  19. Building Land Information Policies

    DEFF Research Database (Denmark)

    Enemark, Stig

    2004-01-01

    The paper presents a conceptual understanding in the areas of Cadastre, Land Administration, and Land Management as a basis for building adequate land information policies. To develop this understanding the paper looks at each area as a system or an infrastructure designed for handling specific...... and judicial setting of the individual country. However, in spite of the different origins, the systems seem to merge into a global model serving some basic societal needs. The paper presents an outline of this development towards a global model for sustainable land administration infrastructures...... of measurement science, spatial information, management, and land management. (2) To establish national professional associations which accommodate a modern interdisciplinary profile. (3) To assess the capacity needs in land administration and to develop the capacity needed at societal, institutional...

  20. Photovoltaic building blocks

    DEFF Research Database (Denmark)

    Hanberg, Peter Jesper; Jørgensen, Anders Michael

    2014-01-01

    it directcompetitive with fossil energy sources a further reduction is needed. By increasing the efficiency of the solar cells one gain an advantage through the whole chain of cost. So that per produced Watt of power less material is spent, installation costs are lower, less area is used etc. With an average...... efficiency of about 15% for commercial Silicon solar cells there is still much to gain. DTU Danchip provides research facilities, equipment and expertise for the building blocks that comprises fabricating the efficient solar cell. In order to get more of the sun light into the device we provide thin film......Photovoltaics (PV), better known as solar cells, are now a common day sight on many rooftops in Denmark.The installed capacity of PV systems worldwide is growing exponentially1 and is the third most importantrenewable energy source today. The cost of PV is decreasing fast with ~10%/year but to make...

  1. Ethical thinking and discrimination in health care

    Directory of Open Access Journals (Sweden)

    Aleksander Mlinšek

    2012-02-01

    Full Text Available RQ: Personal excellence of nursing focusing on self-transcendence and achievements is crucial for achieving excellence in health care. The question is whether there is unequal treatment of patients despite high ethical standards placed in health care.Purpose: Professional nurses code is a guide in assessing their ethical performance. People are different amongst each other, but have the same rights in the health system, which should be provided by health care services. The need to overcome inequalities has become a cornerstone of excellence in health care.Method: A small quantitative survey of nurses was conducted in one of the departments in a Slovenian hospital. To analyse the results, we used frequency statistics, Spearman's rank correlation test and chi-square test. Results: Providers of health care services are aware of the importance of ethics in its formation. Professional Code is relatively well known; 8.4 % of the respondents were not sure if they clearly define the principles of respect for equality. Discrimination, caused by providers of health care, is of a less extent. Ethical awareness among health care providers does not affect identification with the profession. The education level ofnursing personnel and the perception of discrimination based on religious affiliation influenced one another. Education has no influence on the perception of discrimination based on other circumstances.Organization: Health care organizations should integrate hygieneethical thinking among its strategic goals. Quality is not only quantifying the data. Personal excellence of health care providers, which is difficult to measure, is the basic building block of organizational excellence and patient satisfaction.Originality: There are not many research studies on perceptionsof discrimination in health care. The article raises the sensitive issue that we should talk more about.Limitations: The survey was conducted on a small sample size. Further research

  2. Capacity Building in Land Management

    DEFF Research Database (Denmark)

    Enemark, Stig; Ahene, Rexford

    2003-01-01

    There is a significant need for capacity building in the interdisciplinary area of land management especially in developing countries and countries in transition, to deal with the complex issues of building efficient land information systems and sustainable institutional infrastructures. Capacity...... building in land management is not only a question of establishing a sufficient technological level or sufficient economic resources. It is mainly a question of understanding the interdisciplinary and cross-sectoral nature of land administration systems, and understanding the need for human resource...... development in this area. Furthermore, capacity building should ensure that the focus is on building sound institutions and governance rather than just high-level IT-infrastructures.    This overall approach to capacity building in land management is used for implementing a new land policy reform in Malawi...

  3. Building Energy Monitoring and Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Tianzhen; Feng, Wei; Lu, Alison; Xia, Jianjun; Yang, Le; Shen, Qi; Im, Piljae; Bhandari, Mahabir

    2013-06-01

    This project aimed to develop a standard methodology for building energy data definition, collection, presentation, and analysis; apply the developed methods to a standardized energy monitoring platform, including hardware and software, to collect and analyze building energy use data; and compile offline statistical data and online real-time data in both countries for fully understanding the current status of building energy use. This helps decode the driving forces behind the discrepancy of building energy use between the two countries; identify gaps and deficiencies of current building energy monitoring, data collection, and analysis; and create knowledge and tools to collect and analyze good building energy data to provide valuable and actionable information for key stakeholders.

  4. User Driven Innovative Building Design

    DEFF Research Database (Denmark)

    Christiansson, Per; Sørensen, Kristian Birch; Steffensen, K. G.;

    2009-01-01

    to the broad introduction of advanced information and communication technology (ICT). VICMET is a general method for user involvement in every phase of the construction process and with a unique setup for each type of user. VICMET can use already created information in the building process and emphasis...... that the users are the key to next level of successful building projects. VICMET defines four spaces to support the activities in a innovative/creative design process; The Contextual Inquiry Space, the Conceptual Modeling and Game Space, the Functional Building Systems (FBS) Consolidation Space, and the Solution......During recent years there has been an ever-increasing focus on the possibilities to change the building process to raise quality on the final building products as well as on the activities of actors involved in the building process. One reason for this interest is the new opportunities evolving due...

  5. Energy Innovations for Healthy Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Bogucz, Edward

    2016-09-23

    Healthy buildings provide high indoor environmental quality for occupants while simultaneously reducing energy consumption. This project advanced the development and marketability of envisioned healthy, energy-efficient buildings through studies that evaluated the use of emerging technologies in commercial and residential buildings. For commercial buildings, the project evaluated energy consumption and user experiences with a prototype Personalized Environmental Controls Systems (PECS) that enable individuals to control of conditions in their immediate surroundings within a larger office suite. For residential buildings, the project evaluated a variety of domestic hot water (DHW) technologies. The project also included outreach and education concerning energy efficiency in buildings, including resources required for homebuilders to participate in DOE’s Builders Challenge.

  6. Medical students as EMTs: skill building, confidence and professional formation

    Directory of Open Access Journals (Sweden)

    Thomas Kwiatkowski

    2014-07-01

    Full Text Available Objective: The first course of the medical curriculum at the Hofstra North Shore-LIJ School of Medicine, From the Person to the Professional: Challenges, Privileges and Responsibilities, provides an innovative early clinical immersion. The course content specific to the Emergency Medical Technician (EMT curriculum was developed using the New York State Emergency Medical Technician curriculum. Students gain early legitimate clinical experience and practice clinical skills as team members in the pre-hospital environment. We hypothesized this novel curriculum would increase students’ confidence in their ability to perform patient care skills and enhance students’ comfort with team-building skills early in their training. Methods: Quantitative and qualitative data were collected from first-year medical students (n=97 through a survey developed to assess students’ confidence in patient care and team-building skills. The survey was completed prior to medical school, during the final week of the course, and at the end of their first year. A paired-samples t-test was conducted to compare self-ratings on 12 patient care and 12 team-building skills before and after the course, and a theme analysis was conducted to examine open-ended responses. Results: Following the course, student confidence in patient care skills showed a significant increase from baseline (p<0.05 for all identified skills. Student confidence in team-building skills showed a significant increase (p<0.05 in 4 of the 12 identified skills. By the end of the first year, 84% of the first-year students reported the EMT curriculum had ‘some impact’ to ‘great impact’ on their patient care skills, while 72% reported the EMT curriculum had ‘some impact’ to ‘great impact’ on their team-building skills. Conclusions: The incorporation of EMT training early in a medical school curriculum provides students with meaningful clinical experiences that increase their self

  7. Building better boards.

    Science.gov (United States)

    Nadler, David A

    2004-05-01

    Companies facing new requirements for governance are scrambling to buttress financial-reporting systems, overhaul board structures--whatever it takes to comply. But there are limits to how much good governance can be imposed from the outside. Boards know what they ought to be: seats of challenge and inquiry that add value without meddling and make CEOs more effective but not all-powerful. A board can reach that goal only if it functions as a high-performance team, one that is competent, coordinated, collegial, and focused on an unambiguous goal. Such entities don't just evolve; they must be constructed to an exacting blueprint--what the author calls board building. In this article, Nadler offers an agenda and a set of tools that boards can use to define and achieve their objectives. It's important for a board to conduct regular self-assessments and to pay attention to the results of those analyses. As a first step, the directors and the CEO should agree on which of the following common board models best fits the company: passive, certifying, engaged, intervening, or operating. The directors and the CEO should then analyze which business tasks are most important and allot sufficient time and resources to them. Next, the board should take inventory of each director's strengths to ensure that the group as a whole possesses the skills necessary to do its work. Directors must exert more influence over meeting agendas and make sure they have the right information at the right time and in the right format to perform their duties. Finally, the board needs to foster an engaged culture characterized by candor and a willingness to challenge. An ambitious board-building process, devised and endorsed both by directors and by management, can potentially turn a good board into a great one. PMID:15146740

  8. Building better boards.

    Science.gov (United States)

    Nadler, David A

    2004-05-01

    Companies facing new requirements for governance are scrambling to buttress financial-reporting systems, overhaul board structures--whatever it takes to comply. But there are limits to how much good governance can be imposed from the outside. Boards know what they ought to be: seats of challenge and inquiry that add value without meddling and make CEOs more effective but not all-powerful. A board can reach that goal only if it functions as a high-performance team, one that is competent, coordinated, collegial, and focused on an unambiguous goal. Such entities don't just evolve; they must be constructed to an exacting blueprint--what the author calls board building. In this article, Nadler offers an agenda and a set of tools that boards can use to define and achieve their objectives. It's important for a board to conduct regular self-assessments and to pay attention to the results of those analyses. As a first step, the directors and the CEO should agree on which of the following common board models best fits the company: passive, certifying, engaged, intervening, or operating. The directors and the CEO should then analyze which business tasks are most important and allot sufficient time and resources to them. Next, the board should take inventory of each director's strengths to ensure that the group as a whole possesses the skills necessary to do its work. Directors must exert more influence over meeting agendas and make sure they have the right information at the right time and in the right format to perform their duties. Finally, the board needs to foster an engaged culture characterized by candor and a willingness to challenge. An ambitious board-building process, devised and endorsed both by directors and by management, can potentially turn a good board into a great one.

  9. Aplikasi Teori Self-Care Deficit Orem dalam Konteks Tuna Wisma (Studi Literatur) (The Application of Orem’s Self Care Deficit in Homeless Setting)

    OpenAIRE

    Megah Andriyani

    2007-01-01

    Homeless health is government and NGO’s responsibilities for creating optimal citizen health status. Homeless is one of community health nursing clients. The Self Care Theory is used in nursing science for giving conceptual framework as a practical guidance and building self care knowledge through research. Orem described self care as a continuing intervention. It was needed and done by adult to be survived, healthy, and wellness. This theory is also used in homeless setting by many exp...

  10. At what cost care?

    Science.gov (United States)

    Pitman, J; Warelow, P J

    2000-03-01

    This paper looks at the concept of care in nursing and considers the ever-changing focus relative to the meaning of the term care and how this care is delivered by nursing staff. In the process of looking at these issues it examines the theoretical and practical issues and how these factors have changed considerably over the last twenty-five years. This examination touches upon some of the intermingled and not mutually exclusive issues which surround care and caring such as technology, stress and burnout, bureaucracy, fiscal policy, the humanness of the nurse and the ever changing nature of care delivery. Many readers will be able to relate to the issues discussed and understand how some of these factors tend to get in the way of one another and affect good patient care and outcomes. PMID:11141767

  11. 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...

  12. Neuroeconomics and Integrated Care

    DEFF Research Database (Denmark)

    Larsen, Torben

    2012-01-01

    Background: Fragmented specialized care for the frail elderly as claimed by WHO needs horizontal integration across settings. The home of the patient seems to be a promising place to integrate hospital care, primary care and social services for high-risk discharges where the quality...... of rehabilitation makes a difference. Objective: The study aims to reveal how integrated home care may be organised to improve quality of care as compared to usual hospital care. Method: A qualitative case study of the use of a neuroeconomic model in relation to multidisciplianry collaboration on a RCT...... of integrated home care for stroke patients. Results: (1) The classical understanding of CNS is that of a dual system of ANS and Cortex. The new neuroeconomic understanding is that of a reciprocal balance of Limbic System (LS) and Neocortex (NC). This applies directly in favour of integrated homecare compared...

  13. Acute care nurses' spiritual care practices.

    Science.gov (United States)

    Gallison, Barry S; Xu, Yan; Jurgens, Corrine Y; Boyle, Suzanne M

    2013-06-01

    The purpose of this study was to identify barriers in providing spiritual care to hospitalized patients. A convenience sample (N = 271) was recruited at an academic medical center in New York City for an exploratory, descriptive questionnaire. The Spiritual Care Practice (SCP) questionnaire assesses spiritual care practices and perceived barriers to spiritual care. The SCP determines the percentage that provides spiritual support and perceived barriers inhibiting spiritual care. The participation rate was 44.3% (N = 120). Most (61%) scored less than the ideal mean on the SCP. Although 96% (N = 114) believe addressing patients spiritual needs are within their role, nearly half (48%) report rarely participating in spiritual practices. The greatest perceived barriers were belief that patient's spirituality is private, insufficient time, difficulty distinguishing proselytizing from spiritual care, and difficulty meeting needs when spiritual beliefs were different from their own. Although nurses identify themselves as spiritual, results indicate spirituality assessments are inadequate. Addressing barriers will provide nurses opportunities to address spirituality. Education is warranted to improve nurses' awareness of the diversity of our society to better meet the spiritual needs of patients. Understanding these needs provide the nurse with opportunities to address spirituality and connect desires with actions to strengthen communication and the nurse-patient relationship.

  14. Sustainability in Energy and Buildings

    OpenAIRE

    Kinnane, Oliver; Basu, Biswajit

    2014-01-01

    PUBLISHED Cardiff This paper presents a new methodology for characterising the energy performance of buildings suitable for city-scale, top-down energy modelling. Building properties that have the greatest impact on simulated energy performance were identified via a review of sensitivity analysis studies. The methodology greatly simplifies the description of a building to decrease labour and simulation processing overheads. The methodology will be used in the EU FP7 INDICATE project whi...

  15. Building Integration of Aerogel Glazings

    OpenAIRE

    Gao, Tao; Jelle, Bjørn Petter; Gustavsen, Arild

    2016-01-01

    The recent building practices have shown that aerogel glazings can be used as a multifunctional building envelope component for different purposes. Nevertheless, the distinctive physical properties and energy performance of aerogel glazings suggest that building integration of aerogel glazings may create architectural challenges, aesthetic problems, as well as concerns on their durability and environmental impact, thus highlighting the importance of developing guidelines to regulate the use o...

  16. Energy-efficient timber buildings

    OpenAIRE

    Zbašnik-Senegačnik, Martina; Kitek Kuzman, Manja

    2015-01-01

    The choice of materials for a building with high energy efficiency becomes much more important and strategies for reducing the use of primary energy for the production of materials and components becomes key. The positive trend towards wooden construction is dictated by international guidelines, where a wooden building is an important starting point, not only for low-energy, but also low-emission building with exceptional health and safety aspects. In Europe, the most comprehensiv...

  17. Guidelines on Building Regulations 2008

    DEFF Research Database (Denmark)

    Thse guidelines clarify and intepret the provisions of the Building Regulations of 2008 (BR08). The Guidelines, which match BR08 in terms of organisation into Parts, are accompanied by the full text of the regulations and the explanatory notes issued by the Danish Enterprise and Construction...... climate, energy consumotion and services. The Guidelines are aimed at all professionals involved in building projects, particularly building design consultants, contractors and municipal application officers....

  18. Descent in buildings (AM-190)

    CERN Document Server

    Mühlherr, Bernhard; Weiss, Richard M

    2015-01-01

    Descent in Buildings begins with the resolution of a major open question about the local structure of Bruhat-Tits buildings. The authors then put their algebraic solution into a geometric context by developing a general fixed point theory for groups acting on buildings of arbitrary type, giving necessary and sufficient conditions for the residues fixed by a group to form a kind of subbuilding or "form" of the original building. At the center of this theory is the notion of a Tits index, a combinatorial version of the notion of an index in the relative theory of algebraic groups. These results

  19. Electric Propulsion Research Building (EPRB)

    Data.gov (United States)

    Federal Laboratory Consortium — The Electric Propulsion Research Building (EPRB) capability centers on its suite of vacuum chambers, which are configured to meet the unique requirements related to...

  20. Lifetime environmental impact of buildings

    CERN Document Server

    Mequignon, Marc

    2014-01-01

    This work discusses the impact of the life of buildings on? sustainable development methods.?The study of the lifespan of the building is used to assess and?manage the environmental impacts associated?with all the stages of a product's life, from raw material extraction?through to repair, maintenance and?? 'end of life' scenarios. While several papers have discussed thegreenhouse gas emissions of buildings,?less research has been done on how these are affected by the lifespan?of the building. This book serves to?highlight the pertinence of this factor and contributes to providing?new ideas on

  1. Building Energy Monitoring and Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Tianzhen; Feng, Wei; Lu, Alison; Xia, Jianjun; Yang, Le; Shen, Qi; Im, Piljae; Bhandari, Mahabir

    2013-06-01

    U.S. and China are the world’s top two economics. Together they consumed one-third of the world’s primary energy. It is an unprecedented opportunity and challenge for governments, researchers and industries in both countries to join together to address energy issues and global climate change. Such joint collaboration has huge potential in creating new jobs in energy technologies and services. Buildings in the US and China consumed about 40% and 25% of the primary energy in both countries in 2010 respectively. Worldwide, the building sector is the largest contributor to the greenhouse gas emission. Better understanding and improving the energy performance of buildings is a critical step towards sustainable development and mitigation of global climate change. This project aimed to develop a standard methodology for building energy data definition, collection, presentation, and analysis; apply the developed methods to a standardized energy monitoring platform, including hardware and software, to collect and analyze building energy use data; and compile offline statistical data and online real-time data in both countries for fully understanding the current status of building energy use. This helps decode the driving forces behind the discrepancy of building energy use between the two countries; identify gaps and deficiencies of current building energy monitoring, data collection, and analysis; and create knowledge and tools to collect and analyze good building energy data to provide valuable and actionable information for key stakeholders.

  2. Energy Innovations for Healthy Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Bogucz, Edward A. [Syracuse Univ., NY (United States)

    2016-09-23

    Healthy buildings provide high indoor environmental quality for occupants while simultaneously reducing energy consumption. This project advanced the development and marketability of envisioned healthy, energy-efficient buildings through studies that evaluated the use of emerging technologies in commercial and residential buildings. The project also provided resources required for homebuilders to participate in DOE’s Builders Challenge, concomitant with the goal to reduce energy consumption in homes by at least 30% as a first step toward achieving envisioned widespread availability of net-zero energy homes by 2030. In addition, the project included outreach and education concerning energy efficiency in buildings.

  3. Timely and Effective Care - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — Timely and Effective Care measures - state data. This data set includes state-level data for measures of heart attack care, heart failure care, pneumonia care,...

  4. Genital herpes - self-care

    Science.gov (United States)

    Herpes - genital -self-care; Herpes simplex - genital - self-care; Herpesvirus 2 - self-care; HSV-2 - self-care ... yourself healthy can also minimize the risk of future outbreaks. Things you can do include: Get plenty ...

  5. Broken toe - self-care

    Science.gov (United States)

    Fractured toe - self-care; Broken bone - toe - self-care; Fracture - toe - self-care; Fracture phalanx - toe ... often treated without surgery and can be taken care of at home. Severe injuries include: Breaks that ...

  6. Growing ambulatory care nurse leaders in a multigenerational workforce.

    Science.gov (United States)

    Moye, Janet P; Swan, Beth Ann

    2009-01-01

    Ambulatory care faces challenges in sustaining a nursing workforce in the future as newly licensed nurses are heavily recruited to inpatient settings and retirements will impact ambulatory care sooner than other areas. Building a diverse team by recruiting nurses of different ages (generations) and skills may result in a more successful and robust organization. Knowledge about generational characteristics and preferences will aid nurse leaders and recruiters in attracting high-quality, talented nurses. Nurses of Generations X and Y can increase their likelihood of success in ambulatory care by better understanding intergenerational issues. PMID:20050492

  7. The Hospital Building as Project and Matter of Concern

    DEFF Research Database (Denmark)

    Harty, Chris; Tryggestad, Kjell

    2015-01-01

    Mock-ups, scale models and drawings are ubiquitous in building design processes, circulating between various stakeholders. They contribute to the gradual evolution of design, but what else can specific material forms of representations do for the building design and project? The full-scale model...... the building design and project, including the exposition and resolution of controversy concerning size of spaces and bodies. The paper compares the use of two different forms of representation of the same imagined space—a single-bed room in a hospital, and produced for similar purposes—to ascertain what...... the optimum (or minimum) spatial requirements should be to allow effective care of patients. The first representations are physical mock-ups of a single-bed room for Danish hospitals where actual medical and logistical procedures are simulated using real equipment and real people. The second is a three...

  8. FEM Updating of the Heritage Court Building Structure

    DEFF Research Database (Denmark)

    Ventura, C. E.; Brincker, Rune; Dascotte, E.;

    2001-01-01

    . The starting model of the structure was developed from the information provided in the design documentation of the building. Different parameters of the model were then modified using an automated procedure to improve the correlation between measured and calculated modal parameters. Careful attention......This paper describes results of a model updating study conducted on a 15-storey reinforced concrete shear core building. The output-only modal identification results obtained from ambient vibration measurements of the building were used to update a finite element model of the structure...... was placed to the selection of the parameters to be modified by the updating software in order to ensure that the necessary changes to the model were realistic and physically realisable and meaningful. The paper highlights the model updating process and provides an assessment of the usefulness of using...

  9. Design of passive solar buildings in urban areas

    Energy Technology Data Exchange (ETDEWEB)

    Tombazis, A.N.; Preuss, S.A. [Meletitiki-Alexandros N. Tombazis and Associates Architects Ltd., Athens (Greece)

    2001-07-01

    This paper is about designing solar buildings within given urban contexts and the resulting restrictions rather than about town planning with the freedom to arrange buildings freely so as to maximise access to natural resources. A comprehensive bioclimatic design in such a given urban environment must carefully investigate and assess the building's access to natural resources while taking into account the negative influences that might prevail around the site. The associated constraints can be a challenging but very interesting and rewarding starting point for architectural design. If understood and considered from the beginning these constraints can lead to creative, innovative and beautiful architectural solutions, in other words, to real architecture. (Author)

  10. Seismic design of RC buildings theory and practice

    CERN Document Server

    Manohar, Sharad

    2015-01-01

    This book is intended to serve as a textbook for engineering courses on earthquake resistant design. The book covers important attributes for seismic design such as material properties, damping, ductility, stiffness and strength. The subject coverage commences with simple concepts and proceeds right up to nonlinear analysis and push-over method for checking building adequacy. The book also provides an insight into the design of base isolators highlighting their merits and demerits. Apart from the theoretical approach to design of multi-storey buildings, the book highlights the care required in practical design and construction of various building components. It covers modal analysis in depth including the important missing mass method of analysis and tension shift in shear walls and beams. These have important bearing on reinforcement detailing. Detailed design and construction features are covered for earthquake resistant design of reinforced concrete as well as confined and reinforced masonry structures. Th...

  11. Building guide : how to build Xyce from source code.

    Energy Technology Data Exchange (ETDEWEB)

    Keiter, Eric Richard; Russo, Thomas V.; Schiek, Richard Louis; Sholander, Peter E.; Thornquist, Heidi K.; Mei, Ting; Verley, Jason C.

    2013-08-01

    While Xyce uses the Autoconf and Automake system to configure builds, it is often necessary to perform more than the customary %E2%80%9C./configure%E2%80%9D builds many open source users have come to expect. This document describes the steps needed to get Xyce built on a number of common platforms.

  12. Digital Handover of Data from Building Projects to Building Operation

    DEFF Research Database (Denmark)

    Jensen, Per Anker

    2006-01-01

    and construction and on the other side in building opera-tion and facilities management. In Denmark the government has launched a development program called Digital Construction and one of the projects concerns specifying require-ments for building clients in relation to digital handover of data from construction...

  13. Building a St\\"uckelberg Portal

    CERN Document Server

    Feng, Wan-Zhe; Soler, Pablo; Ye, Fang

    2014-01-01

    We construct explicit string theory models realizing the recently proposed "St\\"uckelberg Portal" scenario, a framework for building Z' mediation models without the need to introduce unwanted exotic matter charged under the Standard Model. This scenario can be viewed purely field-theoretically, although it is particularly well motivated from string theory. By analyzing carefully the St\\"uckelberg couplings between the Abelian gauge bosons and the RR axions, we construct the first global intersecting brane models which extend the Standard Model with a genuine hidden sector, to which it is nonetheless connected via U(1) mass mixings. Utilizing the explicit models we construct, we discuss some broad phenomenological properties and experimental implications of this scenario such as Z-Z' mixings, dark matter stability and relic density, and supersymmetry mediation. With an appropriate confining hidden sector, our setup also provides a minimal realization of the hidden valley scenario. We further explore the possib...

  14. Building envelope for New Buildings and Energy Renovation of Existing Buildings. Project results

    DEFF Research Database (Denmark)

    Rudbeck, Claus Christian; Rose, Jørgen; Esbensen, Peter Kjær;

    1999-01-01

    , a group of scientists at the Department of Buildings and Energy, Technical University of Denmark, have started a research project to develop better solutions for new building and energy renovation.The publication report the status after the first 3 year of the Building Envelope Project with emphasis......At the energy conference in 1995, Denmark agreed on reducing the total CO2-emission by 20%. To achieve this goal, it is necessary to increase thermal insulation thickness both in new and retrofitted buildings.This will, for both cases, impose a series of building physics problems, as the knowledge...... on the following subjects:Scientific basis for calculation programs, Development of calculationsmethods for heat transfer, Development of new building envelope components, Roofing system based on wooden roof elements, Roofing system with drying properties, Moisture uptake and drying from brick constructions...

  15. Construction achievements at building in reprocessing plant

    International Nuclear Information System (INIS)

    We have constructed simultaneously four buildings, AB building, DB building, DC building, and KA building in the spent nuclear fuel reprocessing plant at Rokkasho village in Aomori. We were able to complete the massive and complicated building in the highest quality by the method of prefabrication of site work in a short construction term. Moreover, also in the severe winter season, we practiced construction work intentionally. Consequently, we completed three buildings, AB building, DB building, and DC building without the trouble last year. (author)

  16. Virtual building environments (VBE) - Applying information modeling to buildings

    Energy Technology Data Exchange (ETDEWEB)

    Bazjanac, Vladimir

    2004-06-21

    A Virtual Building Environment (VBE) is a ''place'' where building industry project staffs can get help in creating Building Information Models (BIM) and in the use of virtual buildings. It consists of a group of industry software that is operated by industry experts who are also experts in the use of that software. The purpose of a VBE is to facilitate expert use of appropriate software applications in conjunction with each other to efficiently support multidisciplinary work. This paper defines BIM and virtual buildings, and describes VBE objectives, set-up and characteristics of operation. It informs about the VBE Initiative and the benefits from a couple of early VBE projects.

  17. Reinforcement learning for optimal control of low exergy buildings

    International Nuclear Information System (INIS)

    Highlights: • Implementation of reinforcement learning control for LowEx Building systems. • Learning allows adaptation to local environment without prior knowledge. • Presentation of reinforcement learning control for real-life applications. • Discussion of the applicability for real-life situations. - Abstract: Over a third of the anthropogenic greenhouse gas (GHG) emissions stem from cooling and heating buildings, due to their fossil fuel based operation. Low exergy building systems are a promising approach to reduce energy consumption as well as GHG emissions. They consists of renewable energy technologies, such as PV, PV/T and heat pumps. Since careful tuning of parameters is required, a manual setup may result in sub-optimal operation. A model predictive control approach is unnecessarily complex due to the required model identification. Therefore, in this work we present a reinforcement learning control (RLC) approach. The studied building consists of a PV/T array for solar heat and electricity generation, as well as geothermal heat pumps. We present RLC for the PV/T array, and the full building model. Two methods, Tabular Q-learning and Batch Q-learning with Memory Replay, are implemented with real building settings and actual weather conditions in a Matlab/Simulink framework. The performance is evaluated against standard rule-based control (RBC). We investigated different neural network structures and find that some outperformed RBC already during the learning phase. Overall, every RLC strategy for PV/T outperformed RBC by over 10% after the third year. Likewise, for the full building, RLC outperforms RBC in terms of meeting the heating demand, maintaining the optimal operation temperature and compensating more effectively for ground heat. This allows to reduce engineering costs associated with the setup of these systems, as well as decrease the return-of-invest period, both of which are necessary to create a sustainable, zero-emission building

  18. INL High Performance Building Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Jennifer D. Morton

    2010-02-01

    High performance buildings, also known as sustainable buildings and green buildings, are resource efficient structures that minimize the impact on the environment by using less energy and water, reduce solid waste and pollutants, and limit the depletion of natural resources while also providing a thermally and visually comfortable working environment that increases productivity for building occupants. As Idaho National Laboratory (INL) becomes the nation’s premier nuclear energy research laboratory, the physical infrastructure will be established to help accomplish this mission. This infrastructure, particularly the buildings, should incorporate high performance sustainable design features in order to be environmentally responsible and reflect an image of progressiveness and innovation to the public and prospective employees. Additionally, INL is a large consumer of energy that contributes to both carbon emissions and resource inefficiency. In the current climate of rising energy prices and political pressure for carbon reduction, this guide will help new construction project teams to design facilities that are sustainable and reduce energy costs, thereby reducing carbon emissions. With these concerns in mind, the recommendations described in the INL High Performance Building Strategy (previously called the INL Green Building Strategy) are intended to form the INL foundation for high performance building standards. This revised strategy incorporates the latest federal and DOE orders (Executive Order [EO] 13514, “Federal Leadership in Environmental, Energy, and Economic Performance” [2009], EO 13423, “Strengthening Federal Environmental, Energy, and Transportation Management” [2007], and DOE Order 430.2B, “Departmental Energy, Renewable Energy, and Transportation Management” [2008]), the latest guidelines, trends, and observations in high performance building construction, and the latest changes to the Leadership in Energy and Environmental Design

  19. Towards more Manageable Coastal Building; Initial Coastal Building Construction Guidelines

    Directory of Open Access Journals (Sweden)

    Roslan Talib

    2011-01-01

    Full Text Available Problem statement: As we may not be aware that the coastal construction is different from inland construction. Building in a coastal environment is different from building in an inland area. In general, buildings in coastal areas must be designed and built to withstand higher loads due to its more extreme conditions. Nowadays, the issue of global warming, uncertainty of global weather and the climate change effect indirectly creating the coastal area with much more expose to extreme condition. Formulate initial guidelines with certain degree of details how coastal construction requirements are different from those for inland construction. Approach: Due to the exposure to higher loads and extreme conditions, these structures in coastal areas will cost more to design, construct, maintain, repair and insure. Proper and right usage of building materials including electrical and mechanical equipments, are crucial in order to minimize damage. Nowadays, the issue of global warming, uncertainty of global weather and the climate change effect indirectly creating the coastal area with much more expose to extreme condition. Feedback has been gathered from the government local engineers who are doing the management of the Government’s local buildings located along the coastal area of Peninsular Malaysia. Data findings through research method, discussion with the suppliers and discussion with coastal buildings maintenance crews also has been done. Results: The research finding discus the specific characteristics that makes for successful coastal buildings focusing in tropical region. Conclusion: We must accept on the idea of building in coastal areas will require more maintenance and upkeep. By having proper coastal building guideline may create more positive awareness in constructing better management coastal buildings and can save time and money to maintain the said structures.

  20. [A careful look to postmodern tribes: caring for adolescent health in the context of their everyday lives].

    Science.gov (United States)

    da Nóbrega, Juliana Fernandes; Nitschke, Rosane Gonçalves; da Silva, Fernanda Pravato; Carraro, Cláudia Anita Gomes; Alves, Cristiane

    2013-09-01

    This is a theoretical reflection, based on Michel Maffesoli's Comprehensive Sociology, which is concerned with the health care of adolescents in contemporary everyday life, and particularly with the phenomenon of urban tribes. These are understood as groups of people who have emotional ties, building a bond of sociality towards a common goal. This study focuses on the importance to take into account the lifestyle of adolescents and aims to raise awareness among health professionals about such issues, seeking for strategies tuned with reality and care needs in order to promote health, devising ways to improve caring, rethinking health policies for adolescents in contemporary society. PMID:24344604