Spanish Clinical Guidelines on Vascular Access for Haemodialysis.

Science.gov (United States)

Ibeas, José; Roca-Tey, Ramon; Vallespín, Joaquín; Moreno, Teresa; Moñux, Guillermo; Martí-Monrós, Anna; Del Pozo, José Luis; Gruss, Enrique; Ramírez de Arellano, Manel; Fontseré, Néstor; Arenas, María Dolores; Merino, José Luis; García-Revillo, José; Caro, Pilar; López-Espada, Cristina; Giménez-Gaibar, Antonio; Fernández-Lucas, Milagros; Valdés, Pablo; Fernández-Quesada, Fidel; de la Fuente, Natalia; Hernán, David; Arribas, Patricia; Sánchez de la Nieta, María Dolores; Martínez, María Teresa; Barba, Ángel

2017-11-01

Vascular access for haemodialysis is key in renal patients both due to its associated morbidity and mortality and due to its impact on quality of life. The process, from the creation and maintenance of vascular access to the treatment of its complications, represents a challenge when it comes to decision-making, due to the complexity of the existing disease and the diversity of the specialities involved. With a view to finding a common approach, the Spanish Multidisciplinary Group on Vascular Access (GEMAV), which includes experts from the five scientific societies involved (nephrology [S.E.N.], vascular surgery [SEACV], vascular and interventional radiology [SERAM-SERVEI], infectious diseases [SEIMC] and nephrology nursing [SEDEN]), along with the methodological support of the Cochrane Center, has updated the Guidelines on Vascular Access for Haemodialysis, published in 2005. These guidelines maintain a similar structure, in that they review the evidence without compromising the educational aspects. However, on one hand, they provide an update to methodology development following the guidelines of the GRADE system in order to translate this systematic review of evidence into recommendations that facilitate decision-making in routine clinical practice, and, on the other hand, the guidelines establish quality indicators which make it possible to monitor the quality of healthcare. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

Strongly intensive quantities

International Nuclear Information System (INIS)

Gorenstein, M. I.; Gazdzicki, M.

2011-01-01

Analysis of fluctuations of hadron production properties in collisions of relativistic particles profits from use of measurable intensive quantities which are independent of system size variations. The first family of such quantities was proposed in 1992; another is introduced in this paper. Furthermore we present a proof of independence of volume fluctuations for quantities from both families within the framework of the grand canonical ensemble. These quantities are referred to as strongly intensive ones. Influence of conservation laws and resonance decays is also discussed.

The effect of vial type and cocktail quantity on tritium measurement in LSC

International Nuclear Information System (INIS)

Chen Zhilin; Xing Shixiong; Wang Heyi; Chang Ruimin; Wu Guanyin; Zhou Yinhang

2010-01-01

The effect of sample vial type and cocktail quantity on tritium measurement in liquid scintillation counting is studied in this paper. With both high and low level tritium samples, glass vials allow higher counting rates than plastic vials do. We also present detailed analysis of the way to obtain the optimal counting condition by dispensing different quantity of cocktail into sample vials. Results indicate that the optimal counting condition has little relationship with tritium concentration in the sample. The main factor which influences the counting is the quantity of cocktail added into samples. Figure of merit is employed to access the results, which increases as the quantity of cocktail increasing. But when the ratio of cocktail and sample reaches 2.0, increase of ratio makes little contribution to the counts, and the disintegrations per minute comes nearly to be a constant.

Absence of correlation between utrophin localization and quantity and the clinical severity in Duchenne/Becker dystrophies

Energy Technology Data Exchange (ETDEWEB)

Vainzof, M.; Passos-Bueno, M.R.; Man, N.; Zatz, M. [IB USP, Sao Paulo (Brazil)] [and others

1995-09-25

While present in the surface membrane of embryonic muscle fibers, in adult normal muscle fibers, utrophin is restricted to the motor endplate and cells of blood vessel walls. However, the observation that utrophin is maintained in the extrajunctional plasma membrane in Duchenne (DMD) and in mdx muscle fibers has led to the suggestion that excess utrophin might compensate for dystrophin deficiency in the Xp21 muscular dystrophies. In order to detect an inverse correlation of utrophin presence and clinical severity, we have assessed utrophin distribution and quantity in DMD and Becker (BMD) patients of different ages and stages of clinical severity. All patients showed a positive discontinuous immunolabeling of utrophin on the sarcolemma, staining equally small and large muscle fibers, indicating that immature characteristics are maintained in such fibers. On Western blot, utrophin bands with concentrations 2- to 10-fold greater than in normal controls were detected in all DMD/BMD patients. However, no negative correlation was found between the amount of utrophin and the severity of clinical course, implying that the detectable utrophin levels in these patients did not compensate for dystrophin deficiency. In a DMD patient with growth hormone (GH) deficiency and a BMD-like clinical course, utrophin levels were comparable to the other typical DMD cases, which reinforces the hypothesis that the observed increase in utrophin is apparently not responsible for a milder clinical course in some patients with Xp21 muscular dystrophies. 35 refs., 2 figs., 1 tab.

'Ready-access' CT imaging for an orthopaedic trauma clinic.

LENUS (Irish Health Repository)

Cawley, D

2011-03-01

\\'Ready-Access\\' to CT imaging facilities in Orthopaedic Trauma Clinics is not a standard facility. This facility has been available at the regional trauma unit, in Merlin Park Hospital, Galway for the past four years. We reviewed the use of this facility over a 2-year period when 100 patients had CT scans as part of their trauma clinic assessment. The rate of CT scan per clinic was 0.6. The mean waiting time for a CT scan was 30 minutes. 20 (20%) new fractures were confirmed, 33 (33%) fractures were out-ruled, 25 (25%) fractures demonstrated additional information and 8 (8%) had additional fractures. 20 (20%) patients were discharged and 12 (12%) patients were admitted as a result of the CT scan. It adds little time and cost to CT scanning lists.

Demand, capacity, and access of the outpatient clinic: A framework for analysis and improvement.

Science.gov (United States)

van Bussel, Erik Martijn; van der Voort, Marc Boudewijn Victor Rouppe; Wessel, Ronald N; van Merode, Godefridus G

2018-06-01

While theoretical frameworks for optimization of the outpatient processes are abundant, practical step-by-step analyses to give leads for improvement, to forecast capacity, and to support decision making are sparse. This article demonstrates how to evaluate and optimize the triad of demand, (future) capacity, and access time of the outpatient clinic using a structured six-step method. All individual logistical patient data of an orthopaedic outpatient clinic of one complete year were analysed using a 6-step method to evaluate demand, supply, and access time. Trends in the data were retrospectively analysed and evaluated for potential improvements. A model for decision making was tested. Both the analysis of the method and actual results were considered as main outcomes. More than 25 000 appointments were analysed. The 6-step method showed to be sufficient to result in valuable insights and leads for improvement. While the overall match between demand and capacity was considered adequate, the variability in capacity was much higher than in demand, thereby leading to delays in access time. Holidays and subsequent weeks showed to be of great influence for demand, capacity, and access time. Using the six-step method, several unfavourable characteristics of the outpatient clinic were revealed and a better match between demand, supply, and access time could have been reached with only minor adjustments. Last, a clinic specific prediction and decision model for demand and capacity was made using the 6-step method. The 6-step analysis can successfully be applied to redesign and improve the outpatient health care process. The results of the analysis showed that national holidays and variability in demand and capacity have a big influence on the outpatient clinic. Using the 6-step method, practical improvements in outpatient logistics were easily found and leads for future decision making were contrived. © 2018 The Authors Journal of Evaluation in Clinical Practice

Reactivating Neural Circuits with Clinically Accessible Stimulation to Restore Hand Function in Persons with Tetraplegia

Science.gov (United States)

2017-09-01

AWARD NUMBER: W81XWH-16-1-0395 TITLE: Reactivating Neural Circuits with Clinically Accessible Stimulation to Restore Hand Function in...estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data...Clinically Accessible Stimulation to Restore Hand Function in Persons with Tetraplegia 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S

Comparative Assessment of Physical and Social Determinants of Water Quantity and Water Quality Concerns

Science.gov (United States)

Gunda, T.; Hornberger, G. M.

2017-12-01

Concerns over water resources have evolved over time, from physical availability to economic access and recently, to a more comprehensive study of "water security," which is inherently interdisciplinary because a secure water system is influenced by and affects both physical and social components. The concept of water security carries connotations of both an adequate supply of water as well as water that meets certain quality standards. Although the term "water security" has many interpretations in the literature, the research field has not yet developed a synthetic analysis of water security as both a quantity (availability) and quality (contamination) issue. Using qualitative comparative and multi-regression analyses, we evaluate the primary physical and social factors influencing U.S. states' water security from a quantity perspective and from a quality perspective. Water system characteristics are collated from academic and government sources and include access/use, governance, and sociodemographic, and ecosystem metrics. Our analysis indicates differences in variables driving availability and contamination concerns; for example, climate is a more significant determinant in water quantity-based security analyses than in water quality-based security analyses. We will also discuss coevolution of system traits and the merits of constructing a robust water security index based on the relative importance of metrics from our analyses. These insights will improve understanding of the complex interactions between quantity and quality aspects and thus, overall security of water systems.

Doctors and nurses on wards with greater access to clinical dietitians have better focus on clinical nutrition

DEFF Research Database (Denmark)

Thoresen, L.; Rothenberg, E.; Beck, Anne Marie

2008-01-01

According to the Council of Europe, clinical dietitians should assume a more central role in nutritional support. The aim of this study was to assess the opinions among doctors, nurses and clinical dietitians regarding the use of clinical dietitians' expertise in the hospital units and, further......, to assess whether the presence of clinical dietitians in hospital departments influenced doctors and nurses focus on clinical nutrition. A questionnaire about the use of clinical nutrition was mailed to 6000 doctors and 6000 nurses working in hospital units where undernutrition is documented to be common...... into the importance of adequate nutrition was better than those who saw clinical dietitians seldom. Clinical nutrition had a higher priority in units with frequent visits by clinical dietitians. The present study shows that doctors and nurses on wards with greater access to clinical dietitians had better focus...

Quantity processing in deaf and hard of hearing children: evidence from symbolic and nonsymbolic comparison tasks.

Science.gov (United States)

Rodríguez-Santos, José Miguel; Calleja, Marina; García-Orza, Javier; Iza, Mauricio; Damas, Jesús

2014-01-01

Deaf children usually achieve lower scores on numerical tasks than normally hearing peers. Explanations for mathematical disabilities in hearing children are based on quantity representation deficits (Geary, 1994) or on deficits in accessing these representations (Rousselle & Noël, 2008). The present study aimed to verify, by means of symbolic (Arabic digits) and nonsymbolic (dot constellations and hands) magnitude comparison tasks, whether deaf children show deficits in representations or in accessing numerical representations. The study participants were 10 prelocutive deaf children and 10 normally hearing children. Numerical distance and magnitude were manipulated. Response time (RT) analysis showed similar magnitude and distance effects in both groups on the 3 tasks. However, slower RTs were observed among the deaf participants on the symbolic task alone. These results suggest that although both groups' quantity representations were similar, the deaf group experienced a delay in accessing representations from symbolic codes.

Access to emergency hormonal contraception from community pharmacies and family planning clinics

Science.gov (United States)

Lewington, Gaye; Marshall, Kay

2006-01-01

Aims To evaluate differences in the time taken to access progestogen-only emergency hormonal contraception (EHC) by young women from family planning (FP) or community pharmacy settings. Methods An observational study of 203 women requesting EHC from FP clinics and community pharmacies in South-west Kent Primary Care Trust (PCT) from December 2002 to October 2003. Results Access to EHC from community pharmacy was significantly faster than from FP clinics (16 h vs. 41 h, P < 0.001). Older teenagers tended to seek EHC more quickly and were more likely to have had a contraceptive failure rather than have used no contraception at all. Conclusion The results provide further support for pharmacist involvement in the supply of EHC. PMID:16669854

Clinic access and teenage birth rates: Racial/ethnic and spatial disparities in Houston, TX.

Science.gov (United States)

Wisniewski, Megan M; O'Connell, Heather A

2018-03-01

Teenage motherhood is a pressing issue in the United States, and one that is disproportionately affecting racial/ethnic minorities. In this research, we examine the relationship between the distance to the nearest reproductive health clinic and teenage birth rates across all zip codes in Houston, Texas. Our primary data come from the Texas Department of State Health Services. We use spatial regression analysis techniques to examine the link between clinic proximity and local teenage birth rates for all females aged 15 to 19, and separately by maternal race/ethnicity. We find, overall, limited support for a connection between clinic distance and local teenage birth rates. However, clinics seem to matter most for explaining non-Hispanic white teenage birth rates, particularly in high-poverty zip codes. The racial/ethnic and economic variation in the importance of clinic distance suggests tailoring clinic outreach to more effectively serve a wider range of teenage populations. We argue social accessibility should be considered in addition to geographic accessibility in order for clinics to help prevent teenage pregnancy. Copyright © 2018. Published by Elsevier Ltd.

16 CFR 500.25 - Net quantity, average quantity, permitted variations.

Science.gov (United States)

2010-01-01

... good distribution practice and which unavoidably result in change of weight or mass or measure. (c... good packaging practice: Provided, that such variations shall not be permitted to such extent that the... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Net quantity, average quantity, permitted...

Radiation quantities and units

International Nuclear Information System (INIS)

2013-01-01

This fifth chapter presents the conceptual evolution, the definition procedures, the radiological quantities themselves, the relation between them, the new operational quantities and the new quantities defined in the ICRP 60 that replaced ICRP 26 and was included in the CNEN-NN-3.01 standard of 2011

Access to and use of computers among clinical dental students of ...

African Journals Online (AJOL)

Access to and use of computers among clinical dental students of the University of Lagos. PO Ayanbadejo, OO Sofola, OG Uti. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Article Metrics. No metrics found. Metrics powered by PLOS ALM

Shop for quality or quantity? Volumes and costs in clinical laboratories.

Science.gov (United States)

Barletta, Giovanni; Zaninotto, Martina; Faggian, Diego; Plebani, Mario

2013-02-01

The increasing need to reduce the costs of providing diagnostic laboratory services has prompted initiatives based on the centralization and consolidation of laboratory facilities. However, the majority of papers and experiences reported in literature focus on "cost per test" thus overlooking the real value of a laboratory service, which requires more complex economic evaluations, such as cost-benefit, cost-effectiveness, and cost-utility analysis. It is important to perform cost analysis, which is no mean feat, by taking into consideration all variables affecting the final and true cost per test. The present study was conducted in order to evaluate the costs of delivering laboratory services in 20 Italian clinical laboratories using a widely accepted methodology, the so-called "activity-based costing analysis". The finding of a trend towards a decrease in total costs - due to an increase in test volumes - attained statistical significance only for quantities of up to about 1,100,00 tests per year. For 1,800,00 tests and more, the cost per test appeared to range from 1.5 to 2.0 € irrespective of the different volumes. Regarding the relationship between volumes and number of staff, there is an evident linear relationship between the number of senior staff and volumes, whereas this trend is not observed in the case of medical technologists, the degree and type of automation strongly affecting this variable. The findings made in the present study confirm that the relationship between volumes and costs is not linear; since it is complex, numerous variables should be taken into account.

Measurement of new operational quantities with radiation protection instruments designed for working area monitoring and for individual monitoring

International Nuclear Information System (INIS)

Prigent, R.; Chary, J.; Chemtob, M.; Lebouleux, P.

1992-01-01

The ICRP recommended a dose limitation system based on numerical evaluation of the dose equivalent to organs or tissues, H T , which are used to calculate the effective dose, H E , by weighting. The ICRU proposed new operational quantities accessible to measurement which are conservative with respect to these recommendations. The objective of this paper is to recall briefly the basic recommendations and to find out if radiation protection instruments presently used calibrated in terms of the previous quantities are capable to measure these new quantities. A dozen of practical cases are presented

Measurement of new operational quantities with radiation protection instruments designed for working area monitoring and for individual monitoring

International Nuclear Information System (INIS)

Prigent, R.; Chary, J.; Chemtob, M.

1992-01-01

The ICRP recommended a dose limitation system based on numerical evaluation of the dose equivalent to organs or tissues, H T , which are used to calculate the effective dose, H E , by weighting. The ICRU proposed new operational quantities accessible to measurement which are conservative with respect to these recommendations. The objective of this paper is to recall briefly the basic recommendations and to find out if radiation protection instruments presently used calibrated in terms of the previous quantities are capable to measure these new quantities. A dozen of practical cases are presented. (author)

Current status of clinical education in paramedic programs: a descriptive research project.

Science.gov (United States)

Grubbs, K C

1997-01-01

Development of competence in exercising therapeutic judgment skills represents the goal of clinical education. Time (clock hours) is not a valid predictor of attainment of competence in paramedic clinical education. Quantity of patient contact experiences facilitates development of judgment skills, and offers a valid measure of progress toward competence. This project uses national survey data from accredited programs to describe the availability and accessibility of patient contact experiences within paramedic clinical education. Data from this local program supplements the national survey results. The components of clinical judgment are enumerated, and strategies to teach and evaluate clinical judgment skills are discussed.

A Study of Children's Geographic Access to Health Services (Health Care Centers and Clinical Laboratories in Kermanshah City, Iran

Directory of Open Access Journals (Sweden)

Sohyla Reshadat

2018-02-01

Full Text Available Background Given that the protection of children's health is of special importance due to their special age and physical conditions, the present study aimed to investigate the condition of children's Geographic access to health services (Health Centers and Clinical Laboratories in Kermanshah city, Iran. Materials and Methods: In this applied study, the research approach was descriptive-analytic using quantitative models in Geographic information system (GIS environment. The statistical population was the whole population of young girls aged 0-14 years old in Kermanshah, Iran. Moreover, to evaluate the spatial deployment pattern of health services and the correct and true access of this groupto such services, all data and information were collected through the Iranian Statistics Center and evaluated using the Arc-GIS Software. The latest published population statistics on the Population and Housing Census in 2011 were considered the basis for the analyses. Results: The results of the present study demonstrated that more than 40% and 60% of the young girls aged 0-14 years old in Kermanshah were deprived of proper access to health centers and clinical laboratories, respectively. In terms of the status of children’s access in the Second Scenario (access to health services by vehicles and during 5, 10, and 15 minutes, about 5.53%, 93.1% and 15.1% lacked access to health centers, respectively. In addition, in terms of the status of children’s access to clinical laboratories during 5, 10, and 15 minutes, 17.26%, 65.4% and 51% lacked access to clinical laboratories, respectively. Conclusion: The access of young girls aged 0-14 years old to health services in Kermanshah was undesirable in the access to health services through walking. Additionally, the access of this groupto health services in the access to health services by vehicles was far better than the first one.

Internet access and online cancer information seeking among Latino immigrants from safety net clinics.

Science.gov (United States)

Selsky, Claire; Luta, George; Noone, Anne-Michelle; Huerta, Elmer E; Mandelblatt, Jeanne S

2013-01-01

Internet use is widespread, but little is known about Internet use for cancer information among Latinos, especially those who rely on safety net clinics. The authors investigated access to and intended use of the Internet for cancer information among low income, immigrant Latinos predominately from Central and South America. A cross-sectional study of 1,273 Latinos 21 years and older attending safety net clinics or health fairs was conducted from June 2007 to November 2008. The authors used logistic regression models to evaluate associations of age, acculturation, psychosocial factors and other covariates with Internet access and intended use of the Internet for cancer information among those with access. Of the sample, 44% reported Internet access. Higher information self-efficacy and greater trust in the Internet were independently associated with Internet access (p = .05 and p Internet use for cancer information, considering covariates. In addition, those with high (vs. low) perceived risk of cancer (OR = 1.76; 95% CI [1.14, 2.73]; p = .01) and higher levels of trust in online health information (OR = 1.47 per one-point increase; 95% [CI 1.19, 1.82]; p = .0004) were more likely to intend to seek cancer information online. These findings that Internet access is fairly high in the immigrant Latino population and that the Internet is a trusted source of cancer information suggest that the Internet may be a channel for cancer control interventions.

Household computer and Internet access: The digital divide in a pediatric clinic population

Science.gov (United States)

Carroll, Aaron E.; Rivara, Frederick P.; Ebel, Beth; Zimmerman, Frederick J.; Christakis, Dimitri A.

2005-01-01

Past studies have noted a digital divide, or inequality in computer and Internet access related to socioeconomic class. This study sought to measure how many households in a pediatric primary care outpatient clinic had household access to computers and the Internet, and whether this access differed by socio-economic status or other demographic information. We conducted a phone survey of a population-based sample of parents with children ages 0 to 11 years old. Analyses assessed predictors of having home access to a computer, the Internet, and high-speed Internet service. Overall, 88.9% of all households owned a personal computer, and 81.4% of all households had Internet access. Among households with Internet access, 48.3% had high speed Internet at home. There were statistically significant associations between parental income or education and home computer ownership and Internet access. However, the impact of this difference was lessened by the fact that over 60% of families with annual household income of $10,000–$25,000, and nearly 70% of families with only a high-school education had Internet access at home. While income and education remain significant predictors of household computer and internet access, many patients and families at all economic levels have access, and might benefit from health promotion interventions using these modalities. PMID:16779012

VA OpenNotes: exploring the experiences of early patient adopters with access to clinical notes.

Science.gov (United States)

Nazi, Kim M; Turvey, Carolyn L; Klein, Dawn M; Hogan, Timothy P; Woods, Susan S

2015-03-01

To explore the experience of early patient adopters who accessed their clinical notes online using the Blue Button feature of the My HealtheVet portal. A web-based survey of VA patient portal users from June 22 to September 15, 2013. 33.5% of respondents knew that clinical notes could be viewed, and nearly one in four (23.5%) said that they had viewed their notes at least once. The majority of VA Notes users agreed that accessing their notes will help them to do a better job of taking medications as prescribed (80.1%) and be better prepared for clinic visits (88.6%). Nine out of 10 users agreed that use of visit notes will help them understand their conditions better (91.8%), and better remember the plan for their care (91.9%). In contrast, 87% disagreed that VA Notes will make them worry more, and 88.4% disagreed that access to VA Notes will be more confusing than helpful. Users who had either contacted their provider or healthcare team (11.9%) or planned to (13.5%) primarily wanted to learn more about a health issue, medication, or test results (53.7%). Initial assessment of the patient experience within the first 9 months of availability provides evidence that patients both value and benefit from online access to clinical notes. These findings are congruent with OpenNotes study findings on a broader scale. Additional outreach and education is needed to enhance patient awareness. Healthcare professionals should author notes keeping in mind the opportunity patient access presents for enhanced communication. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Facilitating access to prenatal care through an interprofessional student-run free clinic.

Science.gov (United States)

Danhausen, Kathleen; Joshi, Deepa; Quirk, Sarah; Miller, Robert; Fowler, Michael; Schorn, Mavis N

2015-01-01

Addressing the persistent challenge of inadequate prenatal care requires innovative solutions. Student-run free health centers are poised to rise to this challenge. The Shade Tree Clinic Early Pregnancy Program, jointly operated by university medical and nursing programs, functions as an ongoing access-to-care portal for pregnant women without health insurance. The clinic is run by medical students and nurse-midwifery students and uses a service-based learning model that allows students to work and learn in supervised, interprofessional teams while providing evidence-based prenatal care. All data reported in this paper were obtained from a retrospective chart review of women served by the prenatal clinic. These data are descriptive in nature, and include the patient demographics and services provided by the clinic to 152 women between the years of 2010-2013. During this time period, the clinic served a demographically diverse clientele. Approximately half lacked documentation of legal immigration status. The majority of women seeking care were in their first trimester of pregnancy and had previously given birth. Several women had medical or obstetric complications that required timely referral to specialist care; and many women received treatment for infection and other primary care concerns. Shade Tree Clinic provides the basic components of prenatal care and assists women with other medical needs. Women also receive help when applying for and accessing public maternity insurance, and the clinic facilitates entry to any necessary specialist care while that insurance is processed. In many cases, necessary and time-sensitive care would be delayed if Shade Tree Clinic's prenatal services were not available. In addition, the clinic presents a valuable opportunity for interprofessional socialization, increased respect, and improved collaboration between students in different but complementary professions, which is an important experience while we move to meet national

A novel rapid access testicular cancer clinic: prospective evaluation after one year.

Science.gov (United States)

Carey, K; Davis, N F; Elamin, S; Ahern, P; Brady, C M; Sweeney, P

2016-02-01

Our institution has recently developed a rapid access outpatient clinic to investigate men with testicular lumps and/or pain suspicious for testicular cancer (TCa). To present our experience after 12 months. All referrals to the rapid access testicular clinic (RATC) clinic were prospectively analysed from 01/01/2013 to 01/01/2014. The primary outcome variable was incidence of TCa in the referred patient cohort. Secondary outcome variables were waiting times prior to clinical review and waiting times prior to radical orchidectomy in patients diagnosed with TCa. Seventy-four new patients were referred to the RATC during the 1-year period and the mean age was 34 (range 15-81 years). TCa was the most common diagnosis and was found in 18 (25 %) patients. Patients diagnosed with TCa underwent radical orchidectomy, a median of 3 (range 1-5) days after their initial GP referral. Patients requiring surgical intervention for benign scrotal pathology underwent their procedure a median of 32 (range 3-61) days after their initial referral. Of the 18 patients diagnosed with TCa, 9 (50 %) were diagnosed with a seminomatous germ cell tumour on histopathology. The RATC is a new initiative in Ireland that provides expedient and definitive treatment of patients with newly diagnosed TCa. Early treatment will ultimately improve long-term prognosis in this patient cohort.

THE WAYS OF INCREASING OF QUALITY AND ACCESSIBILITY OF PEDIATRIC MEDICAL SERVICE IN OUT-PATIENT CLINICS

Directory of Open Access Journals (Sweden)

A.A. Baranov

2009-01-01

Full Text Available The analysis of dynamics of official statistics rates (population size, morbidity, disability, and mortality, and results of special scientific studies (morbidity, physical development, make it possible to show basic tendencies of children’s health state changes in modern conditions. The result of pediatrists from out-patient clinics survey, questioning of parents and adolescents (12–17 years old, on the problem of children’s health service, are presented. Questionnaire poll was held in regions of Central, Privolzhskiy, and Siberian Federal Districts. The complex analysis of obtained results show low quality level and accessibility of prophylactic and treatment medical service in children. This data became the basis of main directions of work of controlling and public health service in the field of increasing of quality and accessibility of pediatric medical service in out-patient clinics.Key words: children, medical service, out-patient clinics, quality, accessibility.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4:5-9

Genital herpes evaluation by quantitative TaqMan PCR: correlating single detection and quantity of HSV-2 DNA in cervicovaginal lavage fluids with cross-sectional and longitudinal clinical data

Directory of Open Access Journals (Sweden)

Cox Christopher

2010-11-01

Full Text Available Abstract Objective To evaluate the utility of a single quantitative PCR (qPCR measurement of HSV (HSV-1&2 DNA in cervicovaginal lavage (CVL specimens collected from women with predominantly chronic HSV-2 infection in assessing genital HSV shedding and the clinical course of genital herpes (GH within a cohort with semiannual schedule of follow up and collection of specimens. Methods Two previously described methods used for detection of HSV DNA in mucocutaneous swab samples were adapted for quantification of HSV DNA in CVLs. Single CVL specimens from 509 women were tested. Presence and quantity of CVL HSV DNA were explored in relation to observed cross-sectional and longitudinal clinical data. Results The PCR assay was sensitive and reproducible with a limit of quantification of ~50 copies per milliliter of CVL. Overall, 7% of the samples were positive for HSV-2 DNA with median log10 HSV-2 DNA copy number of 3.9 (IQR: 2.6-5.7. No HSV-1 was detected. Presence and quantity of HSV-2 DNA in CVL directly correlated with the clinical signs and symptoms of presence of active symptomatic disease with frequent recurrences. Conclusion Single qPCR measurement of HSV DNA in CVL fluids of women with chronic HSV-2 infection provided useful information for assessing GH in the setting of infrequent sampling of specimens. Observed positive correlation of the presence and quantity of HSV-2 DNA with the presence of active and more severe course of HSV-2 infection may have clinical significance in the evaluation and management of HSV-2 infected patients.

An Adaptive Information Quantity-Based Broadcast Protocol for Safety Services in VANET

Directory of Open Access Journals (Sweden)

Wenjie Wang

2016-01-01

Full Text Available Vehicle-to-vehicle communication plays a significantly important role in implementing safe and efficient road traffic. When disseminating safety messages in the network, the information quantity on safety packets changes over time and space. However, most of existing protocols view each packet the same to disseminate, preventing vehicles from collecting more recent and precise safety information. Hence, an information quantity-based broadcast protocol is proposed in this paper to ensure the efficiency of safety messages dissemination. In particular, we propose the concept of emergency-degree to evaluate packets’ information quantity. Then we present EDCast, an emergency-degree-based broadcast protocol. EDCast differentiates each packet’s priority for accessing the channel based on its emergency-degree so as to provide vehicles with more safety information timely and accurately. In addition, an adaptive scheme is presented to ensure fast dissemination of messages in different network condition. We compare the performance of EDCast with those of three other representative protocols in a typical highway scenario. Simulation results indicate that EDCast achieves higher broadcast efficiency and less redundancy with less delivery delay. What we found demonstrates that it is feasible and necessary for incorporating information quantity of messages in designing an efficient safety message broadcast protocol.

Predictors of pregnancy and changes in pregnancy incidence among HIV-positive women accessing HIV clinical care at 13 large UK clinics

Science.gov (United States)

HUNTINGTON, Susie E; THORNE, Claire; BANSI, Loveleen K; ANDERSON, Jane; NEWELL, Marie-Louise; TAYLOR, Graham P; PILLAY, Deenan; HILL, Teresa; TOOKEY, Pat A; SABIN, Caroline A

2012-01-01

Objectives To describe predictors of pregnancy and changes in pregnancy incidence among HIV-positive women accessing HIV clinical care. Methods Data were obtained through the linkage of two separate studies; the UK Collaborative HIV Cohort study (UK CHIC), a cohort of adults attending 13 large HIV clinics, and the National Study of HIV in Pregnancy and Childhood (NSHPC), a national surveillance study of HIV-positive pregnant women. Pregnancy incidence was measured using the proportion of women in UK CHIC with a pregnancy reported to NSHPC. Generalised estimating equations were used to identify predictors of pregnancy and assess changes in pregnancy incidence in 2000-2009. Results The number of women accessing care at UK CHIC sites increased as did the number of pregnancies (from 72 to 230). Older women were less likely to have a pregnancy (adjusted Relative Rate (aRR) 0.44 per 10 year increment in age [95% CI [0.41-0.46], ppregnancy increased over the study period (aRR 1.05 [1.03-1.07], ppregnancy rate among women accessing HIV clinical care increased in 2000-2009. HIV-positive women with, or planning, a pregnancy require a high level of care and this is likely to continue and increase as more women of older age have pregnancies. PMID:22713479

How Bioethics is Complementing Human Rights in Realizing Health Access for Clinical Trial Participants: The Case of Formative PrEP Access in South Africa.

Science.gov (United States)

Singh, Jerome

2015-06-11

Following the demise of apartheid, human rights in South Africa are now constitutionally enshrined.The right to health in South Africa's Constitution has been credited with transforming the lives of millions of people by triggering programmatic reforms in HIV treatment and the prevention of mother to child transmission (MTCT) of HIV.However, a constitutionally enshrined right to health offers no guarantee that clinical trial participants will enjoy post-trial access to beneficial interventions. Using access to HIV pre-exposure prophylaxis (PrEP) in South Africa as an example, this paper argues that adherence to bioethics norms could realize the right to health for trial participants following the end of a clinical trial. Copyright 2015 Singh. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Quantity and quality of written feedback, action plans, and student ...

African Journals Online (AJOL)

Background. Mini-clinical-evaluation exercise (mini-CEX) assessment forms that have been modified with the addition of specific spaces on separate sheets are expected to improve the quantity and quality of written feedback and the action plan for further learning which is agreed upon, and to encourage written reflection.

Quantity Stickiness versus Stackelberg Leadership

International Nuclear Information System (INIS)

Ferreira, F. A.

2008-01-01

We study the endogenous Stackelberg relations in a dynamic market. We analyze a twice-repeated duopoly where, in the beginning, each firm chooses either a quantity-sticky production mode or a quantity-flexible production mode. The size of the market becomes observable after the first period. In the second period, a firm can adjust its quantity if, and only if, it has adopted the flexible mode. Hence, if one firm chooses the sticky mode whilst the other chooses the flexible mode, then they respectively play the roles of a Stackelberg leader and a Stackelberg follower in the second marketing period. We compute the supply quantities at equilibrium and the corresponding expected profits of the firms. We also analyze the effect of the slope parameter of the demand curve on the expected supply quantities and on the profits.

Linked Data Applications Through Ontology Based Data Access in Clinical Research.

Science.gov (United States)

Kock-Schoppenhauer, Ann-Kristin; Kamann, Christian; Ulrich, Hannes; Duhm-Harbeck, Petra; Ingenerf, Josef

2017-01-01

Clinical care and research data are widely dispersed in isolated systems based on heterogeneous data models. Biomedicine predominantly makes use of connected datasets based on the Semantic Web paradigm. Initiatives like Bio2RDF created Resource Description Framework (RDF) versions of Omics resources, enabling sophisticated Linked Data applications. In contrast, electronic healthcare records (EHR) data are generated and processed in diverse clinical subsystems within hospital information systems (HIS). Usually, each of them utilizes a relational database system with a different proprietary schema. Semantic integration and access to the data is hardly possible. This paper describes ways of using Ontology Based Data Access (OBDA) for bridging the semantic gap between existing raw data and user-oriented views supported by ontology-based queries. Based on mappings between entities of data schemas and ontologies data can be made available as materialized or virtualized RDF triples ready for querying and processing. Our experiments based on CentraXX for biobank and study management demonstrate the advantages of abstracting away from low level details and semantic mediation. Furthermore, it becomes clear that using a professional platform for Linked Data applications is recommended due to the inherent complexity, the inconvenience to confront end users with SPARQL, and scalability and performance issues.

How necessary are the new quantities

International Nuclear Information System (INIS)

Kraus, W.

1991-01-01

The necessity of the ICRU operational quantities is discussed from the point of view of practical, opertional radiation protection, on the basis of ICRU report 43. It is clear that, although the new quantities have some advantages over previous systems of operational quantities, there are some disadvantages as well. The decision to adopt these quantities is, therefore, not clear cut. (orig.)

Increasing the quantity and quality of searching for current best evidence to answer clinical questions: protocol and intervention design of the MacPLUS FS Factorial Randomized Controlled Trials.

Science.gov (United States)

Agoritsas, Thomas; Iserman, Emma; Hobson, Nicholas; Cohen, Natasha; Cohen, Adam; Roshanov, Pavel S; Perez, Miguel; Cotoi, Chris; Parrish, Rick; Pullenayegum, Eleanor; Wilczynski, Nancy L; Iorio, Alfonso; Haynes, R Brian

2014-09-20

Finding current best evidence for clinical decisions remains challenging. With 3,000 new studies published every day, no single evidence-based resource provides all answers or is sufficiently updated. McMaster Premium LiteratUre Service--Federated Search (MacPLUS FS) addresses this issue by looking in multiple high quality resources simultaneously and displaying results in a one-page pyramid with the most clinically useful at the top. Yet, additional logistical and educational barriers need to be addressed to enhance point-of-care evidence retrieval. This trial seeks to test three innovative interventions, among clinicians registered to MacPLUS FS, to increase the quantity and quality of searching for current best evidence to answer clinical questions. In a user-centered approach, we designed three interventions embedded in MacPLUS FS: (A) a web-based Clinical Question Recorder; (B) an Evidence Retrieval Coach composed of eight short educational videos; (C) an Audit, Feedback and Gamification approach to evidence retrieval, based on the allocation of 'badges' and 'reputation scores.' We will conduct a randomized factorial controlled trial among all the 904 eligible medical doctors currently registered to MacPLUS FS at the hospitals affiliated with McMaster University, Canada. Postgraduate trainees (n=429) and clinical faculty/staff (n=475) will be randomized to each of the three following interventions in a factorial design (AxBxC). Utilization will be continuously recorded through clinicians’ accounts that track logins and usage, down to the level of individual keystrokes. The primary outcome is the rate of searches per month per user during the six months of follow-up. Secondary outcomes, measured through the validated Impact Assessment Method questionnaire, include: utility of answers found (meeting clinicians’ information needs), use (application in practice), and perceived usefulness on patient outcomes. Built on effective models for the point

Does lack of resources impair access to breast and cervical cancer screening in Japan?

Science.gov (United States)

Sano, Hiroshi; Goto, Rei; Hamashima, Chisato

2017-01-01

To assess the impact of the quantity of resources for breast and cervical cancer screening on the participation rates in screening in clinical settings in municipalities, as well as to clarify whether lack of resources impairs access to cancer screening in Japan. Of the 1,746 municipalities in 2010, 1,443 (82.6%) and 1,469 (84.1%) were included in the analyses for breast and cervical cancer screening, respectively. In order to estimate the effects of the number of mammography units and of gynecologists on the participation rates in breast and cervical cancer screening in clinical settings, multiple regression analyses were performed using the interaction term for urban municipalities. The average participation rate in screening in clinical settings was 6.01% for breast cancer, and was 8.93% for cervical cancer. The marginal effect of the number of mammography units per 1,000 women was significantly positive in urban municipalities (8.20 percent point). The marginal effect of the number of gynecologists per 1,000 women was significantly positive in all municipalities (2.54 percent point) and rural municipalities (3.68 percent point). Lack of mammography units in urban areas and of gynecologists particularly in rural areas impaired access to breast and cervical cancer screening. Strategies are required that quickly improve access for the residents and increase their participation rates in cancer screening.

Access to What? Creating a Composite Measure of Educational Quantity and Educational Quality for 11 African Countries

Science.gov (United States)

Spaull, Nicholas; Taylor, Stephen

2015-01-01

The aim of the current study is to create a composite statistic of educational quantity and educational quality by combining household data (Demographic and Health Survey) on grade completion and survey data (Southern and Eastern African Consortium for Monitoring Educational Quality) on cognitive outcomes for 11 African countries: Kenya, Lesotho,…

Methodology to Estimate the Quantity, Composition, and Management of Construction and Demolition Debris in the United States

Science.gov (United States)

This report, Methodology to Estimate the Quantity, Composition and Management of Construction and Demolition Debris in the US, was developed to expand access to data on CDD in the US and to support research on CDD and sustainable materials management. Since past US EPA CDD estima...

Improving patient access to an interventional US clinic.

Science.gov (United States)

Steele, Joseph R; Clarke, Ryan K; Terrell, John A; Brightmon, Tonya R

2014-01-01

A continuous quality improvement project was conducted to increase patient access to a neurointerventional ultrasonography (US) clinic. The clinic was experiencing major scheduling delays because of an increasing patient volume. A multidisciplinary team was formed that included schedulers, medical assistants, nurses, technologists, and physicians. The team created an Ishikawa diagram of the possible causes of the long wait time to the next available appointment and developed a flowchart of the steps involved in scheduling and completing a diagnostic US examination and biopsy. The team then implemented a staged intervention that included adjustments to staffing and room use (stage 1); new procedures for scheduling same-day add-on appointments (stage 2); and a lead technician rotation to optimize patient flow, staffing, and workflow (stage 3). Six months after initiation of the intervention, the mean time to the next available appointment had decreased from 25 days at baseline to 1 day, and the number of available daily appointments had increased from 38 to 55. These improvements resulted from a coordinated provider effort and had a net present value of more than $275,000. This project demonstrates that structural changes in staffing, workflow, and room use can substantially reduce scheduling delays for critical imaging procedures. © RSNA, 2014.

Radiation quantities and units

International Nuclear Information System (INIS)

1980-01-01

This report supersedes ICRU Report 19. Since ICRU Report 19 was published, a number of discussions have taken place between members of the Report Committee on Fundamental Quantities and Units and other workers in the field. Some of these discussions have resulted in the acceptance of certain modifications in the material set out in Report 19 and these modifications are incorporated in the current report. In addition, there has been some expansion and rearrangement of the material in the earlier report. In line, with providing more didactic material and useful source material for other ICRU reports, the general considerations in subsection 1.A of Report 19 have been expanded and placed in a separate subsection. The additional material includes discussions of four terms that are used in this document - quantity, unit, stochastic, and non-stochastic - along with a brief discussion of the mathematical formalism used in ICRU reports. As in ICRU Report 19, the definitions of quantities and units specifically designed for radiation protection (Part B) are separated from those of the general quantities (Part A). The inclusion of the index concept outlined in ICRU Report 25[4] required an extension of Part B

A pilot project to improve access to telepsychotherapy at rural clinics.

Science.gov (United States)

Adler, Geri; Pritchett, Lonique R; Kauth, Michael R; Nadorff, Danielle

2014-01-01

The U.S. Department of Veterans Affairs (VA) has pioneered telemental health (TMH) with over 500,000 TMH encounters over the past decade. VA community-based outpatient clinics were established to improve accessibility of mental healthcare for rural Veterans. Despite these clinics clinics and increased availability of TMH, many rural Veterans have difficulty receiving mental healthcare, particularly psychotherapy. Twelve therapists participated in a pilot project using TMH technologies to improve mental healthcare service delivery to rural Veterans treated at six community clinics. Therapists completed online training, and study staff communicated with them monthly and clinical leaders every other month. Therapists completed two questionnaires: before training and 10 months later. This article describes barriers and facilitators to the implementation of the project, as well as therapists' knowledge, confidence, and motivation regarding TMH. Two clinicians were offering telepsychotherapy after 10 months. At all six sites, unanticipated organizational constraints and administrative barriers delayed implementation; establishing organizational practices and therapists' motivation helped facilitate the process. Adopters of the project reported more positive views of the modality and did not worry about staffing, a concern of nonadopters. Despite barriers to implementation, lessons learned from this pilot project have led to improvements and changes in TMH processes. Results from the pilot showed that therapists providing telepsychotherapy had increased confidence, knowledge, and motivation. As TMH continues to expand, formalized decision-making with clinical leaders regarding project goals, better matching of therapists with this modality, and assessment of medical center and clinic readiness are recommended.

Are necessary unmeasurable quantities in radiation protection?

International Nuclear Information System (INIS)

David, M.G.; Correa, M.F.; Videira, A.A.P.

2016-01-01

We discuss in this paper the metrological status of unmeasurable protection quantities and the need to maintain these kind of quantities in the system. The discussion is based on reports from the institutions responsible for the quantities and on scientific publications. In conclusion, we can say that there are alternatives for changing the system in a way that it keep just measurable quantities, nevertheless the present system is well assimilated. Even though a proposal yet to be presented for changing the system, although might simplify and improve it, is not intended to overcome the existence of unmeasurable quantities or the two kinds of quantities. (author)

Patterns of Practice in Palliative Radiotherapy for Painful Bone Metastases: Impact of a Regional Rapid Access Clinic on Access to Care

International Nuclear Information System (INIS)

Wu, Jackson S.Y.; Kerba, Marc; Wong, Rebecca K.S.; Mckimmon, Erin; Eigl, Bernhard; Hagen, Neil A.

2010-01-01

Purpose: External beam radiotherapy (RT) is commonly indicated for the palliation of symptomatic bone metastases, but there is evidence of underutilization of this treatment modality in palliative care for cancer populations. This study was conducted to investigate factors that influenced the use of palliative RT services at a regional comprehensive cancer center. Methods and Materials: A cohort of patients with radiographically confirmed bone metastases and first-time users of palliative RT between 2003 and 2005 was retrospectively reviewed from the time of initial diagnosis of bone metastases to death or last follow-up. Type of radiation treatment service provider used (rapid access or routine access) and patient-, tumor-, and treatment-related factors were analyzed for their influences on the number of treatment courses given over the duration of disease. Results: A total of 887 patients received 1,354 courses of palliative RT for bone metastases at a median interval of 4.0 months between courses. Thirty-three percent of patients required more than one RT course. Increased age and travel distance reduced the likelihood and number of treatment courses, while service through a rapid access clinic was independently associated with an increase in subsequent use of palliative RT. Conclusions: A rapid access service model for palliative RT facilitated access to RT. Travel distance and other factors remained substantial barriers to use of palliative RT services. The pattern of practice suggests an unmet need for symptom control in patients with bone metastases.

Income inequality and access to housing in Europe

NARCIS (Netherlands)

Dewilde, C.; Lancee, B.

2012-01-01

This paper analyses the relation between income inequality and access to housing for low- income households. Three arguments are developed, explaining how inequality might affect housing affordability, quality and quantity. First, it is the absolute level of resources, not their relative

Thermal quantities of 46Ti

International Nuclear Information System (INIS)

Rahmatinejad, A.; Razavi, R.; Kakavand, T.

2015-01-01

Thermodynamic quantities of 46 Ti have been calculated in the framework of the BCS model with inclusion of modified nuclear pairing gap (MPBCS) that was proposed in our previous publication. Using modified paring gap results in an S-shaped heat capacity curve at critical temperature with a smooth behavior instead of singular behavior of the same curve in the BCS calculations. In addition the thermal quantities have been extracted within the framework of a canonical ensemble according to the new experimental data on nuclear level densities measured by the Oslo group. Comparison shows a good agreement between our calculations in MPBCS and the extracted quantities in the canonical ensemble framework

Quantities for environmental monitoring

International Nuclear Information System (INIS)

1989-01-01

It is recommended that if measurements are made with the objective of monitor radiation levels in the environment to elucidate long-term changes in these levels, then air kerma should be used. If the objective is to give an indication that levels from man-made sources are acceptable within specified limits for the exposure of people, then ambient dose equivalent should be used. It should be noted that radiation risks to individuals are best expressed by the quantity effective dose equivalent. If this latter quantity is to be accurately assessed, it may be necessary to obtain details of the quality of the environmental radiation that cannot be described adequately by simple measurements of either air kerma or ambient dose equivalent. If the above objectives pertain, the measurements should record both air kerma and ambient dose equivalent. If neutrons are measured in the environment then ambient dose equivalent is the appropriate quantity for both the above objectives. (author)

Method and means for determining heat quantities

Energy Technology Data Exchange (ETDEWEB)

Waasdorp, G G; de Jong, J J; Bijl, A

1965-08-24

To determine the quantity of potential heat W that has flowed past a certain point in a certain time, the velocity of the combustible Q, the temperature T, and the specific gravity YDTU are measured, and these values are transmitted to a computer which automatically calculates the quantity: ..pi..EQUATION/sup -/ in which delta T is the difference between the combustible temperature T and a reference temperature, and in which the relation f(YDTU, delta T) represents the heat of combustion as a function of the quantities YDTU and delta T and possibly other properties of the combustible. Alternatively the quantity: ..pi..EQUATION/sup -/ may be measured; here the quantities have the same meaning as above.

A Viewpoint on the Quantity "Plane Angle"

Science.gov (United States)

Eder, W. E.

1982-01-01

Properties of the quantity "plane angle" are explored under the hypothesis that it is a dimensional quantity. The exploration proceeds especially with respect to the physical concept, its mathematical treatment, vector concepts, measurement theory, units of related quantities, engineering pragmatism, and SI. An attempt is made to bring these different relations into a rational, logical and consistent framework, and thus to justify the hypothesis. Various types of vectorial quantities are recognized, and their properties described with an outline of the necessary algebraic manipulations. The concept of plane angle is amplified, and its interdependence with the circular arc is explored. The resulting units of plane angle form a class of similar scales of measurement. Consequences of the confirmed hypothesis are developed for mathematical expressions involving trigonometric functions, rotational volumes and areas, mathematical limits, differentiation and series expansion. Consequences for mechanical rotational quantities are developed, with proposals for revisions to a number of expressions for derived units within SI. A revised definition for the quantity "plane angle" is stated to take account of the developed insights. There is a clear need to reconsider the status of plane angle and some other quantities within the international framework of SI.

Emission sources and quantities

International Nuclear Information System (INIS)

Heinen, B.

1991-01-01

The paper examines emission sources and quantities for SO 2 and NO x . Natural SO 2 is released from volcanic sources and to a much lower extent from marsh gases. In nature NO x is mainly produced in the course of the chemical and bacterial denitrification processes going on in the soil. Manmade pollutants are produced in combustion processes. The paper concentrates on manmade pollution. Aspects discussed include: mechanism of pollution development; manmade emission sources (e.g. industry, traffic, power plants and domestic sources); and emission quantities and forecasts. 11 refs., 2 figs., 5 tabs

Nurse-delivered universal point-of-care testing for HIV in an open-access returning traveller clinic.

Science.gov (United States)

Herbert, R; Ashraf, A N; Yates, T A; Spriggs, K; Malinnag, M; Durward-Brown, E; Phillips, D; Mewse, E; Daniel, A; Armstrong, M; Kidd, I M; Waite, J; Wilks, P; Burns, F; Bailey, R; Brown, M

2012-09-01

Early diagnosis of HIV infection reduces morbidity and mortality associated with late presentation. Despite UK guidelines, the HIV testing rate has not increased. We have introduced universal HIV screening in an open-access returning traveller clinic. Data were prospectively recorded for all patients attending the open-access returning traveller clinic between August 2008 and December 2010. HIV testing was offered to all patients from May 2009; initially testing with laboratory samples (phase 1) and subsequently a point-of-care test (POCT) (phase 2). A total of 4965 patients attended the clinic; 1342 in phase 0, 792 in phase 1 and 2831 in phase 2. Testing rates for HIV increased significantly from 2% (38 of 1342) in phase 0 to 23.1% (183 of 792) in phase 1 and further increased to 44.5% (1261 of 2831) during phase 2 (P travelling to the Middle East and Europe were less likely to accept an HIV test with POCT. A nurse-delivered universal point-of-care HIV testing service has been successfully introduced and sustained in an acute medical clinic in a low-prevalence country. Caution is required in communicating reactive results in low-prevalence settings where there may be alternative diagnoses or a low population prevalence of HIV infection. © 2012 British HIV Association.

DIAGNOSTIC IMAGING IN A DIRECT-ACCESS SPORTS PHYSICAL THERAPY CLINIC: A 2-YEAR RETROSPECTIVE PRACTICE ANALYSIS.

Science.gov (United States)

Crowell, Michael S; Dedekam, Erik A; Johnson, Michael R; Dembowski, Scott C; Westrick, Richard B; Goss, Donald L

2016-10-01

While advanced diagnostic imaging is a large contributor to the growth in health care costs, direct-access to physical therapy is associated with decreased rates of diagnostic imaging. No study has systematically evaluated with evidence-based criteria the appropriateness of advanced diagnostic imaging, including magnetic resonance imaging (MRI), when ordered by physical therapists. The primary purpose of this study was to describe the appropriateness of magnetic resonance imaging (MRI) or magnetic resonance arthrogram (MRA) exams ordered by physical therapists in a direct-access sports physical therapy clinic. Retrospective observational study of practice. Greater than 80% of advanced diagnostic imaging orders would have an American College of Radiology (ACR) Appropriateness Criteria rating of greater than 6, indicating an imaging order that is usually appropriate. A 2-year retrospective analysis identified 108 MRI/MRA examination orders from four physical therapists. A board-certified radiologist determined the appropriateness of each order based on ACR appropriateness criteria. The principal investigator and co-investigator radiologist assessed agreement between the clinical diagnosis and MRI/surgical findings. Knee (31%) and shoulder (25%) injuries were the most common. Overall, 55% of injuries were acute. The mean ACR rating was 7.7; scores from six to nine have been considered appropriate orders and higher ratings are better. The percentage of orders complying with ACR appropriateness criteria was 83.2%. Physical therapist's clinical diagnosis was confirmed by MRI/MRA findings in 64.8% of cases and was confirmed by surgical findings in 90% of cases. Physical therapists providing musculoskeletal primary care in a direct-access sports physical therapy clinic appropriately ordered advanced diagnostic imaging in over 80% of cases. Future research should prospectively compare physical therapist appropriateness and utilization to other groups of providers and

Monitoring Accessibility Services in Digital Television

Directory of Open Access Journals (Sweden)

Francisco Utray

2012-01-01

Full Text Available This paper addresses methodology and tools applied to the monitoring of accessibility services in digital television at a time when the principles of accessibility and design are being considered in all new audiovisual media communication services. The main objective of this research is to measure the quality and quantity of existing accessibility services offered by digital terrestrial television (DTT. The preliminary results, presented here, offer the development of a prototype for automatic monitoring and a methodology for obtaining quality measurements, along with the conclusions drawn by initial studies carried out in Spain. The recent approval of the UN Convention on the Rights of Persons with Disabilities gives special relevance to this research because it provides valuable guidelines to help set the priorities to improve services currently available to users.

Telehealth clinics increase access to care for adults with cystic fibrosis living in rural and remote Western Australia.

Science.gov (United States)

Wood, Jamie; Mulrennan, Siobhain; Hill, Kylie; Cecins, Nola; Morey, Sue; Jenkins, Sue

2017-08-01

Introduction A significant proportion (15%, n = 28) of the adults with cystic fibrosis (CF) in Western Australia (WA) live in rural and remote areas and have difficulty accessing specialist care at the state adult CF centre, located in Perth. We aimed to increase access by offering telehealth clinics, and evaluate the impact on health outcomes. Methods Telehealth clinics were offered via videoconference over a 12-month period, with uptake and satisfaction measured at the end of the intervention. Participants could still attend in person clinics at the CF centre if requested. Other outcomes comprised healthcare utilisation (HCU), spirometry, weight and health-related quality of life. Results In 21 participants, total clinic visits increased from 46 (median (range) per participant 2 (0-6)) in the 12-month period preceding the study to 100 (5 (2-8), p vitality domain of the Cystic Fibrosis Questionnaire - Revised ( p < 0.05). Discussion Telehealth had good uptake and increased clinic attendance in adults with CF living in rural and remote WA, and had high satisfaction amongst participants. The increase in HCU, resulting from increased detection and treatment of exacerbations, may improve long-term outcomes in this population.

Open Access Platforms in Spinal Cord Injury: Existing Clinical Trial Data to Predict and Improve Outcomes.

Science.gov (United States)

Kramer, John L K; Geisler, Fred; Ramer, Leanne; Plunet, Ward; Cragg, Jacquelyn J

2017-05-01

Recovery from acute spinal cord injury (SCI) is characterized by extensive heterogeneity, resulting in uncertain prognosis. Reliable prediction of recovery in the acute phase benefits patients and their families directly, as well as improves the likelihood of detecting efficacy in clinical trials. This issue of heterogeneity is not unique to SCI. In fields such as traumatic brain injury, Parkinson's disease, and amyotrophic lateral sclerosis, one approach to understand variability in recovery has been to make clinical trial data widely available to the greater research community. We contend that the SCI community should adopt a similar approach in providing open access clinical trial data.

Method of Converting Wheat Flour Quantity into Rice Flour Quantity in Cookies (Part-1)

OpenAIRE

村田,美穂子; 髙橋,由加

2016-01-01

A method of converting the wheat flour quantity of a recipe of wheat-flour cookies into the rice flour quantity of a recipe of rice-flour cookies used domestically for wheat-allergic children was studied. The proportion of the water content with respect to the flour content (the wheat or rice flour content) in cut cookies prepared according to a commercially available recipe was obtained. Next, four types of rice-flour cookies were prepared according to a recipe for wheat-flour cookies using ...

An Access Control Framework for Reflective Middleware

Institute of Scientific and Technical Information of China (English)

Gang Huang; Lian-Shan Sun

2008-01-01

Reflective middleware opens up the implementation details of middleware platform and applications at runtime for improving the adaptability of middleware-based systems. However, such openness brings new challenges to access control of the middleware-based systems.Some users can access the system via reflective entities, which sometimes cannot be protected by access control mechanisms of traditional middleware. To deliver high adaptability securely, reflective middleware should be equipped with proper access control mechanisms for potential access control holes induced by reflection. One reason of integrating these mechanisms in reflective middleware is that one goal of reflective middleware is to equip applications with reflection capabilities as transparent as possible. This paper studies how to design a reflective J2EE middlewarePKUAS with access control in mind. At first, a computation model of reflective system is built to identify all possible access control points induced by reflection. Then a set of access control mechanisms, including the wrapper of MBeans and a hierarchy of Java class loaders, are equipped for controlling the identified access control points. These mechanisms together with J2EE access control mechanism form the access control framework for PKUAS. The paper evaluates the security and the performance overheads of the framework in quality and quantity.

Association Between Portable Screen-Based Media Device Access or Use and Sleep Outcomes: A Systematic Review and Meta-analysis.

Science.gov (United States)

Carter, Ben; Rees, Philippa; Hale, Lauren; Bhattacharjee, Darsharna; Paradkar, Mandar S

2016-12-01

Sleep is vital to children's biopsychosocial development. Inadequate sleep quantity and quality is a public health concern with an array of detrimental health outcomes. Portable mobile and media devices have become a ubiquitous part of children's lives and may affect their sleep duration and quality. To conduct a systematic review and meta-analysis to examine whether there is an association between portable screen-based media device (eg, cell phones and tablet devices) access or use in the sleep environment and sleep outcomes. A search strategy consisting of gray literature and 24 Medical Subject Headings was developed in Ovid MEDLINE and adapted for other databases between January 1, 2011, and June 15, 2015. Searches of the published literature were conducted across 12 databases. No language restriction was applied. The analysis included randomized clinical trials, cohort studies, and cross-sectional study designs. Inclusion criteria were studies of school-age children between 6 and 19 years. Exclusion criteria were studies of stationary exposures, such as televisions or desktop or personal computers, or studies investigating electromagnetic radiation. Of 467 studies identified, 20 cross-sectional studies were assessed for methodological quality. Two reviewers independently extracted data. The primary outcomes were inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness, studied according to an a priori protocol. Twenty studies were included, and their quality was assessed. The studies involved 125 198 children (mean [SD] age, 14.5 [2.2] years; 50.1% male). There was a strong and consistent association between bedtime media device use and inadequate sleep quantity (odds ratio [OR], 2.17; 95% CI, 1.42-3.32) (P sleep quality (OR, 1.46; 95% CI, 1.14-1.88) (P = .003, I2 = 76%), and excessive daytime sleepiness (OR, 2.72; 95% CI, 1.32-5.61) (P = .007, I2 = 50%). In addition, children who had access to (but did not use) media

Critical review of the current radiation protection quantities and units

International Nuclear Information System (INIS)

Sabol, J.

1998-01-01

Examples exist in dosimetry and radiation protection where primary attention was focused on the unit rather than the corresponding quantity. Another difficulty arises from the fact that quantities in this field cannot be considered as pure physical quantities, they are rather biophysical quantities. There are too many quantities (e. g. 17 quantities based on the dose equivalent), with differences in numerical values of 'similar' quantities, not always satisfactory approximations of virtually unmeasurable quantities by measurable quantities, inconsistency in definitions and interpretations of quantities of some international expert bodies, and problems of weighting and conversion factors. (M.D.)

The new operational quantities for radiation protection

International Nuclear Information System (INIS)

Kellerer, A.M.

1985-01-01

Philosophies and quantities for radiation protection have often been subjected to changes, and some of the developments are traced which ultimately led to recent proposals by ICRU. Development in the past has largely been towards clarification and generalisation of definitions. The present changes, however, reflect a more fundamental issue, the transition from the limitation system to the assessment system in radiation protection. The index quantities were suitable tools to ascertain compliance with the limitation system of radiation protection. The new quantities proposed by ICRU are suitable estimators for effective dose equivalent, which is an essential quantity in the assessment system of radiation protection. A synopsis of the definitions is given. (author)

36 CFR 223.220 - Quantity determination.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Quantity determination. 223.220 Section 223.220 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE AND DISPOSAL OF NATIONAL FOREST SYSTEM TIMBER Special Forest Products § 223.220 Quantity determination...

The DEDUCE Guided Query tool: providing simplified access to clinical data for research and quality improvement.

Science.gov (United States)

Horvath, Monica M; Winfield, Stephanie; Evans, Steve; Slopek, Steve; Shang, Howard; Ferranti, Jeffrey

2011-04-01

In many healthcare organizations, comparative effectiveness research and quality improvement (QI) investigations are hampered by a lack of access to data created as a byproduct of patient care. Data collection often hinges upon either manual chart review or ad hoc requests to technical experts who support legacy clinical systems. In order to facilitate this needed capacity for data exploration at our institution (Duke University Health System), we have designed and deployed a robust Web application for cohort identification and data extraction--the Duke Enterprise Data Unified Content Explorer (DEDUCE). DEDUCE is envisioned as a simple, web-based environment that allows investigators access to administrative, financial, and clinical information generated during patient care. By using business intelligence tools to create a view into Duke Medicine's enterprise data warehouse, DEDUCE provides a Guided Query functionality using a wizard-like interface that lets users filter through millions of clinical records, explore aggregate reports, and, export extracts. Researchers and QI specialists can obtain detailed patient- and observation-level extracts without needing to understand structured query language or the underlying database model. Developers designing such tools must devote sufficient training and develop application safeguards to ensure that patient-centered clinical researchers understand when observation-level extracts should be used. This may mitigate the risk of data being misunderstood and consequently used in an improper fashion. Copyright © 2010 Elsevier Inc. All rights reserved.

Indonesian infertility patients’ health seeking behaviour and patterns of access to biomedical infertility care: an interviewer administered survey conducted in three clinics

Science.gov (United States)

2012-01-01

Background Indonesia has high levels of biological need for infertility treatment, great sociological and psychological demand for children, and yet existing infertility services are underutilized. Access to adequate comprehensive reproductive health services, including infertility care, is a basic reproductive right regardless of the economic circumstances in which individuals are born into. Thus, identifying and implementing strategies to improve access to assisted reproductive technology (ART) in Indonesia is imperative. The principle objectives of this article are to improve our understanding of infertility patients’ patterns of health seeking behaviour and their patterns of access to infertility treatment in Indonesia, in order to highlight the possibilities for improving access. Methods An interviewer-administered survey was conducted with 212 female infertility patients recruited through three Indonesian infertility clinics between July and September 2011. Participants were self-selected and data was subject to descriptive statistical analysis. Results Patients identified a number of barriers to access, including: low confidence in infertility treatment and high rates of switching between providers due to perceived treatment failure; the number and location of clinics; the lack of a well established referral system; the cost of treatment; and patients also experienced fear of receiving a diagnosis of sterility, of vaginal examinations and of embarrassment. Women’s age of marriage and the timing of their initial presentation to gynaecologists were not found to be barriers to timely access to infertility care. Conclusions The findings based on the responses of 212 female infertility patients indicated four key areas of opportunity for improving access to infertility care. Firstly, greater patient education about the nature and progression of infertility care was required among this group of women. Secondly, increased resources in terms of the number and

Algorithmic Approach With Clinical Pathology Consultation Improves Access to Specialty Care for Patients With Systemic Lupus Erythematosus.

Science.gov (United States)

Chen, Lei; Welsh, Kerry J; Chang, Brian; Kidd, Laura; Kott, Marylee; Zare, Mohammad; Carroll, Kelley; Nguyen, Andy; Wahed, Amer; Tholpady, Ashok; Pung, Norin; McKee, Donna; Risin, Semyon A; Hunter, Robert L

2016-09-01

Harris Health System (HHS) is a safety net system providing health care to the underserved of Harris County, Texas. There was a 6-month waiting period for a rheumatologist consult for patients with suspected systemic lupus erythematosus (SLE). The objective of the intervention was to improve access to specialty care. An algorithmic approach to testing for SLE was implemented initially through the HHS referral center. The algorithm was further offered as a "one-click" order for physicians, with automated reflex testing, interpretation, and case triaging by clinical pathology. Data review revealed that prior to the intervention, 80% of patients did not have complete laboratory workups available at the first rheumatology visit. Implementation of algorithmic testing and triaging of referrals by pathologists resulted in decreasing the waiting time for a rheumatologist by 50%. Clinical pathology intervention and case triaging can improve access to care in a county health care system. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Conceptual Model of Quantities, Units, Dimensions, and Values

Science.gov (United States)

Rouquette, Nicolas F.; DeKoenig, Hans-Peter; Burkhart, Roger; Espinoza, Huascar

2011-01-01

JPL collaborated with experts from industry and other organizations to develop a conceptual model of quantities, units, dimensions, and values based on the current work of the ISO 80000 committee revising the International System of Units & Quantities based on the International Vocabulary of Metrology (VIM). By providing support for ISO 80000 in SysML via the International Vocabulary of Metrology (VIM), this conceptual model provides, for the first time, a standard-based approach for addressing issues of unit coherence and dimensional analysis into the practice of systems engineering with SysML-based tools. This conceptual model provides support for two kinds of analyses specified in the International Vocabulary of Metrology (VIM): coherence of units as well as of systems of units, and dimension analysis of systems of quantities. To provide a solid and stable foundation, the model for defining quantities, units, dimensions, and values in SysML is explicitly based on the concepts defined in VIM. At the same time, the model library is designed in such a way that extensions to the ISQ (International System of Quantities) and SI Units (Systeme International d Unites) can be represented, as well as any alternative systems of quantities and units. The model library can be used to support SysML user models in various ways. A simple approach is to define and document libraries of reusable systems of units and quantities for reuse across multiple projects, and to link units and quantity kinds from these libraries to Unit and QuantityKind stereotypes defined in SysML user models.

Concept of ICRU's operational quantity and its application

International Nuclear Information System (INIS)

Murakami, Hiroyuki

1995-01-01

The operational quantity which was introduced in the ICRU report 39 published in 1985 was shocking rather than fresh for the author. The report was translated into Japanese, but at the beginning, the contents were not able to be understood. Thereafter, the measurement of ICRU sphere dose equivalent was introduced in a national law. But it is feared that the understanding of this operational quantity is limited to specialist level, and is not by men of practical works. The meaning of ''operational'' must be that workers measure and obtain dose on the spot for the radiation protection for themselves. The principles used when ICRU considered the new practical measured quantity are shown. In the definition of operational quantity in area monitoring, two concepts of expanded and aligned connect real measurement with the operational quantity. The problems of measuring individual dose equivalent are discussed. As to the reality of applying the operational quantity, the fundamentals of the calibration of measuring instruments, the investigation of the operational quantity in relation to measuring instruments and measurement mode, and the relation of area monitoring and individual monitoring are described. (K.I.)

Quantifying cannabis: A field study of marijuana quantity estimation.

Science.gov (United States)

Prince, Mark A; Conner, Bradley T; Pearson, Matthew R

2018-05-17

The assessment of marijuana use quantity poses unique challenges. These challenges have limited research efforts on quantity assessments. However, quantity estimates are critical to detecting associations between marijuana use and outcomes. We examined accuracy of marijuana users' estimations of quantities of marijuana they prepared to ingest and predictors of both how much was prepared for a single dose and the degree of (in)accuracy of participants' estimates. We recruited a sample of 128 regular-to-heavy marijuana users for a field study wherein they prepared and estimated quantities of marijuana flower in a joint or a bowl as well as marijuana concentrate using a dab tool. The vast majority of participants overestimated the quantity of marijuana that they used in their preparations. We failed to find robust predictors of estimation accuracy. Self-reported quantity estimates are inaccurate, which has implications for studying the link between quantity and marijuana use outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

30 CFR 75.325 - Air quantity.

Science.gov (United States)

2010-07-01

... the exposure of miners. (i) A ventilating air quantity that is less than what is required by paragraph... results of sampling that demonstrate that the lesser air quantity will maintain continuous compliance with applicable TLV ®'s. (j) If during sampling required by § 70.1900(c) of this subchapter the ventilating air is...

Dose rate constants for new dose quantities

International Nuclear Information System (INIS)

Tschurlovits, M.; Daverda, G.; Leitner, A.

1992-01-01

Conceptual changes and new quantities made is necessary to reassess dose rate quantities. Calculations of the dose rate constant were done for air kerma, ambient dose equivalent and directional dose equivalent. The number of radionuclides is more than 200. The threshold energy is selected as 20 keV for the dose equivalent constants. The dose rate constant for the photon equivalent dose as used mainly in German speaking countries as a temporary quantity is also included. (Author)

Municipal water quantities and health in Nunavut households: an exploratory case study in Coral Harbour, Nunavut, Canada

Directory of Open Access Journals (Sweden)

Kiley Daley

2014-03-01

Full Text Available Background: Access to adequate quantities of water has a protective effect on human health and well-being. Despite this, public health research and interventions are frequently focused solely on water quality, and international standards for domestic water supply minimums are often overlooked or unspecified. This trend is evident in Inuit and other Arctic communities even though numerous transmissible diseases and bacterium infections associated with inadequate domestic water quantities are prevalent. Objectives: Our objective was to explore the pathways by which the trucked water distribution systems being used in remote northern communities are impacting health at the household level, with consideration given to the underlying social and environmental determinants shaping health in the region. Methods: Using a qualitative case study design, we conducted 37 interviews (28 residents, 9 key informants and a review of government water documents to investigate water usage practices and perspectives. These data were thematically analysed to understand potential health risks in Arctic communities and households. Results: Each resident receives an average of 110 litres of municipal water per day. Fifteen of 28 households reported experiencing water shortages at least once per month. Of those 15, most were larger households (5 people or more with standard sized water storage tanks. Water shortages and service interruptions limit the ability of some households to adhere to public health advice. The households most resilient, or able to cope with domestic water supply shortages, were those capable of retrieving their own drinking water directly from lake and river sources. Residents with extended family and neighbours, whom they can rely on during shortages, were also less vulnerable to municipal water delays. Conclusions: The relatively low in-home water quantities observed in Coral Harbour, Nunavut, appear adequate for some families. Those living in

7 CFR 61.102 - Determination of quantity index.

Science.gov (United States)

2010-01-01

... the quantity index shall equal four times percentage of oil plus six times percentage of ammonia, plus 5. (b) For American Pima cottonseed the quantity index shall equal four times percentage of oil... 7 Agriculture 3 2010-01-01 2010-01-01 false Determination of quantity index. 61.102 Section 61.102...

The Acquisition of Quantity Contrasts in Guina-ang Bontok

Science.gov (United States)

Aoyama, Katsura; Reid, Lawrence A.

2016-01-01

This study reports on the acquisition of quantity contrasts in Guina-ang Bontok, an indigenous language spoken in the Philippines. Four-year-old and 5-year-old children's perception and production of quantity contrasts were examined using a pair of names that contrast in the quantity of the medial nasal. Frequencies of the quantity contrast were…

Memory-Based Quantity Discrimination in Coyotes (Canis latrans

Directory of Open Access Journals (Sweden)

Salif Mahamane

2014-08-01

Full Text Available Previous research has shown that the ratio between competing quantities of food significantly mediates coyotes‘ (Canis latrans ability to choose the larger of two food options. These previous findings are consistent with predictions made by Weber‘s Law and indicate that coyotes possess quantity discrimination abilities that are similar to other species. Importantly, coyotes‘ discrimination abilities are similar to domestic dogs (Canis lupus familiaris, indicating that quantitative discrimination may remain stable throughout certain species‘ evolution. However, while previously shown in two domestic dogs, it is unknown whether coyotes possess the ability to discriminate visual quantities from memory. Here, we address this question by displaying different ratios of food quantities to 14 coyotes before placing the choices out of sight. The coyotes were then allowed to select one of either non-visible food quantities. Coyotes‘ discrimination of quantity from memory does not follow Weber‘s Law in this particular task. These results suggest that working memory in coyotes may not be adapted to maintain information regarding quantity as well as in domestic dogs. The likelihood of a coyote‘s choosing the large option increased when it was presented with difficult ratios of food options first, before it was later presented with trials using more easily discriminable ratios, and when the large option was placed on one particular side. This suggests that learning or motivation increased across trials when coyotes experienced difficult ratios first, and that location of food may have been more salient in working memory than quantity of food.

'Clinics aren't meant for men': sexual health care access and seeking behaviours among men in Gauteng province, South Africa.

Science.gov (United States)

Leichliter, Jami S; Paz-Bailey, Gabriela; Friedman, Allison L; Habel, Melissa A; Vezi, Alex; Sello, Martha; Farirai, Thato; Lewis, David A

2011-01-01

Men may be key players in the transmission of sexually transmitted infections (STI), and it is important that STI/HIV health services reach men. The objective of this study was to explore sexual health care access and seeking behaviours in men. This study used focus groups to examine sexual health care access and seeking behaviours in men 5 years after implementation of free antiretroviral therapy (ART) in the South African public sector. Six focus groups (N=58) were conducted with men ≫18 years in an urban area of Gauteng province. Men were recruited from various locations throughout the community. Men reported several barriers and facilitators to the use of public and private clinics for sexual health services including HIV testing, and many men reported seeking care from traditional healers. Men often viewed public clinics as a place for women and reported experiences with some female nurses who were rude or judgmental of the men. Additionally, some men reported that they sought sexual health care services at public clinics; however, they were not given physical examinations by health care providers to diagnose their STI syndrome. Most men lacked knowledge about ART and avoided HIV testing because of fear of death or being abandoned by their families or friends. Study findings suggest that men still require better access to high-quality, non-judgmental sexual health care services. Future research is needed to determine the most effective method to increase men's access to sexual health care services.

Clinical use of femoral artery hemostasis sticking after interventional procedure via femoral artery access

International Nuclear Information System (INIS)

Zhu Zhongsheng; Chen Shaoliang; Ye Fei; Zhang Junjie; Zhou Jie; Tian Nailiang; Lin Song; Liu Zhizhong; Xiao Pingxi; Qu Hong

2010-01-01

Objective: To observe the clinical effect of the use of femoral artery hemostasis sticking V+PAD after the interventional procedure via femoral artery access. Methods: By using random permutation list 80 patients, who decided to receive coronary angiography and percutaneous transluminal coronary angioplasty, were randomly selected. Of the 80 patients, hemostasis sticking V + PAD was employed in 40 patients with even numbers (trial group), only manual compression was adopted to stop bleeding in another 40 patients with odd numbers (control group). All the patients were informed about this trial and had to sign a consent letter. The pressure time, the treatment method of access site after hemostasis, the posture in bed, the immobilization time, the comfort degree of patients, the complications of access site prior to discharge, etc. were observed and the results were compared between two groups. Results: There was no significant difference between two groups as respect to age, gender ratios,activated clotting time (ACT) value and blood pressure. However, significantly difference in the compression time and bed rest time existed between the two groups. The compression time in trial group and control group was (7.9 ± 0.5) min and (19.8 ± 5.1) min respectively (P<0.01), while the bed rest time in trial group and control group was (6.1 ± 5.0) hours and (23.9 ± 0.2) hours respectively (P<0.01). All patients in trial group was supine in bed with the head side of the bed raised at 30 degree immediately after the procedure, and the head side of the bed was further raised to 90 degree one hour later. The puncture site was bandaged with conventional compression and immobilization was not employed. Patients could lie in bed with free posture and the patient's comfort degree was greatly improved. During hospitalization no complications related to puncture site occurred in all patients except one obese woman in trial group who developed pseudoaneurysm. Conclusion: Femoral

Public Health Investment in Team Care: Increasing Access to Clinical Preventive Services in Los Angeles County

Directory of Open Access Journals (Sweden)

Tony Kuo

2018-02-01

Full Text Available As part of federal and local efforts to increase access to high quality, clinical preventive services (CPS in underserved populations, the Los Angeles County Department of Public Health (DPH partnered with six local health system and community organization partners to promote the use of team care for CPS delivery. Although these partners were at different stages of organizational capacity, post-program review suggests that each organization advanced team care in their clinical or community environments, potentially affecting >250,000 client visits per year. Despite existing infrastructure and DPH’s funding support of CPS integration, partner efforts faced several challenges. They included lack of sustainable funding for prevention services; limited access to community resources that support disease prevention; and difficulties in changing health-care provider behavior. Although team care can serve as a catalyst or vehicle for delivering CPS, downstream sustainability of this model of practice requires further state and national policy changes that prioritize prevention. Public health is well positioned to facilitate these policy discussions and to assist health system and community organizations in strengthening CPS integration.

Quantities used in radiological protection

International Nuclear Information System (INIS)

Menossi, Carlos

2010-01-01

The application of ICRP recommendations requires knowledge of a variety of concepts and magnitudes. Many of them are employed in other fields of science and precision in its definition reflects this wide application. In this regard, information on quantities and basic units of radiation, which exists in numerous publications, are subjects of great interest. The characteristics and radiation effects are studied by physicists, biologists and chemists mainly. However, there are basics that must be known and to be recognized by general practitioners and specialists from all branches of medicine. The information on quantities and units are used only in radiation protection, have been obtained from the reports listed on the attached bibliography. Such quantities and units contain weighting factors used to provide for different types of radiation and energies that affect the body and thus take into account the relative radio-sensitivity of different tissues. Additionally, they have added a series of data for a better understanding of the units: for example, multiples and sub-multiples, and some examples of converting the units used in radiation protection. (author) [es

48 CFR 916.504 - Indefinite-quantity contracts.

Science.gov (United States)

2010-10-01

... indefinite-quantity, multiple award contracts to ensure that adequate consideration exists to contractually... contracts. 916.504 Section 916.504 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Indefinite-Delivery Contracts 916.504 Indefinite-quantity...

The covariance matrix of derived quantities and their combination

International Nuclear Information System (INIS)

Zhao, Z.; Perey, F.G.

1992-06-01

The covariance matrix of quantities derived from measured data via nonlinear relations are only approximate since they are functions of the measured data taken as estimates for the true values of the measured quantities. The evaluation of such derived quantities entails new estimates for the true values of the measured quantities and consequently implies a modification of the covariance matrix of the derived quantities that was used in the evaluation process. Failure to recognize such an implication can lead to inconsistencies between the results of different evaluation strategies. In this report we show that an iterative procedure can eliminate such inconsistencies

Continuing Professional Development in the quantity surveying ...

African Journals Online (AJOL)

1991-01-01

Jan 1, 1991 ... The research established that quantity surveyors regarded handing in their CPD ... Surveying, Walter Sisulu University, PO Box 1421, East London, 5200, South Africa. ... Keywords: Continuing professional development, quantity surveying, perception .... In spite of this opportunity enshrined in the Act, the.

Modified open-access scheduling for new patient evaluations at an academic chronic pain clinic increased patient access to care, but did not materially reduce their mean cancellation rate: A retrospective, observational study.

Science.gov (United States)

Sivanesan, Eellan; Lubarsky, David A; Ranasinghe, Chaturani T; Sarantopoulos, Constantine D; Epstein, Richard H

2017-09-01

To determine if open-access scheduling would reduce the cancellation rate for new patient evaluations in a chronic pain clinic by at least 50%. Retrospective, observational study using electronic health records. Chronic pain clinic of an academic anesthesia department. All patients scheduled for evaluation or follow-up appointments in the chronic pain clinic between April 1, 2014, and December 31, 2015. Open-access scheduling was instituted in April 2015 with appointments offered on a date of the patient's choosing ≥1 business day after calling, with no limit on the daily number of new patients. Mean cancellation rates for new patients were compared between the 12-month baseline period prior to and for 7months after the change, following an intervening 2-month washout period. The method of batch means (by month) and the 2-sided Student t-test were used; Pnew patient mean cancellation rate decreased from a baseline of 35.7% by 4.2% (95% confidence interval [CI] 1.4% to 6.9%; P=0.005); however, this failed to reach the 50% reduction target of 17.8%. Appointment lag time decreased by 4.7days (95% CI 2.3 to 7.0days, Pnew patient group. More new patients were seen within 1week compared to baseline (50.6% versus 19.1%; Pnew patient visits per month increased from 158.5 to 225.0 (P=0.0004). The cancellation rate and appointment lag times did not decrease for established patient visits, as expected because open-access scheduling was not implemented for this group. Access to care for new chronic pain patients improved with modified open-access scheduling. However, their mean cancellation rate only decreased from 35.7% to 31.5%, making this a marginally effective strategy to reduce cancellations. Copyright © 2017 Elsevier Inc. All rights reserved.

Continuing Professional Development in the quantity surveying ...

African Journals Online (AJOL)

This research study was conducted in order to investigate Continuing Professional Development (CPD) in the South African quantity surveying profession. The study further aimed to establish the reasons why some quantity surveyors do not acquire the required CPD hours and face losing their professional registration with ...

Hypergraph topological quantities for tagged social networks

Science.gov (United States)

Zlatić, Vinko; Ghoshal, Gourab; Caldarelli, Guido

2009-09-01

Recent years have witnessed the emergence of a new class of social networks, which require us to move beyond previously employed representations of complex graph structures. A notable example is that of the folksonomy, an online process where users collaboratively employ tags to resources to impart structure to an otherwise undifferentiated database. In a recent paper, we proposed a mathematical model that represents these structures as tripartite hypergraphs and defined basic topological quantities of interest. In this paper, we extend our model by defining additional quantities such as edge distributions, vertex similarity and correlations as well as clustering. We then empirically measure these quantities on two real life folksonomies, the popular online photo sharing site Flickr and the bookmarking site CiteULike. We find that these systems share similar qualitative features with the majority of complex networks that have been previously studied. We propose that the quantities and methodology described here can be used as a standard tool in measuring the structure of tagged networks.

By Default: The Effect of Prepopulated Prescription Quantities on Opioid Prescribing in the Emergency Department.

Science.gov (United States)

Santistevan, Jamie R; Sharp, Brian R; Hamedani, Azita G; Fruhan, Scott; Lee, Andrew W; Patterson, Brian W

2018-03-01

before and after the intervention, the clinical significance of this is unclear. An observed wider distribution of the quantity of tablets prescribed after removal of the default quantity of 20 may reflect more appropriate prescribing patterns (i.e., less severe indications receiving fewer tabs and more severe indications receiving more). A default value of 20 tablets for opioid prescriptions may be an example of the electronic medical record's ability to reduce practice variability in medication orders actually counteracting optimal patient care.

Policies for patient access to clinical data via PHRs: current state and recommendations.

Science.gov (United States)

Collins, Sarah A; Vawdrey, David K; Kukafka, Rita; Kuperman, Gilad J

2011-12-01

Healthcare delivery organizations are increasingly using online personal health records (PHRs) to provide patients with direct access to their clinical information; however, there may be a lack of consistency in the data made available. We aimed to understand the general use and functionality of PHRs and the organizational policies and decision-making structures for making data available to patients. A cross-sectional survey was administered by telephone structured interview to 21 organizations to determine the types of data made available to patients through PHRs and the presence of explicit governance for PHR data release. Organizations were identified based on a review of the literature, PHR experts, and snowball sampling. Organizations that did not provide patients with electronic access to their data via a PHR were excluded. Interviews were conducted with 17 organizations for a response rate of 81%. Half of the organizations had explicit governance in the form of a written policy that outlined the data types made available to patients. Overall, 88% of the organizations used a committee structure for the decision-making process and included senior management and information services. All organizations sought input from clinicians. Discussion There was considerable variability in the types of clinical data and the time frame for releasing these data to patients. Variability in data release policies may have implications for PHR use and adoption. Future policy activities, such as requirement specification for the latter stages of Meaningful Use, should be leveraged as an opportunity to encourage standardization of functionality and broad deployment of PHRs.

Remarks and suggestions concerned with formulation of the definition of quantity ''committed dose'' and quantity ''radiation burden'' useful in estimates of population exposure

International Nuclear Information System (INIS)

Cwik, T.

1990-01-01

The paper contains remarks to the definitions of the quantity ''commited dose'' given in the publications of the ICRP. The suggestions are presented on the mode of formulating the definition of the quantity ''commited dose'' and the definition of the quantity denoted hitherto by the symbol H 50 . The other suggestions deal with introduction of the quantity ''radiation burden'', assigned for use in assessments of irradiation expressed ''per caput'' of population. 9 refs. (author)

Comparison of fingerprint and facial biometric verification technologies for user access and patient identification in a clinical environment

Science.gov (United States)

Guo, Bing; Zhang, Yu; Documet, Jorge; Liu, Brent; Lee, Jasper; Shrestha, Rasu; Wang, Kevin; Huang, H. K.

2007-03-01

As clinical imaging and informatics systems continue to integrate the healthcare enterprise, the need to prevent patient mis-identification and unauthorized access to clinical data becomes more apparent especially under the Health Insurance Portability and Accountability Act (HIPAA) mandate. Last year, we presented a system to track and verify patients and staff within a clinical environment. This year, we further address the biometric verification component in order to determine which Biometric system is the optimal solution for given applications in the complex clinical environment. We install two biometric identification systems including fingerprint and facial recognition systems at an outpatient imaging facility, Healthcare Consultation Center II (HCCII). We evaluated each solution and documented the advantages and pitfalls of each biometric technology in this clinical environment.

Sustainable access to safe drinking water: fundamental human right in the international and national scene

Directory of Open Access Journals (Sweden)

Celso Maran de Oliveira

2017-12-01

Full Text Available Access to potable water is absolutely essential to the maintenance of life, as well as to provide regular exercise of other human rights. The lack of access to water in sufficient quantity or access to non-potable water may cause serious and irreparable damage to people. This paper investigates the evolution of international and national recognition of this fundamental human right, whether implicit or explicit. This was accomplished by the study of international human rights treaties, bibliographic information on water resources and their corresponding legal systems, national and international. The results suggest that sustainable access to drinking water is a fundamental human right in the context of international relations and the State. Further, even without explicitly stating this right in the Constitution of 1988, Brazil has incorporated the main international provisions on the subject, but this right must be acknowledged according to the principles of non-typical fundamental rights and the dignity of the human person. This right should be universally guaranteed by the Government in sufficient quantity and quality, regardless of the economic resources of individuals.

Project Baiterek: A Patient Access Program to Improve Clinical Outcomes and Quality of Life in Children with Type 1 Diabetes in Kazakhstan.

Science.gov (United States)

Muratalina, Aigul; Smith-Palmer, Jayne; Nurbekova, Akmaral; Abduakhassova, Gulmira; Zhubandykova, Leila; Roze, Stéphane; Karamalis, Manolis; Shamshatova, Gulzhakhan; Demessinov, Adi; D'Agostino, Nicola Dunne; Lynch, Peter; Yedigarova, Larisa; Klots, Motty; Valentine, William; Welsh, John; Kaufman, Francine

2015-09-01

Diabetes is a key driver in the rise of noncommunicable diseases globally. It causes expensive and burdensome short- and long-term complications, with both an economic and social impact. In many countries, however, access to care and disease management in type 1 diabetes is suboptimal, increasing the risk for complications. In 2011, Project Baiterek was initiated as a collaborative effort between the Kazakhstan Ministry of Health, industry (Medtronic Plc), local physicians, and the Diabetes Association of the Republic of Kazakhstan to enhance patient access to continuous subcutaneous insulin infusion (CSII) therapy. It was the first countrywide project to provide equity and universal access to insulin pump therapy among children with type 1 diabetes, increasing pump use from zero to two-thirds of this population in less than 3 years. The project also involved instigating longitudinal data collection, and long-term clinical outcomes continue to be monitored. Here, we provide an overview of the clinical, quality-of-life, and economic outcomes to date associated with providing CSII therapy to children with type 1 diabetes in Kazakhstan. Initial clinical data show that CSII therapy improved clinical outcomes and quality of life for patients entered into the program and that CSII therapy was cost-effective relative to multiple daily injection therapy. The positive outcomes of Project Baiterek provide a template for similar patient access programs in other settings, and its framework could be adapted to initiatives to change health care infrastructures and standards of care for other noncommunicable diseases. Copyright © 2015. Published by Elsevier Inc.

41 CFR 101-27.102 - Economic order quantity principle.

Science.gov (United States)

2010-07-01

... MANAGEMENT 27.1-Stock Replenishment § 101-27.102 Economic order quantity principle. The economic order quantity (EOQ) principle is a means for achieving economical inventory management. Application of the EOQ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Economic order quantity...

Confidence and Information Access in Clinical Decision-Making: An Examination of the Cognitive Processes that affect the Information-seeking Behavior of Physicians.

Science.gov (United States)

Uy, Raymonde Charles; Sarmiento, Raymond Francis; Gavino, Alex; Fontelo, Paul

2014-01-01

Clinical decision-making involves the interplay between cognitive processes and physicians' perceptions of confidence in the context of their information-seeking behavior. The objectives of the study are: to examine how these concepts interact, to determine whether physician confidence, defined in relation to information need, affects clinical decision-making, and if information access improves decision accuracy. We analyzed previously collected data about resident physicians' perceptions of information need from a study comparing abstracts and full-text articles in clinical decision accuracy. We found that there is a significant relation between confidence and accuracy (φ=0.164, p<0.01). We also found various differences in the alignment of confidence and accuracy, demonstrating the concepts of underconfidence and overconfidence across years of clinical experience. Access to online literature also has a significant effect on accuracy (p<0.001). These results highlight possible CDSS strategies to reduce medical errors.

Relevance of protection quantities in medical exposures

International Nuclear Information System (INIS)

Pradhan, A.S.

2008-01-01

International Commission on Radiological Protection (ICRP) continues to classify the exposures to radiation in three categories; namely 1- occupational exposure, 2- public exposure, and 3- medical exposure. Protection quantities are primarily meant for the regulatory purpose in radiological protection for controlling and limiting stochastic risks in occupational and public exposures. These are based on two basic assumptions of 1- linear no-threshold dose-effect relationship (LNT) at low doses and 2- long-term additivity of low doses. Medical exposure are predominantly delivered to individuals (patients) undergoing diagnostic examinations, interventional procedures and radiation therapy but also include individual caring for or comforting patients incurring exposure and the volunteers of biomedical medical research programmes. Radiation protection is as relevant to occupational and public exposure as to medical exposures except that the dose limits set for the formers are not applicable to medical exposure but reference levels and dose constrains are recommended for diagnostic and interventional medical procedures. In medical institutions, both the occupational and medical exposure takes place. Since the doses in diagnostic examinations are low, it has been observed that not only the protection quantities are often used in such cases but these are extended to estimate the number of cancer deaths due to such practices. One of the striking features of the new ICRP recommendations has been to elaborate the concepts of the dosimetric quantities. The limitation of protection quantities ((Effective dose, E=Σ RT D TR .W T .W R and Equivalent Dose H T =Σ RT D TR .W R ) have been brought out and this has raised a great concern and initiated debates on the use of these quantities in medical exposures. Consequently, ICRP has set a task group to provide more details and the recommendations. It has, therefore, became important to draw the attention of medical physics community

Accessing the public MIMIC-II intensive care relational database for clinical research.

Science.gov (United States)

Scott, Daniel J; Lee, Joon; Silva, Ikaro; Park, Shinhyuk; Moody, George B; Celi, Leo A; Mark, Roger G

2013-01-10

The Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC-II) database is a free, public resource for intensive care research. The database was officially released in 2006, and has attracted a growing number of researchers in academia and industry. We present the two major software tools that facilitate accessing the relational database: the web-based QueryBuilder and a downloadable virtual machine (VM) image. QueryBuilder and the MIMIC-II VM have been developed successfully and are freely available to MIMIC-II users. Simple example SQL queries and the resulting data are presented. Clinical studies pertaining to acute kidney injury and prediction of fluid requirements in the intensive care unit are shown as typical examples of research performed with MIMIC-II. In addition, MIMIC-II has also provided data for annual PhysioNet/Computing in Cardiology Challenges, including the 2012 Challenge "Predicting mortality of ICU Patients". QueryBuilder is a web-based tool that provides easy access to MIMIC-II. For more computationally intensive queries, one can locally install a complete copy of MIMIC-II in a VM. Both publicly available tools provide the MIMIC-II research community with convenient querying interfaces and complement the value of the MIMIC-II relational database.

DOE approach to threshold quantities

International Nuclear Information System (INIS)

Wickham, L.E.; Kluk, A.F.; Department of Energy, Washington, DC)

1985-01-01

The Department of Energy (DOE) is developing the concept of threshold quantities for use in determining which waste materials must be handled as radioactive waste and which may be disposed of as nonradioactive waste at its sites. Waste above this concentration level would be managed as radioactive or mixed waste (if hazardous chemicals are present); waste below this level would be handled as sanitary waste. Ideally, the threshold must be set high enough to significantly reduce the amount of waste requiring special handling. It must also be low enough so that waste at the threshold quantity poses a very small health risk and multiple exposures to such waste would still constitute a small health risk. It should also be practical to segregate waste above or below the threshold quantity using available instrumentation. Guidance is being prepared to aid DOE sites in establishing threshold quantity values based on pathways analysis using site-specific parameters (waste stream characteristics, maximum exposed individual, population considerations, and site specific parameters such as rainfall, etc.). A guidance dose of between 0.001 to 1.0 mSv/y (0.1 to 100 mrem/y) was recommended with 0.3 mSv/y (30 mrem/y) selected as the guidance dose upon which to base calculations. Several tasks were identified, beginning with the selection of a suitable pathway model for relating dose to the concentration of radioactivity in the waste. Threshold concentrations corresponding to the guidance dose were determined for waste disposal sites at a selected humid and arid site. Finally, cost-benefit considerations at the example sites were addressed. The results of the various tasks are summarized and the relationship of this effort with related developments at other agencies discussed

Physical quantities, their role and treatment in gasflow measurement techniques

International Nuclear Information System (INIS)

Narjes, L.

1977-06-01

We begin by taking a closer look at the concepts physical quantity, dimension and unit of measurement. Then a survey is given of the physical quantities applied in gasflow measurement techniques. Here the volume-, as well as the mass-flow rate, as derived quantities are of particular interest. The application of these quantities in relation to the legal units of measurement is specifically described. In addition the quantity equation and further the quantity equation adapted to the use of suitable units and their modes of application are compared. In the appendix four examples clarify these modes. Special attention is paid to the quantity equation adapted to practically oriented units. The applications of this type of equation in VDI regulations, standards and other technical guidelines for measurement of flow are mentioned. Moreover, the meaning of the standard state for the comparison of flows of gaseous fluids is illustrated. The difficulties concerning an international agreement on uniform standard temperature are explained. Starting from there, the advantages of the fundamental quantity 'amount of substance' applied to the measurement of flow are described. The use of this quantity for the thermodynamic state of ideal and real gases, respectively gas mixtures, is demonstrated in the appendix by an example. (orig.) [de

Discounting of quantity surveying fees in South Africa

African Journals Online (AJOL)

by clients have forced Quantity Surveying firms into competition with ... Furthermore, 43% of consulting engineering firms were discounting their fees at a rate of .... Quantity. Surveying services are also offered in the fields of dispute resolution,.

New quantities in radiation protection and conversion coefficients

International Nuclear Information System (INIS)

1986-01-01

Four new quantities have been proposed by the ICRP for use in radiation protection from external sources, i.e. the ambient dose equivalent, the directional dose equivalent, the individual dose equivalent (penetrating), and the individual dose equivalent (superficial). These quantities are briefly described together with two new concepts of expanded and aligned fields. The BCRU recommends that these quantities should be adopted for use in the UK together with conversion coefficients when re-calibrating existing instruments, reporting the results of measurements and designing instruments. (UK)

Are HPV vaccination services accessible to high-risk communities? A spatial analysis of HPV-associated cancer and Chlamydia rates and safety-net clinics.

Science.gov (United States)

Tsui, Jennifer; Rodriguez, Hector P; Gee, Gilbert C; Escobedo, Loraine A; Kominski, Gerald F; Bastani, Roshan

2013-12-01

While HPV vaccines can greatly benefit adolescents and young women from high-risk areas, little is known about whether safety-net immunization services are geographically accessible to communities at greatest risk for HPV-associated diseases. We explore the spatial relationship between areas with high HPV risk and proximity to safety-net clinics from an ecologic perspective. We used cancer registry data and Chlamydia surveillance data to identify neighborhoods within Los Angeles County with high risk for HPV-associated cancers. We examined proximity to safety-net clinics among neighborhoods with the highest risk. Proximity was measured as the shortest distance between each neighborhood center and the nearest clinic and having a clinic within 3 miles of each neighborhood center. The average 5-year non-age-adjusted rates were 1,940 cases per 100,000 for Chlamydia and 60 per 100,000 for HPV-associated cancers. A large majority, 349 of 386 neighborhoods with high HPV-associated cancer rates and 532 of 537 neighborhoods with high Chlamydia rates, had a clinic within 3 miles of the neighborhood center. Clinics were more likely to be located within close proximity to high-risk neighborhoods in the inner city. High-risk neighborhoods outside of this urban core area were less likely to be near accessible clinics. The majority of high-risk neighborhoods were geographically near safety-net clinics with HPV vaccination services. Due to low rates of vaccination, these findings suggest that while services are geographically accessible, additional efforts are needed to improve uptake. Programs aimed to increase awareness about the vaccine and to link underserved groups to vaccination services are warranted.

A global survey of clinicians' awareness, accessibility, utilization of e-continuous education, and quality of clinical blood use: policy considerations

Directory of Open Access Journals (Sweden)

Smit Sibinga CT

2017-07-01

Full Text Available Cees Th Smit Sibinga,1 Maruff A Oladejo,2 Olamide Hakeem Adejumo,3 Quentin Eichbaum,4 Midori Kumagawa,5 Shuichi Kino,5 Sima Zolfaghari,6 Silvano Wendel,7 Gordana Rasovic,8 Namjil Erdenebayar,9 Maya Makhmudova,10 Loyiso Mpuntsha,11 Charlotte Ingram,11 Bakyt B Kharabaev,12 Isaac Kajja,13 Zainab Mukhtar Hussain Sanji,14 Maria M M Satti15 1IQM Consulting for International Development of Quality Management in Transfusion Medicine, University of Groningen, Groningen, the Netherlands; 2Department of Educational Management, University of Lagos, Lagos, 3Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria; 4Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA; 5Japanese Red Cross Hokkaido Block Blood Center, Japan; 6IBTO, Tehran, Iran; 7Blood Bank, Hospital Sirio Libanês, Sao Paulo, Brazil; 8Montenegro National Blood Transfusion Center, Podgorica, Montenegro; 9National Center for Transfusion Medicine, Ulaanbaatar, Mongolia; 10Consultant IQM Consulting, Tashkent, Uzbekistan; 11South Africa National Blood Transfusion Service, Johannesburg, South Africa; 12National Blood Transfusion Service, Bishkek, Kyrgyzstan; 13Department of Orthopedics, Mulago Hospital, Makerere University, Uganda; 14Consultant, Dow University of Health Sciences, Karachi, Pakistan; 15National Blood Transfusion Service, Khartoum, Sudan Introduction: Clinical use of blood has shown the least developed part in the vein-to-vein transfusion chain. This global study was carried out in order to investigate the level of awareness, accessibility and utilization of continuous e-learning and education, and quality of blood use among blood prescribing clinicians and nurses.Approach: Descriptive ex post facto survey design.Methods: A total of 264 purposively selected blood prescribing clinicians and nurses from the four Human Development Index (HDI groups of countries (low, medium, high, and very high participated in this study

A conserved quantity in thin body dynamics

International Nuclear Information System (INIS)

Hanna, J.A.; Pendar, H.

2016-01-01

Thin, solid bodies with metric symmetries admit a restricted form of reparameterization invariance. Their dynamical equilibria include motions with both rigid and flowing aspects. On such configurations, a quantity is conserved along the intrinsic coordinate corresponding to the symmetry. As an example of its utility, this conserved quantity is combined with linear and angular momentum currents to construct solutions for the equilibria of a rotating, flowing string, for which it is akin to Bernoulli's constant. - Highlights: • A conserved quantity relevant to the dynamical equilibria of thin structures. • A mixed Lagrangian–Eulerian non-material action principle for fixed windows of axially moving systems. • Analytical solutions for rotating, flowing strings (yarn balloons). • Noether meets Bernoulli in a textile factory.

A conserved quantity in thin body dynamics

Energy Technology Data Exchange (ETDEWEB)

Hanna, J.A., E-mail: hannaj@vt.edu [Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061 (United States); Department of Physics, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061 (United States); Pendar, H. [Department of Biomedical Engineering and Mechanics, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061 (United States)

2016-02-15

Thin, solid bodies with metric symmetries admit a restricted form of reparameterization invariance. Their dynamical equilibria include motions with both rigid and flowing aspects. On such configurations, a quantity is conserved along the intrinsic coordinate corresponding to the symmetry. As an example of its utility, this conserved quantity is combined with linear and angular momentum currents to construct solutions for the equilibria of a rotating, flowing string, for which it is akin to Bernoulli's constant. - Highlights: • A conserved quantity relevant to the dynamical equilibria of thin structures. • A mixed Lagrangian–Eulerian non-material action principle for fixed windows of axially moving systems. • Analytical solutions for rotating, flowing strings (yarn balloons). • Noether meets Bernoulli in a textile factory.

The ICRU dose equivalence quantities in radiation protection

International Nuclear Information System (INIS)

Grimbergen, T.W.M.

1990-09-01

The definitions and application of the new ICRU radiation protection quantities have been reviewed and studied in literature. Special emphasis was laid on the consequences of the use of the new quantities by personnel dosimetry services, and on the consequences of the use of the new quantities during an intercomparison programme for dosimetry services. The study shows that the recommendations of the ICRU are not yet complete and not fully realizable. This means that the dosimetry services always have to make certain approximations, when they use the new quantities. In literature, several approaches have been proposed. The feasibility of an approach depends on the characteristics of the dosimeters used. The use of different approaches by the dosimetry services is thought to be of possible influence on the results of an intercomparison programme. (author). 42 refs.; 3 figs.; 1 tab

Foreign materials in the repository - update of estimated quantities

International Nuclear Information System (INIS)

Hagros, A.

2007-03-01

In a repository for spent nuclear fuel, a variety of materials are used during the construction process and during the operation of the repository. In addition to materials necessary for the construction and operation, some materials may be transported into the repository through the ventilation air, as emissions from vehicles, as waste produced by the staff etc. Both of these two types of materials are considered here and their quantities - both the introduced quantities and the quantities that remain after closure - in the repository constructed at Olkiluoto in Eurajoki, Finland are estimated here based on new information. This work is intended to update the estimations that have been made previously, and it takes advantage of the experience collected during the construction of the underground rock characterisation facility ONKALO at Olkiluoto. During this construction process, the quantities of the different construction materials introduced into the underground openings have been monitored and they form a basis for estimating the quantities to be used in the future. The estimations made in this report are specific to a KBS-3V type repository and to the Olkiluoto site, although in some cases more generic information has been used, particularly when the relevant quantities have not been monitored in the ONKALO. The estimations are based on the new repository layout produced in 2006 and consider the latest plans for grouting and rock support. As these plans are generally not final yet, several different alternative plans are assumed when necessary. Also two different strategies for the backfilling of the tunnels are considered. The most significant differences with respect to the results of an earlier estimation are related to the materials used in grouting, shotcreting and in support bolts. In the cases where a mixture of bentonite and crushed rock is the used backfill alternative, gypsum and cement are the materials with the largest quantities remaining in the

Quantities of natural gas transmitted in January-December 2012. Quantities of natural gas transported in January-December 2012

International Nuclear Information System (INIS)

2013-01-01

GRTgaz is a European leader in natural gas transmission, a world expert in gas transmission networks and systems, and an operator firmly committed to the energy transition. It owns and operates the gas transmission network throughout most of France and it manages the transmission network in Germany, thereby helping to ensure correct operation of the French and European gas market. It contributes to the energy security of regional supply systems and performs a public service mission to ensure the continuity of consumer supply. This document presents the monthly key figures of GRTgaz activity in 2012: Total quantities transmitted by GRTgaz (Inputs to the GRTgaz network/Outputs from the GRTgaz network); Maximum and minimum daily flow (Daily quantities transported, Daily consumption, Daily inputs excluding storage); Quantities exchanged on the wholesale market; Consumption on the GRTgaz Network (gross monthly consumption and Average monthly temperatures)

Quantity discrimination in wolves (Canis lupus

Directory of Open Access Journals (Sweden)

Ewelina eUtrata

2012-11-01

Full Text Available Quantity discrimination has been studied extensively in different non-human animal species. In the current study, we tested eleven hand-raised wolves (Canis lupus in a two-way choice task. We placed a number of food items (one to four sequentially into two opaque cans and asked the wolves to choose the larger amount. Moreover, we conducted two additional control conditions to rule out non-numerical properties of the presentation that the animals might have used to make the correct choice. Our results showed that wolves are able to make quantitative judgments at the group, but also at the individual level even when alternative strategies such as paying attention to the surface area or time and total amount are ruled out. In contrast to previous canine studies on dogs (Canis familiaris and coyotes (Canis latrans, our wolves’ performance did not improve with decreasing ratio, referred to as Weber’s law. However, further studies using larger quantities than we used in the current setup are still needed to determine whether and when wolves’ quantity discrimination conforms to Weber’s law.

Access control based on attribute certificates for medical intranet applications.

Science.gov (United States)

Mavridis, I; Georgiadis, C; Pangalos, G; Khair, M

2001-01-01

Clinical information systems frequently use intranet and Internet technologies. However these technologies have emphasized sharing and not security, despite the sensitive and private nature of much health information. Digital certificates (electronic documents which recognize an entity or its attributes) can be used to control access in clinical intranet applications. To outline the need for access control in distributed clinical database systems, to describe the use of digital certificates and security policies, and to propose the architecture for a system using digital certificates, cryptography and security policy to control access to clinical intranet applications. We have previously developed a security policy, DIMEDAC (Distributed Medical Database Access Control), which is compatible with emerging public key and privilege management infrastructure. In our implementation approach we propose the use of digital certificates, to be used in conjunction with DIMEDAC. Our proposed access control system consists of two phases: the ways users gain their security credentials; and how these credentials are used to access medical data. Three types of digital certificates are used: identity certificates for authentication; attribute certificates for authorization; and access-rule certificates for propagation of access control policy. Once a user is identified and authenticated, subsequent access decisions are based on a combination of identity and attribute certificates, with access-rule certificates providing the policy framework. Access control in clinical intranet applications can be successfully and securely managed through the use of digital certificates and the DIMEDAC security policy.

Comparison of Radial Access, Guided Femoral Access, and Non-Guided Femoral Access Among Women Undergoing Percutaneous Coronary Intervention.

Science.gov (United States)

Koshy, Linda M; Aberle, Laura H; Krucoff, Mitchell W; Hess, Connie N; Mazzaferri, Ernest; Jolly, Sanjit S; Jacobs, Alice; Gibson, C Michael; Mehran, Roxana; Gilchrist, Ian C; Rao, Sunil V

2018-01-01

This study was conducted to determine the association between radial access, guided femoral access, and non-guided femoral access on postprocedural bleeding and vascular complications after percutaneous coronary intervention (PCI). Bleeding events and major vascular complications after PCI are associated with increased morbidity, mortality, and cost. While the radial approach has been shown to be superior to the femoral approach in reducing bleeding and vascular complications, whether the use of micropuncture, fluoroscopy, or ultrasound mitigates these differences is unknown. We conducted a post hoc analysis of women in the SAFE-PCI for Women trial who underwent PCI and had the access method identified (n = 643). The primary endpoint of postprocedure bleeding or vascular complications occurring within 72 hours or at discharge was adjudicated by an independent clinical events committee and was compared based on three categories of access technique: radial, guided femoral (fluoroscopy, micropuncture, ultrasound), or non-guided femoral (none of the aforementioned). Differences between the groups were determined using multivariate logistic regression using radial access as the reference. Of the PCI population, 330 underwent radial access, 228 underwent guided femoral access, and 85 underwent non-guided femoral access. There was a statistically significant lower incidence of the primary endpoint with radial access vs non-guided femoral access; however, there was no significant difference between radial approach and femoral access guided by fluoroscopy, micropuncture, or ultrasound. This post hoc analysis demonstrates that while radial access is safer than non-guided femoral access, guided femoral access appears to be associated with similar bleeding events or vascular complications as radial access.

Layer-Mean Quantities, Local Conservation Laws, and Vorticity

International Nuclear Information System (INIS)

Camassa, R.; Levermore, C.D.

1997-01-01

We derive local conservation laws for layer-mean quantities in two general settings. When applied to Euler flows, the first of these settings yields well-known local conservation laws for quantities averaged between material surfaces. The second, however, leads to new local conservation laws for quantities involving the vorticity that are averaged between arbitrary surfaces. These produce the crucial vorticity conservation laws in shallow water models that admit nonhydrostatic and noncolumnar motion. Moreover, they seem to lie outside the Hamiltonian paradigm of fluid dynamics. The formalism generalizes to skew-symmetric matrix fields; applications to electromagnetism are suggested. copyright 1997 The American Physical Society

Scaling-up access to antiretroviral therapy for children: a cohort study evaluating care and treatment at mobile and hospital-affiliated HIV clinics in rural Zambia.

Directory of Open Access Journals (Sweden)

Janneke H van Dijk

Full Text Available Travel time and distance are barriers to care for HIV-infected children in rural sub-Saharan Africa. Decentralization of care is one strategy to scale-up access to antiretroviral therapy (ART, but few programs have been evaluated. We compared outcomes for children receiving care in mobile and hospital-affiliated HIV clinics in rural Zambia.Outcomes were measured within an ongoing cohort study of HIV-infected children seeking care at Macha Hospital, Zambia from 2007 to 2012. Children in the outreach clinic group received care from the Macha HIV clinic and transferred to one of three outreach clinics. Children in the hospital-affiliated clinic group received care at Macha HIV clinic and reported Macha Hospital as the nearest healthcare facility.Seventy-seven children transferred to the outreach clinics and were included in the analysis. Travel time to the outreach clinics was significantly shorter and fewer caretakers used public transportation, resulting in lower transportation costs and fewer obstacles accessing the clinic. Some caretakers and health care providers reported inferior quality of service provision at the outreach clinics. Sixty-eight children received ART at the outreach clinics and were compared to 41 children in the hospital-affiliated clinic group. At ART initiation, median age, weight-for-age z-scores (WAZ and CD4(+ T-cell percentages were similar for children in the hospital-affiliated and outreach clinic groups. Children in both groups experienced similar increases in WAZ and CD4(+ T-cell percentages.HIV care and treatment can be effectively delivered to HIV-infected children at rural health centers through mobile ART teams, removing potential barriers to uptake and retention. Outreach teams should be supported to increase access to HIV care and treatment in rural areas.

The Radiometric Measurement Quantity for SAR Images

OpenAIRE

Döring, Björn J.; Schwerdt, Marco

2013-01-01

A Synthetic Aperture Radar (SAR) system measures among other quantities the terrain radar reflectivity. After image calibration, the pixel intensities are commonly expressed in terms of radar cross sections (for point targets) or as backscatter coefficients (for distributed targets), which are directly related. This paper argues that pixel intensities are not generally proportional to radar cross section or derived physical quantities. The paper further proposes to replace the inaccurate term...

Average Transverse Momentum Quantities Approaching the Lightfront

OpenAIRE

Boer, Daniel

2015-01-01

In this contribution to Light Cone 2014, three average transverse momentum quantities are discussed: the Sivers shift, the dijet imbalance, and the $p_T$ broadening. The definitions of these quantities involve integrals over all transverse momenta that are overly sensitive to the region of large transverse momenta, which conveys little information about the transverse momentum distributions of quarks and gluons inside hadrons. TMD factorization naturally suggests alternative definitions of su...

Direct and Electronic Health Record Access to the Clinical Decision Support for Immunizations in the Minnesota Immunization Information System.

Science.gov (United States)

Rajamani, Sripriya; Bieringer, Aaron; Wallerius, Stephanie; Jensen, Daniel; Winden, Tamara; Muscoplat, Miriam Halstead

2016-01-01

Immunization information systems (IIS) are population-based and confidential computerized systems maintained by public health agencies containing individual data on immunizations from participating health care providers. IIS hold comprehensive vaccination histories given across providers and over time. An important aspect to IIS is the clinical decision support for immunizations (CDSi), consisting of vaccine forecasting algorithms to determine needed immunizations. The study objective was to analyze the CDSi presentation by IIS in Minnesota (Minnesota Immunization Information Connection [MIIC]) through direct access by IIS interface and by access through electronic health records (EHRs) to outline similarities and differences. The immunization data presented were similar across the three systems examined, but with varying ability to integrate data across MIIC and EHR, which impacts immunization data reconciliation. Study findings will lead to better understanding of immunization data display, clinical decision support, and user functionalities with the ultimate goal of promoting IIS CDSi to improve vaccination rates.

A conserved quantity in thin body dynamics

Science.gov (United States)

Hanna, J. A.; Pendar, H.

2016-02-01

Thin, solid bodies with metric symmetries admit a restricted form of reparameterization invariance. Their dynamical equilibria include motions with both rigid and flowing aspects. On such configurations, a quantity is conserved along the intrinsic coordinate corresponding to the symmetry. As an example of its utility, this conserved quantity is combined with linear and angular momentum currents to construct solutions for the equilibria of a rotating, flowing string, for which it is akin to Bernoulli's constant.

Relationships of chemical composition, quantity of milt to fertility and ...

African Journals Online (AJOL)

African Journal of Food, Agriculture, Nutrition and Development ... determining the right quantity of milt that can be used to fertilize certain quantity of eggs. ... quantity of milt used for artificial reproduction in fish significantly affect water quality used ... is the major organic substance that supplies the spermatozoa with energy.

Six categories of ionizing radiation quantities practical in various fields

International Nuclear Information System (INIS)

Zheng Junzheng; Zhuo Weihai

2011-01-01

This paper is the part of review on the evolvement of the systems for ionizing radiation quantities and units. In the paper, for better understanding and correct use of the relevant quantities of ionizing radiation, the major ionizing radiation quantities in various fields are divided into six categories. (authors)

Lie-Mei symmetry and conserved quantities of the Rosenberg problem

International Nuclear Information System (INIS)

Liu Xiao-Wei; Li Yuan-Cheng

2011-01-01

The Rosenberg problem is a typical but not too complicated problem of nonholonomic mechanical systems. The Lie—Mei symmetry and the conserved quantities of the Rosenberg problem are studied. For the Rosenberg problem, the Lie and the Mei symmetries for the equation are obtained, the conserved quantities are deduced from them and then the definition and the criterion for the Lie—Mei symmetry of the Rosenberg problem are derived. Finally, the Hojman conserved quantity and the Mei conserved quantity are deduced from the Lie—Mei symmetry. (general)

Lie-Mei symmetry and conserved quantities of the Rosenberg problem

Science.gov (United States)

Liu, Xiao-Wei; Li, Yuan-Cheng

2011-07-01

The Rosenberg problem is a typical but not too complicated problem of nonholonomic mechanical systems. The Lie—Mei symmetry and the conserved quantities of the Rosenberg problem are studied. For the Rosenberg problem, the Lie and the Mei symmetries for the equation are obtained, the conserved quantities are deduced from them and then the definition and the criterion for the Lie—Mei symmetry of the Rosenberg problem are derived. Finally, the Hojman conserved quantity and the Mei conserved quantity are deduced from the Lie—Mei symmetry.

Optimal trading quantity integration as a basis for optimal portfolio management

Directory of Open Access Journals (Sweden)

Saša Žiković

2005-06-01

Full Text Available The author in this paper points out the reason behind calculating and using optimal trading quantity in conjunction with Markowitz’s Modern portfolio theory. In the opening part the author presents an example of calculating optimal weights using Markowitz’s Mean-Variance approach, followed by an explanation of basic logic behind optimal trading quantity. The use of optimal trading quantity is not limited to systems with Bernoulli outcome, but can also be used when trading shares, futures, options etc. Optimal trading quantity points out two often-overlooked axioms: (1 a system with negative mathematical expectancy can never be transformed in a system with positive mathematical expectancy, (2 by missing the optimal trading quantity an investor can turn a system with positive expectancy into a negative one. Optimal trading quantity is that quantity which maximizes geometric mean (growth function of a particular system. To determine the optimal trading quantity for simpler systems, with a very limited number of outcomes, a set of Kelly’s formulas is appropriate. In the conclusion the summary of the paper is presented.

21 CFR 1314.20 - Restrictions on sales quantity.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Restrictions on sales quantity. 1314.20 Section 1314.20 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE RETAIL SALE OF SCHEDULED LISTED CHEMICAL PRODUCTS Sales by Regulated Sellers § 1314.20 Restrictions on sales quantity. (a) Without...

Feedback using an ePortfolio for medicine long cases: quality not quantity.

Science.gov (United States)

Bleasel, Jane; Burgess, Annette; Weeks, Ruth; Haq, Inam

2016-10-21

The evidence for the positive impact of an electronic Portfolio (ePortfolio) on feedback in medicine is mixed. An ePortfolio for medical long cases in a Graduate Medical Program was developed. The purpose of this study was to explore the perceptions of medical students and faculty of the impact of the ePortfolio on the feedback process. In total, 130 Year 3 medical students, and six faculty participated in the study. This is a mixed methods study, using a combination of both quantitative and qualitative approaches. Quantitative methods were used to quantify the number of long cases performed. Qualitative methods were used to explore the relationship between quantity and quality of feedback, and provide a rich understanding of both students' and faculty's experience and perceptions of the ePortfolio. Students received a variable quantity of feedback at each of the three studied clinical schools, with an average of between 4 - 5.4 feedback episodes per student. Feedback that was constructive, specific and timely and delivered by a senior academic was important. Quantity was not an essential factor, with two episodes of detailed feedback reported to be adequate. The barriers to the use of the ePortfolio were technical aspects of the platform that interfered with student engagement. Feedback using the ePortfolio for medical long cases is a valuable tool providing a senior clinician delivers detailed, constructive and personalized feedback in a timely fashion. The ePortfolio system needs to be user-friendly to engage students.

Quantity-split strategy under two-contractor competitive procurement environment

OpenAIRE

Boger, Dan C.; Liao, Shu S.

1988-01-01

This report discusses the various market scenarios that provide bid price manipulation opportunities under the dual source competition environment. Two different quantity-split strategies were developed one for the case when one of the suppliers does not have the capacity to produce the majority of the annual quantity requirement and the other for the case when neither contractor is interested in using low prices to capture the larger share of annual quantity. Keywords: Dual sourcing, Quantit...

A Meta-analysis of randomized clinical trials assessing hemodialysis access thrombosis based on access flow monitoring: Where do we stand?

Science.gov (United States)

Muchayi, Timothy; Salman, Loay; Tamariz, Leonardo J; Asif, Arif; Rizvi, Abid; Lenz, Oliver; Vazquez-Padron, Roberto I.; Tabbara, Marwan; Contreras, Gabriel

2015-01-01

The National Kidney Foundation Kidney Disease Outcomes Quality Initiative recommends the routine use of hemodialysis arteriovenous (AV) access surveillance to detect hemodynamically significant stenoses and appropriately correct them to reduce the incidence of thrombosis and to improve accesses patency rates. Access blood flow monitoring is considered as one of the preferred surveillance method for both AV fistulas (AVF) and AV grafts (AVG); however, published studies have reported conflicting results of its utility that led healthcare professionals to doubt the benefits of this surveillance method. We performed a meta-analysis of the published randomized controlled trials (RCTs) of AV access surveillance using access blood flow monitoring. Our hypothesis was that access blood flow monitoring lowers the risk of AV access thrombosis and that the outcome differs between AVF and AVG. The estimated overall pooled risk ratio (RR) of thrombosis was 0.87 (95% confidence interval [CI], 0.67 to 1.13) favoring access blood flow monitoring. The pooled RR of thrombosis were 0.64 (95% CI, 0.41 to 1.01) and 1.06 (95% CI, 0.77 to 1.46) in the subgroups of only AVF and only AVG, respectively. Our results added to the uncertainty of access blood flow monitoring as a surveillance method of hemodialysis accesses. PMID:25644548

Testing a bedside personal computer Clinical Care Classification System for nursing students using Microsoft Access.

Science.gov (United States)

Feeg, Veronica D; Saba, Virginia K; Feeg, Alan N

2008-01-01

This study tested a personal computer-based version of the Sabacare Clinical Care Classification System on students' performance of charting patient care plans. The application was designed as an inexpensive alternative to teach electronic charting for use on any laptop or personal computer with Windows and Microsoft Access. The data-based system was tested in a randomized trial with the control group using a type-in text-based-only system also mounted on a laptop at the bedside in the laboratory. Student care plans were more complete using the data-based system over the type-in text version. Students were more positive but not necessarily more efficient with the data-based system. The results demonstrate that the application is effective for improving student nursing care charting using the nursing process and capturing patient care information with a language that is standardized and ready for integration with other patient electronic health record data. It can be implemented on a bedside stand in the clinical laboratory or used to aggregate care planning over a student's clinical experience.

Editorial: New operational dose equivalent quantities

International Nuclear Information System (INIS)

Harvey, J.R.

1985-01-01

The ICRU Report 39 entitled ''Determination of Dose Equivalents Resulting from External Radiation Sources'' is briefly discussed. Four new operational dose equivalent quantities have been recommended in ICRU 39. The 'ambient dose equivalent' and the 'directional dose equivalent' are applicable to environmental monitoring and the 'individual dose equivalent, penetrating' and the 'individual dose equivalent, superficial' are applicable to individual monitoring. The quantities should meet the needs of day-to-day operational practice, while being acceptable to those concerned with metrological precision, and at the same time be used to give effective control consistent with current perceptions of the risks associated with exposure to ionizing radiations. (U.K.)

Ethics approval in applications for open-access clinical trial data: An analysis of researcher statements to clinicalstudydatarequest.com.

Directory of Open Access Journals (Sweden)

Derek So

Full Text Available Although there are a number of online platforms for patient-level clinical trial data sharing from industry sponsors, they are not very harmonized regarding the role of local ethics approval in the research proposal review process. The first and largest of these platforms is ClinicalStudyDataRequest.com (CSDR, which includes over three thousand trials from thirteen sponsors including GlaxoSmithKline, Novartis, Roche, Sanofi, and Bayer. CSDR asks applicants to state whether they have received ethics approval for their research proposal, but in most cases does not require that they submit evidence of approval. However, the website does require that applicants without ethical approval state the reason it was not required. In order to examine the perspectives of researchers on this topic, we coded every response to that question received by CSDR between June 2014 and February 2017. Of 111 applicants who stated they were exempt from ethics approval, 63% mentioned de-identification, 57% mentioned the use of existing data, 33% referred to local or jurisdictional regulations, and 20% referred to the approvals obtained by the original study. We conclude by examining the experience of CSDR within the broader context of the access mechanisms and policies currently being used by other data sharing platforms, and discuss how our findings might be used to help clinical trial data providers design clear and informative access documents.

Vascular access: a never-ending story.

Science.gov (United States)

Hedin, U

2014-12-01

Vascular surgeons are more and more becoming responsible for "life-line" creation well functioning and maintenance of hemodialysis patients and to provide a well functioning and multidisciplinary access service together with nefrologists, dialysis staff, and interventional radiology. For many, this sometimes arduous surgery with associated complicated clinical decision making, becomes a constant and challenging burden but much through the appearance of national and international guidelines and especially the endovascular technology, feasible solutions are easily at hand and the life as an access surgeon more pleasant. Here, basics in dialysis access care are presented together with some examples of novel available solutions to troublesome clinical problems.

48 CFR 245.7309-8 - Variations in quantity or weight.

Science.gov (United States)

2010-10-01

... Inventory 245.7309-8 Variations in quantity or weight. When property is sold on a “unit price” basis, the Contractor reserves the right to vary by up to 15 percent the quantity or weight listed in the Invitation and... price shall be adjusted in accordance with the unit price and on the basis of the quantity or weight...

Access to scientific information. A national survey of the Italian Society of Clinical Biochemistry and Laboratory Medicine (SIBioC).

Science.gov (United States)

Lippi, Giuseppe; Ciaccio, Marcello; Giavarina, Davide

2016-09-01

Digital libraries are typically used for retrieving and accessing articles in academic journals and repositories. Previous studies have been published about the performance of various biomedical research platforms, but no information is available about access preferences. A six-question survey was designed by the Italian Society of Clinical Biochemistry and Laboratory Medicine (SIBioC) using the platform Google Drive, and made available for 1 month to the members of the society. The information about the survey was published on the website of SIBioC and also disseminated by two sequential newsletters. Overall, 165 replies were collected throughout the 1-month survey availability. The largest number of replies were provided by laboratory professionals working in the national healthcare system (44.2%), followed by those working in private facilities (13.9%), university professors (12.7%) and specialization training staff (12.7%). The majority of responders published zero to one articles per year (55.2%), followed by two to five articles per year (37.6%), whereas only 7.3% published more than five articles per year. A total of 34.5% of the responders consulted biomedical research platforms on weekly basis, followed by 33.9% who did so on daily basis. PubMed/Medline was the most accessed scientific database, followed by Scopus, ISI Web of Science and Google Scholar. The impact factor was the leading reason when selecting which journal to publish in. The most consulted journals in the field of laboratory medicine were Clinical Chemistry and Laboratory Medicine and Biochimica Clinica. This survey provides useful indications about the personal inclination towards access to scientific information in our country.

Discussion on concepts for radiological dosimetric quantities in the Japan Health Physics Society

International Nuclear Information System (INIS)

Takahashi, Fumiaki; Oda, Keiji

2007-01-01

Many dosimetric quantities have been used for radiation protection purpose. The International Commission on Radiological Protection (ICRP) has recommended protection quantities and the International Commission on Radiation Units and Measurements (ICRU) has introduced operational quantities to provide a reasonable estimate of the protection quantities. Enthusiastic discussions are continuously made on the issues of the dosimetric quantities, such as basic biological data for the definition of these quantities and applicability of the quantities to actual radiation protection practice. At the moment, some changes are being proposed concerning dosimetric quantities in the draft recommendations of ICRP, opened for consultation in recent years. Thus, the Japan Health Physics Society (JHPS) established the Expert Committee on concepts of Dosimetric Quantities used in radiological protection (ECDQ) in April 2005 to reviewed and discuss issues in the dosimetric quantities. (author)

Management of small quantities of radioactive waste

International Nuclear Information System (INIS)

1998-09-01

The main objective of this publication is to provide practical guidance primarily to developing Member States on the predisposal management of small quantities of radioactive waste arising from hospitals, laboratories, industries, institutions, research reactors and research centres.The publication covers the management of liquid, solid and gaseous radioactive wastes at the users' premises and gives general guidance on procedures at a centralized waste management facility. Predisposal management of radioactive waste includes handling, treatment, conditioning, storage and transportation. This publication provides information and guidance on the following topics: national waste management framework; origin and characteristics of radioactive waste arising from users generating small quantities of waste; radioactive waste management concepts appropriate for small quantities; local waste management; the documentation and approval necessary for the consignment of waste to a centralized waste management facility; centralized waste management; exemption of radionuclides from the regulatory body; transportation; environmental monitoring; quality assurance for the whole predisposal process; regional co-operation aspects

Lateral Transorbital Endoscopic Access to the Hippocampus, Amygdala, and Entorhinal Cortex: Initial Clinical Experience.

Science.gov (United States)

Chen, H Isaac; Bohman, Leif-Erik; Emery, Lyndsey; Martinez-Lage, Maria; Richardson, Andrew G; Davis, Kathryn A; Pollard, John R; Litt, Brian; Gausas, Roberta E; Lucas, Timothy H

2015-01-01

Transorbital approaches traditionally have focused on skull base and cavernous sinus lesions medial to the globe. Lateral orbital approaches to the temporal lobe have not been widely explored despite several theoretical advantages compared to open craniotomy. Recently, we demonstrated the feasibility of the lateral transorbital technique in cadaveric specimens with endoscopic visualization. We describe our initial clinical experience with the endoscope-assisted lateral transorbital approach to lesions in the temporal lobe. Two patients with mesial temporal lobe pathology presenting with seizures underwent surgery. The use of a transpalpebral or Stallard-Wright eyebrow incision enabled access to the intraorbital compartment, and a lateral orbital wall 'keyhole' opening permitted visualization of the anterior temporal pole. This approach afforded adequate access to the surgical target and surrounding structures and was well tolerated by the patients. To the best of our knowledge, this report constitutes the first case series describing the endoscope-assisted lateral transorbital approach to the temporal lobe. We discuss the limits of exposure, the nuances of opening and closing, and comparisons to open craniotomy. Further prospective investigation of this approach is warranted for comparison to traditional approaches to the mesial temporal lobe. © 2015 S. Karger AG, Basel.

Dosimetric radiation protection quantities. Impact of the forthcoming ICRP recommendations

International Nuclear Information System (INIS)

Pradhan, A.S.; Lee, J.I.; Kim, J.L.; Kim, B.H.

2008-01-01

The physical quantities namely fluence, kerma and absorbed dose provide the base for the operational and the protection quantities. The absorbed dose continues to be the fundamental physical quantity for the radiological protection. The most striking feature relating the quantities in the forthcoming recommendations is the updating of the radiation and tissue weighting factors based on the latest available scientific information on radiobiology and the physics of radiation exposure. This is bound to make a significant impact in arriving at the equivalent doses and effective dose. For external exposures of neutrons, the forthcoming recommendations are going to improve the relationship between the operational and protection quantities. The changes in the tissue weighting factors of some tissues/organs, the inclusion of several new tissues/organs for the consideration of tissue weighting factors and the use of the proposed Reference Male and Reference Female voxel phantoms would require new conversion coefficients and dose coefficients for external and internal exposures. The other striking feature appears to be the details of the concepts to ensure that the protections quantities are used for the appropriate and intended purposes only and the misuse is avoided. (author)

Does open access improve the process and outcome of podiatric care?

Science.gov (United States)

Wrobel, James S; Davies, Michael L; Robbins, Jeffrey M

2011-05-19

Open access to clinics is a management strategy to improve healthcare delivery. Providers are sometimes hesitant to adopt open access because of fear of increased visits for potentially trivial complaints. We hypothesized open access clinics would result in decreased wait times, increased number of podiatry visits, fewer no shows, higher rates of acute care visits, and lower minor amputation rates over control clinics without open access. This study was a national retrospective case-control study of VHA (Veterans Hospital Administration) podiatry clinics in 2008. Eight case facilities reported to have open podiatry clinic access for at least one year were identified from an email survey. Sixteen control facilities with similar structural features (e.g., full time podiatrists, health tech, residency program, reconstructive foot surgery, vascular, and orthopedic surgery) were identified in the same geographic region as the case facilities. Twenty-two percent of facilities responded to the survey. Fifty-four percent reported open access and 46% did not. There were no differences in facility or podiatry panel size, podiatry visits, or visit frequency between the cases and controls. Podiatry visits trended higher for control facilities but didn't reach statistical significance. Case facilities had more new consults seen within 30 days (96%, 89%; P = 0.050) and lower minor amputation rates (0.62/1,000, 1.0/1,000; P = 0.041). The VHA is the worlds largest managed care organization and it relies on clinical efficiencies as one mechanism to improve the quality of care. Open access clinics had more timely access for new patients and lower rates of minor amputations.

Feedback using an ePortfolio for medicine long cases: quality not quantity

Directory of Open Access Journals (Sweden)

Jane Bleasel

2016-10-01

Full Text Available Abstract Background The evidence for the positive impact of an electronic Portfolio (ePortfolio on feedback in medicine is mixed. An ePortfolio for medical long cases in a Graduate Medical Program was developed. The purpose of this study was to explore the perceptions of medical students and faculty of the impact of the ePortfolio on the feedback process. Methods In total, 130 Year 3 medical students, and six faculty participated in the study. This is a mixed methods study, using a combination of both quantitative and qualitative approaches. Quantitative methods were used to quantify the number of long cases performed. Qualitative methods were used to explore the relationship between quantity and quality of feedback, and provide a rich understanding of both students’ and faculty’s experience and perceptions of the ePortfolio. Results Students received a variable quantity of feedback at each of the three studied clinical schools, with an average of between 4 – 5.4 feedback episodes per student. Feedback that was constructive, specific and timely and delivered by a senior academic was important. Quantity was not an essential factor, with two episodes of detailed feedback reported to be adequate. The barriers to the use of the ePortfolio were technical aspects of the platform that interfered with student engagement. Conclusions Feedback using the ePortfolio for medical long cases is a valuable tool providing a senior clinician delivers detailed, constructive and personalized feedback in a timely fashion. The ePortfolio system needs to be user-friendly to engage students.

Calibration of personal dosimeters: Quantities and terminology

International Nuclear Information System (INIS)

Aleinikov, V.E.

1999-01-01

The numerical results obtained in the interpretation of individual monitoring of external radiation depend not only on the accurate calibration of the radiation measurement instruments involved, but also on the definition of the quantities in term of which these instruments are calibrated The absence of uniformity in terminology not only makes it difficult to understand properly the scientific and technical literature but can also lead to incorrect interpretation of particular concepts and recommendations. In this paper, brief consideration is given to definition of radiation quantities and terminology used in calibration procedures. (author)

An exploratory investigation of the intuition of physical quantity among 15 to 17 year old high school students from an evolutionary epistemological perspective

Science.gov (United States)

Chernavski, Ghennady

This study examines the issue of perception of extreme amounts of various physical quantities among 14 to 17 year old public schools students. The methods used in this investigation consisted of combined multiple-choice-open response questions and clinical interviews. The subjects in this study have relatively well defined ideas about quantitative relationships of the physical world as long as the quantities involved lie within their perceptual limits. Beyond these limits, their quantitative understanding was vague across all concepts with respect to their inability to do adequate quantitative comparisons. Very small physical quantities as well as very small changes in quantities did not seem to be present in the mental frameworks of the subjects. Most subjects were able to comprehend micro-quantities and micro-changes by relating them to those within their mesocosmical range. Analogical reasoning appeared to be central to this process. The subjects failed to perceive identical physical situations as analogical if one of them involved mesocosmical quantities and the other contained those lying beyond their mental mesocosmical range. Crossing mesocosmical boundaries in one's mind caused interruption in analogical reasoning. Very large physical quantities, namely those beyond the human range of sensual perception, were present in the subjects' mental frameworks. However, they were unable to reason adequately about quantitative differences between distinct quantities of the same concept if these quantities were beyond their sensual range. The findings of this study provide empirical support to Vollmer's (1984) theory of mesocosmical mind.

On pure-strategy Nash equilibria in price-quantity games

NARCIS (Netherlands)

Bos, I.; Vermeulen, A.J.

2015-01-01

This paper examines the existence and characteristics of pure-strategy Nash equilibria in oligopoly models in which firms set both prices and quantities. Existence is proved for a broad and natural class of price-quantity games. With differentiated products, the equilibrium outcome is similar to

Consumer direct access to clinical laboratory testing: what are the critical issues?

Science.gov (United States)

Wilkinson, David S; Pontius, C Anne

2003-01-01

Americans are demanding, independent people. In most aspects of our lives, we are used to walking into a store or other place of business with the expectation that the personnel working for the business will make every effort to satisfy our requests quickly and without the need for a third party to intervene or approve the transaction. Hence, the popularity of convenience stores, do-it-yourself stores and kits, and e-commerce. The delivery of health-care services, however, generally does not conform to this model. Before most diagnostic tests or treatments are ordered, patients usually consult a physician. In many cases, prior to tests or treatments being performed, additional consultations are required with insurance plans. But the winds of change, they are a-blowing. More and more, people demand an active role in managing their health care. One emerging trend is direct patient access to clinical laboratory testing (1).

The Effects of Type and Quantity of Input on Iranian EFL Learners’ Oral Language Proficiency

Directory of Open Access Journals (Sweden)

Zahra Hassanzadeh

2014-05-01

Full Text Available In the written texts on foreign language learning, a group of studies has stressed the function of learning context and learning chances for learners’ language input. The present thesis had two main goals: on the one hand, different types of input to which Iranian grade four high school EFL learners’ are exposed were looked at; on the other hand, the possible relationship between types and quantity of input and Iranian EFL learners’ oral proficiency was investigated. It was supposed that EFL learners who have access to more input will show better oral proficiency than those who do not have. Instruments used in the present study for the purpose of data collation included  PET test, researcher- made questionnaire, oral language proficiency test and face- to -face interview. Data were gathered from 50 Iranian female grade four high school foreign language learners who were selected from among 120 students whose score on PET test were +1SD from the mean score. The results of the Spearman rank –order correlation test for the types of input and oral language proficiency scores, showed that the participants’ oral proficiency score significantly correlated with the intended four sources of input including spoken (rho= 0.416, sig=0.003, written (rho= 0.364, sig=0.009, aural (rho= 0.343, sig=0.015 and visual or audio-visual types of input (rho= 0.47, sig=0.00. The findings of Spearman rank –order correlation test for the quantity of input and oral language proficiency scores also showed a significant relationship between quantity of input and oral language proficiency (rho= 0.543, sig= 0.00. The findings showed that EFL learners’ oral proficiency is significantly correlated with efficient and effective input. The findings may also suggest  answers to the question why most Iranian English learners fail to speak English fluently, which might be due to  lack of effective input. This may emphasize the importance of the types and quantity of

Definitions of Quantities and Units.

Science.gov (United States)

Spurgin, C. B.

1983-01-01

Compares various methods of defining derived quantities, arguing for a definitional formula using base or fundamental units in a word equation, or symbol-equations with the symbols explained. Suggests that fundamental units be defined operationally or left regarded as intuitive as in the case of length and time. (JM)

Using the eSexual Health Clinic to access chlamydia treatment and care via the internet: a qualitative interview study.

Science.gov (United States)

Aicken, Catherine R H; Sutcliffe, Lorna J; Gibbs, Jo; Tickle, Laura J; Hone, Kate; Harding-Esch, Emma M; Mercer, Catherine H; Sonnenberg, Pam; Sadiq, S Tariq; Estcourt, Claudia S; Shahmanesh, Maryam

2018-06-01

We developed the eSexual Health Clinic (eSHC), an innovative, complex clinical and public health intervention, embedded within a specialist sexual health service. Patients with genital chlamydia access their results online and are offered medical management via an automated online clinical consultation, leading to antibiotic collection from community pharmacy. A telephone helpline, staffed by Sexual Health Advisers, is available to support patients and direct them to conventional services if appropriate. We sought to understand how patients used this ehealth intervention. Within exploratory studies of the eSHC (2014-2015), we conducted in-depth interviews with a purposive sample of 36 patients diagnosed with chlamydia, who had chosen to use the eSHC (age 18-35, 20 female, 16 male). Thematic analysis was conducted. Participants described choosing to use this ehealth intervention to obtain treatment rapidly, conveniently and privately, within busy lifestyles that hindered clinic access. They described completing the online consultation promptly, discreetly and with ease. The information provided online was considered comprehensive, reassuring and helpful, but some overlooked it in their haste to obtain treatment. Participants generally described being able to collect treatment from pharmacies discreetly and promptly, but for some, poor awareness of the eSHC by pharmacy staff undermined their ability to do this. Those unsuitable for remote management, who were directed to clinic, described frustration and concern about health implications and clinic attendance. However, the helpline was a highly valued source of information, assistance and support. The eSHC is a promising adjunct to traditional care. Its users have high expectations for convenience, speed and privacy, which may be compromised when transitioning from online to face-to-face elements of the eSHC. Managing expectations and improving implementation of the pharmacy process, could improve their experiences

Detection Dynamics Of Nitrogen Based Explosive Quantities In Selected Cylindrical Containers

Directory of Open Access Journals (Sweden)

Ngusha Tavershima Almighty

2017-12-01

Full Text Available An experimental set up for examining the variation of detection intensity with explosive quantity has been studied. Containers made from ceramic carbon steel wood and HDPE were filled with explosive masses ranging from 10 kg to 500 kg and irradiated by a 14.1 MeV point isotropic neutron source. The resulting gamma photons were analyzed for their C N and O composition and the sum computed to yield a quantity known as the material quotient MQ. Examination of MQ values indicates an initial increase in detection intensity with increasing explosive quantity. Saturation is however reached at an explosive quantity of about 25kg where detection intensity reduces with further increase in explosive quantity. Effects of variation in explosive quantity appeared to be more pronounced for explosives contained in HDPE and wooden containers and least pronounced for those in steel containers. Source-detector configuration was identified as a major factor affecting effective detection of large masses of explosives.

Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1).

Science.gov (United States)

Lima, Estevao; Rodrigues, Pedro L; Mota, Paulo; Carvalho, Nuno; Dias, Emanuel; Correia-Pinto, Jorge; Autorino, Riccardo; Vilaça, João L

2017-10-01

Puncture of the renal collecting system represents a challenging step in percutaneous nephrolithotomy (PCNL). Limitations related to the use of standard fluoroscopic-based and ultrasound-based maneuvers have been recognized. To describe the technique and early clinical outcomes of a novel navigation system for percutaneous kidney access. This was a proof-of-concept study (IDEAL phase 1) conducted at a single academic center. Ten PCNL procedures were performed for patients with kidney stones. Flexible ureterorenoscopy was performed to determine the optimal renal calyx for access. An electromagnetic sensor was inserted through the working channel. Then the selected calyx was punctured with a needle with a sensor on the tip guided by real-time three-dimensional images observed on the monitor. The primary endpoints were the accuracy and clinical applicability of the system in clinical use. Secondary endpoints were the time to successful puncture, the number of attempts for successful puncture, and complications. Ten patients were enrolled in the study. The median age was 47.1 yr (30-63), median body mass index was 22.85kg/m 2 (19-28.3), and median stone size was 2.13cm (1.5-2.5cm). All stones were in the renal pelvis. The Guy's stone score was 1 in nine cases and 2 in one case. All 10 punctures of the collecting system were successfully completed at the first attempt without X-ray exposure. The median time to successful puncture starting from insertion of the needle was 20 s (range 15-35). No complications occurred. We describe the first clinical application of a novel navigation system using real-time electromagnetic sensors for percutaneous kidney access. This new technology overcomes the intrinsic limitations of traditional methods of kidney access, allowing safe, precise, fast, and effective puncture of the renal collecting system. We describe a new technology allowing safe and easy puncture of the kidney without radiation exposure. This could significantly

Workplace stress experienced by quantity surveyors

African Journals Online (AJOL)

Paul (P.A.) Bowen, Department of Construction Economics and Management,. University of Cape Town, Private ..... Explore workplace stress levels among quantity surveyors in the developing nation of ...... London: Free. Association Books.

Vascular Access in Children

International Nuclear Information System (INIS)

Krishnamurthy, Ganesh; Keller, Marc S.

2011-01-01

Establishment of stable vascular access is one of the essential and most challenging procedures in a pediatric hospital. Many clinical specialties provide vascular service in a pediatric hospital. At the top of the “expert procedural pyramid” is the pediatric interventional radiologist, who is best suited and trained to deliver this service. Growing awareness regarding the safety and high success rate of vascular access using image guidance has led to increased demand from clinicians to provide around-the-clock vascular access service by pediatric interventional radiologists. Hence, the success of a vascular access program, with the pediatric interventional radiologist as the key provider, is challenging, and a coordinated multidisciplinary team effort is essential for success. However, there are few dedicated pediatric interventional radiologists across the globe, and also only a couple of training programs exist for pediatric interventions. This article gives an overview of the technical aspects of pediatric vascular access and provides useful tips for obtaining vascular access in children safely and successfully using image guidance.

Recognizing Prefixes in Scientific Quantities

Science.gov (United States)

Sokolowski, Andrzej

2015-01-01

Although recognizing prefixes in physical quantities is inherent for practitioners, it might not be inherent for students, who do not use prefixes in their everyday life experiences. This deficiency surfaces in AP Physics exams. For example, readers of an AP Physics exam reported "a common mistake of incorrectly converting nanometers to…

30 CFR 75.322 - Harmful quantities of noxious gases.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Harmful quantities of noxious gases. 75.322... quantities of noxious gases. Concentrations of noxious or poisonous gases, other than carbon dioxide, shall... Governmental Industrial Hygienists in “Threshold Limit Values for Substance in Workroom Air” (1972). Detectors...

48 CFR 52.217-6 - Option for Increased Quantity.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Option for Increased....217-6 Option for Increased Quantity. As prescribed in 17.208(d), insert a clause substantially the same as the following: Option for Increased Quantity (MAR 1989) The Government may increase the...

41 CFR 109-27.102 - Economic order quantity principle.

Science.gov (United States)

2010-07-01

... PROCUREMENT 27-INVENTORY MANAGEMENT 27.1-Stock Replenishment § 109-27.102 Economic order quantity principle. ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Economic order quantity principle. 109-27.102 Section 109-27.102 Public Contracts and Property Management Federal Property...

Photosynthesis-related quantities for education and modeling.

Science.gov (United States)

Antal, Taras K; Kovalenko, Ilya B; Rubin, Andrew B; Tyystjärvi, Esa

2013-11-01

A quantitative understanding of the photosynthetic machinery depends largely on quantities, such as concentrations, sizes, absorption wavelengths, redox potentials, and rate constants. The present contribution is a collection of numbers and quantities related mainly to photosynthesis in higher plants. All numbers are taken directly from a literature or database source and the corresponding reference is provided. The numerical values, presented in this paper, provide ranges of values, obtained in specific experiments for specific organisms. However, the presented numbers can be useful for understanding the principles of structure and function of photosynthetic machinery and for guidance of future research.

Category 3 threshold quantities for hazard categorization of nonreactor facilities

International Nuclear Information System (INIS)

Mandigo, R.L.

1996-01-01

This document provides the information necessary to determine Hazard Category 3 threshold quantities for those isotopes of interest not listed in WHC-CM-4-46, Section 4, Table 1.''Threshold Quantities.''

19 CFR 144.33 - Minimum quantities to be withdrawn.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Minimum quantities to be withdrawn. 144.33 Section 144.33 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT... Warehouse § 144.33 Minimum quantities to be withdrawn. Unless by special authority of the Commissioner of...

The impact of a novel franchise clinic network on access to medicines and vaccinations in Kenya: a cross-sectional study

Science.gov (United States)

Adhvaryu, Achyuta

2012-01-01

Objectives To study the impact of a new franchise health clinic model (The HealthStore Foundation's CFWShops) on access to vaccinations and treatment for acute illnesses in a nationally representative sample of children in Kenya. Design The authors used multivariate linear and count regressions to examine associations between receipt of vaccinations or treatment and proximity to a franchise health clinic, adjusting for individual, household and clinic attributes as well as region fixed effects. Setting Demographic and Health Survey data from Kenya, 2008–2009. Participants 6079 Kenyan children younger than 5 years, of whom 2310 reported recent acute illness. Main outcome measures Outcomes for all children were number of polio doses received, number of DPT doses received, receipt of BCG vaccine, receipt of measles vaccine and number of total vaccinations received. Outcomes for acutely ill children were receipt of any medical treatment, treatment for fever, treatment for malaria and treatments specifically stocked by CFWShops. Results Children living within 30 km of a CFWShop received 0.129 (p=0.017) and 0.113 (p=0.025) more DPT and polio doses, respectively; and 0.285 more total vaccinations (p=0.023). Among acutely ill children, CFWShop proximity was associated with significant increases in the probabilities of receiving any medical treatment (0.142; pfranchise health clinic model could substantially increase access to essential vaccinations and treatments in low-income countries. Moreover, the model's benefits may accrue to lesser- and higher-income households alike. PMID:22786948

The impact of a novel franchise clinic network on access to medicines and vaccinations in Kenya: a cross-sectional study.

Science.gov (United States)

Berk, Justin; Adhvaryu, Achyuta

2012-01-01

To study the impact of a new franchise health clinic model (The HealthStore Foundation's CFWShops) on access to vaccinations and treatment for acute illnesses in a nationally representative sample of children in Kenya. The authors used multivariate linear and count regressions to examine associations between receipt of vaccinations or treatment and proximity to a franchise health clinic, adjusting for individual, household and clinic attributes as well as region fixed effects. Demographic and Health Survey data from Kenya, 2008-2009. 6079 Kenyan children younger than 5 years, of whom 2310 reported recent acute illness. Outcomes for all children were number of polio doses received, number of DPT doses received, receipt of BCG vaccine, receipt of measles vaccine and number of total vaccinations received. Outcomes for acutely ill children were receipt of any medical treatment, treatment for fever, treatment for malaria and treatments specifically stocked by CFWShops. Children living within 30 km of a CFWShop received 0.129 (p=0.017) and 0.113 (p=0.025) more DPT and polio doses, respectively; and 0.285 more total vaccinations (p=0.023). Among acutely ill children, CFWShop proximity was associated with significant increases in the probabilities of receiving any medical treatment (0.142; pfranchise health clinic model could substantially increase access to essential vaccinations and treatments in low-income countries. Moreover, the model's benefits may accrue to lesser- and higher-income households alike.

Quantity Estimation Of The Interactions

International Nuclear Information System (INIS)

Gorana, Agim; Malkaj, Partizan; Muda, Valbona

2007-01-01

In this paper we present some considerations about quantity estimations, regarding the range of interaction and the conservations laws in various types of interactions. Our estimations are done under classical and quantum point of view and have to do with the interaction's carriers, the radius, the influence range and the intensity of interactions

Information quantity in a pixel of digital image

OpenAIRE

Kharinov, M.

2014-01-01

The paper is devoted to the problem of integer-valued estimating of information quantity in a pixel of digital image. The definition of an integer estimation of information quantity based on constructing of the certain binary hierarchy of pixel clusters is proposed. The methods for constructing hierarchies of clusters and generating of hierarchical sequences of image approximations that minimally differ from the image by a standard deviation are developed. Experimental results on integer-valu...

Accessibility of antiretroviral therapy in Ghana: convenience of access.

Science.gov (United States)

Addo-Atuah, Joyce; Gourley, Dick; Gourley, Greta; White-Means, Shelley I; Womeodu, Robin J; Faris, Richard J; Addo, Nii Akwei

2012-01-01

The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care, the availability, or otherwise, of special considerations, with respect to the waiting time to receive care, for those PLWHA who were in active employment in the formal sector, the frequency of clinic visits before and after initiating ART, and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin's case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. • Reported travel time to receive ART services ranged from 2 to 12 h for 30% of the PLWHA. • Waiting time to receive care was from 4 to 9 h. • While known government workers, such as teachers, were attended to earlier in some of the centres, this was not a consistent practice in all the four ART centres studied. • The PLWHA corroborated the providers' description of the procedure for initiating and monitoring ART in Ghana. • PLWHA did not see the same provider every time, but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers, but the participants alluded to other factors, including open provider-patient communication, which might explain the PLWHA's understanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana, however, calls for the replication of this study to identify

Processing ordinality and quantity: the case of developmental dyscalculia.

Directory of Open Access Journals (Sweden)

Orly Rubinsten

Full Text Available In contrast to quantity processing, up to date, the nature of ordinality has received little attention from researchers despite the fact that both quantity and ordinality are embodied in numerical information. Here we ask if there are two separate core systems that lie at the foundations of numerical cognition: (1 the traditionally and well accepted numerical magnitude system but also (2 core system for representing ordinal information. We report two novel experiments of ordinal processing that explored the relation between ordinal and numerical information processing in typically developing adults and adults with developmental dyscalculia (DD. Participants made "ordered" or "non-ordered" judgments about 3 groups of dots (non-symbolic numerical stimuli; in Experiment 1 and 3 numbers (symbolic task: Experiment 2. In contrast to previous findings and arguments about quantity deficit in DD participants, when quantity and ordinality are dissociated (as in the current tasks, DD participants exhibited a normal ratio effect in the non-symbolic ordinal task. They did not show, however, the ordinality effect. Ordinality effect in DD appeared only when area and density were randomized, but only in the descending direction. In the symbolic task, the ordinality effect was modulated by ratio and direction in both groups. These findings suggest that there might be two separate cognitive representations of ordinal and quantity information and that linguistic knowledge may facilitate estimation of ordinal information.

Processing ordinality and quantity: the case of developmental dyscalculia.

Science.gov (United States)

Rubinsten, Orly; Sury, Dana

2011-01-01

In contrast to quantity processing, up to date, the nature of ordinality has received little attention from researchers despite the fact that both quantity and ordinality are embodied in numerical information. Here we ask if there are two separate core systems that lie at the foundations of numerical cognition: (1) the traditionally and well accepted numerical magnitude system but also (2) core system for representing ordinal information. We report two novel experiments of ordinal processing that explored the relation between ordinal and numerical information processing in typically developing adults and adults with developmental dyscalculia (DD). Participants made "ordered" or "non-ordered" judgments about 3 groups of dots (non-symbolic numerical stimuli; in Experiment 1) and 3 numbers (symbolic task: Experiment 2). In contrast to previous findings and arguments about quantity deficit in DD participants, when quantity and ordinality are dissociated (as in the current tasks), DD participants exhibited a normal ratio effect in the non-symbolic ordinal task. They did not show, however, the ordinality effect. Ordinality effect in DD appeared only when area and density were randomized, but only in the descending direction. In the symbolic task, the ordinality effect was modulated by ratio and direction in both groups. These findings suggest that there might be two separate cognitive representations of ordinal and quantity information and that linguistic knowledge may facilitate estimation of ordinal information.

Central Venous Access

International Nuclear Information System (INIS)

Ganeshan, Arul; Warakaulle, Dinuke R.; Uberoi, Raman

2007-01-01

Central venous access plays an important role in the management of an ever-increasing population of patients ranging from those that are critically ill to patients with difficult clinical access. Interventional radiologists are key in delivering this service and should be familiar with the wide range of techniques and catheters now available to them. A comprehensive description of these catheters with regard to indications, technical aspects of catheterization, success rates, and associated early and late complications, as well as a review of various published guidelines on central venous catheter insertion are given in this article

Sleep quantity, quality, and insomnia symptoms of medical students during clinical years

Science.gov (United States)

Alsaggaf, Mohammed A.; Wali, Siraj O.; Merdad, Roah A.; Merdad, Leena A.

2016-01-01

Objectives: To determine sleep habits and sleep quality in medical students during their clinical years using validated measures; and to investigate associations with academic performance and psychological stress. Methods: In this cross-sectional study, medical students (n=320) were randomly selected from a list of all enrolled clinical-year students in a Saudi medical school from 2011-2012. Students filled a questionnaire including demographic and lifestyle factors, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Perceived Stress Scale. Results: Students acquired on average, 5.8 hours of sleep each night, with an average bedtime at 01:53. Approximately 8% reported acquiring sleep during the day, and not during nighttime. Poor sleep quality was present in 30%, excessive daytime sleepiness (EDS) in 40%, and insomnia symptoms in 33% of students. Multivariable regression models revealed significant associations between stress, poor sleep quality, and EDS. Poorer academic performance and stress were associated with symptoms of insomnia. Conclusion: Sleep deprivation, poor sleep quality, and EDS are common among clinical years medical students. High levels of stress and the pressure of maintaining grade point averages may be influencing their quality of sleep. PMID:26837401

Outcomes of patients presenting to a dedicated rapid access lung cancer clinic.

LENUS (Irish Health Repository)

Dunican, E

2012-02-01

We examined the outcomes of the first 500 patients referred to a dedicated Rapid Access Lung Cancer Clinic. A total of 206 patients (41.2%) were diagnosed with a thoracic malignancy; 179 had primary lung cancer and 27 had secondary or other thoracic cancers. Pulmonary nodules requiring ongoing surveillance were found in a further 79 patients (15.8%). Of those patients found to have primary lung cancer, 24 (13.4%) had Small Cell and 145 (81%) had Non Small Cell Lung Cancer. In patients with Non small cell tumours, 26 (21.1%) were stage 1, 14 (11.4%) stage II, 37 (30.1%) stage III and 46 (37.4%) stage IV at diagnosis. For the 129 patients (72%) in whom the thoracic MDT recommended active treatment, primary therapy was surgical resection in 44 (24.6%), combined chemoradiation in 31 patients (17.3%), chemotherapy alone in 39 (21.8%) and radiation in 15 (8.4%).

Review of clinical approaches and diagnostic quantities used in pedobarographic measurements.

Science.gov (United States)

Deschamps, K; Roosen, P; Nobels, F; Deleu, P A; Birch, I; Desloovere, K; Bruyninckx, H; Matricali, G; Staes, F

2015-03-01

The non-invasive nature of pedobarographic measurements is particularly attractive to researchers for analyzing and characterizing the impact of specific pathological foot conditions. However, adequate clinical use of pedobarographic technology requires a profound technical and methodological knowledge. Several papers summarized the technical capacities of pedobarographic technology. Moreover, methodological expertise has grown considerably during the last two decades. Therefore, two crucial decisions have to be made before pathomechanical modelling or functional interpretation of foot and lower limb disorders can be pursued. The first is the selection of the specific method to analyse the dynamic plantar footprint, and the second is the choice of parameters to quantify the results. In the first part of this paper, we review the different methods used to analyse the dynamic plantar footprint and discuss their conceptual backgrounds. We also aim to illustrate the clinical relevance of each method and elaborate on the future perspectives. In the second part, we review quantification methods of pedobarographic measurements. The latter is of primary relevance to clinicians and investigators with a special interest in foot and lower limb biomechanics.

Quantity estimation based on numerical cues in the mealworm beetle (Tenebrio molitor

Directory of Open Access Journals (Sweden)

Pau eCarazo

2012-11-01

Full Text Available In this study, we used a biologically relevant experimental procedure to ask whether mealworm beetles (Tenebrio molitor are spontaneously capable of assessing quantities based on numerical cues. Like other insect species, mealworm beetles adjust their reproductive behaviour (i.e. investment in mate guarding according to the perceived risk of sperm competition (i.e. probability that a female will mate with another male. To test whether males have the ability to estimate numerosity based on numerical cues, we staged matings between virgin females and virgin males in which we varied the number of rival males the experimental male had access to immediately preceding mating as a cue to sperm competition risk (from 1 to 4. Rival males were presented sequentially, and we controlled for continuous cues by ensuring that males in all treatments were exposed to the same amount of male-male contact. Males exhibited a marked increase in the time they devoted to mate guarding in response to an increase in the number of different rival males they were exposed to. Since males could not rely on continuous cues we conclude that they kept a running tally of the number of individuals they encountered serially, which meets the requirements of the basic ordinality and cardinality principles of proto-counting. Our results thus offer good evidence of ‘true’ numerosity estimation or quantity estimation and, along with recent studies in honey-bees, suggest that vertebrates and invertebrates share similar core systems of non-verbal numerical representation.

Foreign materials in the repository. Update of estimated quantities

International Nuclear Information System (INIS)

Karvonen, T.

2011-06-01

A variety of materials are used during the construction process and the operation of the repository for spent nuclear fuel at Olkiluoto in Eurajoki, Finland. In addition to materials necessary for the construction and operation, some materials may be transported into the repository with the ventilation air, as emissions from vehicles etc. Both of these two types of materials are considered here and both introduced quantities and the quantities that remain after the closure in the repository are estimated here based on the most recent information. This work is intended to update the previous estimations, and it takes advantage of the experience collected during the construction of the underground rock characterisation facility called ONKALO at Olkiluoto. The implemented quantities as well as designs and preliminary designs have been used in calculating the quantities of the foreign materials. The estimations made in this report are specific to a KBS-3V type repository. In some cases more generic information has been used, particularly when the relevant quantities have not been monitored in ONKALO. The estimations are based on the new repository layout produced in 2010 and consider the latest plans for grouting and rock support. As all of these plans are not final some quantities may change in the future. As the repository layout may still go through some changes this report also provides the foreign materials for a hundred meters of different deposition tunnels designed for the OL and LO type canisters1. The results have also been calculated for a space demanded by a deposition tunnel end plug and the tunnel lengths before and after one. The most significant foreign materials are certain accessory minerals of the clay materials followed by organic materials (including the organic carbon from the clay materials), cement, steel and silica. (orig.)

Calibration of personal dosemeters in terms of the ICRU operational quantities

International Nuclear Information System (INIS)

McDonald, J.C.; Hertel, N.E.

1992-01-01

The International Commission on Radiological Units and Measurements (ICRU) has defined several new operational quantities for radiation protection purposes. The quantities to be used for personal monitoring are defined at depths in the human body. Because these quantities are impossible to measure directly, the ICRU has recommended that personal dosimeters should be calibrated under simplified conditions on an appropriate phantom, such as the ICRU sphere. The U.S. personal dosimetry accreditation programs make use of a 30 x 30 x 15 cm polymethylmethacrylate (PMMA) phantom; therefore it is necessary to relate the response of dosimeters calibrated on this phantom to the ICRU operational quantities. Calculations of the conversion factors to compute dosimeter response in terms of the operational quantities have been performed using the code MCNP. These calculations have also been compared to experimental measurements using thermoluminescent (TLD) detectors. (author)

Calibration of personal dosemeters in terms of the ICRU operational quantities

International Nuclear Information System (INIS)

McDonald, J.C.; Hertel, N.E.

1992-05-01

The International Commission on Radiological Units and Measurements (ICRU) has defined several new operational quantities for radiation protection purposes. The quantities to be used for personal monitoring are defined at depths in the human body. Because these quantities are impossible to measure directly, the ICRU has recommended that personal dosemeters should be calibrated under simplified conditions on an appropriate phantom, such as the ICRU sphere. The US personal dosimetry accreditation programs make use of a 30 x 30 x 15 cm polymethymethacrylate (PMMA) phantom, therefore it is necessary to relate the response of dosemeters calibrated on this phantom to the ICRU operational quantities. Calculations of the conversion factors to compute dosemeter response in terms of the operational quantities have been performed using the code MCNP. These calculations have also been compared to experimental measurements using thermoluminescent (TLD) detectors

The Motivation-Facilitation Theory of Prenatal Care Access.

Science.gov (United States)

Phillippi, Julia C; Roman, Marian W

2013-01-01

Despite the availability of services, accessing health care remains a problem in the United States and other developed countries. Prenatal care has the potential to improve perinatal outcomes and decrease health disparities, yet many women struggle with access to care. Current theories addressing access to prenatal care focus on barriers, although such knowledge is minimally useful for clinicians. We propose a middle-range theory, the motivation-facilitation theory of prenatal care access, which condenses the prenatal care access process into 2 interacting components: motivation and facilitation. Maternal motivation is the mother's desire to begin and maintain care. Facilitation represents the goal of the clinic to create easy, open access to person-centered beneficial care. This simple model directs the focus of research and change to the interface of the woman and the clinic and encourages practice-level interventions that facilitate women entering and maintaining prenatal care. © 2013 by the American College of Nurse‐Midwives.

Facilitators of prenatal care access in rural Appalachia.

Science.gov (United States)

Phillippi, Julia C; Myers, Carole R; Schorn, Mavis N

2014-12-01

There are many providers and models of prenatal care, some more effective than others. However, quantitative research alone cannot determine the reasons beneficial models of care improve health outcomes. Perspectives of women receiving care from effective clinics can provide valuable insight. We surveyed 29 women receiving care at a rural, Appalachian birth center in the United States with low rates of preterm birth. Semi-structured interviews and demographic questionnaires were analyzed using conventional qualitative content analysis of manifest content. Insurance was the most common facilitator of prenatal access. Beneficial characteristics of the provider and clinic included: personalized care, unrushed visits, varied appointment times, short waits, and choice in the type and location of care. There is a connection between compassionate and personalized care and positive birth outcomes. Women were willing to overcome barriers to access care that met their needs. To facilitate access to prenatal care and decrease health disparities, healthcare planners, and policy makers need to ensure all women can afford to access prenatal care and allow women a choice in their care provider. Clinic administrators should create a welcoming clinic environment with minimal wait time. Unrushed, woman-centered prenatal visits can increase access to and motivation for care and are easily integrated into prenatal care with minimal cost. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Conserved quantities for generalized KdV equations

International Nuclear Information System (INIS)

Calogero, F.; Rome Univ.; Degasperis, A.; Rome Univ.

1980-01-01

It is noted that the nonlinear evolution equation usub(t) = α(t)usub(xxx) - 6ν(t) usub(x)u, u is identical to u(x,t), possesses three (and, in some cases, four) conserved quantities, that are explicitly displayed. These results are of course relevant only to the cases in which this evolution equation is not known to possess an infinite number of conserved quantities. Purpose and scope of this paper is to report three or four simple conservation laws possessed by the evolution equation usub(t) = α(t)usub(xxx) - 6ν(t)usub(x)u, u is identical to u(x,t). (author)

A geochemical module for "AMDTreat" to compute caustic quantity, effluent quantity, and sludge volume

Science.gov (United States)

Cravotta,, Charles A.; Parkhurst, David L.; Means, Brent P; McKenzie, Bob; Morris, Harry; Arthur, Bill

2010-01-01

Treatment with caustic chemicals typically is used to increase pH and decrease concentrations of dissolved aluminum, iron, and/or manganese in largevolume, metal-laden discharges from active coal mines. Generally, aluminum and iron can be removed effectively at near-neutral pH (6 to 8), whereas active manganese removal requires treatment to alkaline pH (~10). The treatment cost depends on the specific chemical used (NaOH, CaO, Ca(OH)2, Na2CO3, or NH3) and increases with the quantities of chemical added and sludge produced. The pH and metals concentrations do not change linearly with the amount of chemical added. Consequently, the amount of caustic chemical needed to achieve a target pH and the corresponding effluent composition and sludge volume can not be accurately determined without empirical titration data or the application of geochemical models to simulate the titration of the discharge water with caustic chemical(s). The AMDTreat computer program (http://amd.osmre.gov/ ) is widely used to compute costs for treatment of coal-mine drainage. Although AMDTreat can use results of empirical titration with industrial grade caustic chemicals to compute chemical costs for treatment of net-acidic or net-alkaline mine drainage, such data are rarely available. To improve the capability of AMDTreat to estimate (1) the quantity and cost of caustic chemicals to attain a target pH, (2) the concentrations of dissolved metals in treated effluent, and (3) the volume of sludge produced by the treatment, a titration simulation is being developed using the geochemical program PHREEQC (wwwbrr.cr.usgs.gov/projects/GWC_coupled/phreeqc/) that will be coupled as a module to AMDTreat. The simulated titration results can be compared with or used in place of empirical titration data to estimate chemical quantities and costs. This paper describes the development, evaluation, and potential utilization of the PHREEQC titration module for AMDTreat.

Establishment and Evaluation of Decommissioning Plant Inventory DB and Waste Quantity

International Nuclear Information System (INIS)

Oh, Jae Yong; Moon, Sang-Rae; Yun, Taesik; Kim, Hee-Geun; Sung, Nak-Hoon; Jung, Seung Hyuk

2016-01-01

Korea Hydro and Nuclear Power (KHNP) made a decision for permanent shutdown of Kori-1 and has progressed the strategy determination and R and D for the decommissioning of Kori-1. Decommissioning waste, Structure, System and Components (SSCs) is one of the most important elements. Decommissioning waste quantity is calculated based on Plant Inventory Database (PI DB) with activation and contamination data. Due to the largest portion of waste management and disposal in decommissioning, it is necessary to exactly evaluate waste quantity (applying the regulation, guideline and site-specific characterization) for economic feasibility. In this paper, construction of PI DB and evaluation of waste quantity for Optimized Pressurized Reactor (OPR-1000) are mainly described. Decommissioning waste quantities evaluated are going to be applied to calculation of the project cost. In fact, Ministry of Trade, Industry and Energy (MOTIE) in Korea expected the decommissioning waste quantity in a range of 14,500-18,850 drums, and predicted appropriate liability for decommissioning fund by using waste quantity. The result of this study is also computed by the range of 14,500-18,850 drums. Since there is no site-specific data for the NPP site, this evaluation is the preliminary analysis

Establishment and Evaluation of Decommissioning Plant Inventory DB and Waste Quantity

Energy Technology Data Exchange (ETDEWEB)

Oh, Jae Yong; Moon, Sang-Rae; Yun, Taesik; Kim, Hee-Geun [KHNP CRI, Daejeon (Korea, Republic of); Sung, Nak-Hoon; Jung, Seung Hyuk [KONES Corp., Seoul (Korea, Republic of)

2016-10-15

Korea Hydro and Nuclear Power (KHNP) made a decision for permanent shutdown of Kori-1 and has progressed the strategy determination and R and D for the decommissioning of Kori-1. Decommissioning waste, Structure, System and Components (SSCs) is one of the most important elements. Decommissioning waste quantity is calculated based on Plant Inventory Database (PI DB) with activation and contamination data. Due to the largest portion of waste management and disposal in decommissioning, it is necessary to exactly evaluate waste quantity (applying the regulation, guideline and site-specific characterization) for economic feasibility. In this paper, construction of PI DB and evaluation of waste quantity for Optimized Pressurized Reactor (OPR-1000) are mainly described. Decommissioning waste quantities evaluated are going to be applied to calculation of the project cost. In fact, Ministry of Trade, Industry and Energy (MOTIE) in Korea expected the decommissioning waste quantity in a range of 14,500-18,850 drums, and predicted appropriate liability for decommissioning fund by using waste quantity. The result of this study is also computed by the range of 14,500-18,850 drums. Since there is no site-specific data for the NPP site, this evaluation is the preliminary analysis.

Community clinic offers access to care. A system and a city collaborate to care for an immigrant population.

Science.gov (United States)

Bauer, S

1993-10-01

The Southwest Community Health Clinic (SCHC) has been providing free preventive healthcare to the poor residents of its Houston neighborhood since June 1991. Sponsored by the Sisters of Charity of the Incarnate Word Health Care System and the city of Houston, the clinic invites healing through hospitality, unlike many free clinics. The family-focused clinic takes a multidisciplinary team approach to preventive healthcare. The staff of approximately 30 healthcare professionals provides prenatal and pediatric care; immunizations; tuberculosis screenings; and a variety of social services for patients' physical, emotional, and spiritual needs. SCHC's well-child program screens children from birth through age five for physical and developmental problems. Clinic staff teach and guide parents on their children's health. The program stresses early identification of developmental delays and disabilities, with referral to appropriate services. SCHC has also implemented a tuberculosis testing program to prevent spread of the disease. Persons who test positive are referred to the City of Houston Department of Health and Human Service's chest clinics for follow-up and treatment. Community outreach is a major ingredient of SCHC's preventive healthcare program. A community health advocate, who is familiar with the cultures, traditions, and languages of the population being served, identifies families needing care and supports their access and use of healthcare services.

29 CFR 780.814 - “Grown in commercial quantities.”

Science.gov (United States)

2010-07-01

... OF GENERAL POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS EXEMPTIONS APPLICABLE TO AGRICULTURE, PROCESSING OF AGRICULTURAL COMMODITIES, AND RELATED SUBJECTS UNDER THE FAIR LABOR STANDARDS ACT... “commercial” quantities, the trade understanding of what are “commercial” quantities of cotton would be...

Personalized medicine and access to genetic technologies.

Science.gov (United States)

den Exter, André

2010-01-01

Personalized medicine started after the Human Genome Project and is a relatively new concept that will dramatically change clinical practice. It offers clear clinical advantages by applying genetic diagnostic tests and then treating the patient with targeted medicines based on his or her genetic make-up. Its potential seems promising but there are quite a few legal concerns. One of these questions deals with the right to health care and access to genetic technologies. In this paper, the author explains the meaning of such a right to health care under international human rights law, its relevance for making genetic services eligible for public funding, how to cope with quality concerns of commercial testing, and finally, the patentability controversy and clinical access to genetic information. Apart from more traditional human rights concerns (consent, privacy, confidentiality) and genetics, States should be aware of the meaning of the equal access concept under international law and its consequences when introducing new technologies such genetic testing and services.

Access to DIII-D data located in multiple files and multiple locations

International Nuclear Information System (INIS)

McHarg, B.B. Jr.

1993-10-01

The General Atomics DIII-D tokamak fusion experiment is now collecting over 80 MB of data per discharge once every 10 min, and that quantity is expected to double within the next year. The size of the data files, even in compressed format, is becoming increasingly difficult to handle. Data is also being acquired now on a variety of UNIX systems as well as MicroVAX and MODCOMP computer systems. The existing computers collect all the data into a single shot file, and this data collection is taking an ever increasing amount of time as the total quantity of data increases. Data is not available to experimenters until it has been collected into the shot file, which is in conflict with the substantial need for data examination on a timely basis between shots. The experimenters are also spread over many different types of computer systems (possibly located at other sites). To improve data availability and handling, software has been developed to allow individual computer systems to create their own shot files locally. The data interface routine PTDATA that is used to access DIII-D data has been modified so that a user's code on any computer can access data from any computer where that data might be located. This data access is transparent to the user. Breaking up the shot file into separate files in multiple locations also impacts software used for data archiving, data management, and data restoration

Radiation quantities and units. ICRU report 33

International Nuclear Information System (INIS)

Anon.

1987-01-01

This report supersedes ICRU Report 19. Since ICRU Report 19 was published, a number of discussions have taken place between members of the Report Committee on Fundamental Quantities and Units and other workers in the field. Some of these discussions have resulted in the acceptance of certain modifications in the material set out in Report 19 and these modifications are incorporated in the current report. In addition, there has been some expansion and rearrangement of the material in the earlier report. It is recommended that energy state be inserted into the definition of activity and that the word transformation be replaced by transition. These modifications have now been incorporated into the current definition. Helpful comments on the previous quantities and units report have resulted in clarification of several points in the present Report. In line with providing more didactic material and useful source material for other ICRU reports, the general considerations in subsection I.A of Report 19 have been expanded and placed in a separate subsection. The additional material includes discussions of four terms that are used in this document - quantity, unit, stochastic, and non-stochastic - along with a brief discussion of the mathematical formalism used in ICRU reports. 11 refs., 4 tabs

Trained Quantity Abilities in Horses (Equus caballus: A Preliminary Investigation

Directory of Open Access Journals (Sweden)

Maria Elena Miletto Petrazzini

2014-07-01

Full Text Available Once believed to be a human prerogative, the capacity to discriminate between quantities now has also been reported in several vertebrates. To date, only two studies investigated numerical abilities in horses (Equus caballus but reported contrasting data. To assess whether horses can be trained to discriminate between quantities, I have set up a new experimental protocol using operant conditioning. One adult female was trained to discriminate between 1 and 4 (Test 1 in three different conditions: non-controlled continuous variables (numerical and continuous quantities that co-vary with number are simultaneously available, 50% controlled continuous variables (intermediate condition, and 100% controlled continuous variables (only numerical information available. The subject learned the discrimination in all conditions, showing the capacity to process numerical information. When presented with a higher numerical ratio (2 vs. 4, Test 2, the subject still discriminated between the quantities but its performance was statistically significant only in the non-controlled condition, suggesting that the subject used multiple cues in presence of a more difficult discrimination. On the whole, the results here reported encourage the use of this experimental protocol as a valid tool to investigate the capacity to process numerical and continuous quantities in horses in future research.

On the Output-Inflation Relationship When Price and Quantity Adjustments are Costly

DEFF Research Database (Denmark)

Danziger, Leif; Kreiner, Claus Thustrup

A vast literature analyzes the real effects of price-adjustment costs assuming that quantity adjustments are costless. In this paper, we analyze whether the presence of quantity-adjustments costs, which presumably are significant, change the traditional results on the impact of inflation....... In particular, recent findings suggest that quantity-adjustment costs may remove the linkage between output and inflation. We show that this is not the case when inflation is anticipated. On the contrary, quantity-adjustment costs may significantly amplify the consequences of price-adjustment costs...

Estimated quantities of residual materials in a KBS-3H repository at Olkiluoto

Energy Technology Data Exchange (ETDEWEB)

Hagros, Annika (Sannio and Riekkola OY (Finland))

2008-12-15

The quantities of residual materials in a KBS-3H type repository have been estimated in this report. The repository is assumed to be constructed at Olkiluoto in Eurajoki, Western Finland. Both the total quantities of the materials introduced into the repository and the quantities of materials that remain in the repository after closure have been calculated. The calculations are largely based on a similar work regarding the material quantities in the Finnish KBS-3V repository and the main goal has been to identify the differences between the KBS-3H and KBS-3V repositories with respect to the type and quantities of residual materials. As the design of the KBS-3H repository is not final yet, the results are only preliminary. Several alternative designs were assumed in the calculations, resulting in different total quantities of materials. The design alternatives that had the greatest effect on the total material quantities were the two different tunnel backfill options, bentonite-crushed rock and Friedland clay. If Friedland clay is used instead of a bentonite-crushed rock mixture, the total quantity of pyrite remaining in the repository is 20 times larger and the quantities of organic materials and gypsum are also increased significantly. The other design alternatives did not have a substantial effect on the total material quantities. The remaining quantity of cement can be reduced by some 20% by selecting the silica grouting alternative in the sealing of the rock mass and low-pH cement in the shotcreting of the repository, instead of using the ordinary cement alternatives. If the total quantity of steel should be minimised, the use of the DAWE design alternative would be better than the Basic Design, although the total reduction would be less than 10%. The main difference between the different drift end plug alternatives is related to the total remaining quantity of silica, which is some 80% smaller if the rock plug is used instead of the LHHP (Low Heat High

Estimated quantities of residual materials in a KBS-3H repository at Olkiluoto

International Nuclear Information System (INIS)

Hagros, Annika

2008-12-01

The quantities of residual materials in a KBS-3H type repository have been estimated in this report. The repository is assumed to be constructed at Olkiluoto in Eurajoki, Western Finland. Both the total quantities of the materials introduced into the repository and the quantities of materials that remain in the repository after closure have been calculated. The calculations are largely based on a similar work regarding the material quantities in the Finnish KBS-3V repository and the main goal has been to identify the differences between the KBS-3H and KBS-3V repositories with respect to the type and quantities of residual materials. As the design of the KBS-3H repository is not final yet, the results are only preliminary. Several alternative designs were assumed in the calculations, resulting in different total quantities of materials. The design alternatives that had the greatest effect on the total material quantities were the two different tunnel backfill options, bentonite-crushed rock and Friedland clay. If Friedland clay is used instead of a bentonite-crushed rock mixture, the total quantity of pyrite remaining in the repository is 20 times larger and the quantities of organic materials and gypsum are also increased significantly. The other design alternatives did not have a substantial effect on the total material quantities. The remaining quantity of cement can be reduced by some 20% by selecting the silica grouting alternative in the sealing of the rock mass and low-pH cement in the shotcreting of the repository, instead of using the ordinary cement alternatives. If the total quantity of steel should be minimised, the use of the DAWE design alternative would be better than the Basic Design, although the total reduction would be less than 10%. The main difference between the different drift end plug alternatives is related to the total remaining quantity of silica, which is some 80% smaller if the rock plug is used instead of the LHHP (Low Heat High

A statistical law in the perception of risks and physical quantities in traffic

DEFF Research Database (Denmark)

Elvik, Rune

2015-01-01

This paper suggests that a universal psychophysical law influences the perception of risks and physical quantities in traffic. This law states that there will be a tendency to overestimate low probabilities or small quantities, while high probabilities or large quantities may be underestimated....... Studies of the perception of risk and physical quantities in traffic have found a highly consistent pattern....

Entropy and Its Correlations with Other Related Quantities

Directory of Open Access Journals (Sweden)

Jing Wu

2014-02-01

Full Text Available In order to find more correlations between entropy and other related quantities, an analogical analysis is conducted between thermal science and other branches of physics. Potential energy in various forms is the product of a conserved extensive quantity (for example, mass or electric charge and an intensive quantity which is its potential (for example, gravitational potential or electrical voltage, while energy in specific form is a dissipative quantity during irreversible transfer process (for example mechanical or electrical energy will be dissipated as thermal energy. However, it has been shown that heat or thermal energy, like mass or electric charge, is conserved during heat transfer processes. When a heat transfer process is for object heating or cooling, the potential of internal energy U is the temperature T and its potential “energy” is UT/2 (called entransy and it is the simplified expression of thermomass potential energy; when a heat transfer process is for heat-work conversion, the potential of internal energy U is (1 − T0/T, and the available potential energy of a system in reversible heat interaction with the environment is U − U0 − T0(S − S0, then T0/T and T0(S − S0 are the unavailable potential and the unavailable potential energy of a system respectively. Hence, entropy is related to the unavailable potential energy per unit environmental temperature for heat-work conversion during reversible heat interaction between the system and its environment. Entropy transfer, like other forms of potential energy transfer, is the product of the heat and its potential, the reciprocal of temperature, although it is in form of the quotient of the heat and the temperature. Thus, the physical essence of entropy transfer is the unavailable potential energy transfer per unit environmental temperature. Entropy is a non-conserved, extensive, state quantity of a system, and entropy generation in an irreversible heat transfer process

A national analysis of dental waiting lists and point-in-time geographic access to subsidised dental care: can geographic access be improved by offering public dental care through private dental clinics?

Science.gov (United States)

Dudko, Yevgeni; Kruger, Estie; Tennant, Marc

2017-01-01

Australia is one of the least densely populated countries in the world, with a population concentrated on or around coastal areas. Up to 33% of the Australian population are likely to have untreated dental decay, while people with inadequate dentition (fewer than 21 teeth) account for up to 34% of Australian adults. Historically, inadequate access to public dental care has resulted in long waiting lists, received much media coverage and been the subject of a new federal and state initiative. The objective of this research was to gauge the potential for reducing the national dental waiting list through geographical advantage, which could arise from subcontracting the delivery of subsidised dental care to the existing network of private dental clinics across Australia. Eligible population data were collected from the Australian Bureau of Statistics website. Waiting list data from across Australia were collected from publicly available sources and confirmed through direct communication with each individual state or territory dental health body. Quantum geographic information system software was used to map distribution of the eligible population across Australia by statistical area, and to plot locations of government and private dental clinics. Catchment areas of 5 km for metropolitan clinics and 5 km and 50 km for rural clinics were defined. The number of people on the waiting list and those eligible for subsidised dental care covered by each of the catchment areas was calculated. Percentage of the eligible population and those on the waiting list that could benefit from the potential improvement in geographic access was ascertained for metropolitan and rural residents. Fifty three percent of people on the waiting list resided within metropolitan areas. Rural and remote residents made up 47% of the population waiting to receive care. The utilisation of both government and private dental clinics for the delivery of subsidised dental care to the eligible population

Import and export of small quantities of nuclear materials

International Nuclear Information System (INIS)

Grenier, M.

1986-06-01

Administrative procedures for import export of nuclear materials are specific for each country. In France regulations are reviewed for small quantities, lower threshold, in some cases, allows a simplified procedure, however thresholds are not the same in the different texts (and for one of them, concerning proliferation, is zero). It is obvious that regulations are necessary even for small quantities but national and international threshold should be harmonized [fr

7 CFR 35.13 - Minimum quantity.

Science.gov (United States)

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Minimum quantity. 35.13 Section 35.13 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... part, transport or receive for transportation to any foreign destination, a shipment of 25 packages or...

A qualitative study examining methods of accessing and identifying research relevant to clinical practice among rehabilitation clinicians.

Science.gov (United States)

Patel, Drasti; Koehmstedt, Christine; Jones, Rebecca; Coffey, Nathan T; Cai, Xinsheng; Garfinkel, Steven; Shaewitz, Dahlia M; Weinstein, Ali A

2017-01-01

Research examining the utilization of evidence-based practice (EBP) specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice. A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed. There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information. Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur.

Biologically Weighted Quantities in Radiotherapy: an EMRP Joint Research Project

Directory of Open Access Journals (Sweden)

Rabus Hans

2014-01-01

Full Text Available Funded within the European Metrology Research Programme (EMRP [1], the joint research project “Biologically weighted quantities in radiotherapy” (BioQuaRT [2] aims to develop measurement and simulation techniques for determining the physical properties of ionising particle tracks on different length scales (about 2 nm to 10 μm, and to investigate the correlation of these track structure characteristics with the biological effects of radiation at the cellular level. Work package 1 develops micro-calorimeter prototypes for the direct measurement of lineal energy and will characterise their response for different ion beams by experiment and modelling. Work package 2 develops techniques to measure particle track structure on different length scales in the nanometre range as well as a measurement device integrating a silicon microdosimeter and a nanodosimeter. Work package 3 investigates the indirect effects of radiation based on probes for quantifying particular radical and reactive oxygen species (ROS. Work package 4 focuses on the biological aspects of radiation damage and will produce data on initial DNA damage and late effects for radiotherapy beams of different qualities. Work package 5 provides evaluated data sets of DNA cross-sections and develops a multi-scale model to address microscopic and nanometric track structure properties. The project consortium includes three linked researchers holding so-called Researcher Excellence Grants, who carry out ancillary investigations such as developing and benchmarking a new biophysical model for induction of early radiation damage and developing methods for the translation of quantities derived from particle track structure to clinical applications in ion beam therapy.

Process of quantity determination of uranium by chromatography in liquid zone

International Nuclear Information System (INIS)

Muller, J.P.; Cojean, J.; Daubizit, M.

1993-01-01

The invention concerns a process of quantity determination of uranium by chromatography in liquid zone, usable to determine the quantity of uranium traces. Solutions to be treated can be aqueous or organic

Impact of the Velo 2 half misalignment on physical quantities

CERN Document Server

Roguljic, Matej; Borghi, Silvia; Grillo, Lucia; CERN. Geneva. EP Department

2016-01-01

The impact of the misalignment of the Vertex Locator of the LHCb experiment on the physical quantities of the decay "$D^{*+} \\rightarrow (D^{0}\\rightarrow K^{-}\\pi^{+}) \\pi^{+} $" is studied in this note. Different misalignments of the 2 halves are applied to Monte Carlo data and the variations of the physical quantities with respect to the case without misalignment are evaluated. The results show the importance of the VELO 2 half alignment which can significantly affect the physics performance in the large misalignment case. A misalignment equal to the precision of the real-time alignment of the Vertex Locator is found to have a negligible effect on the studied physical quantities.

Open-access databases as unprecedented resources and drivers of cultural change in fisheries science

Energy Technology Data Exchange (ETDEWEB)

McManamay, Ryan A [ORNL; Utz, Ryan [National Ecological Observatory Network

2014-01-01

Open-access databases with utility in fisheries science have grown exponentially in quantity and scope over the past decade, with profound impacts to our discipline. The management, distillation, and sharing of an exponentially growing stream of open-access data represents several fundamental challenges in fisheries science. Many of the currently available open-access resources may not be universally known among fisheries scientists. We therefore introduce many national- and global-scale open-access databases with applications in fisheries science and provide an example of how they can be harnessed to perform valuable analyses without additional field efforts. We also discuss how the development, maintenance, and utilization of open-access data are likely to pose technical, financial, and educational challenges to fisheries scientists. Such cultural implications that will coincide with the rapidly increasing availability of free data should compel the American Fisheries Society to actively address these problems now to help ease the forthcoming cultural transition.

Association between work-family conflict and smoking quantity among daily smokers.

Science.gov (United States)

Macy, Jonathan T; Chassin, Laurie; Presson, Clark C

2013-11-01

Recent work demonstrated a direct relation between work-family conflict and likelihood of smoking. This study furthered this area of research by (a) testing the association between work-family conflict and smoking quantity and (b) testing demographic, workplace, and home factors as moderators of this relation. Participants (N = 423) were daily smokers from a Midwestern community-based sample. Ordinal regression analysis tested work-to-home and home-to-work conflict as predictors (after controlling for demographic characteristics, home factors, and workplace factors) of smoking quantity. Additionally, we tested whether the demographic, home, and workplace factors moderated the effects of work-to-home conflict and home-to-work conflict on smoking quantity. Males (OR = 8.81, p = .005), older participants (OR = 1.09, p = .012), those with less educational attainment (OR = 1.87, p = .001), those who reported lower levels of workplace smoking restrictions (OR = 0.87, p = .019), and those who reported higher levels of work-to-home conflict (OR = 1.39, p = .026) smoked more cigarettes per day. There was no significant main effect of home-to-work conflict on smoking quantity (OR = 1.46, p = .099). A significant interaction (OR = 0.55, p = .043) revealed that home-to-work conflict was associated with smoking quantity for females but not for males. After controlling for demographic characteristics and potential confounders, work-to-home conflict had a negative impact on smoking quantity for all participants, and home-to-work conflict was associated with smoking quantity for women. Workplace wellness programs to reduce smoking among employees should take into account the direction of conflict and how the effect of the conflict on smoking behavior may vary based on other factors.

Quantities of natural gas transported in January-December 2009

International Nuclear Information System (INIS)

2010-01-01

GRTgaz is a European leader in natural gas transmission, a world expert in gas transmission networks and systems, and an operator firmly committed to the energy transition. It owns and operates the gas transmission network throughout most of France and it manages the transmission network in Germany, thereby helping to ensure correct operation of the French and European gas market. It contributes to the energy security of regional supply systems and performs a public service mission to ensure the continuity of consumer supply. This document presents the monthly key figures of GRTgaz activity in 2009: Total quantities transmitted by GRTgaz (Inputs to the GRTgaz network/Outputs from the GRTgaz network); Maximum and minimum daily flow (Daily quantities transported, Daily consumption, Daily inputs excluding storage); Quantities exchanged on the wholesale market; Consumption on the GRTgaz Network (gross monthly consumption and Average monthly temperatures)

48 CFR 852.270-2 - Bread and bakery products-quantities.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Bread and bakery products... Bread and bakery products—quantities. As prescribed in 870.111-3, insert the following clause: Bread and Bakery Products—Quantities (JAN 2008) The bidder agrees to furnish up to 25 percent more or 25 percent...

Informal Urban Green-Space: Comparison of Quantity and Characteristics in Brisbane, Australia and Sapporo, Japan

Science.gov (United States)

Rupprecht, Christoph D. D.; Byrne, Jason A.

2014-01-01

Informal urban green-space (IGS) such as vacant lots, brownfields and street or railway verges is receiving growing attention from urban scholars. Research has shown IGS can provide recreational space for residents and habitat for flora and fauna, yet we know little about the quantity, spatial distribution, vegetation structure or accessibility of IGS. We also lack a commonly accepted definition of IGS and a method that can be used for its rapid quantitative assessment. This paper advances a definition and typology of IGS that has potential for global application. Based on this definition, IGS land use percentage in central Brisbane, Australia and Sapporo, Japan was systematically surveyed in a 10×10 km grid containing 121 sampling sites of 2,500 m2 per city, drawing on data recorded in the field and aerial photography. Spatial distribution, vegetation structure and accessibility of IGS were also analyzed. We found approximately 6.3% of the surveyed urban area in Brisbane and 4.8% in Sapporo consisted of IGS, a non-significant difference. The street verge IGS type (80.4% of all IGS) dominated in Brisbane, while lots (42.2%) and gaps (19.2%) were the two largest IGS types in Sapporo. IGS was widely distributed throughout both survey areas. Vegetation structure showed higher tree cover in Brisbane, but higher herb cover in Sapporo. In both cities over 80% of IGS was accessible or partly accessible. The amount of IGS we found suggests it could play a more important role than previously assumed for residents' recreation and nature experience as well as for fauna and flora, because it substantially increased the amount of potentially available greenspace in addition to parks and conservation greenspace. We argue that IGS has potential for recreation and conservation, but poses some challenges to urban planning. To address these challenges, we propose some directions for future research. PMID:24941046

Clinical Trials

Medline Plus

Full Text Available ... Working at the NHLBI Contact and FAQs Accessible Search Form Search the NHLBI, use the drop down list to ... to learn more about clinical research and to search for clinical trials: NHLBI Clinical Trials Browse a ...

Access to abortion: what women want from abortion services.

Science.gov (United States)

Wiebe, Ellen R; Sandhu, Supna

2008-04-01

Whether Canadian physicians can refuse to refer women for abortion and whether private clinics can charge for abortions are matters of controversy. We sought to identify barriers to access for women seeking therapeutic abortion and to have them identify what they considered to be most important about access to abortion services. Women presenting for abortion over a two-month period at two free-standing abortion clinics, one publicly funded and the other private, were invited to participate in the study. Phase I of the study involved administration of a questionnaire seeking information about demographics, perceived barriers to access to abortion, and what the women wanted from abortion services. Phase II involved semi-structured interviews of a convenience sample of women to record their responses to questions about access. Responses from Phase I questionnaires were compared between the two clinics, and qualitative analysis was performed on the interview responses. Of 423 eligible women, 402 completed questionnaires, and of 45 women approached, 39 completed interviews satisfactorily. Women received information about abortion services from their physicians (60.0%), the Internet (14.8%), a telephone directory (7.8%), friends or family (5.3%), or other sources (12.3%). Many had negative experiences in gaining access. The most important issue regarding access was the long wait time; the second most important issue was difficulty in making appointments. In the private clinic, 85% of the women said they were willing to pay for shorter wait times, compared with 43.5% in the public clinic. Physicians who failed to refer patients for abortion or provide information about obtaining an abortion caused distress and impeded access for a significant minority of women requesting an abortion. Management of abortion services should be prioritized to reflect what women want: particularly decreased wait times for abortion and greater ease and convenience in booking appointments

Amnesia and future thinking: Exploring the role of memory in the quantity and quality of episodic future thoughts.

Science.gov (United States)

Cole, Scott N; Morrison, Catriona M; Barak, Ohr; Pauly-Takacs, Katalin; Conway, Martin A

2016-06-01

To examine the impact of memory accessibility on episodic future thinking. Single-case study of neurological patient HCM and an age-matched comparison group of neurologically Healthy Controls. We administered a full battery of tests assessing general intelligence, memory, and executive functioning. To assess autobiographical memory, the Autobiographical Memory Interview (Kopelman, Wilson, & Baddeley, 1990. The Autobiographical Memory Interview. Bury St. Edmunds, UK: Thames Valley Test Company) was administered. The Past Episodic and Future Episodic sections of Dalla Barba's Confabulation Battery (Dalla Barba, 1993, Cogn. Neuropsychol., 1, 1) and a specifically tailored Mental Time Travel Questionnaire were administered to assess future thinking in HCM and age-matched controls. HCM presented with a deficit in forming new memories (anterograde amnesia) and recalling events from before the onset of neurological impairment (retrograde amnesia). HCM's autobiographical memory impairments are characterized by a paucity of memories from Recent Life. In comparison with controls, two features of his future thoughts are apparent: Reduced episodic future thinking and outdated content of his episodic future thoughts. This article suggests neuropsychologists should look beyond popular conceptualizations of the past-future relation in amnesia via focussing on reduced future thinking. Investigating both the quantity and quality of future thoughts produced by amnesic patients may lead to developments in understanding the complex nature of future thinking disorders resulting from memory impairments. We highlight the clinical importance of examining the content of future thoughts in amnesic patients, rather than only its quantitative reduction. We propose an explanation of how quantitative and qualitative aspects of future thinking could be affected by amnesia. This could provide a useful approach to understand clinical cases of impaired prospection. Systematic group investigations

How tobacco companies have used package quantity for consumer targeting.

Science.gov (United States)

Persoskie, Alexander; Donaldson, Elisabeth A; Ryant, Chase

2018-05-31

Package quantity refers to the number of cigarettes or amount of other tobacco product in a package. Many countries restrict minimum cigarette package quantities to avoid low-cost packs that may lower barriers to youth smoking. We reviewed Truth Tobacco Industry Documents to understand tobacco companies' rationales for introducing new package quantities, including companies' expectations and research regarding how package quantity may influence consumer behaviour. A snowball sampling method (phase 1), a static search string (phase 2) and a follow-up snowball search (phase 3) identified 216 documents, mostly from the 1980s and 1990s, concerning cigarettes (200), roll-your-own tobacco (9), smokeless tobacco (6) and 'smokeless cigarettes' (1). Companies introduced small and large packages to motivate brand-switching and continued use among current users when faced with low market share or threats such as tax-induced price increases or competitors' use of price promotions. Companies developed and evaluated package quantities for specific brands and consumer segments. Large packages offered value-for-money and matched long-term, heavy users' consumption rates. Small packages were cheaper, matched consumption rates of newer and lighter users, and increased products' novelty, ease of carrying and perceived freshness. Some users also preferred small packages as a way to try to limit consumption or quit. Industry documents speculated about many potential effects of package quantity on appeal and use, depending on brand and consumer segment. The search was non-exhaustive, and we could not assess the quality of much of the research or other information on which the documents relied. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A shared system of representation governing quantity discrimination in canids

Directory of Open Access Journals (Sweden)

Joseph M Baker

2012-10-01

Full Text Available One way to investigate the evolution of cognition is to compare the abilities of phylogenetically related species. The domestic dog (Canis lupus familiaris, for example, still shares cognitive abilities with the coyote (C. latrans. Both of these canids possess the ability to make psychophysical less/more discriminations of food based on quantity. Like many other species including humans, this ability is mediated by Weber’s Law: discrimination of continuous quantities is dependent on the ratio between the two quantities. As two simultaneously presented quantities of food become more similar, choice of the large or small option becomes random in both dogs and coyotes. It remains unknown, however, whether these closely related species within the same family—one domesticated, and one wild—make such quantitative comparisons with comparable accuracy. Has domestication honed or diminished this quantitative ability? Might different selective and ecological pressures facing coyotes drive them to be more or less able to accurately represent and discriminate food quantity than domesticated dogs? This study is an effort to elucidate this question concerning the evolution of non-verbal quantitative cognition.Here, we tested the quantitative discrimination ability of 16 domesticated dogs. Each animal was given 9 trials in which two different quantities of food were simultaneously displayed to them. The domesticated dogs’ performance on this task was then compared directly to the data from 16 coyotes’ performance on this same task reported by Baker and colleagues (2011.The quantitative discrimination abilities between the two species were strikingly similar. Domesticated dogs demonstrated similar quantitative sensitivity as coyotes, suggesting that domestication may not have significantly altered the psychophysical discrimination abilities of canids. Instead, this study provides further evidence for similar nonverbal quantitative abilities across

Variation in Quantity of Heat Produced from Charcoal of Prosopis ...

African Journals Online (AJOL)

Data were collected using the copper calorimeter, a thermometer, an air tight burner and a weight balance. The results showed a gradual decrease in the quantity of heat produced as combustion time increased from 10 40 minutes in all wood species. Significant differences (p<0.05) in the quantity of heat produced both ...

Safeguards Implementation Guide for States with Small Quantities Protocols

International Nuclear Information System (INIS)

2013-01-01

The International Atomic Energy Agency (IAEA) works to enhance the contribution of nuclear energy for peace and prosperity around the world, while helping to ensure that nuclear material is not diverted to nuclear weapons or other nuclear explosive devices. In implementing safeguards, the IAEA plays an instrumental independent verification role, providing credible assurances that States' safeguards commitments are being respected. Most of the world's non-nuclear-weapon States (NNWSs) have concluded comprehensive safeguards agreements (CSAs) with the IAEA, pursuant to the Treaty on the Non- Proliferation of Nuclear Weapons (NPT). The IAEA and States are required to cooperate in the implementation of such agreements. Effective cooperation demonstrates a State's commitment to the peaceful use of nuclear energy and furthers the State's national interests by reducing the risk of unauthorized use of nuclear material. Over 100 NNWSs party to the NPT have very limited quantities of nuclear material and have concluded protocols to their CSAs which hold in abeyance many procedures in Part II of a CSA. These protocols are referred to as 'small quantities protocols' or 'SQPs' and remain in effect as long as the State meets certain eligibility criteria. The purpose of an SQP is to reduce the burden of safeguards implementation for States with little or no nuclear activities, while retaining the integrity of the safeguards system. States with SQPs have very important obligations they must fulfil under their CSAs. In 1997, as part of the IAEA's efforts to strengthen its safeguards system, the Model Additional Protocol to the Agreement(s) between State(s) and the International Atomic Energy Agency for the Application of Safeguards was developed to provide the IAEA with broader access to information and locations, thus significantly increasing the IAEA's ability to provide assurance of the absence of undeclared nuclear material and activities in States. Many States with SQPs have

The effects of quantity and depth of processing on children's time perception.

Science.gov (United States)

Arlin, M

1986-08-01

Two experiments were conducted to investigate the effects of quantity and depth of processing on children's time perception. These experiments tested the appropriateness of two adult time-perception models (attentional and storage size) for younger ages. Children were given stimulus sets of equal time which varied by level of processing (deep/shallow) and quantity (list length). In the first experiment, 28 children in Grade 6 reproduced presentation times of various quantities of pictures under deep (living/nonliving categorization) or shallow (repeating label) conditions. Students also compared pairs of durations. In the second experiment, 128 children in Grades K, 2, 4, and 6 reproduced presentation times under similar conditions with three or six pictures and with deep or shallow processing requirements. Deep processing led to decreased estimation of time. Higher quantity led to increased estimation of time. Comparative judgments were influenced by quantity. The interaction between age and depth of processing was significant. Older children were more affected by depth differences than were younger children. Results were interpreted as supporting different aspects of each adult model as explanations of children's time perception. The processing effect supported the attentional model and the quantity effect supported the storage size model.

Testing quantity theory of money for the Turkish economy

OpenAIRE

Levent, Korap

2007-01-01

In this paper, it is tried to test the main assumptions of the Quantity Theory of Money for the Turkish economy. Using some contemporaneous estimation techniques to examine the long-run stationary economic relationships on which the quantity theory is constructed, it is found that stationary characteristics of the velocitities of narrowly and broadly defined monetary aggregates cannot be rejected. However, monetary aggregates seem to be endogenous for the long-run evoluation of prices and rea...

Association Between Work–Family Conflict and Smoking Quantity Among Daily Smokers

Science.gov (United States)

2013-01-01

Introduction: Recent work demonstrated a direct relation between work–family conflict and likelihood of smoking. This study furthered this area of research by (a) testing the association between work–family conflict and smoking quantity and (b) testing demographic, workplace, and home factors as moderators of this relation. Methods: Participants (N = 423) were daily smokers from a Midwestern community-based sample. Ordinal regression analysis tested work-to-home and home-to-work conflict as predictors (after controlling for demographic characteristics, home factors, and workplace factors) of smoking quantity. Additionally, we tested whether the demographic, home, and workplace factors moderated the effects of work-to-home conflict and home-to-work conflict on smoking quantity. Results: Males (OR = 8.81, p = .005), older participants (OR = 1.09, p = .012), those with less educational attainment (OR = 1.87, p = .001), those who reported lower levels of workplace smoking restrictions (OR = 0.87, p = .019), and those who reported higher levels of work-to-home conflict (OR = 1.39, p = .026) smoked more cigarettes per day. There was no significant main effect of home-to-work conflict on smoking quantity (OR = 1.46, p = .099). A significant interaction (OR = 0.55, p = .043) revealed that home-to-work conflict was associated with smoking quantity for females but not for males. Conclusions: After controlling for demographic characteristics and potential confounders, work-to-home conflict had a negative impact on smoking quantity for all participants, and home-to-work conflict was associated with smoking quantity for women. Workplace wellness programs to reduce smoking among employees should take into account the direction of conflict and how the effect of the conflict on smoking behavior may vary based on other factors. PMID:23709611

Quantities of natural gas transported in August-December 2007

International Nuclear Information System (INIS)

2008-01-01

GRTgaz is a European leader in natural gas transmission, a world expert in gas transmission networks and systems, and an operator firmly committed to the energy transition. It owns and operates the gas transmission network throughout most of France and it manages the transmission network in Germany, thereby helping to ensure correct operation of the French and European gas market. It contributes to the energy security of regional supply systems and performs a public service mission to ensure the continuity of consumer supply. This document presents the available monthly key figures of GRTgaz activity from August to December 2007: Total quantities transmitted by GRTgaz (Inputs to the GRTgaz network/Outputs from the GRTgaz network); Maximum and minimum daily flow (Daily quantities transported, Daily consumption, Daily inputs excluding storage); Quantities exchanged on the wholesale market; Consumption on the GRTgaz Network (gross monthly consumption and Average monthly temperatures)

Symbols and definitions of quantities and units in isotope stoichiometry

International Nuclear Information System (INIS)

Junghans, P.; Krumbiegel, P.; Faust, H.

1982-01-01

On the basis of the International System of Units and recent recommendations of the IUPAC on 'Symbols and Terminology for Physicochemical Quantities and Units' a system is proposed of uniform and unambiguous symbols and definitions of quantities and units used in the isotope dilution technique. The close relationship between isotope stoichiometry and common stoichiometry is demonstrated. (author)

Varieties of Quantity Estimation in Children

Science.gov (United States)

Sella, Francesco; Berteletti, Ilaria; Lucangeli, Daniela; Zorzi, Marco

2015-01-01

In the number-to-position task, with increasing age and numerical expertise, children's pattern of estimates shifts from a biased (nonlinear) to a formal (linear) mapping. This widely replicated finding concerns symbolic numbers, whereas less is known about other types of quantity estimation. In Experiment 1, Preschool, Grade 1, and Grade 3…

Issues With Access to Acquisition Data and Information in the Department of Defense

Science.gov (United States)

2017-01-01

retailers scored 670 (Sternstein, 2015).1 One way that enterprises, and possibly DoD, can deal with collecting, storing , accessing, and sharing an...intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to...management strategy.2 Data warehouses store vast quantities of structured data using a multidimensional approach but do not allow data quality

40 CFR 273.8 - Applicability-household and conditionally exempt small quantity generator waste.

Science.gov (United States)

2010-07-01

... conditionally exempt small quantity generator waste. 273.8 Section 273.8 Protection of Environment ENVIRONMENTAL....8 Applicability—household and conditionally exempt small quantity generator waste. (a) Persons... universal wastes defined at § 273.9; and/or (2) Conditionally exempt small quantity generator wastes that...

Developing a Mental Health eClinic to Improve Access to and Quality of Mental Health Care for Young People: Using Participatory Design as Research Methodologies.

Science.gov (United States)

Ospina-Pinillos, Laura; Davenport, Tracey A; Ricci, Cristina S; Milton, Alyssa C; Scott, Elizabeth M; Hickie, Ian B

2018-05-28

Each year, many young Australians aged between 16 and 25 years experience a mental health disorder, yet only a small proportion access services and even fewer receive timely and evidence-based treatments. Today, with ever-increasing access to the Internet and use of technology, the potential to provide all young people with access (24 hours a day, 7 days a week) to the support they require to improve their mental health and well-being is promising. The aim of this study was to use participatory design (PD) as research methodologies with end users (young people aged between 16 and 25 years and youth health professionals) and our research team to develop the Mental Health eClinic (a Web-based mental health clinic) to improve timely access to, and better quality, mental health care for young people across Australia. A research and development (R&D) cycle for the codesign and build of the Mental Health eClinic included several iterative PD phases: PD workshops; translation of knowledge and ideas generated during workshops to produce mockups of webpages either as hand-drawn sketches or as wireframes (simple layout of a webpage before visual design and content is added); rapid prototyping; and one-on-one consultations with end users to assess the usability of the alpha build of the Mental Health eClinic. Four PD workshops were held with 28 end users (young people n=18, youth health professionals n=10) and our research team (n=8). Each PD workshop was followed by a knowledge translation session. At the conclusion of this cycle, the alpha prototype was built, and one round of one-on-one end user consultation sessions was conducted (n=6; all new participants, young people n=4, youth health professionals n=2). The R&D cycle revealed the importance of five key components for the Mental Health eClinic: a home page with a visible triage system for those requiring urgent help; a comprehensive online physical and mental health assessment; a detailed dashboard of results; a

Vascular access in critical limb ischemia.

Science.gov (United States)

Kang, Won Yu; Campia, Umberto; Ota, Hideaki; Didier, Romain J; Negi, Smita I; Kiramijyan, Sarkis; Koifman, Edward; Baker, Nevin C; Magalhaes, Marco A; Lipinski, Michael J; Escarcega, Ricardo O; Torguson, Rebecca; Waksman, Ron; Bernardo, Nelson L

2016-01-01

Currently, percutaneous endovascular intervention is considered a first line of therapy for treating patients with critical limb ischemia. As the result of remarkable development of techniques and technologies, percutaneous endovascular intervention has led to rates of limb salvage comparable to those achieved with bypass surgery, with fewer complications, even in the presence of lower rates of long-term patency. Currently, interventionalists have a multiplicity of access routes including smaller arteries, with both antegrade and retrograde approaches. Therefore, the choice of the optimal access site has become an integral part of the success of the percutaneous intervention. By understanding the technical aspects, as well as the advantages and limitations of each approach, the interventionalists can improve clinical outcomes in patients with severe peripheral arterial disease. This article reviews the access routes in critical limb ischemia, their advantages and disadvantages, and the clinical outcomes of each. Copyright © 2016 Elsevier Inc. All rights reserved.

A qualitative study examining methods of accessing and identifying research relevant to clinical practice among rehabilitation clinicians

Directory of Open Access Journals (Sweden)

Patel D

2017-12-01

Full Text Available Drasti Patel,1 Christine Koehmstedt,1 Rebecca Jones,1 Nathan T Coffey,1 Xinsheng Cai,2 Steven Garfinkel,2 Dahlia M Shaewitz,2 Ali A Weinstein1 1Center for Study of Chronic Illness and Disability, College of Health and Human Services, George Mason University, Fairfax, VA, 2American Institutes for Research, Washington, DC, USA Purpose: Research examining the utilization of evidence-based practice (EBP specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice.Methods: A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed.Results: There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information.Conclusion: Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur. Keywords: health information, information behavior, knowledge utilization

Quantity of Candida Colonies in Saliva: 
A Diagnostic Evaluation for Oral Candidiasis.

Science.gov (United States)

Zhou, Pei Ru; Hua, Hong; Liu, Xiao Song

To investigate the relationship between the quantity of Candida colonies in saliva and oral candidiasis (OC), as well as to identify the threshold for distinguishing oral candidiasis from healthy carriage. A diagnostic test was conducted in 197 patients with different oral problems. The diagnosis of OC was established based on clinical features. Whole saliva samples from the subjects were cultured for Candida species. Receiver operating characteristic (ROC) curve analysis was used in this study. OC patients had significantly more Candida colony-forming units per millilitre saliva (795 cfu/ml) than asymptomatic carriers (40 cfu/ml; P candidiasis, the quantity of Candida colonies differed. The number of Candida colonies in pseudomembranous type was significantly higher than that in the erythematous type (P < 0.05). Candida albicans was the predominant species of Candida. The cut-off point with the best fit for OC diagnosis was calculated to be 266 cfu/ml. The sensitivity and specificity were 0.720 and 0.825, respectively. Analysis of the ROC curve indicated that Candida colonies had a high diagnostic value for OC, as demonstrated by the area under the curve (AUC = 0.873). Based on this study, the value of 270 cfu/ml was considered a threshold for distinguishing OC from carriage.

Memory for multiple cache locations and prey quantities in a food-hoarding songbird

Directory of Open Access Journals (Sweden)

Nicola eArmstrong

2012-12-01

Full Text Available Most animals can discriminate between pairs of numbers that are each less than four without training. However, North Island robins (Petroica longipes, a food hoarding songbird endemic to New Zealand, can discriminate between quantities of items as high as eight without training. Here we investigate whether robins are capable of other complex quantity discrimination tasks. We test whether their ability to discriminate between small quantities declines with 1. the number of cache sites containing prey rewards and 2. the length of time separating cache creation and retrieval (retention interval. Results showed that subjects generally performed above chance expectations. They were equally able to discriminate between different combinations of prey quantities that were hidden from view in 2, 3 and 4 cache sites from between 1, 10 and 60 seconds. Overall results indicate that North Island robins can process complex quantity information involving more than two discrete quantities of items for up to one minute long retention intervals without training.

Charaterisation of function spaces via mollification; fractal quantities for distributions

Directory of Open Access Journals (Sweden)

Hans Triebel

2003-01-01

Full Text Available The aim of this paper is twofold. First we characterise elements f belonging to the Besov spaces Bpqs(ℝn with s∈ℝ,  0quantities for distributions generalising well-known corresponding quantities for Radon measures.

The effect of quantity of added eggs on whole meal pasta quality

Directory of Open Access Journals (Sweden)

Filipović Jelena S.

2014-01-01

Full Text Available This paper investigates the convenience of different chemical and rheological methods for determining the quality of two spelt cultivars for pasta making and the influence of egg quantity on whole meal pasta quality. Post-hoc Tukey’s HSD test at 95% confidence limit has been calculated to show significant differences between different samples. Score analysis is being useful tool for accessing the effect of eggs to spelt pasta quality, and this analysis proved that though lower scores (0.270 for rheological characteristics experienced with cultivar Eco, the addition of eggs is positively contributing to the spelt pasta quality yielding the best score for pasta (0.75, contrary to the cultivar Austria attributed with superior rheology scores. Whole meal spelt is characterised by lower Ca, but higher Fe and Mn content in comparison to bread wheat. In comparison with common pasta, spelt is a suitable raw material for a new product with improved functional properties at the market.[Projekat Ministarstva nauke Republike Srbije, br. TRI 46005 i br. TR 31055

Features and selection of vascular access devices.

Science.gov (United States)

Sansivero, Gail Egan

2010-05-01

To review venous anatomy and physiology, discuss assessment parameters before vascular access device (VAD) placement, and review VAD options. Journal articles, personal experience. A number of VAD options are available in clinical practice. Access planning should include comprehensive assessment, with attention to patient participation in the planning and selection process. Careful consideration should be given to long-term access needs and preservation of access sites. Oncology nurses are uniquely suited to perform a key role in VAD planning and placement. With knowledge of infusion therapy, anatomy and physiology, device options, and community resources, nurses can be key leaders in preserving vascular access and improving the safety and comfort of infusion therapy. Copyright 2010 Elsevier Inc. All rights reserved.

Prices versus Quantities

DEFF Research Database (Denmark)

Hansen, Lars Gårn; Jensen, Frank

illustrate that this result does not generalise to a search fishery, where marginal costs are allowed to depend on harvest. Hansen et al (2008) study a fishery where non-compliance with regulations is a problem. When the regulator is uncertain about non-compliance (compliance uncertainty), then landing fees......Weitzman (2002) studies the regulation of a fishery characterised by constant marginal harvest costs and shows that price regulation performs better than quantity regulation when the regulator is uncertain about the biological reproduction function (ecological uncertainty). Here, we initially...... are the preferred type of regulation, and Hansen et al (2008) find that this result does generalise to a search fishery where marginal costs depend on harvest. In this paper, we simulate a stochastic stock-recruitment model for the Danish cod fishery in the Kategat capturing both ecological and compliance...

Allen's astrophysical quantities

CERN Document Server

2000-01-01

This new, fourth, edition of Allen's classic Astrophysical Quantities belongs on every astronomer's bookshelf. It has been thoroughly revised and brought up to date by a team of more than ninety internationally renowned astronomers and astrophysicists. While it follows the basic format of the original, this indispensable reference has grown to more than twice the size of the earlier editions to accommodate the great strides made in astronomy and astrophysics. It includes detailed tables of the most recent data on: - General constants and units - Atoms, molecules, and spectra - Observational astronomy at all wavelengths from radio to gamma-rays, and neutrinos - Planetary astronomy: Earth, planets and satellites, and solar system small bodies - The Sun, normal stars, and stars with special characteristics - Stellar populations - Cataclysmic and symbiotic variables, supernovae - Theoretical stellar evolution - Circumstellar and interstellar material - Star clusters, galaxies, quasars, and active galactic nuclei ...

Variations of influence quantities in industrial irradiators and their effect on dosimetry performance

International Nuclear Information System (INIS)

Chu, R.D.H.

1999-01-01

Many environmental factors, including irradiation temperature, post-irradiation storage temperature, dose rate, relative humidity, oxygen content and the energy spectrum may affect the response of dosimetry systems used in industrial radiation processing. Although the effects of individual influence quantities have been extensively studied, the variations of these influence quantities in production irradiators and the complex relationships between the effects of different influence quantities make it difficult to assess the overall effect on the measurement uncertainty. In the development of new dosimetry systems it is important to know the effect of each influence quantity and developers of new dosimetry systems should perform studies over a wide range of irradiation conditions. Analysis parameters and manufacturing specifications should be chosen to minimize the effect of influence quantities in the environments where the dosimeters will be used. Because of possible relationships between different influence quantities, care must be taken to ensure that the response function determined in the calibration of the dosimetry system is applicable for the conditions in which the dosimeters will be used. Reference standard dosimetry systems which have been thoroughly studied and have known relationships between dose response and influence quantities should be used to verify the calibration of routine dosimetry systems under the actual conditions of use. Better understanding of the variations in influence quantities in industrial irradiators may be obtained by modeling or direct measurements and may provide improvements in the calibration of routine dosimetry system and reduction of the overall measurement uncertainty. (author)

Clinical Trials

Medline Plus

Full Text Available ... need to travel or stay in hospitals to take part in clinical trials. For example, the National Institutes of Health Clinical Center in ... Maryland, runs clinical trials. Many other clinical trials take place in medical centers and ... trial can have many benefits. For example, you may gain access to new treatments before ...

Patterns in new dimensionless quantities containing melting temperature, and their dependence on pressure

Directory of Open Access Journals (Sweden)

U. WALZER

1980-06-01

Full Text Available The relationships existing between melting temperature and other
macroscopic physical quantities are investigated. A new dimensionless
quantity Q(1 not containing the Grtineisen parameter proves to be suited for serving in future studies as a tool for the determination of the melting temperature in the outer core of the Earth. The pressure dependence of more general dimensionless quantities Q„ is determined analytically and, for the chemical elements, numerically, too. The patterns of various interesting dimensionless quantities are shown in the Periodic Table and compared.

Birthday Cake Activity Structured Arrangement for Helping Children Determining Quantities

Directory of Open Access Journals (Sweden)

Neni Mariana

2010-07-01

Full Text Available Few researches have been concerned about relation between children’s spatial thinking and number sense. Narrowing for this small research, we focused on one component of spatial thinking, that is structuring objects, and one component of number senses, that is cardinality by determining quantities. This study focused on a design research that was conducted in Indonesia in which we investigated pre-school children’s (between 2 and 3.5 years old ability in making structured arrangement and their ability to determine the quantities by looking at the arrangements. The result shows us that some of the children were able to make such arrangement. However, the children found difficulties either to determine quantities from those arrangements or to compare some structures to easily recognize number of objects.

Accessing antiretroviral therapy for children: Caregivers' voices

Directory of Open Access Journals (Sweden)

Margaret (Maggie Williams

2016-10-01

Full Text Available Despite efforts to scale up access to antiretroviral therapy (ART, particularly at primary health care (PHC facilities, antiretroviral therapy (ART continues to be out of reach formany human immunodeficiency virus (HIV-positive children in sub-Saharan Africa. In resource limited settings decentralisation of ART is required to scale up access to essential medication. Traditionally, paediatric HIV care has been provided in tertiary care facilities which have better human and material resources, but limited accessibility in terms of distance for caregivers of HIV-positive children. The focus of this article is on the experiences of caregivers whilst accessing ART for HIV-positive children at PHC (decentralised care facilities in Nelson Mandela Bay (NMB in the Eastern Cape, South Africa. A qualitative, explorative, descriptive and contextual research design was used. The target population comprised caregivers of HIV-positive children. Data were collected by means of indepth individual interviews, which were thematically analysed. Guba's model was usedto ensure trustworthiness. Barriers to accessing ART at PHC clinics for HIV-positive children included personal issues, negative experiences, lack of support and finance, stigma and discrimination. The researchers recommend standardised programmes be developed and implemented in PHC clinics to assist in providing treatment, care and support for HIV positive children.

Accessing antiretroviral therapy for children: Caregivers' voices

Directory of Open Access Journals (Sweden)

Margaret (Maggie Williams

2016-12-01

Full Text Available Despite efforts to scale up access to antiretroviral therapy (ART, particularly at primary health care (PHC facilities, antiretroviral therapy (ART continues to be out of reach for many human immunodeficiency virus (HIV-positive children in sub-Saharan Africa. In resource limited settings decentralisation of ART is required to scale up access to essential medication. Traditionally, paediatric HIV care has been provided in tertiary care facilities which have better human and material resources, but limited accessibility in terms of distance for caregivers of HIV-positive children. The focus of this article is on the experiences of caregivers whilst accessing ART for HIV-positive children at PHC (decentralised care facilities in Nelson Mandela Bay (NMB in the Eastern Cape, South Africa. A qualitative, explorative, descriptive and contextual research design was used. The target population comprised caregivers of HIV-positive children. Data were collected by means of in-depth individual interviews, which were thematically analysed. Guba's model was used to ensure trustworthiness. Barriers to accessing ART at PHC clinics for HIV-positive children included personal issues, negative experiences, lack of support and finance, stigma and discrimination. The researchers recommend standardised programmes be developed and implemented in PHC clinics to assist in providing treatment, care and support for HIV-positive children.

Effect of improved access to antiretroviral therapy on clinical characteristics of patients enrolled in the HIV care and treatment clinic, at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania.

Science.gov (United States)

Mugusi, Sabina F; Mwita, Julius C; Francis, Joel M; Aboud, Said; Bakari, Muhammad; Aris, Eric A; Swai, Andrew B; Mugusi, Ferdinand M; Pallangyo, Kisali; Sandstrom, Eric

2010-05-28

Sub-Saharan Africa has been severely affected by the HIV and AIDS pandemic. Global efforts at improving care and treatment has included scaling up use of antiretroviral therapy (ART). In Tanzania, HIV care and treatment program, including the provision of free ART started in 2004 with a pilot program at Muhimbili National Hospital in Dar es Salaam. This study describes the socio-demographic and clinical features of patients enrolled at the care and treatment clinic at MNH, Dar es Salaam, Tanzania. A cross-sectional study looking at baseline characteristics of patients enrolled at the HIV clinic at MNH between June 2004-Dec 2005 compared to those enrolled between 2006 and September 2008. Of all enrolled patients, 2408 (58.5%) were used for analysis. More females than males were attending the clinic. Their baseline median CD4 cell count was low (136 cells/microl) with 65.7% having below 200 cells/microl. Females had higher CD4 cell counts (150 cells/microl) than males (109 cells/microl) p MNH HIV clinic were predominantly females, and presented with advanced immune-deficiency. Improved access to HIV care and treatment services seems to be associated with patients' early presentation to the clinics in the course of HIV disease.

[Dynamics of change of ureaplasma laboratory strain titers and quantity of their DNA in transport medium at varying temperature].

Science.gov (United States)

Gamova, N A; Ivanova, T A

2013-01-01

Study of preservation dynamics of ureaplasma laboratory strain live cultures and their DNA in transport medium at varying temperature. The study was carried out in laboratory strains Ureaplasma urealyticum serotype 8 and Ureaplasma parvum serotype 1. The quantity of live ureaplasmas was determined by method of tenfold dilutions in liquid medium. The growth of ureaplasmas was registered by changes in the color of the cultivation medium due to its alkalization by metabolism products and expressed in CCU/ml. DNA quantity in samples was determined by real time PCR performed by using Florocenosis-micoplasmas-FL test system produced by ILS. Live ureaplasmas wer shown to be preserved in transport medium at 4 degrees C for 12 - 29 days, at 18 - 22 degrees C--for 9 - 20 days and at 37 degrees C--for only 2 days. In samples incubated at 37 degrees C the quantity of live ureaplasmas increased and then sharply decreased to 0, at lower temperature titers of the cells decreased smoothly. The quantity of ureaplasma DNA in the process of their incubation did not change significantly. Fundamental differences in the duration of survival of U. urealyticum strain and U. parvum strain in transport medium at varying temperature were not detected. Based on the studies performed a practical conclusion can be drawn that in cases of emergency when clinical material transportation is necessary its storage in transport medium for several days is acceptable.

[Relativity among starch quantity, polysaccharides content and total alkaloid content of Dendrobium loddigesii].

Science.gov (United States)

Zhu, Hua; Teng, Jianbei; Cai, Yi; Liang, Jie; Zhu, Yilin; Wei, Tao

2011-12-01

To find out the relativity among starch quantity, polysaccharides content and total alkaloid content of Dendrobium loddigesii. Microscopy-counting process was applied to starch quantity statistics, sulfuric acid-anthrone colorimetry was used to assay polysaccharides content and bromocresol green colorimetry was used to assay alkaloid content. Pearson product moment correlation analysis, Kendall's rank correlation analysis and Spearman's concordance coefficient analysis were applied to study their relativity. Extremely significant positive correlation was found between starch quantity and polysaccharides content, and significant negative correlation between alkaloid content and starch quantity was discovered, as well was between alkaloid content and polysaccharides content.

Electronic information sources access and use for healthcare ...

African Journals Online (AJOL)

Background: Access to and use of electronic information sources for clinical decision is the key to the attainment of health related sustainable goals. Therefore, this study was to assess Electronic Information Sources (EIS) access and use for healthcare service among hospitals of Western Oromia, Ethiopia, 2013. Materials ...

Non-Noether Conserved Quantity for Relativistic Nonholonomic System with Variable Mass

International Nuclear Information System (INIS)

Qiao Yongfen; Li Renjie; Ma Yongsheng

2005-01-01

Using form invariance under special infinitesimal transformations in which time is not variable, the non-Noether conserved quantity of the relativistic nonholonomic system with variable mass is studied. The differential equations of motion of the system are established. The definition and criterion of the form invariance of the system under infinitesimal transformations are studied. The necessary and sufficient condition under which the form invariance is a Lie symmetry is given. The condition under which the form invariance can be led to a non-Noether conserved quantity and the form of the conserved quantity are obtained. Finally, an example is given to illustrate the application of the result.

Exercise quantity-dependent muscle hypertrophy in adult zebrafish (Danio rerio).

Science.gov (United States)

Hasumura, Takahiro; Meguro, Shinichi

2016-07-01

Exercise is very important for maintaining and increasing skeletal muscle mass, and is particularly important to prevent and care for sarcopenia and muscle disuse atrophy. However, the dose-response relationship between exercise quantity, duration/day, and overall duration and muscle mass is poorly understood. Therefore, we investigated the effect of exercise duration on skeletal muscle to reveal the relationship between exercise quantity and muscle hypertrophy in zebrafish forced to exercise. Adult male zebrafish were exercised 6 h/day for 4 weeks, 6 h/day for 2 weeks, or 3 h/day for 2 weeks. Flow velocity was adjusted to maximum velocity during continual swimming (initial 43 cm/s). High-speed consecutive photographs revealed that zebrafish mainly drove the caudal part. Additionally, X-ray micro computed tomography measurements indicated muscle hypertrophy of the mid-caudal half compared with the mid-cranial half part. The cross-sectional analysis of the mid-caudal half muscle revealed that skeletal muscle (red, white, or total) mass increased with increasing exercise quantity, whereas that of white muscle and total muscle increased only under the maximum exercise load condition of 6 h/day for 4 weeks. Additionally, the muscle fiver size distributions of exercised fish were larger than those from non-exercised fish. We revealed that exercise quantity, duration/day, and overall duration were correlated with skeletal muscle hypertrophy. The forced exercise model enabled us to investigate the relationship between exercise quantity and skeletal muscle mass. These results open up the possibility for further investigations on the effects of exercise on skeletal muscle in adult zebrafish.

Clinical Trials

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Full Text Available ... and treatments that work best. How Clinical Trials Work If you take part in a clinical trial, ... Learn More Connect With Us Contact Us Directly Policies Privacy Policy Freedom of Information Act (FOIA) Accessibility ...

BIRTHDAY CAKE ACTIVITY STRUCTURED ARRANGEMENT FOR HELPING CHILDREN DETERMINING QUANTITIES

Directory of Open Access Journals (Sweden)

Neni Mariana

2010-07-01

Full Text Available Few researches have been concerned about relation between children’s spatialthinking and number sense. Narrowing for this small research, we focused onone component of spatial thinking, that is structuring objects, and onecomponent of number senses, that is cardinality by determining quantities. Thisstudy focused on a design research that was conducted in Indonesia in which weinvestigated pre-school children’s (between 2 and 3.5 years old ability inmaking structured arrangement and their ability to determine the quantities bylooking at the arrangements. The result shows us that some of the children wereable to make such arrangement. However, the children found difficulties eitherto determine quantities from those arrangements or to compare some structuresto easily recognize number of objects.Keywords: structures, structured arrangement, cardinality DOI: http://dx.doi.org/10.22342/jme.1.1.790.53-70

The Cervix Cancer Research Network (CCRN: Increasing access to cancer clinical trials in low- and middle-income countries

Directory of Open Access Journals (Sweden)

Gita eSuneja

2015-02-01

Full Text Available Introduction: The burden of cervical cancer is large and growing in developing countries, due in large part to limited access to screening services and lack of human papillomavirus (HPV vaccination. In spite of modern advances in diagnostic and therapeutic modalities, outcomes from cervical cancer have not markedly improved in recent years. Novel clinical trials are urgently needed to improve outcomes from cervical cancer worldwide. Methods: The Cervix Cancer Research Network (CCRN, a subsidiary of the Gynecologic Cancer InterGroup (GCIG, is a multi-national, multi-institutional consortium of physicians and scientists focused on improving cervical cancer outcomes worldwide by making cancer clinical trials available in low-, middle-, and high-income countries. Standard operating procedures for participation in CCRN include a pre-qualifying questionnaire to evaluate clinical activities and research infrastructure, followed by a site visit. Once a site is approved, they may choose to participate in one of four currently accruing clinical trials.Results: To date, 13 different CCRN site visits have been performed. Of these 13 sites visited, 10 have been approved as CCRN sites including Tata Memorial Hospital, India; Bangalore, India; Trivandrum, India; Ramathibodi, Thailand; Siriaj, Thailand; Pramongkutklao, Thailand; Ho Chi Minh, Vietnam; Blokhin Russian Cancer Research Center; the Hertzen Moscow Cancer Research Institute; and the Russian Scientific Center of Roentgenoradiology. The four currently accruing clinical trials are TACO, OUTBACK, INTERLACE, and SHAPE.Discussion: The CCRN has successfully enrolled 10 sites in developing countries to participate in four randomized clinical trials. The primary objectives are to provide novel therapeutics to regions with the greatest need and to improve the validity and generalizability of clinical trial results by enrolling a diverse sample of patients.

Sequential algorithm analysis to facilitate selective biliary access for difficult biliary cannulation in ERCP: a prospective clinical study.

Science.gov (United States)

Lee, Tae Hoon; Hwang, Soon Oh; Choi, Hyun Jong; Jung, Yunho; Cha, Sang Woo; Chung, Il-Kwun; Moon, Jong Ho; Cho, Young Deok; Park, Sang-Heum; Kim, Sun-Joo

2014-02-17

Numerous clinical trials to improve the success rate of biliary access in difficult biliary cannulation (DBC) during ERCP have been reported. However, standard guidelines or sequential protocol analysis according to different methods are limited in place. We planned to investigate a sequential protocol to facilitate selective biliary access for DBC during ERCP. This prospective clinical study enrolled 711 patients with naïve papillae at a tertiary referral center. If wire-guided cannulation was deemed to have failed due to the DBC criteria, then according to the cannulation algorithm early precut fistulotomy (EPF; cannulation time > 5 min, papillary contacts > 5 times, or hook-nose-shaped papilla), double-guidewire cannulation (DGC; unintentional pancreatic duct cannulation ≥ 3 times), and precut after placement of a pancreatic stent (PPS; if DGC was difficult or failed) were performed sequentially. The main outcome measurements were the technical success, procedure outcomes, and complications. Initially, a total of 140 (19.7%) patients with DBC underwent EPF (n = 71) and DGC (n = 69). Then, in DGC group 36 patients switched to PPS due to difficulty criteria. The successful biliary cannulation rate was 97.1% (136/140; 94.4% [67/71] with EPF, 47.8% [33/69] with DGC, and 100% [36/36] with PPS; P EPF, 314.8 (65.2) seconds in DGC, and 706.0 (469.4) seconds in PPS (P EPF, DGC, and PPS may be safe and feasible for DBC. The use of EPF in selected DBC criteria, DGC in unintentional pancreatic duct cannulations, and PPS in failed or difficult DGC may facilitate successful biliary cannulation.

The UNOSAT-GRID Project: Access to Satellite Imagery through the Grid Environment

CERN Document Server

Méndez-Lorenzo, P; Lamanna, M; Meyer, X; Lazeyras, M; Bjorgo, E; Retiere, A; Falzone, A; Venuti, N; Maccarone, S; Ugolotti, B

2007-01-01

UNOSAT is a United Nations activity to provide access to satellite images and geographic system services for humanitarian operations for rescue or aid activities. UNOSAT is implemented by the UN Institute for Training and Research (UNITAR) and managed by the UN Office for Project Services (UNOPS). In addition, partners from different organizations constitute the UNOSAT consortium. Among these partners, CERN participates actively providing the required computational and storage resources. The critical part of the UNOSAT activity is the storage and processing of large quantities of satellite images. The fast and secure access to these images from any part of the world is mandatory during these activities. Based on two successful CERN-GRID/UNOSAT pilot projects (data storage/compression/download and image access through mobile phone), the GRIDUNOSAT project has consolidated the considerable work undertaken so far in the present activity. The main use case already demonstrated is the delivery of satellite images ...

Complexity in an Unexpected Place: Quantities in Selected Acquisition Reports

Science.gov (United States)

2017-12-01

by the Army Acquisition Executive contains the following language . As a recently delegated Acquisition Category IC program, the AH-64E Apache...Complexity in an Unexpected Place: Quantities in Selected Acquisition Reports Gregory A. Davis, Project Leader Margaret L. Giles David M. Tate I...F E N S E A N A L Y S E S IDA Paper P-8490 Complexity in an Unexpected Place: Quantities in Selected Acquisition Reports Gregory A. Davis

Which journals do primary care physicians and specialists access from an online service?

Science.gov (United States)

McKibbon, K Ann; Haynes, R Brian; McKinlay, R James; Lokker, Cynthia

2007-07-01

The study sought to determine which online journals primary care physicians and specialists not affiliated with an academic medical center access and how the accesses correlate with measures of journal quality and importance. Observational study of full-text accesses made during an eighteen-month digital library trial was performed. Access counts were correlated with six methods composed of nine measures for assessing journal importance: ISI impact factors; number of high-quality articles identified during hand-searches of key clinical journals; production data for ACP Journal Club, InfoPOEMs, and Evidence-Based Medicine; and mean clinician-provided clinical relevance and newsworthiness scores for individual journal titles. Full-text journals were accessed 2,322 times by 87 of 105 physicians. Participants accessed 136 of 348 available journal titles. Physicians often selected journals with relatively higher numbers of articles abstracted in ACP Journal Club. Accesses also showed significant correlations with 6 other measures of quality. Specialists' access patterns correlated with 3 measures, with weaker correlations than for primary care physicians. Primary care physicians, more so than specialists, chose full-text articles from clinical journals deemed important by several measures of value. Most journals accessed by both groups were of high quality as measured by this study's methods for assessing journal importance.

Symmetries and conserved quantities in geodesic motion

International Nuclear Information System (INIS)

Hojman, S.; Nunez, L.; Patino, A.; Rago, H.

1986-01-01

Recently obtained results linking several constants of motion to one (non-Noetherian) symmetry to the problem of geodesic motion in Riemannian space-times are applied. The construction of conserved quantities in geodesic motion as well as the deduction of geometrical statements about Riemannian space-times are achieved

A re-conceptualization of access for 21st century healthcare.

Science.gov (United States)

Fortney, John C; Burgess, James F; Bosworth, Hayden B; Booth, Brenda M; Kaboli, Peter J

2011-11-01

Many e-health technologies are available to promote virtual patient-provider communication outside the context of face-to-face clinical encounters. Current digital communication modalities include cell phones, smartphones, interactive voice response, text messages, e-mails, clinic-based interactive video, home-based web-cams, mobile smartphone two-way cameras, personal monitoring devices, kiosks, dashboards, personal health records, web-based portals, social networking sites, secure chat rooms, and on-line forums. Improvements in digital access could drastically diminish the geographical, temporal, and cultural access problems faced by many patients. Conversely, a growing digital divide could create greater access disparities for some populations. As the paradigm of healthcare delivery evolves towards greater reliance on non-encounter-based digital communications between patients and their care teams, it is critical that our theoretical conceptualization of access undergoes a concurrent paradigm shift to make it more relevant for the digital age. The traditional conceptualizations and indicators of access are not well adapted to measure access to health services that are delivered digitally outside the context of face-to-face encounters with providers. This paper provides an overview of digital "encounterless" utilization, discusses the weaknesses of traditional conceptual frameworks of access, presents a new access framework, provides recommendations for how to measure access in the new framework, and discusses future directions for research on access.

ADM pseudotensors, conserved quantities and covariant conservation laws in general relativity

International Nuclear Information System (INIS)

Fatibene, L.; Ferraris, M.; Francaviglia, M.; Lusanna, L.

2012-01-01

The ADM formalism is reviewed and techniques for decomposing generic components of metric, connection and curvature are obtained. These techniques will turn out to be enough to decompose not only Einstein equations but also covariant conservation laws. Then a number of independent sets of hypotheses that are sufficient (though not necessary) to obtain standard ADM quantities (and Hamiltonian) from covariant conservation laws are considered. This determines explicitly the range in which standard techniques are equivalent to covariant conserved quantities. The Schwarzschild metric in different coordinates is then considered, showing how the standard ADM quantities fail dramatically in non-Cartesian coordinates or even worse when asymptotically flatness is not manifest; while, in view of their covariance, covariant conservation laws give the correct result in all cases. - Highlights: ► In the paper ADM conserved quantities for GR are obtained from augmented conservation laws. ► Boundary conditions for this to be possible are considered and compared with the literature. ► Some different forms of Schwarzschild solutions are considered as simple examples of different boundary conditions.

Studies on quantity and composition of dairy cow excreta

International Nuclear Information System (INIS)

Peschke, H.

1982-01-01

After feeding a lactating dairy cow a day ration completely enriched with 15 N, the quantities of feces and urine were registered over a period of ten days and put into proportion to the animal mass. The fecal dry matter was put into proportion to the dry matter of the fodder by means of 15 N analysis the N excretion with the excreta was determined concerning quantity and time. Selected feces and urine charges were used to produce a slurry model. The content of nutritive elements of the initial components and of the organic fertilizer are discussed. (author)

Validity of the concept of absorbed dose as a physical quantity

International Nuclear Information System (INIS)

Tada, Jun-Ichiro; Katoh, Kazuaki.

1995-01-01

The concept of the 'absorbed dose' of ionizing radiation is scrutinized from physical point of view. It is shown that the concept and definition of the quantity in the ICRU system is disqualified as a physical quantity and the absorbed dose can not always be a 'measure of cause' in describing causality relation between radiation and effects on matter. The current absorbed dose depends even on the energy that have already been brought out from the matter, contrary to the intention of introducing the quantity. Trials to remove these difficulties are made. However, it is also shown there still exists an essential problem that cannot be solved by improving the formulation. (author)

Property of Fluctuations of Sales Quantities by Product Category in Convenience Stores.

Directory of Open Access Journals (Sweden)

Gaku Fukunaga

Full Text Available The ability to ascertain the extent of product sale fluctuations for each store and locality is indispensable to inventory management. This study analyzed POS data from 158 convenience stores in Kawasaki City, Kanagawa Prefecture, Japan and found a power scaling law between the mean and standard deviation of product sales quantities for several product categories. For the statistical domains of low sales quantities, the power index was 1/2; for large sales quantities, the power index was 1, so called Taylor's law holds. The value of sales quantities with changing power indixes differed according to product category. We derived a Poissonian compound distribution model taking into account fluctuations in customer numbers to show that the scaling law could be explained theoretically for most of items. We also examined why the scaling law did not hold in some exceptional cases.

Property of Fluctuations of Sales Quantities by Product Category in Convenience Stores.

Science.gov (United States)

Fukunaga, Gaku; Takayasu, Hideki; Takayasu, Misako

2016-01-01

The ability to ascertain the extent of product sale fluctuations for each store and locality is indispensable to inventory management. This study analyzed POS data from 158 convenience stores in Kawasaki City, Kanagawa Prefecture, Japan and found a power scaling law between the mean and standard deviation of product sales quantities for several product categories. For the statistical domains of low sales quantities, the power index was 1/2; for large sales quantities, the power index was 1, so called Taylor's law holds. The value of sales quantities with changing power indixes differed according to product category. We derived a Poissonian compound distribution model taking into account fluctuations in customer numbers to show that the scaling law could be explained theoretically for most of items. We also examined why the scaling law did not hold in some exceptional cases.

Abdominal auscultation does not provide clear clinical diagnoses.

Science.gov (United States)

Durup-Dickenson, Maja; Christensen, Marie Kirk; Gade, John

2013-05-01

Abdominal auscultation is a part of the clinical examination of patients, but the determining factors in bowel sound evaluation are poorly described. The aim of this study was to assess inter- and intra-observer agreement in physicians' evaluation of pitch, intensity and quantity in abdominal auscultation. A total of 100 physicians were presented with 20 bowel sound recordings in a blinded set-up. Recordings had been made in a mix of healthy volunteers and emergency patients. They evaluated pitch, intensity and quantity of bowel sounds in a questionnaire with three, three and four categories of answers, respectively. Fleiss' multi-rater kappa (κ) coefficients were calculated for inter-observer agreement; for intra-observer agreement, calculation of probability was performed. Inter-observer agreement regarding pitch, intensity and quantity yielded κ-values of 0.19 (p auscultation increases with addition of history and clinics, and may be further improved by systematic training, it should still be used in the examination of patients with acute abdominal pain. not relevant. not relevant.

Decentralization, healthcare access, and inequality in Mpumalanga, South Africa.

Science.gov (United States)

Winchester, Margaret S; King, Brian

2018-04-27

Healthcare access and utilization remain key challenges in the Global South. South Africa represents this given that more than twenty years after the advent of democratic elections, the national government continues to confront historical systems of spatial manipulation that generated inequities in healthcare access. While the country has made significant advancements, governmental agencies have mirrored international strategies of healthcare decentralization and focused on local provision of primary care to increase healthcare access. In this paper, we show the significance of place in shaping access and health experiences for rural populations. Using data from a structured household survey, focus group discussions, qualitative interviews, and clinic data conducted in northeast South Africa from 2013 to 2016, we argue that decentralization fails to resolve the uneven landscapes of healthcare in the contemporary period. This is evidenced by the continued variability across the study area in terms of government-sponsored healthcare, and constraints in the clinics in terms of staffing, privacy, and patient loads, all of which challenge the access-related assumptions of healthcare decentralization. Copyright © 2018 Elsevier Ltd. All rights reserved.

16 CFR 500.7 - Net quantity of contents, method of expression.

Science.gov (United States)

2010-01-01

... expression. The net quantity of contents shall be expressed in terms of weight or mass, measure, numerical... consumers. The net quantity of contents statement shall be in terms of fluid measure if the commodity is liquid, or in terms of weight or mass if the commodity is solid, semi-solid, or viscous, or a mixture of...

A small quantity of sodium arsenite will kill large cull hardwoods

Science.gov (United States)

Francis M. Rushmore

1956-01-01

Although it is well known that sodium arsenite is an effective silvicide, forestry literature contains little information about the minimum quantities of this chemical that are required to kill large cull trees. Such information would be of value because if small quantities of a chemical will produce satisfactory results, small holes or frills in the tree will hold it...

Uncertainty analysis of thermal quantities measurement in a centrifugal compressor

Science.gov (United States)

Hurda, Lukáš; Matas, Richard

2017-09-01

Compressor performance characteristics evaluation process based on the measurement of pressure, temperature and other quantities is examined to find uncertainties for directly measured and derived quantities. CFD is used as a tool to quantify the influences of different sources of uncertainty of measurements for single- and multi-thermocouple total temperature probes. The heat conduction through the body of the thermocouple probe and the heat-up of the air in the intake piping are the main phenomena of interest.

Evaluation of the Esthetic Properties of Developmental Defects of Enamel: A Spectrophotometric Clinical Study

Directory of Open Access Journals (Sweden)

Fabrizio Guerra

2015-01-01

Full Text Available Objectives. Detailed clinical quantification of optical properties of developmental defect of enamel is possible with spectrophotometric evaluation. Developmental defects of enamel (DDE are daily encountered in clinical practice. DDE are an alteration in quality and quantity of the enamel, caused by disruption and/or damage to the enamel organ during amelogenesis. Methods. Several clinical indices have been developed to categorize enamel defects based on their nature, appearance, microscopic features, or cause. A sample of 39 permanent teeth presenting DDE on labial surface was examined using the DDE Modified Index and SpectroShade evaluation. The spectrophotometric approach quantifies L* (luminosity, a* (quantity of green-red, and b* (quantity of blue-yellow of different DDE. Conclusions. SpectroShade evaluation of the optical properties of the enamel defect enhances clinical understanding of severity and extent of the defect and characterizes the enamel alteration in terms of color discrepancy and surface characterization.

Measuring nanocurie quantities of tritium bred in metallic lithium and lithium oxide samples

International Nuclear Information System (INIS)

Bertone, P.C.

1985-01-01

The LBM program requires that nanocurie quantities of tritium, bred in both lithium oxide pellets and lithium samples, be measured with an uncertainty not exceeding + or - 6%. Two methods of accurately measuring nanocurie quantities of tritium bred in LBM lithium oxide pellets and one method of accurately measuring nanocurie quantities of tritium bred in lithium samples are described. Potential errors associated with these tritium measurement techniques are also discussed

A SEASONAL AND MONTHLY APPROACH FOR PREDICTING THE DELIVERED ENERGY QUANTITY IN A PHOTOVOLTAIC POWER PLANT IN ROMANIA

Directory of Open Access Journals (Sweden)

George Căruțașu

2016-12-01

Full Text Available In this paper, we present solutions that facilitate the forecasting of the delivered energy quantity in a photovoltaic power plant using the data measured from the solar panels' sensors: solar irradiation level, present module temperature, environmental temperature, atmospheric pressure and humidity. We have developed and analyzed a series of Artificial Neural Networks (ANNs based on the Levenberg-Marquardt algorithm, using seasonal and monthly approaches. We have also integrated our developed Artificial Neural Networks into callable functions that we have compiled using the Matlab Compiler SDK. Thus, our solution can be accessed by developers through multiple Application Programming Interfaces when programming software that predicts the photovoltaic renewable energy production considering the seasonal particularities of the Romanian weather patterns

Food quantity affects the sensitivity of Daphnia to road salt.

Science.gov (United States)

Brown, Arran H; Yan, Norman D

2015-04-07

Road deicing operations have raised chloride (Cl) levels in many temperate lakes in Europe and North America. These lakes vary widely in trophic status, but to date, no one has quantified the interaction between food quantity and road salt toxicity. We examined the effects of food quantity (particulate algal C concentration (C)) on the chronic toxicity of Cl to Daphnia in soft-water bioassays. There was a strong positive linear relationship (r(2) = 0.92 for NaCl and r(2) = 0.96 for CaCl2) between food quantity and Cl LC50. As food quantity increased from 0.2 to 1.0 mg C/L (levels characteristic of oligotrophic to eutrophic lakes, respectively), the chronic Cl LC50 increased from 55.7 to 284.8 mg Cl/L. Salt type (NaCl or CaCl2) did not affect the Cl LC50, Daphnia life history parameters, or the intrinsic rate of population increase (r). The life history parameter most sensitive to Cl was neonate production. Cl did not inhibit egg production, nor was the maternal lipid investment in eggs changed, but egg viability and the subsequent release of live neonates decreased as Cl levels increased and food decreased. Our results suggest the trophic status of lakes should be considered when assessing ecological threat from Cl.

Effect of Improved access to Antiretroviral Therapy on clinical characteristics of patients enrolled in the HIV care and treatment clinic, at Muhimbili National Hospital (MNH, Dar es Salaam, Tanzania

Directory of Open Access Journals (Sweden)

Swai Andrew B

2010-05-01

Full Text Available Abstract Background Sub-Saharan Africa has been severely affected by the HIV and AIDS pandemic. Global efforts at improving care and treatment has included scaling up use of antiretroviral therapy (ART. In Tanzania, HIV care and treatment program, including the provision of free ART started in 2004 with a pilot program at Muhimbili National Hospital in Dar es Salaam. This study describes the socio-demographic and clinical features of patients enrolled at the care and treatment clinic at MNH, Dar es Salaam, Tanzania. Methods A cross-sectional study looking at baseline characteristics of patients enrolled at the HIV clinic at MNH between June 2004 - Dec 2005 compared to those enrolled between 2006 and September 2008. Results Of all enrolled patients, 2408 (58.5% were used for analysis. More females than males were attending the clinic. Their baseline median CD4 cell count was low (136 cells/μl with 65.7% having below 200 cells/μl. Females had higher CD4 cell counts (150 cells/μl than males (109 cells/μl p Conclusion Patients enrolled to the MNH HIV clinic were predominantly females, and presented with advanced immune-deficiency. Improved access to HIV care and treatment services seems to be associated with patients' early presentation to the clinics in the course of HIV disease.

Price effects of changing quantities supplied at the integrated european fish market

DEFF Research Database (Denmark)

Nielsen, Max; Smit, Jos; Guillen, Jordi

2012-01-01

to be −1.1. This implies that price flexibilities previously estimated for single European countries underestimate price changes at the European level caused by quantity changes. Results indicate that changing quantities can increase revenues from individual species with large own-price flexibilities...

Automated Decisional Model for Optimum Economic Order Quantity Determination Using Price Regressive Rates

Science.gov (United States)

Roşu, M. M.; Tarbă, C. I.; Neagu, C.

2016-11-01

The current models for inventory management are complementary, but together they offer a large pallet of elements for solving complex problems of companies when wanting to establish the optimum economic order quantity for unfinished products, row of materials, goods etc. The main objective of this paper is to elaborate an automated decisional model for the calculus of the economic order quantity taking into account the price regressive rates for the total order quantity. This model has two main objectives: first, to determine the periodicity when to be done the order n or the quantity order q; second, to determine the levels of stock: lighting control, security stock etc. In this way we can provide the answer to two fundamental questions: How much must be ordered? When to Order? In the current practice, the business relationships with its suppliers are based on regressive rates for price. This means that suppliers may grant discounts, from a certain level of quantities ordered. Thus, the unit price of the products is a variable which depends on the order size. So, the most important element for choosing the optimum for the economic order quantity is the total cost for ordering and this cost depends on the following elements: the medium price per units, the stock cost, the ordering cost etc.

Thermodynamic quantities for the Klein–Gordon equation

Indian Academy of Sciences (India)

We study some thermodynamic quantities for the Klein–Gordon equation with a linear plus inverselinear, scalar potential. We obtain the energy eigenvalues with the help of the quantization rule from the biconfluent Heun's equation.We use a method based on the Euler–MacLaurin formula to analytically compute thethermal ...

19 CFR 351.409 - Differences in quantities.

Science.gov (United States)

2010-04-01

... DUTIES Calculation of Export Price, Constructed Export Price, Fair Value, and Normal Value § 351.409... comparing export price or constructed export price with normal value, the Secretary will make a reasonable... section 773(a)(6)(C)(i) of the Act.) (b) Sales with quantity discounts in calculating normal value. The...

16 CFR 1.23 - Quantity limit rules.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Quantity limit rules. 1.23 Section 1.23 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL... Robinson-Patman Act. These rules have the force and effect of law. [32 FR 8444, June 13, 1967. Redesignated...

7 CFR 1427.170 - Quantity for loan.

Science.gov (United States)

2010-01-01

... to the preservation or safety of the loan collateral. Loans may be made on a lower percentage basis... 7 Agriculture 10 2010-01-01 2010-01-01 false Quantity for loan. 1427.170 Section 1427.170... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS COTTON Recourse Seed Cotton Loans § 1427.170...

High mobile phone ownership but low internet access and use among Young adults attending an Urban HIV clinic in Uganda.

OpenAIRE

Parkes-Ratanshi, Rosalind; Namukasa Wanyama, Jane

2018-01-01

Whilst there is increasing interest in the use of mobile phones and other technology (mHealth) for improving health outcomes; limited data exists on how young people living with HIV use mhealth technologies to get information and to support their health. We sought to assess access and use of mobile phones and the Internet among young adults living with HIV attending the Infectious Diseases Institute (IDI) clinic, Kampala. Data collection took place between March 2014 and January 2016 among yo...

Urgency of increasing the quantity and quality of student creativity program

Science.gov (United States)

Sarmini; Prasetya, Ketut; Nadiroh, Ulin

2018-01-01

Student creativity is very important to improve the quality and quantity. The purpose of this paper is to identify the quality and quantity of the Student Creativity Program. The method in this research is exploratory study. The subjects taken are the leaders of deans and vice deans at the State University of Surabaya. Data collection techniques used are kusioner. The result of this research is creativity program in student is very important. Not only improve the quality and quantity of creativity, but also affect the image of the institution. It is necessary to have written rules on the regulations on the Student Creativity Program and to take a comprehensive and comprehensive approach, and to organize the budget is the main thing.

Uncertainties of exposure-related quantities in mammographic x-ray unit quality control

International Nuclear Information System (INIS)

Gregory, Kent J.; Pattison, John E.; Bibbo, Giovanni

2006-01-01

Breast screening programs operate in many countries with mammographic x-ray units subject to stringent quality control tests. These tests include the evaluation of quantities based on exposure measurements, such as half value layer, automatic exposure control reproducibility, average glandular dose, and radiation output rate. There are numerous error sources that contribute to the uncertainty of these exposure-related quantities, some of which are unique to the low energy x-ray spectrum produced by mammographic x-ray units. For each of these exposure-related quantities, the applicable error sources and their magnitudes vary, depending on the test equipment used to make the measurement, and whether or not relevant corrections have been applied. This study has identified and quantified a range of error sources that may be used to estimate the combined uncertainty of these exposure-related quantities, given the test equipment used and corrections applied. The uncertainty analysis uses methods described by the International Standards Organization's Guide to the Expression of Uncertainty in Measurement. Examples of how these error sources combine to give the uncertainty of the exposure-related quantities are presented. Using the best test equipment evaluated in this study, uncertainties of the four exposure-related quantities at the 95% confidence interval were found to be ±1.6% (half value layer), ±0.0008 (automatic exposure control reproducibility), ±2.3% (average glandular dose), and ±2.1% (radiation output rate). In some cases, using less precise test equipment or failing to apply corrections, resulted in uncertainties more than double in magnitude

Reducing the default dispense quantity for new opioid analgesic prescriptions: study protocol for a cluster randomised controlled trial.

Science.gov (United States)

Bachhuber, Marcus A; Nash, Denis; Southern, William N; Heo, Moonseong; Berger, Matthew; Schepis, Mark; Cunningham, Chinazo O

2018-04-20

As opioid analgesic consumption has grown, so have opioid use disorder and opioid-related overdoses. Reducing the quantity of opioid analgesics prescribed for acute non-cancer pain can potentially reduce risks to the individual receiving the prescription and to others who might unintentionally or intentionally consume any leftover tablets. Reducing the default dispense quantity for new opioid analgesic prescriptions in the electronic health record (EHR) is a promising intervention to reduce prescribing. This study is a prospective cluster randomised controlled trial with two parallel arms. Primary care sites (n=32) and emergency departments (n=4) will be randomised in matched pairs to either a modification of the EHR so that new opioid analgesic prescriptions default to a dispense quantity of 10 tablets (intervention) or to no EHR change (control). The dispense quantity will remain fully modifiable by providers in both arms. From 6 months preintervention to 18 months postintervention, patient-level data will be analysed (ie, the patient is the unit of inference). Patient eligibility criteria are: (A) received a new opioid analgesic prescription, defined as no other opioid analgesic prescription in the prior 6 months; (B) age ≥18 years; and (C) no cancer diagnosis within 1 year prior to the new opioid analgesic prescription. The primary outcome will be the quantity of opioid analgesics prescribed in the initial prescription. Secondary outcomes will include opioid analgesic reorders and health service utilisation within 30 days after the initial prescription. Outcomes will be compared between study arms using a difference-in-differences analysis. This study has been approved by the Montefiore Medical Center/Albert Einstein College of Medicine Institutional Review Board with a waiver of informed consent (2016-6036) and is registered on ClinicalTrials.gov (NCT03003832, 6 December 2016). Findings will be disseminated through publication, conferences and meetings

Multidemand Multisource Order Quantity Allocation with Multiple Transportation Alternatives

Directory of Open Access Journals (Sweden)

Jun Gang

2015-01-01

Full Text Available This paper focuses on a multidemand multisource order quantity allocation problem with multiple transportation alternatives. To solve this problem, a bilevel multiobjective programming model under a mixed uncertain environment is proposed. Two levels of decision makers are considered in the model. On the upper level, the purchaser aims to allocate order quantity to multiple suppliers for each demand node with the consideration of three objectives: total purchase cost minimization, total delay risk minimization, and total defect risk minimization. On the lower level, each supplier attempts to optimize the transportation alternatives with total transportation and penalty costs minimization as the objective. In contrast to prior studies, considering the information asymmetry in the bilevel decision, random and fuzzy random variables are used to model uncertain parameters of the construction company and the suppliers. To solve the bilevel model, a solution method based on Kuhn-Tucker conditions, sectional genetic algorithm, and fuzzy random simulation is proposed. Finally, the applicability of the proposed model and algorithm is evaluated through a practical case from a large scale construction project. The results show that the proposed model and algorithm are efficient in dealing with practical order quantity allocation problems.

A method for quantitative analysis of standard and high-throughput qPCR expression data based on input sample quantity.

Directory of Open Access Journals (Sweden)

Mateusz G Adamski

Full Text Available Over the past decade rapid advances have occurred in the understanding of RNA expression and its regulation. Quantitative polymerase chain reactions (qPCR have become the gold standard for quantifying gene expression. Microfluidic next generation, high throughput qPCR now permits the detection of transcript copy number in thousands of reactions simultaneously, dramatically increasing the sensitivity over standard qPCR. Here we present a gene expression analysis method applicable to both standard polymerase chain reactions (qPCR and high throughput qPCR. This technique is adjusted to the input sample quantity (e.g., the number of cells and is independent of control gene expression. It is efficiency-corrected and with the use of a universal reference sample (commercial complementary DNA (cDNA permits the normalization of results between different batches and between different instruments--regardless of potential differences in transcript amplification efficiency. Modifications of the input quantity method include (1 the achievement of absolute quantification and (2 a non-efficiency corrected analysis. When compared to other commonly used algorithms the input quantity method proved to be valid. This method is of particular value for clinical studies of whole blood and circulating leukocytes where cell counts are readily available.

Freely Accessible Chemical Database Resources of Compounds for in Silico Drug Discovery.

Science.gov (United States)

Yang, JingFang; Wang, Di; Jia, Chenyang; Wang, Mengyao; Hao, GeFei; Yang, GuangFu

2018-05-07

In silico drug discovery has been proved to be a solidly established key component in early drug discovery. However, this task is hampered by the limitation of quantity and quality of compound databases for screening. In order to overcome these obstacles, freely accessible database resources of compounds have bloomed in recent years. Nevertheless, how to choose appropriate tools to treat these freely accessible databases are crucial. To the best of our knowledge, this is the first systematic review on this issue. The existed advantages and drawbacks of chemical databases were analyzed and summarized based on the collected six categories of freely accessible chemical databases from literature in this review. Suggestions on how and in which conditions the usage of these databases could be reasonable were provided. Tools and procedures for building 3D structure chemical libraries were also introduced. In this review, we described the freely accessible chemical database resources for in silico drug discovery. In particular, the chemical information for building chemical database appears as attractive resources for drug design to alleviate experimental pressure. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The impact of privatization on access in Tanzania.

Science.gov (United States)

Benson, J S

2001-06-01

In the late 1980s, many developing countries were forced to adopt structural adjustment policies as a condition for securing loans from the International Monetary Fund (IMF) and the World Bank. One of the World Bank's recommended policies was to change the mix of private and public health facilities. This study, based on fieldwork done in Tanzania in 1993, examines the impact of this policy on health-care accessibility in two northern Tanzanian districts, one rural and one urban. Accessibility was measured in terms of equality and equity of coverage. The placement of the very few government clinics opened during the years 1985-1993 did much more to improve coverage than the haphazard location of many new private clinics. Equity was not improved as very few clinics were placed in demographically needy areas.

Principles and foundation: national standards on quantities and units in nuclear science field

International Nuclear Information System (INIS)

Chen Lishu

1993-11-01

The main contents of National Standards on Quantities and units of atomic and nuclear physics (GB 3102.9) and Quantities and Units of nuclear reactions and ionizing radiations (GB 310.10) are presented in which most important quantities with their symbols and definitions in the nuclear scientific field are given. The principles and foundation, including the International System of Units (SI) and its application to the nuclear scientific field, in the setting of the National Standards are explained

Hay intake improves performance and rumen development of calves fed higher quantities of milk.

Science.gov (United States)

Khan, M A; Weary, D M; von Keyserlingk, M A G

2011-07-01

Research to date has suggested that access to forage before weaning can limit rumen development in calves, but no research has yet addressed the role of forage for calves fed higher quantities of milk. This study compared performance and rumen development of calves provided high volumes (equivalent to approximately 20% of calf birth weight) of milk with and without access to hay. At d 3 of age, individually housed calves were randomly assigned to treatment (either ad libitum access to chopped grass hay or no forage; n=15 calves per treatment, 10 heifers, and 5 bulls). All calves were provided ad libitum access to water and starter throughout the study. All calves were offered 8L of milk/d from a nipple bottle from d 3 to 35, 4 L/d from d 36 to 53, and 2L/d until weaning at d 56. Solid feed intake and growth parameters were monitored from d 3 to 70. At d 70, males from both treatments were slaughtered to measure rumen development parameters. Overall dry matter (DM) intake from solid feed did not differ between treatments before wk 5. However, during wk 6 to 10, calves fed forage consumed more total DM (starter plus hay) than did calves fed no forage. Hip and wither height, heart girth, and body barrel at d 3, 56, and 70 did not differ between treatments. Reticulorumen weight was heavier in calves fed hay versus those fed only starter (12.77±1.29 vs. 7.99±0.69 kg with digesta; 1.89±0.05 vs.1.60±0.09 kg without digesta). Body weight without digesta was similar in calves fed forage or no forage. Mean rumen pH was higher in calves fed hay compared with those fed no forage (5.49±0.08 vs. 5.06±0.04). In conclusion, provision of chopped hay to calves fed high volumes of milk can promote solid feed DM intake and rumen development without affecting BW gain. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

The price of 'free'. Quantifying the costs incurred by rural residents attending publically funded outpatient clinics in rural and base hospitals.

Science.gov (United States)

Fearnley, David; Kerse, Ngaire; Nixon, Garry

2016-09-01

INTRODUCTION Rural living is associated with increased costs in many areas, including health care. However, there is very little local data to quantify these costs, and their unknown quantity means that costs are not always taken into account in health service planning and delivery. AIM The aim of this study was to calculate the average time and travel costs of attending rural and base hospital outpatient clinics for rural Central Otago residents. METHODS A survey of 51 people attending rural hospital outpatient clinics. Individual costs in terms of travel and time were quantified and an average cost of both rural and base hospital attendance was calculated. RESULTS The average travel and lost time cost of attending a rural outpatient clinic was NZ$182 and 61% of respondents reported this cost had a significant effect on their weekly budget. The average cost incurred by residents associated with a base hospital attendance in Dunedin was NZ$732. DISCUSSION This study data show that costs are substantial and probably higher than most people might expect for both rural and base hospital attendances. It seems likely that these costs are a potential barrier to service access. However, the full implications of the personal costs incurred by rural residents in accessing health services are largely unstudied and therefore remain unknown in New Zealand.

Construction of ethics in clinical research: clinical trials registration

OpenAIRE

C. A. Caramori

2007-01-01

Scientific development that has been achieved through decades finds in clinical research a great possibility of translating findings to human health application. Evidence given by clinical trials allows everyone to have access to the best health services. However, the millionaire world of pharmaceutical industries has stained clinical research with doubt and improbability. Study results (fruits of controlled clinical trials) and scientific publications (selective, manipulated and with wrong c...

Are essential medicines in Malaysia accessible, affordable and available?

Science.gov (United States)

Saleh, Kamaruzaman; Ibrahim, Mohamed I M

2005-12-01

To assess the pharmaceutical sector to know whether people have access to essential medicines. The study was conducted in 20 public health clinics, five public district drug stores and 20 private retail pharmacies selected randomly in five different areas randomly selected (four states and a federal territory). The methodology used was adopted from the World Health Organization study protocol. The degree of attainment of the strategic pharmaceutical objectives of improved access is measured by a list of tested indicators. Access is measured in terms of the availability and affordability of essential medicines, especially to the poor and in the public sector. The first survey in the public health clinics and public district drug stores gathered information about current availability of essential medicines, prevalence of stock-outs and affordability of treatment (except drug stores). The second survey assessed affordability of treatment in public health clinics and private retail pharmacies. Availability, stock-out duration, percent of medicines dispensed, accessibility and affordability of key medicines. The average availability of key medicines in the public health clinics for the country was 95.4%. The average stock-out duration of key medicines was 6.5 days. However, average availability of key medicines in the public district drug stores was 89.2%; with an average stock-out duration of 32.4 days. Medicines prescribed were 100% dispensed to the patients. Average affordability for public health clinics was 1.5 weeks salary and for the private pharmacies, 3.7 weeks salary. The present pharmaceutical situation in the context of essential medicines list implementation reflected that the majority of the population in Malaysia had access to affordable essential medicines. If medicines need to be obtained from the private sector, they are hardly affordable. Although the average availability of essential medicines in Malaysia was high being more than 95.0%, in certain

Precise and efficient evaluation of gravimetric quantities at arbitrarily scattered points in space

Science.gov (United States)

Ivanov, Kamen G.; Pavlis, Nikolaos K.; Petrushev, Pencho

2017-12-01

Gravimetric quantities are commonly represented in terms of high degree surface or solid spherical harmonics. After EGM2008, such expansions routinely extend to spherical harmonic degree 2190, which makes the computation of gravimetric quantities at a large number of arbitrarily scattered points in space using harmonic synthesis, a very computationally demanding process. We present here the development of an algorithm and its associated software for the efficient and precise evaluation of gravimetric quantities, represented in high degree solid spherical harmonics, at arbitrarily scattered points in the space exterior to the surface of the Earth. The new algorithm is based on representation of the quantities of interest in solid ellipsoidal harmonics and application of the tensor product trigonometric needlets. A FORTRAN implementation of this algorithm has been developed and extensively tested. The capabilities of the code are demonstrated using as examples the disturbing potential T, height anomaly ζ , gravity anomaly Δ g , gravity disturbance δ g , north-south deflection of the vertical ξ , east-west deflection of the vertical η , and the second radial derivative T_{rr} of the disturbing potential. After a pre-computational step that takes between 1 and 2 h per quantity, the current version of the software is capable of computing on a standard PC each of these quantities in the range from the surface of the Earth up to 544 km above that surface at speeds between 20,000 and 40,000 point evaluations per second, depending on the gravimetric quantity being evaluated, while the relative error does not exceed 10^{-6} and the memory (RAM) use is 9.3 GB.

Conserved quantities for stationary Einstein-Maxwell space-times

International Nuclear Information System (INIS)

Esposito, F.P.; Witten, L.

1978-01-01

It is shown that every stationary Einstein-Maxwell space-time has eight divergence-free vector fields and these are isolated in general form. The vector fields and associated conserved quantities are calculated for several families of space-times. (Auth.)

Monitoring the eye lens: which dose quantity is adequate?

International Nuclear Information System (INIS)

Behrens, R; Dietze, G

2010-01-01

Recent epidemiological studies suggest a rather low dose threshold (below 0.5 Gy) for the induction of a cataract of the eye lens. Some other studies even assume that there is no threshold at all. Therefore, protection measures have to be optimized and current dose limits for the eye lens may be reduced in the future. The question of which personal dose equivalent quantity is appropriate for monitoring the dose to the eye lens arises from this situation. While in many countries dosemeters calibrated in terms of the dose equivalent quantity H p (0.07) have been seen as being adequate for monitoring the dose to the eye lens, this might be questionable in the case of reduced dose limits and, thus, it may become necessary to use the dose equivalent quantity H p (3) for this purpose. To discuss this question, the dose conversion coefficients for the equivalent dose of the eye lens (in the following eye lens dose) were determined for realistic photon and beta radiation fields and compared with the values of the corresponding conversion coefficients for the different operational quantities. The values obtained lead to the following conclusions: in radiation fields where most of the dose comes from photons, especially x-rays, it is appropriate to use dosemeters calibrated in terms of H p (0.07) on a slab phantom, while in other radiation fields (dominated by beta radiation or unknown contributions of photon and beta radiation) dosemeters calibrated in terms of H p (3) on a slab phantom should be used. As an alternative, dosemeters calibrated in terms of H p (0.07) on a slab phantom could also be used; however, in radiation fields containing beta radiation with the end point energy near 1 MeV, an overestimation of the eye lens dose by up to a factor of 550 is possible.

Manual of symbols and terminology for physicochemical quantities and units

CERN Document Server

Whiffen, D H

2013-01-01

Manual of Symbols and Terminology for Physicochemical Quantities and Units, 1979 Edition contains physical quantity tabulations of products. The Commission on Symbols, Terminology, and Units is a part of the Division of Physical Chemistry of the International Union of Pure and Applied Chemistry. Its general responsibilities are to secure clarity and precision, and wider agreement in the use of symbols, by chemists in different countries, among physicists, chemists, and engineers, and by editors of scientific journals. This book is composed of 13 chapters, and begins with the determination o

Units for physical quantities used in dosimetry and radiation protection

Energy Technology Data Exchange (ETDEWEB)

Taubert, R; Wagner, S

1976-04-01

The 15th General Conference on Weights and Measures (1975) decided to introduce the name Becquerel for the SI unit of the quantity activity (1 Bq = 1 s/sup -1/) and the name Gray for the SI unit of ionizing radiations (1 Gy = 1 J/kg). The consequences of this latter decision are discussed. The Bundesanstalt is of the opinion that no further names for this unit should be introduced, but that the Gray should be used also for other quantities of the same dimension, especially for the dose equivalent.

Is open access sufficient? A review of the quality of open-access nursing journals.

Science.gov (United States)

Crowe, Marie; Carlyle, Dave

2015-02-01

The present study aims to review the quality of open-access nursing journals listed in the Directory of Open Access Journals that published papers in 2013 with a nursing focus, written in English, and were freely accessible. Each journal was reviewed in relation to their publisher, year of commencement, number of papers published in 2013, fee for publication, indexing, impact factor, and evidence of requirements for ethics and disclosure statements. The quality of the journals was assessed by impact factors and the requirements for indexing in PubMed. A total of 552 were published in 2013 in the 19 open-access nursing journals that met the inclusion criteria. No journals had impact factors listed in Web of Knowledge, but three had low Scopus impact factors. Only five journals were indexed with PubMed. The quality of the 19 journals included in the review was evaluated as inferior to most subscription-fee journals. Mental health nursing has some responsibility to the general public, and in particular, consumers of mental health services and their families, for the quality of papers published in open-access journals. The way forward might involve dual-platform publication or a process that enables assessment of how research has improved clinical outcomes. © 2014 Australian College of Mental Health Nurses Inc.

Measuring influenza RNA quantity after prolonged storage or multiple freeze/thaw cycles.

Science.gov (United States)

Granados, Andrea; Petrich, Astrid; McGeer, Allison; Gubbay, Jonathan B

2017-09-01

In this study, we aim to determine what effects prolonged storage and repeated freeze/thaw cycles have on the stability of influenza A(H1N1)pdm09 (influenza A/H1N1)RNA. Cloned influenza A/H1N1 RNA transcripts were serially diluted from 8.0-1.0 log 10 copies/μl. RT-qPCR was used to measure RNA loss in transcripts stored at -80°C, -20°C, 4°C and 25°C for up to 84days or transcripts undergoing a total of 10 freeze/thaw cycles. Viral load was measured in clinical specimens stored at-80°C for three years (n=89 influenza A RNA extracts; n=35 primary specimens) and in 10 clinical specimens from the 2015/2016 influenza season that underwent 7 freeze/thaw cycles. RNA stored at -80°C, -20°C, 4°C and 25°C is stable for up to 56, 56, 21, and 7days respectively or up to 9 freeze/thaw cycles when stored at -80°C. There is no difference in viral load in clinical specimens that have been stored for up to three years at -80°C if they are re-extracted. Similarly, clinical specimens undergoing up to 7 freeze/thaw cycles are stable if they are re-extracted between cycles. Influenza specimens can be stored for up to three years at -80°C or undergo up to 7 freeze/thaw cycles without loss of RNA quantity if re-extracted. Copyright © 2017 Elsevier B.V. All rights reserved.

Would more social partners leads to enhanced health? The paradox between quantity and quality.

Science.gov (United States)

Xing, Cai; Zhang, Xin; Cheng, Sheung-Tak

2017-09-01

In the current investigation, we examined the association between social network composition (SNC) and mental health, as well as whether quantity and quality of social network could influence mental health differently. The social network quantity and quality of 345 middle-aged and older Chinese adults were measured by the Social Convoy Questionnaire. The Chinese version of the Medical Outcome Studies 36-item Short-Form Health Survey (SF-36) was used to assess mental health while controlling for physical health. It was found that both quantity and quality of social network were associated with mental health, and more specifically that (1) quantity of peripheral partners (PP) was positively associated with mental health; (2) quality of emotionally close social partners (ECSP) influenced mental health the most; and (3) paradoxically, the effect of ECSP quality on mental health depended on quantity of ECSP, that is, participants with more ECSP showed a stronger association between ECSP quality and mental health. The findings replicated and extended previous studies on SNC and suggested that structure/quantity and quality of SNC were both important for mental health. © 2017 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

Clinical importance of caffeine dependence and abuse.

Science.gov (United States)

Ogawa, Naoshi; Ueki, Hirofumi

2007-06-01

Caffeine is the most widely consumed psychoactive substance and is a legal stimulant that is readily available to children. Caffeine has occasionally been considered a drug of abuse and the potential for dependence on caffeine has been debated. Presently, due to a paucity of clinical evidence on caffeine dependence or abuse, no such diagnosis is included in the Diagnostic and Statistical Manual of Mental Disorder-fourth edition. The authors present two cases of abuse or dependence on the caffeine contained in 'eutrophic' (energy/nutritional) beverages or caffeine preparations, followed by a review of clinical studies demonstrating evidence that some people can manifest a clinical syndrome of caffeine dependence or abuse. The cases suggest that caffeine can produce a clinical dependence syndrome similar to those produced by other psychoactive substances and has a potential for abuse. In a recent study using a structured interview and the Diagnostic and Statistical Manual of Mental Disorder-fourth edition criteria for substance dependence and abuse, a subset of the general population was found to demonstrate caffeine dependence or caffeine abuse. Therefore, the authors propose that companies or businesses manufacturing or marketing caffeine or products containing caffeine must meet the following guidelines: (i) clearly indicate the caffeine content of products containing comparatively higher quantities of caffeine; (ii) warn that such products should be avoided by infants and children wherever possible, and inform adult consumers about the precise quantity of caffeine that is considered safe for consumption; and (iii) clearly state that consuming large quantities of caffeine and the long-term use of caffeine carry health risks.

Clinical Views: Object-Oriented Views for Clinical Databases

Science.gov (United States)

Portoni, Luisa; Combi, Carlo; Pinciroli, Francesco

1998-01-01

We present here a prototype of a clinical information system for the archiving and the management of multimedia and temporally-oriented clinical data related to PTCA patients. The system is based on an object-oriented DBMS and supports multiple views and view schemas on patients' data. Remote data access is supported too.

Conducting a fully mobile and randomised clinical trial for depression: access, engagement and expense.

Science.gov (United States)

Anguera, Joaquin A; Jordan, Joshua T; Castaneda, Diego; Gazzaley, Adam; Areán, Patricia A

2016-01-01

Advances in mobile technology have resulted in federal and industry-level initiatives to facilitate large-scale clinical research using smart devices. Although the benefits of technology to expand data collection are obvious, assumptions about the reach of mobile research methods ( access ), participant willingness to engage in mobile research protocols ( engagement ), and the cost of this research ( cost ) remain untested. To assess the feasibility of a fully mobile randomised controlled trial using assessments and treatments delivered entirely through mobile devices to depressed individuals. Using a web-based research portal, adult participants with depression who also owned a smart device were screened, consented and randomised to 1 of 3 mental health apps for treatment. Assessments of self-reported mood and cognitive function were conducted at baseline, 4, 8 and 12 weeks. Physical and social activity was monitored daily using passively collected phone use data. All treatment and assessment tools were housed on each participant's smart phone or tablet. A cognitive training application, an application based on problem-solving therapy, and a mobile-sensing application promoting daily activities. Access : We screened 2923 people and enrolled 1098 participants in 5 months. The sample characteristics were comparable to the 2013 US census data. Recruitment via Craigslist.org yielded the largest sample. Engagement : Study engagement was high during the first 2 weeks of treatment, falling to 44% adherence by the 4th week. Cost : The total amount spent on for this project, including staff costs and β testing, was $314 264 over 2 years. These findings suggest that mobile randomised control trials can recruit large numbers of participants in a short period of time and with minimal cost, but study engagement remains challenging. NCT00540865.

Predictors of nonfunctional arteriovenous access at hemodialysis initiation and timing of access creation: A registry-based study.

Directory of Open Access Journals (Sweden)

Natalia Alencar de Pinho

Full Text Available Determinants of nonfunctional arteriovenous (AV access, including timing of AV access creation, have not been sufficiently described. We studied 29 945 patients who had predialysis AV access placement and were included in the French REIN registry from 2005 through 2013. AV access was considered nonfunctional when dialysis began with a catheter. We estimated crude and adjusted odds ratio (OR with 95% confidence intervals (CI of nonfunctional versus functional AV access associated with case-mix, facility characteristics, and timing of AV access creation. Analyses were stratified by dialysis start condition (planned or as an emergency and comorbidity profile. Overall, 18% patients had nonfunctional AV access at hemodialysis initiation. In the group with planned dialysis start, female gender (OR 1.43, 95% CI 1.32-1.56, diabetes (OR 1.28, 95% CI 1.15-1.44, and a higher number of cardiovascular comorbidities (OR 1.27, 95% CI 1.09-1.49, and 1.31, 1.05-1.64, for 3 and >3 cardiovascular comorbidities versus none, respectively were independent predictors of nonfunctional AV access. A higher percentage of AV access creation at the region level was associated with a lower rate of nonfunctional AV access (OR 0.98, 95% CI 0.98-0.99 per 1% increase. The odds of nonfunctional AV access decreased as time from creation to hemodialysis initiation increased up to 3 months in nondiabetic patients with fewer than 2 cardiovascular comorbidities and 6 months in patients with diabetes or 2 or more such comorbidities. In conclusion, both patient characteristics and clinical practices may play a role in successful AV access use at hemodialysis initiation. Adjusting the timing of AV access creation to patients' comorbidity profiles may improve functional AV access rates.

Improving access to urologists through an electronic consultation service

Science.gov (United States)

Witherspoon, Luke; Liddy, Clare; Afkham, Amir; Keely, Erin; Mahoney, John

2017-01-01

Introduction Access to specialist services is limited by wait times and geographic availability. Champlain Building Access to Specialist Advice (BASE) has been implemented in our service region to facilitate access to specialists by primary care providers (PCPs). Through a secure web-based system, PCPs are able to send eConsults instead of requesting a formal in-office consultation. Methods Urology eConsults completed through the Champlain BASE service from March 2013 to January 2015 were analyzed. Each consult was characterized in regard to the type of question asked by the referring physician and the clinical content of the referral. Using the mandatory close-out surveys, we analyzed rates of referral avoidance, physician satisfaction, and overall impact on patient care. Results Of 190 eConsultations, 70% were completed in less than 10 minutes. The most common clinical questions related to the interpretation of imaging reports (16%) and tests to choose for investigating a condition (15%). The most common diagnoses were hematuria (13%) and renal mass (8%). In 35% of cases, referral to a urologist had originally been contemplated and was avoided. In 8% of cases, a PCP did not believe a consultation was initially needed, but a referral was ultimately initiated after the eConsultation. Conclusions Our study shows that although certain clinical presentations still require a formal in-person urological consultation, eConsultations can potentially reduce unnecessary clinic visits while identifying patients who may benefit from early urological consultation. Through both these mechanisms, we may improve timely access to urologists. PMID:28798830

Symbolic Estrangement: Evidence against a Strong Association between Numerical Symbols and the Quantities They Represent

Science.gov (United States)

Lyons, Ian M.; Ansari, Daniel; Beilock, Sian L.

2012-01-01

Are numerals estranged from a sense of the actual quantities they represent? We demonstrate that, irrespective of numerical size or distance, direct comparison of the relative quantities represented by symbolic and nonsymbolic formats leads to performance markedly worse than when comparing 2 nonsymbolic quantities (Experiment 1). Experiment 2…

Handbook of physical quantities

CERN Document Server

Meilikhov, Evgenii Z

1997-01-01

Reliable and quickly accessible information concerning the physical phenomena and properties of various media is in great demand by many scientists in their everyday work. This extensive reference provides such information, presenting basic physical parameters and properties of substances employed in modern science and industry.

Radiation quantities, units and measurements. Final report 1999

International Nuclear Information System (INIS)

Wambersie, A.; Allisy, A.; Caswell, R.S.

2000-01-01

The determination of human exposure to radiation and radioactivity, whether arising from environmental exposures, medical practice or industrial activities, requires a fundamental set of quantities and units with which exposures can be specified and the means and ability to make measurements which yield results in terms of these quantities and units. Radiation protection then, as well as effective use of radiation in medical applications, requires the capability to accurately quantify the characteristics and extent of radiation exposure, so that appropriate and useful assessments of the potential health consequences and risks, whether for protection of the public and workers or for diagnosis and treatment of disease, can be formulated. The work carried out via this concerted action on ''Radiation quantities, units and measurements'' has addressed these needs. Measurement of radiation is a complex subject and is a science in itself. Yet many users of radiation who need to make radiation measurements cannot be expected to become experts in this particular field. They need authoritative guidance on how to deal with the measurement problems connected with their particular use of radiation. The work carried out pursuant to this concerted action has resulted in publications that meet this need. Important achievements include the publication of seven new ICRU reports, the completion of all but the printing of three other ICRU reports, completion of the drafting work on two other reports, the development of many others reports and the initiation of seven new activities that will result in ICRU reports representing important future contribution to the needs identified in this project. (orig.)

Quantity assessment of waste in the dismantlement of liquid waste treatment plant and its actual state

International Nuclear Information System (INIS)

Uchiyama, Takafumi; Mitsuhashi, Ishi; Matsumoto, Tetsuo; Morishima, Kayoko; Tanzawa, Tomio

2016-01-01

From the progress of decommissioning project work of Tokyo City University Atomic Energy Research Institute, this paper reports the comparison between the actual amount of the waste generated during dismantlement work at liquid waste treatment facilities and the assessment quantity before starting the dismantlement. The quantity assessment was made on the basis of the installation license application, design specifications, drawings, records, history of use, site investigation results, etc. Since this quantity assessment did not take into account the dismantling contents of reservoir concrete, the assessed quantity of non-radioactive waste (NR waste) did not match the sum of actual NR waste. However, if an actually generated quantity of concrete of radioactive waste was added to the quantity assessment as NR waste, the quantity of actually generated NR waste and that of assessed NR waste were nearly consistent, which verified the validity of this assessment. This method is considered to be able to be utilized in the future quantity assessment of decommissioning work and the like. On the other hand, it was found that the number of drums that were actually stored tended to increase more than the estimated number of drum conversion. In old buildings, it is necessary to take into account the generation of waste other than radioactive materials in the quantity assessment stage and dismantlement stage. (A.O.)

Access block in NSW hospitals, 1999-2001: does the definition matter?

Science.gov (United States)

Forero, Roberto; Mohsin, Mohammed; Bauman, Adrian E; Ieraci, Sue; Young, Lis; Phung, Hai N; Hillman, Kenneth M; McCarthy, Sally M; Hugelmeyer, C David

2004-01-19

To estimate the magnitude of access block and its trend over time in New South Wales hospitals, using different definitions of access block, and to explore its association with clinical and non-clinical factors. An epidemiological study using the Emergency Department Information System datasets (1 January 1999 to 31 December 2001) from a sample of 55 NSW hospitals. Prevalence of access block measured by four different definitions; strength of association between access block, type of hospital, year of presentation, mode and time of arrival, triage category (an indicator of urgency), age and sex. Rates of access block (for all four definitions) increased between 1999 and 2001 by 1%-2% per year. There were increases across all regions of NSW, but urban regions in particular. Patients presenting to Principal Referral hospitals and those who arrived at night were more likely to experience access block. After adjusting for triage category and year of presentation, the mode of arrival, time of arrival, type of hospital, age and sex were significantly associated with access block. Access block continues to increase across NSW, whatever the definition used. We recommend that hospitals in NSW and Australia move to the use of one standard definition of access block, as our study suggests there is no significant additional information emerging from the use of multiple definitions.

Safeguards Implementation Guide for States with Small Quantities Protocols (Spanish Edition)

International Nuclear Information System (INIS)

2013-01-01

The International Atomic Energy Agency (IAEA) works to enhance the contribution of nuclear energy for peace and prosperity around the world, while helping to ensure that nuclear material is not diverted to nuclear weapons or other nuclear explosive devices. In implementing safeguards, the IAEA plays an instrumental independent verification role, providing credible assurances that States' safeguards commitments are being respected. Most of the world's non-nuclear-weapon States (NNWSs) have concluded comprehensive safeguards agreements (CSAs) with the IAEA, pursuant to the Treaty on the Non- Proliferation of Nuclear Weapons (NPT). The IAEA and States are required to cooperate in the implementation of such agreements. Effective cooperation demonstrates a State's commitment to the peaceful use of nuclear energy and furthers the State's national interests by reducing the risk of unauthorized use of nuclear material. Over 100 NNWSs party to the NPT have very limited quantities of nuclear material and have concluded protocols to their CSAs which hold in abeyance many procedures in Part II of a CSA. These protocols are referred to as 'small quantities protocols' or 'SQPs' and remain in effect as long as the State meets certain eligibility criteria. The purpose of an SQP is to reduce the burden of safeguards implementation for States with little or no nuclear activities, while retaining the integrity of the safeguards system. States with SQPs have very important obligations they must fulfil under their CSAs. In 1997, as part of the IAEA's efforts to strengthen its safeguards system, the Model Additional Protocol to the Agreement(s) between State(s) and the International Atomic Energy Agency for the Application of Safeguards was developed to provide the IAEA with broader access to information and locations, thus significantly increasing the IAEA's ability to provide assurance of the absence of undeclared nuclear material and activities in States. Many States with SQPs have

Safeguards Implementation Guide for States with Small Quantities Protocols (French Edition)

International Nuclear Information System (INIS)

2013-01-01

The International Atomic Energy Agency (IAEA) works to enhance the contribution of nuclear energy for peace and prosperity around the world, while helping to ensure that nuclear material is not diverted to nuclear weapons or other nuclear explosive devices. In implementing safeguards, the IAEA plays an instrumental independent verification role, providing credible assurances that States' safeguards commitments are being respected. Most of the world's non-nuclear-weapon States (NNWSs) have concluded comprehensive safeguards agreements (CSAs) with the IAEA, pursuant to the Treaty on the Non- Proliferation of Nuclear Weapons (NPT). The IAEA and States are required to cooperate in the implementation of such agreements. Effective cooperation demonstrates a State's commitment to the peaceful use of nuclear energy and furthers the State's national interests by reducing the risk of unauthorized use of nuclear material. Over 100 NNWSs party to the NPT have very limited quantities of nuclear material and have concluded protocols to their CSAs which hold in abeyance many procedures in Part II of a CSA. These protocols are referred to as 'small quantities protocols' or 'SQPs' and remain in effect as long as the State meets certain eligibility criteria. The purpose of an SQP is to reduce the burden of safeguards implementation for States with little or no nuclear activities, while retaining the integrity of the safeguards system. States with SQPs have very important obligations they must fulfil under their CSAs. In 1997, as part of the IAEA's efforts to strengthen its safeguards system, the Model Additional Protocol to the Agreement(s) between State(s) and the International Atomic Energy Agency for the Application of Safeguards was developed to provide the IAEA with broader access to information and locations, thus significantly increasing the IAEA's ability to provide assurance of the absence of undeclared nuclear material and activities in States. Many States with SQPs have

Threshold quantities for infectious diseases in periodic environments

NARCIS (Netherlands)

Heesterbeek, J.A.P.; Roberts, M.G.

1995-01-01

In this short note we give threshold quantities that determine the stability of the infection-free steady state for periodic deterministic systems that describe the spread of infectious diseases in populations whose individuals can be divided into a finite number of distinct groups. We concentrate

Quality and quantity: the role of social interactions in individual health

OpenAIRE

Damiano, Fiorillo; Fabio, Sabatini

2011-01-01

The public health literature focusing on the detrimental effects of social isolation has shown that the quantity of social connections is positively correlated with individual health. Drawing on pooled cross-sectional data, we test this hypothesis on a representative sample of the Italian population. Our findings show that, besides the quantity of interactions, it is their quality – as measured by subjective satisfaction derived from relationships with friends – that works as the best pre...

Unified Symmetry and Conserved Quantities of Mechanical System in Phase Space

International Nuclear Information System (INIS)

Fang Jianhui; Ding Ning; Wang Peng

2006-01-01

In this paper, a new symmetry and its conserved quantities of a mechanical system in phase space are studied. The definition of this new symmetry, i.e., a unified one is presented, and the criterion of this symmetry is also given. The Noether, the generalized Hojman and the Mei conserved quantities of the unified symmetry of the system are obtained. The unified symmetry contains the Noether, the Lie and the Mei symmetries, and has more generalized significance.

Abortion in Australia: access versus protest.

Science.gov (United States)

Dean, Rebecca Elizabeth; Allanson, Susie

2004-05-01

Currently in Australia anti-choice protesters' right to freedom of speech and freedom to protest is privileged over a woman's right to privacy and to access a health service safely, free from harassment, intimidation and obstruction. This article considers how this situation is played out daily at one Victorian abortion-providing clinic. The Fertility Control Clinic was thrown into the spotlight after the murder of its security guard by an anti-choice crusader in July 2001. Australian common law appears not to offer women protection from anti-choice protesters. By contrast, United States and Canadian "bubble" legislation sits comfortably with key constitutional rights. It would be a useful development if Australian governments passed legislation to ensure the rights, wellbeing and safety of Australian women accessing health services. Such legislation would be another step away from the misogynistic and androcentric values once central to our legislative framework.

The Effect of Aerobic Exercise on Quantity and Quality of Sleep Among Elderly People Referring to Health Centers of Lar City, Southern of Iran; A Randomized Controlled Clinical Trial.

Science.gov (United States)

Sharif, Farkhondeh; Seddigh, Maryam; Jahanbin, Iran; Keshavarzi, Sareh

2015-01-01

Aging is associated with reduced quality and quantity of sleep. 50% of senior citizens living in the community and 70% of those living in nursing homes suffer from sleep disorders. Moreover, insomnia increases the risk of mortality and morbidity in older adults. We aimed to investigate the effect of aerobic exercise on quantity and quality of sleep among the elderly people referring to health centers of Lar city, southern Iran. We enrolled 60 elderly people whose age range was 60-75 years and (mean ±SD) age was (64.8±5.2). Participants were randomly assigned into two groups of 30 each (case group= 30 and control group=30). The patients in the case group participated in exercise trainings consisted of three one-hour sessions per week for 12 consecutive weeks. Sleep quantity and quantity in the participants was evaluated before and after intervention using Pittsburgh Sleep Quality Index (PSQI). Independent t-test showed that sleep quality score was improved by 44.46% in the case group (pelderly. It could also be used as a cost effective and long lasting method of therapy with no side effect which could be used for the treatment of insomnia in older people.

Evaluation of a simple, non-surgical concept for management of urinary incontinence (minimal care) in an open-access, interdisciplinary incontinence clinic

DEFF Research Database (Denmark)

Sander, P; Mouritsen, L; Andersen, J T

2000-01-01

influence on lower urinary tract function. More than half of the patients had urge or mixed incontinence. Most of the patients were managed with conservative treatment. Fifteen percent were referred to in-hospital treatment, with 5% to incontinence surgery. In total 44% felt cured or very much improved......Our objective was to evaluate a new concept for assessment and treatment of urinary incontinence in an open-access, interdisciplinary incontinence clinic. A standardized program for investigation and treatment of incontinence was based on minimal relevant investigations, primarily non......-surgical treatment with a limited consumption of resources ("minimal care"). This was a prospective observational study of 408 consecutive women examined and treated in the clinic. The main characteristics of the women were a high median age and a high prevalence of severe concomitant diseases with possible...

Cartographic Mapping and Travel Burden to Assess and Develop Strategies to Improve Minority Access to National Cancer Clinical Trials

International Nuclear Information System (INIS)

Bruner, Deborah Watkins; Pugh, Stephanie L.; Yeager, Katherine A.; Bruner, Jesse; Curran, Walter

2015-01-01

Purpose: To assess how accrual to clinical trials is related to US minority population density relative to clinical trial site location and distance traveled to Radiation Therapy Oncology Group (RTOG) clinical trial sites. Methods and Materials: Data included member site address and ZIP codes, patient accrual, and patient race or ethnicity and ZIP code. Geographic Information System maps were developed for overall, Latino, and African American accrual to trials by population density. The Kruskal-Wallis test was used to assess differences in distance traveled by site, type of trial, and race or ethnicity. Results: From 2006 to 2009, 6168 patients enrolled on RTOG trials. The RTOG US site distribution is generally concordant with overall population density. Sites with highest accrual are located throughout the United States and parts of Canada and do not cluster, nor does highest minority accrual cluster in areas of highest US minority population density. Of the 4913 US patients with complete data, patients traveled a median of 11.6 miles to participate in clinical trials. Whites traveled statistically longer distances (12.9 miles; P<.0001) to participate, followed by Latinos (8.22 miles) and African Americans (5.85 miles). Patients were willing to drive longer distances to academic sites than community sites, and there was a trend toward significantly longer median travel for therapeutic versus cancer control or metastatic trials. Conclusions: Location matters, but only to a degree, for minority compared with nonminority participation in clinical trials. Geographic Information System tools help identify gaps in geographic access and travel burden for clinical trials participation. Strategies that emerged using these tools are discussed.

Cartographic Mapping and Travel Burden to Assess and Develop Strategies to Improve Minority Access to National Cancer Clinical Trials

Science.gov (United States)

Bruner, Deborah Watkins; Pugh, Stephanie L.; Yeager, Katherine A.; Bruner, Jesse; Curran, Walter

2015-01-01

Purpose To assess how accrual to clinical trials is related to U.S. minority population density relative to clinical trial site location and distance traveled to Radiation Therapy Oncology Group (RTOG) clinical trials sites. Methods Data included member site address and zip codes, patient accrual, and patient race/ethnicity and zip code. Geographic Information System (GIS) maps were developed for overall, Latino and African American accrual to trials by population density. The Kruskal-Wallis test was used to assess differences in distance traveled by site, type of trial and race/ethnicity. Results From 2006–2009, 6168 patients enrolled on RTOG trials. RTOG U.S. site distribution is generally concordant with overall population density. Sites with highest accrual are located throughout the U.S. and parts of Canada and do not cluster, nor does highest minority accrual cluster in areas of highest U.S. minority population density. Of the 4913 U.S. patients with complete data, patients traveled a median of 11.6 miles to participate in clinical trials. Whites traveled statistically longer distances (12.9 miles; p<0.0001) to participate followed by Latinos (8.22 miles), and African Americans (5.85 miles). Patients were willing to drive longer distances to academic sites than community sites and there was a trend toward significantly longer median travel for therapeutic vs cancer control or metastatic trials. Conclusions Location matters, but only to a degree, for minority compared to non-minority participation in clinical trials. GIS tools help identify gaps in geographic access and travel burden for clinical trials participation. Strategies that emerged using these tools are discussed. PMID:26281827

Cartographic Mapping and Travel Burden to Assess and Develop Strategies to Improve Minority Access to National Cancer Clinical Trials

Energy Technology Data Exchange (ETDEWEB)

Bruner, Deborah Watkins, E-mail: deborah.w.bruner@emory.edu [Emory University, Atlanta, Georgia (United States); Pugh, Stephanie L. [NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Yeager, Katherine A.; Bruner, Jesse; Curran, Walter [Emory University, Atlanta, Georgia (United States)

2015-11-01

Purpose: To assess how accrual to clinical trials is related to US minority population density relative to clinical trial site location and distance traveled to Radiation Therapy Oncology Group (RTOG) clinical trial sites. Methods and Materials: Data included member site address and ZIP codes, patient accrual, and patient race or ethnicity and ZIP code. Geographic Information System maps were developed for overall, Latino, and African American accrual to trials by population density. The Kruskal-Wallis test was used to assess differences in distance traveled by site, type of trial, and race or ethnicity. Results: From 2006 to 2009, 6168 patients enrolled on RTOG trials. The RTOG US site distribution is generally concordant with overall population density. Sites with highest accrual are located throughout the United States and parts of Canada and do not cluster, nor does highest minority accrual cluster in areas of highest US minority population density. Of the 4913 US patients with complete data, patients traveled a median of 11.6 miles to participate in clinical trials. Whites traveled statistically longer distances (12.9 miles; P<.0001) to participate, followed by Latinos (8.22 miles) and African Americans (5.85 miles). Patients were willing to drive longer distances to academic sites than community sites, and there was a trend toward significantly longer median travel for therapeutic versus cancer control or metastatic trials. Conclusions: Location matters, but only to a degree, for minority compared with nonminority participation in clinical trials. Geographic Information System tools help identify gaps in geographic access and travel burden for clinical trials participation. Strategies that emerged using these tools are discussed.

Cartographic Mapping and Travel Burden to Assess and Develop Strategies to Improve Minority Access to National Cancer Clinical Trials.

Science.gov (United States)

Bruner, Deborah Watkins; Pugh, Stephanie L; Yeager, Katherine A; Bruner, Jesse; Curran, Walter

2015-11-01

To assess how accrual to clinical trials is related to US minority population density relative to clinical trial site location and distance traveled to Radiation Therapy Oncology Group (RTOG) clinical trial sites. Data included member site address and ZIP codes, patient accrual, and patient race or ethnicity and ZIP code. Geographic Information System maps were developed for overall, Latino, and African American accrual to trials by population density. The Kruskal-Wallis test was used to assess differences in distance traveled by site, type of trial, and race or ethnicity. From 2006 to 2009, 6168 patients enrolled on RTOG trials. The RTOG US site distribution is generally concordant with overall population density. Sites with highest accrual are located throughout the United States and parts of Canada and do not cluster, nor does highest minority accrual cluster in areas of highest US minority population density. Of the 4913 US patients with complete data, patients traveled a median of 11.6 miles to participate in clinical trials. Whites traveled statistically longer distances (12.9 miles; P<.0001) to participate, followed by Latinos (8.22 miles) and African Americans (5.85 miles). Patients were willing to drive longer distances to academic sites than community sites, and there was a trend toward significantly longer median travel for therapeutic versus cancer control or metastatic trials. Location matters, but only to a degree, for minority compared with nonminority participation in clinical trials. Geographic Information System tools help identify gaps in geographic access and travel burden for clinical trials participation. Strategies that emerged using these tools are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluating the Quantity and Quality of Continuing medical education Programs from the Viewpoint of General Medical Practitioners, Ilam Province

Directory of Open Access Journals (Sweden)

Mohsen Fatahi

2015-07-01

Full Text Available Background and purpose: The purpose of this research was to evaluate the quantity and quality of continuing medical education programs from the viewpoint of general medical practitioners in Ilam province.Methods: The research method was descriptive survey and the statistic sample was a group of 61 general medical practitioners who have been working in Ilam during 2010-2011 and were chosen by simple random sampling method. The data collection tool was a questionnaire with 50 items and reliability coefficient obtained using Cronbach's alpha which was 88%.Results: The findings showed that there is a meaningful/significant relationship between CME (Continuing Medical Education/retraining programs and improving GPs (General Practitioner clinical skills with reliability of 99% and this relationship is direct and positive (r=0.502. It means that increasing the quality and quantity of these programs has positive effect on improving general practitioners’ clinical skills. There was no meaningful/significant relationship between the method of teaching and GPs satisfaction (r=0.160. It means most of these practitioners were not satisfied with using training equipment, teaching methods, teachers' knowledge and manners. Also, there was no meaningful/significant relationship between teaching times and educational materials and GPs satisfaction (r=0.73 .It shows that the rate of GPs satisfaction from teaching times and educational materials is very low and there is little coherence between them. But there was a meaningful/significant relationship between GPs job requirements and educational materials with reliability of 95% (r=0.326. It means presenting suitable teaching materials and content related to GPs jobs requirements led to increase GPs desire to attend educational classes .There was no meaningful/significant relationship between time dedicated to each topic and improving GPs skills (r=0.096. So, findings indicate that there is no coincidence between

SU-F-BRB-13: Correlation of Improved Target and Organ-At-Risk Dosimetric Quantities and Clinical Outcomes for Helical Tomotherapy Treated Mesothelioma

Energy Technology Data Exchange (ETDEWEB)

Qi, S; Kishan, A; Alexander, S; Lee, P; Selch, M; Kupelian, P; Steiberg, M; Low, D [UCLA, Los Angeles, CA (United States)

2015-06-15

Purpose: We have observed improved local control probability (LCP) for adjuvant mesothelioma radiotherapy following pleurectomy/decortication using Tomotherapy compared to the conventional 3D technique (p<0.05). This work assesses the correlation between the improved clinical outcomes against dosimetry quantities. Methods: Thirty-eight mesothelioma cases consecutively treated at our clinic were retrospectively analyzed. Sixteen patients were treated using 3D technique planned on the Eclipse for c-arm accelerators prior to 7/2012; the other 22 cases were treated on Tomotherapy using helical IMRT after 7/2012. Typical 3D plans consisting of 15 MV AP/PA photon fields prescribed to 10 cm depth followed by matching electron fields with energy ranging from 8–16 MeV. Tomotherapy plans were designed using 2.5cm jaw, 0.287 pitch with directional blocking of the contralateral lung. The same prescription of 45 Gy (1.8GyX25) was used for both techniques. The dosimetry metrics for the critical structures: ipsilateral-/contralateral-lung, heart, cord, esophagus, etc were compared between two techniques. Results: Superior LCP is closely associated with improved target coverage. Tomotherapy plans yielded dramatically better target coverage and less dose heterogeneity despite of more advanced/larger disease. The averaged PTV volumes were 2287.3±569.9 (Tomotherapy) vs. 1904.8±312.3cc (3D); V100s were: 91.1±4.0 (%) vs. 47.8±12.7 (%) with heterogeneity indices of 1.20±0.1 vs.1.37±0.38 and for the Tomotherapy and 3D plans, respectively. Compared to the 3D technique, we observed significant lower maximum cord doses (p<0.001), lower mean esophagus doses (p<0.002), and lower heart mean doses when tumor was left-sided (p=0.002). For ipsilateral-/contralateral-lungs, however, the mean doses and V20, V5 of Tomotherapy plans were significantly higher than the 3D plans (p<0.01) regardless which sides of lung were treated. However, rates of radiation pneumonitis were no different

Access to Experimental Cancer Drugs

Science.gov (United States)

An experimental drug has been tested in the lab and with animals and approved for testing in people by the FDA, but can’t yet be advertised, sold, or prescribed. Experimental drugs may be available through clinical trials or expanded access programs - learn more about these programs and how to talk to your doctor.

Dangerous quantities of radioactive material (D-values)

International Nuclear Information System (INIS)

2010-01-01

Radioactive material is widely used in industry, medicine, education and agriculture. In addition, it occurs naturally. The health risk posed by these materials vary widely depending on many factors, the most important of which are the amount of the material involved and its physical and chemical form. Therefore, there is a need to identify the quantity and type of radioactive material for which emergency preparedness and other arrangements (e.g. security) are warrant due to the health risk they pose. The aim of this publication is to provide practical guidance for Member States on that quantity of radioactive material that may be considered dangerous. A dangerous quantity is that, which if uncontrolled, could be involved in a reasonable scenario resulting in the death of an exposed individual or a permanent injury, which decreases that person's quality of life. This publication is published as part of the IAEA Emergency Preparedness and Response Series. It supports several publications including: the IAEA Safety Requirements 'Preparedness and Response for a Nuclear or Radiological Emergency', IAEA Safety Standards Series No. GS-R-2. IAEA, Vienna (2002). IAEA Safety Guide 'Categorization of Radioactive Sources', IAEA Safety Standards Series No RS-G-1.9, IAEA, Vienna (2005) and IAEA Safety Guide 'Arrangements for Preparedness for a Nuclear or Radiological Emergency' IAEA Safety Standards Series No. GS-G-2.1, IAEA, Vienna (2006). The procedures and data in this publication have been prepared with due attention to accuracy. However, as part of the review process, they undergo ongoing quality assurance checks. Comments are welcome and, following a period that will allow for a more extensive review, the IAEA may revise this publication as part of the process of continuous improvement. The publication uses a number of exposure scenarios, risk models and dosimetric data, which could be used during the response to nuclear or radiological emergency or other purposes

Access to care for patients with time-sensitive conditions in Pennsylvania.

Science.gov (United States)

Salhi, Rama A; Edwards, J Matthew; Gaieski, David F; Band, Roger A; Abella, Benjamin S; Carr, Brendan G

2014-05-01

Collective knowledge and coordination of vital interventions for time-sensitive conditions (ST-segment elevation myocardial infarction [STEMI], stroke, cardiac arrest, and septic shock) could contribute to a comprehensive statewide emergency care system, but little is known about population access to the resources required. We seek to describe existing clinical management strategies for time-sensitive conditions in Pennsylvania hospitals. All Pennsylvania emergency departments (EDs) open in 2009 were surveyed about resource availability and practice patterns for time-sensitive conditions. The frequency with which EDs provided essential clinical bundles for each condition was assessed. Penalized maximum likelihood regressions were used to evaluate associations between ED characteristics and the presence of the 4 clinical bundles of care. We used geographic information science to calculate 60-minute ambulance access to the nearest facility with these clinical bundles. The percentage of EDs providing each of the 4 clinical bundles in 2009 ranged from 20% to 57% (stroke 20%, STEMI 32%, cardiac arrest 34%, sepsis 57%). For STEMI and stroke, presence of a board-certified/board-eligible emergency physician was significantly associated with presence of a clinical bundle. Only 8% of hospitals provided all 4 care bundles. However, 53% of the population was able to reach this minority of hospitals within 60 minutes. Reliably matching patient needs to ED resources in time-dependent illness is a critical component of a coordinated emergency care system. Population access to critical interventions for the time-dependent diseases discussed here is limited. A population-based planning approach and improved coordination of care could improve access to interventions for patients with time-sensitive conditions. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Whither the Nigerian Quantity Surveyors in the Information ...

African Journals Online (AJOL)

The paucity of information on the computing status of the quantity surveyors in Nigeria have been scanty and without empirical substantiation. The basic platform for entry to the information technology gateway is the acquisition, adoption and utilization of the computer. Baseline information is therefore indispensable for the ...

THE RELATION BETWEEN RESUDUE CHLOR QUANTITY AND WATER RELATED DISEASES IN AYDIN

Directory of Open Access Journals (Sweden)

Emine Didem EVCI

2006-02-01

Full Text Available Objectives: The correlation between the residue chlor quantity in water sampled in different points of Aydin province in 2004 and the incidence of infections via water (diarrhea, thyphoid fever, amoebic and bacillary dysentery is studied. Materials and Methods: A retrospective definitive study is performed during June-July 2005. Results: 924 physical and chemical analysis are performed in 2004. In winter season, the mean residue chlor was 0,57±0,10 mg/lt; there were 310 diarrhea cases and a bacillary dysentery case. In summer season, the mean residue chlor was 0,46±0,13 mg/lt; there were 529 diarrhea cases and an amoebic dysentery. Both seasons determined that there was a negative correlation between diarrhea and the residue chlor quantity and there was a poor connection between them and it was statistically unsignificant (for winter r= -0,242, p=0,224; for summer r= -0,148, p=0,480 Conclusion: However there is no determined, expressive connection between diarrhea cases and residue chlor quantity it was seen that as the residue chlor quantity evaluated, the diarrhea cases were reduced. [TAF Prev Med Bull 2006; 5(1.000: 1-7

Mining Waste Classification and Quantity of Non-Metal Minesin Slovenia

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Ana Burger

2007-06-01

Full Text Available Mining is an important human activity that creates wealth and supplies materials for maintaining standard of living and further human development. However, mining has also negative impacts on the environment and society. One of them is the production of mining waste throughout the entire mining cycle, in particular in the mine development and operation /production stage.Due to the EU Directive 2006/21/EC on the management of waste from the extractive industries and its implementation in Member state, estimation on quality and quantity of mining waste from active non-metal mines in Slovenia was carried out. In the selected mines mining and processing was closely examined. With material flow analysis quantity and characteristics of mining waste were defined for several mines of different commodities.Data on mining waste were afterwards generalized in order to get an overall country evaluation on mining waste “production” of non-metal mines.Mining waste as a result of mining and beneficiation processes in non-metal mines of Slovenia is either inert or non-hazardous. Most of the mining waste is used for mine reclamation running simultaneously with the production phase. The largest amounts of mining waste per unit produced are created in dimension stone industry. Since the dimensionstone production is small, the waste amount is negligible. Large quantities of mining waste are produced in crushed stone and, sand and gravel operations, because aggregate production is pretty large with regard to other non-metals production in Slovenia. We can therefore conclude that large quantities of mining waste from non-metal mines, which are mostly used in reclamation and for side products, do not represent danger to the environment.

Quantity and configuration of available elephant habitat and related conservation concerns in the Lower Kinabatangan floodplain of Sabah, Malaysia.

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Jason G Estes

Full Text Available The approximately 300 (298, 95% CI: 152-581 elephants in the Lower Kinabatangan Managed Elephant Range in Sabah, Malaysian Borneo are a priority sub-population for Borneo's total elephant population (2,040, 95% CI: 1,184-3,652. Habitat loss and human-elephant conflict are recognized as the major threats to Bornean elephant survival. In the Kinabatangan region, human settlements and agricultural development for oil palm drive an intense fragmentation process. Electric fences guard against elephant crop raiding but also remove access to suitable habitat patches. We conducted expert opinion-based least-cost analyses, to model the quantity and configuration of available suitable elephant habitat in the Lower Kinabatangan, and called this the Elephant Habitat Linkage. At 184 km(2, our estimate of available habitat is 54% smaller than the estimate used in the State's Elephant Action Plan for the Lower Kinabatangan Managed Elephant Range (400 km(2. During high flood levels, available habitat is reduced to only 61 km(2. As a consequence, short-term elephant densities are likely to surge during floods to 4.83 km(-2 (95% CI: 2.46-9.41, among the highest estimated for forest-dwelling elephants in Asia or Africa. During severe floods, the configuration of remaining elephant habitat and the surge in elephant density may put two villages at elevated risk of human-elephant conflict. Lower Kinabatangan elephants are vulnerable to the natural disturbance regime of the river due to their limited dispersal options. Twenty bottlenecks less than one km wide throughout the Elephant Habitat Linkage, have the potential to further reduce access to suitable habitat. Rebuilding landscape connectivity to isolated habitat patches and to the North Kinabatangan Managed Elephant Range (less than 35 km inland are conservation priorities that would increase the quantity of available habitat, and may work as a mechanism to allow population release, lower elephant density, reduce

Quantity and quality limit detritivore growth: mechanisms revealed by ecological stoichiometry and co-limitation theory.

Science.gov (United States)

Halvorson, Halvor M; Sperfeld, Erik; Evans-White, Michelle A

2017-12-01

Resource quantity and quality are fundamental bottom-up constraints on consumers. Best understood in autotroph-based systems, co-occurrence of these constraints may be common but remains poorly studied in detrital-based systems. Here, we used a laboratory growth experiment to test limitation of the detritivorous caddisfly larvae Pycnopsyche lepida across a concurrent gradient of oak litter quantity (food supply) and quality (phosphorus : carbon [P:C ratios]). Growth increased simultaneously with quantity and quality, indicating co-limitation across the resource gradients. We merged approaches of ecological stoichiometry and co-limitation theory, showing how co-limitation reflected shifts in C and P acquisition throughout homeostatic regulation. Increased growth was best explained by elevated consumption rates and improved P assimilation, which both increased with elevated quantity and quality. Notably, C assimilation efficiencies remained unchanged and achieved maximum 18% at low quantity despite pronounced C limitation. Detrital C recalcitrance and substantive post-assimilatory C losses probably set a minimum quantity threshold to achieve positive C balance. Above this threshold, greater quality enhanced larval growth probably by improving P assimilation toward P-intensive growth. We suggest this interplay of C and P acquisition contributes to detritivore co-limitation, highlighting quantity and quality as potential simultaneous bottom-up controls in detrital-based ecosystems, including under anthropogenic change like nutrient enrichment. © 2017 by the Ecological Society of America.

Effects of Fuel Quantity on Soot Formation Process for Biomass-Based Renewable Diesel Fuel Combustion

KAUST Repository

Jing, Wei

2016-12-01

Soot formation process was investigated for biomass-based renewable diesel fuel, such as biomass to liquid (BTL), and conventional diesel combustion under varied fuel quantities injected into a constant volume combustion chamber. Soot measurement was implemented by two-color pyrometry under quiescent type diesel engine conditions (1000 K and 21% O2 concentration). Different fuel quantities, which correspond to different injection widths from 0.5 ms to 2 ms under constant injection pressure (1000 bar), were used to simulate different loads in engines. For a given fuel, soot temperature and KL factor show a different trend at initial stage for different fuel quantities, where a higher soot temperature can be found in a small fuel quantity case but a higher KL factor is observed in a large fuel quantity case generally. Another difference occurs at the end of combustion due to the termination of fuel injection. Additionally, BTL flame has a lower soot temperature, especially under a larger fuel quantity (2 ms injection width). Meanwhile, average soot level is lower for BTL flame, especially under a lower fuel quantity (0.5 ms injection width). BTL shows an overall low sooting behavior with low soot temperature compared to diesel, however, trade-off between soot level and soot temperature needs to be carefully selected when different loads are used.

A Neural Network Approach to Fluid Quantity Measurement in Dynamic Environments

CERN Document Server

Terzic, Edin; Nagarajah, Romesh; Alamgir, Muhammad

2012-01-01

Sloshing causes liquid to fluctuate, making accurate level readings difficult to obtain in dynamic environments. The measurement system described uses a single-tube capacitive sensor to obtain an instantaneous level reading of the fluid surface, thereby accurately determining the fluid quantity in the presence of slosh. A neural network based classification technique has been applied to predict the actual quantity of the fluid contained in a tank under sloshing conditions.   In A neural network approach to fluid quantity measurement in dynamic environments, effects of temperature variations and contamination on the capacitive sensor are discussed, and the authors propose that these effects can also be eliminated with the proposed neural network based classification system. To examine the performance of the classification system, many field trials were carried out on a running vehicle at various tank volume levels that range from 5 L to 50 L. The effectiveness of signal enhancement on the neural network base...

Internet access and use among Nigerian dental students ...

African Journals Online (AJOL)

Objective: The aim of this study was to determine access to internet /e-mail and its usage among Nigerian clinical dental students in year 4 to year 6. Methods: This is a cross-sectional study involving clinical dental students in year 4 to year 6 of the College of Medicine, University of Lagos. Information obtained from the ...

Adaptation of the present concept of dosimetric radiation protection quantities for external radiation to radiation protection practice

International Nuclear Information System (INIS)

Boehm, J.; Thompson, I. M. G.

2004-01-01

The present concept of dosimetric radiation protection quantities for external radiation is reviewed. For everyday application of the concept some adaptations are recommended. The check of the compliance with dose limits should be performed either by the comparison with values of the respective operational quantities directly or by the calculation of the protection quantity by means of the operational quantity, the appertaining conversion coefficient and additional information of the radiation field. Only four operational quantities are regarded to be sufficient for most applications in radiation protection practice. The term equivalent should be used in the connection dose equivalent only. Proposals are made for names of frequently used operational quantities which are denoted up to now by symbols only. (authors)

Quality or Quantity: A Statement for Teacher Training in Turkey

Directory of Open Access Journals (Sweden)

Ali AZAR

2011-01-01

Full Text Available Developed countries are initiating and implementing effective and appropriate technics in the field of teacher training. In Turkey, much research has been done in order to determine the qualification of teachers and, by this way, to train qualified teachers. Ministry of Education, Turkish Council of Higher Education, Faculties of Education and Faculties of Sciences have cooperated some certification systems, however, the research which is not supported by preliminary studies but exposured to political coercions lowered the quality of education. Besides, quantity is increased by pedagogical formation programs. In this study, Turkish teacher training system is analyzed with respect to quantity and quality.

Appraisal of Information Technology Requirements in Quantity Surveying Firms in Northern Nigeria

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Y. U. Datti

2017-06-01

Full Text Available A worrisome trend in the adoption of emerging technologies for competitive advantages and improved productivities by QSs have been observed in that there is overwhelming evidence that there is an increasing usage of IT in quantity surveying firms but little or no noticeable benefits on the practice. It however becomes pertinent to ask then, that despite the increases adoption of computing and telecommunication technologies, why isn’t there any noticeable change due to the impacts of IT in the Nigerian Construction Industry with particular reference to Quantity Surveying practices. The study appraised the requirement of IT in quantity surveying practice in Nigeria. It examined the position of IT in quantity surveying firms in terms of its requirement and analyzed IT requirements-based problem constraining quantity surveying firms. The study is a survey research designed to obtain information on information technology in QS firms. A self-administered questionnaire was employed to quantity surveyors in consulting firms for responses. Responses were returned and analyzed using severity index and later ranked in order of importance. The results indicate a high level of computerization of professional services among the firms with greater number of their computers being networked. However, despite high level of networking of available computers, sharing of printers and other scarce tools/technologies are not established. Compared to developed countries such as Canada, Australia, United Kingdom and USA, the position of IT requirements in QS firms in Nigeria can be said to be at basic level with organization possessing and applying basic IT tools and technologies (e.g. scanners, digital cameras, dvd/cd-rom, general purpose software, QS application software, chat programs etc. in their daily operation and processes. While most firms are progressing toward intermediate level by possessing intermediate IT tools and technologies (e.g. teleconferencing

Characteristics Data Base: Programmer's guide to the LWR Quantities Data Base

International Nuclear Information System (INIS)

Jones, K.E.; Moore, R.S.

1990-08-01

The LWR Quantities Data Base is a menu-driven PC data base developed as part of OCRWM's waste, technical data base on the characteristics of potential repository wastes, which also includes non-LWR spent fuel, high-level and other materials. This programmer's guide completes the documentation for the LWR Quantities Data Base, the user's guide having been published previously. The PC data base itself may be requested from the Oak Ridge National Laboratory, using the order form provided in Volume 1 of publication DOE/RW-0184

Optimizing basin-scale coupled water quantity and water quality management with stochastic dynamic programming

DEFF Research Database (Denmark)

Davidsen, Claus; Liu, Suxia; Mo, Xingguo

2015-01-01

Few studies address water quality in hydro-economic models, which often focus primarily on optimal allocation of water quantities. Water quality and water quantity are closely coupled, and optimal management with focus solely on either quantity or quality may cause large costs in terms of the oth......-er component. In this study, we couple water quality and water quantity in a joint hydro-economic catchment-scale optimization problem. Stochastic dynamic programming (SDP) is used to minimize the basin-wide total costs arising from water allocation, water curtailment and water treatment. The simple water...... quality module can handle conservative pollutants, first order depletion and non-linear reactions. For demonstration purposes, we model pollutant releases as biochemical oxygen demand (BOD) and use the Streeter-Phelps equation for oxygen deficit to compute the resulting min-imum dissolved oxygen...

EFFECT OF SALES PROMOTION SCHEMES ON PURCHASE QUANTITY: A STUDY OF MALAYSIAN CONSUMERS

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Hawa JALLOW

2016-11-01

Full Text Available The research aims to study the effect of sales promotion on the purchase quantity and recommend sales promotional means and methods that could improve sales for retail sector in Malaysia. The impact of coupons, bonus packages, premiums, free samples and price discount is measured on purchase quantity of Malaysian retail consumers. Empirical data is gathered from 150 respondents using self-administered questionnaire and analyzed using correlation and regression analysis to examine the relationship between variables. The findings of the study reveal that all independent variables influences purchase quantity positively and significantly while free samples and price discounts are most influential factors for Malaysian market.

Coordinated Lot-sizing and Dynamic Prizing under a Supplier All-units Quantity Discount

Directory of Open Access Journals (Sweden)

Sandra Transchel

2008-05-01

Full Text Available We consider an economic order quantity model where the supplier offers an all-units quantity discount and a price sensitive customer demand. We compare a decentralized decision framework where selling price and replenishment policy are determined independently to simultaneous decision making. Constant and dynamic pricing are distinguished. We derive structural properties and develop algorithms that determine the optimal pricing and replenishment policy and show how quantity discounts not only influence the purchasing strategy but also the pricing policy. A sensitivity analysis indicates the impact of the fixed-holding cost ratio, the discount policy, and the customers' price sensitivity on the optimal decisions.

QUANTITY DISCOUNTS IN SUPPLIER SELECTION PROBLEM BY USE OF FUZZY MULTI-CRITERIA PROGRAMMING

Directory of Open Access Journals (Sweden)

Tunjo Perić

2011-02-01

Full Text Available Supplier selection in supply chain is a multi-criteria problem that involves a number of quantitative and qualitative factors. This paper deals with a concrete problem of flour purchase by a company that manufactures bakery products and the purchasing price of flour depends on the quantity ordered. The criteria for supplier selection and quantities supplied by individual suppliers are: purchase costs, product quality and reliability of suppliers. The problem is solved using a model that combines revised weighting method and fuzzy multi-criteria linear programming (FMCLP. The paper highlights the efficiency of the proposed methodology in conditions when purchasing prices depend on order quantities.

Determination of the quantity of acetyl CoA carboxylase by [14C]methyl avidin binding

International Nuclear Information System (INIS)

Roman-Lopez, C.R.; Goodson, J.; Allred, J.B.

1987-01-01

Conditions are described under which monomeric [ 14 C]methyl avidin binds to SDS-denatured biotin enzymes and remains bound through polyacrylamide gel electrophoresis. The location of radioactive proteins on the dried gel was determined by fluorography and their identity was established by subunit molecular weight. The relative quantity of bound radioactive avidin, stoichiometrically equivalent to the molar quantity of biotin protein, can be determined by scanning the fluorograph with a soft laser densitometer. To determine the absolute quantity of biotin protein, the radioactive areas of the dried gel were cut out, resolubilized, and assayed for radioactivity. Since the specific radioactivity of the [ 14 C]methyl avidin was known, the quantity of avidin bound and therefore the quantity of biotin enzyme could be calculated. The method is illustrated by the analysis of purified acetyl CoA carboxylase and is applied to the analysis of biotin enzymes in isolated rat liver mitochondria

Near-infrared vascular imaging in peripheral venous and arterial access

OpenAIRE

Cuper, N.J.

2012-01-01

Venous and arterial access are among the most widespread medical procedures performed in children. Especially in young children venous and arterial access can be problematic due to tiny blood vessels that are difficult to localize beneath a layer of baby fat. This thesis describes the development and clinical evaluation of the VascuLuminator, a guidance tool for peripheral venous and arterial access by visualizing blood vessels underneath the skin with near-infrared light. In a third to a fif...

The impact of symbolic and non-symbolic quantity on spatial learning.

Directory of Open Access Journals (Sweden)

Koleen McCrink

Full Text Available An implicit mapping of number to space via a "mental number line" occurs automatically in adulthood. Here, we systematically explore the influence of differing representations of quantity (no quantity, non-symbolic magnitudes, and symbolic numbers and directional flow of stimuli (random flow, left-to-right, or right-to-left on learning and attention via a match-to-sample working memory task. When recalling a cognitively demanding string of spatial locations, subjects performed best when information was presented right-to-left. When non-symbolic or symbolic numerical arrays were embedded in these spatial locations, and mental number line congruency prompted, this effect was attenuated and in some cases reversed. In particular, low-performing female participants who viewed increasing non-symbolic number arrays paired with the spatial locations exhibited better recall for left-to-right directional flow information relative to right-to-left, and better processing for the left side of space relative to the right side of space. The presence of symbolic number during spatial learning enhanced recall to a greater degree than non-symbolic number--especially for female participants, and especially when cognitive load is high--and this difference was independent of directional flow of information. We conclude that quantity representations have the potential to scaffold spatial memory, but this potential is subtle, and mediated by the nature of the quantity and the gender and performance level of the learner.

Minimal care--a new concept for the management of urinary incontinence in an open access, interdisciplinary incontinence clinic. The way ahead?

DEFF Research Database (Denmark)

Andersen, J T; Sander, P

1996-01-01

A new concept for assessment and treatment of urinary incontinence in an open access, interdisciplinary clinic is evaluated prospectively. Based on the patients needs and expectations, a minimal relevant investigative programme was planned. The patients were primarily offered conservative, non...... of the patients were managed by conservative treatment modalities whereas only 10% of the patients were referred to in-hospital treatment with invasive treatment modalities, mainly surgical procedures for urinary incontinence. Subjectively, 68% felt cured or very much improved, 23% experienced improvement and 9...... and treatment of urinary incontinence....

Influence of Cattle Trails on Runoff Quantity and Quality.

Science.gov (United States)

Miller, Jim J; Curtis, Tony; Chanasyk, David S; Willms, Walter D

2017-03-01

Cattle trails in grazed pastures close to rivers may adversely affect surface water quality of the adjacent river by directing runoff to it. The objective of this 3-yr study (2013-2015) in southern Alberta, Canada, was to determine if cattle trails significantly increased the risk of runoff and contaminants (sediment, nutrients) compared with the adjacent grazed pasture (control). A portable rainfall simulator was used to generate artificial rainfall (140 mm h) and runoff. The runoff properties measured were time to runoff and initial abstraction (infiltration), total runoff depth and average runoff rates, as well as concentrations and mass loads of sediment, N, and P fractions. Cattle trails significantly ( ≤ 0.10) decreased time to runoff and initial abstraction (26-32%) in the 2 yr measured and increased total runoff depth, runoff coefficients, and average runoff rates (21-51%) in 2 of 3 yr. Concentrations of sediment, N, and P fractions in runoff were not significantly greater for cattle trails than for control areas. However, mass loads of total suspended solids (57-85% increase), NH-N (31-90%), and dissolved reactive P (DRP) (30-92%) were significantly greater because of increased runoff volumes. Overall, runoff quantity and loads of sediment, NH-N, and DRP were greater for cattle trails compared with the adjacent grazed pasture, and hydrologic connection with cattle-access sites on the riverbank suggests that this could adversely affect water quality in the adjacent river. Extrapolation of the study results should be tempered by the specific conditions represented by this rainfall simulation study. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

The orientation distribution of tunneling-related quantities

Science.gov (United States)

Seif, W. M.; Refaie, A. I.; Botros, M. M.

2018-03-01

In the nuclear tunneling processes involving deformed nuclei, most of the tunneling-related quantities depend on the relative orientations of the participating nuclei. In the presence of different multipole deformations, we study the variation of a few relevant quantities for the α-decay and the sub-barrier fusion processes, in an orientation degree of freedom. The knocking frequency and the penetration probability are evaluated within the Wentzel-Kramers-Brillouin approximation. The interaction potential is calculated with Skyrme-type nucleon-nucleon interaction. We found that the width of the potential pocket, the Coulomb barrier radius, the penetration probability, the α-decay width, and the fusion cross-section follow consistently the orientation-angle variation of the radius of the deformed nucleus. The orientation distribution patterns of the pocket width, the barrier radius, the logarithms of the penetrability, the decay width, and the fusion cross-section are found to be highly analogous to pattern of the deformed-nucleus radius. The curve patterns of the orientation angle distributions of the internal pocket depth, the Coulomb barrier height and width, as well as the knocking frequency simulate inversely the variation of the deformed nucleus radius. The predicted orientation behaviors will be of a special interest in predicting the optimum orientations for the tunneling processes.

A Comparative Study of Face Milling of D2 Steel Using Al2O3 Based Nanofluid Minimum Quantity Lubrication and Minimum Quantity Lubrication

Directory of Open Access Journals (Sweden)

Muhammad Ahsan Ul Haq

2018-03-01

Full Text Available This study aims to investigate the effects of process parameters feed, depth of cut and flow rate, on the temperature during face milling of the D2 tool steel under two different lubricant conditions, Minimum Quantity Lubrication (MQL and Nanofluid Minimum Quantity Lubrication (NFMQL. Distilled water with the flow rate range 200-400 ml/hr was used in MQL. 2% by weight concentration of Al2O3 nanoparticles with distilled water as the base fluid used as NFMQL with same flow rate. Response surface methodology RSM central composite design CCD was used to design experiment run, modeling, and analysis. ANOVA was used for the adequacy and validation of the system. The comparison shows that NFMQL condition reduced more temperature during machining.

Terms and definitions in the field of radiological technique. Dose quantities and units

International Nuclear Information System (INIS)

1985-12-01

The standard gives the terms and definitions of concepts, dose quantities and units. The radiation field condition 'secondary electron equilibrium', which forms part of the definition of standard ion dose, is given more precisely. The term 'free in air' is used in its original meaning, i.e. characterization of measuring conditions excluding avoidable stray radiation, which deviates from DIN 6814, part 3/06.72. Dosemeters for measurement of standard ion dose of air kerma are calibrated 'free in air', but this calibration condition is not part of the quantity definition. The quantities standard ion dose or air kerma therefore can also be measured in any other material. The qunatitative relationships between standard ion dose and the quantities 'exposure' and air kerma, as given in the ICRU publication 33 'Quantities and Units' (1980), are explained. The standard introduces the SI units Gray (for energy dose), Sievert (for dose equivalent), and Becquerel (for the activity of a radioactive substance). As the change to the SI units conceals the approximated equality of the numerical values of the standrd ion dose of photon radiation in roentgen, of the energy dose for soft tissue in rad, and of the dose equivalent in rem, new definitions are given in accordance with ICRU 33 for the quantities specified dose rate, dose rate constant, and area exposure product. These definitions use the terms 'energy dose' and 'kerma'. The dose concepts applied in the field of radiation protection, especially ambient dose and individual dose, are defined as dose equivalents in compliance with the Radiation Protection Ordinance. The relevant sections present information on the conversion of standard ion dose values to the corresponding values of kerma, energy dose, or dose equivalent. (orig./HP) [de

Strategic Planning in Irish Quantity Surveying Pracitces

OpenAIRE

Murphy, Roisin

2011-01-01

The role and usefulness of strategic planning has been well documented over several decades of strategic management research. Despite the significant body of existing knowledge in the field of strategic planning, there remains a paucity of investigation into the construction sector, specifically in Professional Service Firms (PSF’s) operating within it. The aim of this research was to ascertain the type, scope and extent of strategic planning within Irish Quantity Surveying (QS) practices and...

An accessible four-dimensional treatment of Maxwell's equations in terms of differential forms

Science.gov (United States)

Sá, Lucas

2017-03-01

Maxwell’s equations are derived in terms of differential forms in the four-dimensional Minkowski representation, starting from the three-dimensional vector calculus differential version of these equations. Introducing all the mathematical and physical concepts needed (including the tool of differential forms), using only knowledge of elementary vector calculus and the local vector version of Maxwell’s equations, the equations are reduced to a simple and elegant set of two equations for a unified quantity, the electromagnetic field. The treatment should be accessible for students taking a first course on electromagnetism.

Direct and indirect patient costs of dermatology clinic visits and their impact on access to care and provider preference.

Science.gov (United States)

Rothstein, Brooke E; Gonzalez, Jessica; Cunningham, Kiera; Saraiya, Ami; Dornelles, Adriana C; Nguyen, Bichchau M

2017-12-01

The direct and indirect costs of dermatology clinic visits are infrequently quantified. Indirect costs, such as the time spent traveling to and from appointments and the value of lost earnings from time away from work, are substantial costs that often are not included in economic analyses but may pose barriers to receiving care. Due to the national shortage of dermatologists, patients may have to wait longer for appointments or travel further to see dermatologists outside of their local community, resulting in high time and travel costs for patients. Patients' lost time and earnings comprise the opportunity cost of obtaining care. A monetary value for this opportunity cost can be calculated by multiplying a patient's hourly wage by the number of hours that the patient dedicated to attending the dermatology appointment. Using a single institution survey, this study quantified the direct and indirect patient costs, including opportunity costs and time burden, associated with dermatology clinic visits to better appreciate the impact of these factors on health care access and dermatologic provider preference.

Development of blueberry liquor: influence of distillate, sweetener and fruit quantity.

Science.gov (United States)

Caldeira, Ilda; Lopes, Daniel; Delgado, Teresa; Canas, Sara; Anjos, Ofélia

2018-02-01

In this work different formulations of blueberry liquor were tested and characterised based on their physico-chemical and sensory characteristics. Three factors were evaluated: the distillate used to produce the liquor (wine spirit or grape marc spirit); the sweetener (white sugar or honey) and the fruit quantity (two doses). For each liquor, pH, total acidity, dry soluble solids content, dry extract, alcoholic strength, reducing sugars, colour intensity, methanol content, acetaldehyde and fusel alcohols were determined. Sensory tests were carried out with a trained panel. The three factors studied significantly influenced the physico-chemical features of the liquors, being the quantity of fruit the most discriminating factor, except for the volatile compounds which were mainly influenced by the distillate. As regards the sensory analysis, it was found that the most appreciated liquor was that prepared with wine spirit, sugar and a lower dose of blueberry, and the less appreciated formulation was the one made with grape marc spirit, honey and a lower quantity of blueberry. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

Review of clinically accessible methods to determine lean body mass for normalization of standardized uptake values

International Nuclear Information System (INIS)

DEVRIESE, Joke; POTTEL, Hans; BEELS, Laurence; MAES, Alex; VAN DE WIELE, Christophe; GHEYSENS, Olivier

2016-01-01

With the routine use of 2-deoxy-2-[ 18 F]-fluoro-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scans, metabolic activity of tumors can be quantitatively assessed through calculation of SUVs. One possible normalization parameter for the standardized uptake value (SUV) is lean body mass (LBM), which is generally calculated through predictive equations based on height and body weight. (Semi-)direct measurements of LBM could provide more accurate results in cancer populations than predictive equations based on healthy populations. In this context, four methods to determine LBM are reviewed: bioelectrical impedance analysis, dual-energy X-ray absorptiometry. CT, and magnetic resonance imaging. These methods were selected based on clinical accessibility and are compared in terms of methodology, precision and accuracy. By assessing each method’s specific advantages and limitations, a well-considered choice of method can hopefully lead to more accurate SUVLBM values, hence more accurate quantitative assessment of 18F-FDG PET images.

Race and time from diagnosis to radical prostatectomy: does equal access mean equal timely access to the operating room?--Results from the SEARCH database.

Science.gov (United States)

Bañez, Lionel L; Terris, Martha K; Aronson, William J; Presti, Joseph C; Kane, Christopher J; Amling, Christopher L; Freedland, Stephen J

2009-04-01

African American men with prostate cancer are at higher risk for cancer-specific death than Caucasian men. We determine whether significant delays in management contribute to this disparity. We hypothesize that in an equal-access health care system, time interval from diagnosis to treatment would not differ by race. We identified 1,532 African American and Caucasian men who underwent radical prostatectomy (RP) from 1988 to 2007 at one of four Veterans Affairs Medical Centers that comprise the Shared Equal-Access Regional Cancer Hospital (SEARCH) database with known biopsy date. We compared time from biopsy to RP between racial groups using linear regression adjusting for demographic and clinical variables. We analyzed risk of potential clinically relevant delays by determining odds of delays >90 and >180 days. Median time interval from diagnosis to RP was 76 and 68 days for African Americans and Caucasian men, respectively (P = 0.004). After controlling for demographic and clinical variables, race was not associated with the time interval between diagnosis and RP (P = 0.09). Furthermore, race was not associated with increased risk of delays >90 (P = 0.45) or >180 days (P = 0.31). In a cohort of men undergoing RP in an equal-access setting, there was no significant difference between racial groups with regard to time interval from diagnosis to RP. Thus, equal-access includes equal timely access to the operating room. Given our previous finding of poorer outcomes among African Americans, treatment delays do not seem to explain these observations. Our findings need to be confirmed in patients electing other treatment modalities and in other practice settings.

The false dichotomy of quality and quantity in the discourse around assessment in competency-based education.

Science.gov (United States)

Ten Cate, Olle

2015-08-01

Competency-based medical education stresses the attainment of competencies rather than the completion of fixed time in rotations. This sometimes leads to the interpretation that quantitative features of a program are of less importance, such as procedures practiced and weeks or months spent in clinical practice. An educational philosophy like "We don't require numbers of procedures completed but focus on competencies" suggests a dichotomy of either competency-based or time and procedures based education. The author argues that this dichotomy is not useful, and may even compromise education, as long as valid assessment of all relevant competencies is not possible or feasible. Requiring quantities of experiences of learners is not in contrast with competency-based education.

Estimating waste disposal quantities from raw waste samples

International Nuclear Information System (INIS)

Negin, C.A.; Urland, C.S.; Hitz, C.G.; GPU Nuclear Corp., Middletown, PA)

1985-01-01

Estimating the disposal quantity of waste resulting from stabilization of radioactive sludge is complex because of the many factors relating to sample analysis results, radioactive decay, allowable disposal concentrations, and options for disposal containers. To facilitate this estimation, a microcomputer spread sheet template was created. The spread sheet has saved considerable engineering hours. 1 fig., 3 tabs

The Ica-Atom using as access platform, dissemination and description of archival documents public institutions

Directory of Open Access Journals (Sweden)

Eliseu dos Santos Lima

2016-12-01

Full Text Available Introduction: Information technology has caused changes in various segments of society. In archival area its presence is remarkable, so much that lately has increased the quantity of institutions that make use of computerized systems, repositories and platforms that automate activities such as description, diffusion, and even provide access to archival documentary heritage. Objective: To discuss the functionality and usefulness of the platform International Archives Council - Access to Memory (ICA-AtoM in archival description of activities, dissemination and access to archival documentary heritage. Methodology: bibliographical research, drawn from the archival legislation, especially through research resulting from Master's dissertations, articles published in journals of the Science field of Information and manuals produced by members of the Group of CNPq-UFSM Research: Electronic Management of archival documents - Ged / A. Results: It was observed that the platform is used to describe both the permanent documents, and to provide access to information recorded in current and intermediate documents, in order to streamline access to documentary resources of public institutions. Conclusions: It is considered that the ICA-Atom besides serving the description, can provide an authentic environment for the secure storage and as a source of evidence of digital and digitized institutional documents, as well as to provide for preservation and long term access if It is connected to a RDC-Arq, like Archivematica, for example.

Use and perceptions of information among family physicians: sources considered accessible, relevant, and reliable.

Science.gov (United States)

Kosteniuk, Julie G; Morgan, Debra G; D'Arcy, Carl K

2013-01-01

The research determined (1) the information sources that family physicians (FPs) most commonly use to update their general medical knowledge and to make specific clinical decisions, and (2) the information sources FPs found to be most physically accessible, intellectually accessible (easy to understand), reliable (trustworthy), and relevant to their needs. A cross-sectional postal survey of 792 FPs and locum tenens, in full-time or part-time medical practice, currently practicing or on leave of absence in the Canadian province of Saskatchewan was conducted during the period of January to April 2008. Of 666 eligible physicians, 331 completed and returned surveys, resulting in a response rate of 49.7% (331/666). Medical textbooks and colleagues in the main patient care setting were the top 2 sources for the purpose of making specific clinical decisions. Medical textbooks were most frequently considered by FPs to be reliable (trustworthy), and colleagues in the main patient care setting were most physically accessible (easy to access). When making specific clinical decisions, FPs were most likely to use information from sources that they considered to be reliable and generally physically accessible, suggesting that FPs can best be supported by facilitating easy and convenient access to high-quality information.

Learning Clinical Procedures Through Internet Digital Objects: Experience of Undergraduate Students Across Clinical Faculties

Science.gov (United States)

Li, Tse Yan; Wong, Kin; Tse, Christine Shuk Kwan; Chan, Ying Yee

2015-01-01

Background Various digital learning objects (DLOs) are available via the World Wide Web, showing the flow of clinical procedures. It is unclear to what extent these freely accessible Internet DLOs facilitate or hamper students’ acquisition of clinical competence. Objective This study aimed to understand the experience of undergraduate students across clinical disciplines—medicine, dentistry, and nursing—in using openly accessible Internet DLOs, and to investigate the role of Internet DLOs in facilitating their clinical learning. Methods Mid-year and final-year groups were selected from each undergraduate clinical degree program of the University of Hong Kong—Bachelor of Medicine and Bachelor of Surgery (MBBS), Bachelor of Dental Surgery (BDS), and Bachelor of Nursing (BNurs). All students were invited to complete a questionnaire on their personal and educational backgrounds, and their experiences and views on using Internet DLOs in learning clinical procedures. The questionnaire design was informed by the findings of six focus groups. Results Among 439 respondents, 97.5% (428/439) learned a variety of clinical procedures through Internet DLOs. Most nursing students (107/122, 87.7%) learned preventive measures through Internet DLOs, with a lower percentage of medical students (99/215, 46.0%) and dental students (43/96, 45%) having learned them this way (both Pstudents accessed DLOs through public search engines, whereas 93.2% (409/439) accessed them by watching YouTube videos. Students often shared DLOs with classmates (277/435, 63.7%), but rarely discussed them with teachers (54/436, 12.4%). The accuracy, usefulness, and importance of Internet DLOs were rated as 6.85 (SD 1.48), 7.27 (SD 1.53), and 7.13 (SD 1.72), respectively, out of a high score of 10. Conclusions Self-exploration of DLOs in the unrestricted Internet environment is extremely common among current e-generation learners and was regarded by students across clinical faculties as an important

Evaluating the uncertainty of input quantities in measurement models

Science.gov (United States)

Possolo, Antonio; Elster, Clemens

2014-06-01

The Guide to the Expression of Uncertainty in Measurement (GUM) gives guidance about how values and uncertainties should be assigned to the input quantities that appear in measurement models. This contribution offers a concrete proposal for how that guidance may be updated in light of the advances in the evaluation and expression of measurement uncertainty that were made in the course of the twenty years that have elapsed since the publication of the GUM, and also considering situations that the GUM does not yet contemplate. Our motivation is the ongoing conversation about a new edition of the GUM. While generally we favour a Bayesian approach to uncertainty evaluation, we also recognize the value that other approaches may bring to the problems considered here, and focus on methods for uncertainty evaluation and propagation that are widely applicable, including to cases that the GUM has not yet addressed. In addition to Bayesian methods, we discuss maximum-likelihood estimation, robust statistical methods, and measurement models where values of nominal properties play the same role that input quantities play in traditional models. We illustrate these general-purpose techniques in concrete examples, employing data sets that are realistic but that also are of conveniently small sizes. The supplementary material available online lists the R computer code that we have used to produce these examples (stacks.iop.org/Met/51/3/339/mmedia). Although we strive to stay close to clause 4 of the GUM, which addresses the evaluation of uncertainty for input quantities, we depart from it as we review the classes of measurement models that we believe are generally useful in contemporary measurement science. We also considerably expand and update the treatment that the GUM gives to Type B evaluations of uncertainty: reviewing the state-of-the-art, disciplined approach to the elicitation of expert knowledge, and its encapsulation in probability distributions that are usable in

European union water policy--tasks for implementing "Water Framework Directive" in pre-accession countries.

Science.gov (United States)

Sözen, Seval; Avcioglu, Ebru; Ozabali, Asli; Görgun, Erdem; Orhon, Derin

2003-08-01

Water Framework Directive aiming to maintain and improve the aquatic environment in the EU was launched by the European Parliament in 2000. According to this directive, control of quantity is an ancillary element in securing good water quality and therefore measures on quantity, serving the objective of ensuring good quality should also be established. Accordingly, it is a comprehensive and coordinated package that will ensure all European waters to be protected according to a common standard. Therefore, it refers to all other Directives related to water resources management such as Urban Wastewater Treatment Directive Nitrates Directive, Drinking Water Directive, Integrated Pollution Prevention Control etc. Turkey, as a candidate state targeting full-membership, should comply the necessary preparations for the implementation of the "Water Framework Directive" as soon as possible. In this study, the necessary legislative, political, institutional, and technical attempts of the pre-accession countries have been discussed and effective recommendations have been offered for future activities in Turkey.

Prefrontal cortex and sensory cortices during working memory: quantity and quality.

Science.gov (United States)

Ku, Yixuan; Bodner, Mark; Zhou, Yong-Di

2015-04-01

The activity in sensory cortices and the prefrontal cortex (PFC) throughout the delay interval of working memory (WM) tasks reflect two aspects of WM-quality and quantity, respectively. The delay activity in sensory cortices is fine-tuned to sensory information and forms the neural basis of the precision of WM storage, while the delay activity in the PFC appears to represent behavioral goals and filters out irrelevant distractions, forming the neural basis of the quantity of task-relevant information in WM. The PFC and sensory cortices interact through different frequency bands of neuronal oscillation (theta, alpha, and gamma) to fulfill goal-directed behaviors.

Non-Noether conserved quantity for differential equations of motion in the phase space

Institute of Scientific and Technical Information of China (English)

无

2002-01-01

A non-Noether conserved quantity for the differential equations of motion of mechanical systems in the phase space is studied. The differential equations of motion of the systems are established and the determining equations of Lie symmetry are given. An existence theorem of non-Noether conserved quantity is obtained. An example is given to illustrate the application of the result.

Arrangement for the measurement of the quantity of asphalt in an asphaltic compound

International Nuclear Information System (INIS)

Noma, I.; Taniguchi, K.

1978-01-01

The arrangement for the measurement of the quantity of asphalt in an asphaltic compound in an apparatus for the mixture of asphalt components and an aggregate for the formation of an asphaltic compound characterized by the inclusion of a member for the transmission of a neutron beam which reacts with the hydrogen atoms in the asphaltic compound in such a way that the energy of a neutron beam is adsorbed; a continuous transport device feeds a continuous supply of the asphalt compound past the neutron beam; a member responds to an automatic detector for the quantity of asphaltic components in the asphaltic compound and provides an adjustment so that the quantity [of asphaltic components in asphaltic compound] may be held at a constant value. (G.C.)

Does quantity generate quality? Testing the fundamental principle of brainstorming.

Science.gov (United States)

Muñoz Adánez, Alfredo

2005-11-01

The purpose of this work is to test the chief principle of brainstorming, formulated as "quantity generates quality." The study is included within a broad program whose goal is to detect the strong and weak points of creative techniques. In a sample of 69 groups, containing between 3 and 8 members, the concurrence of two commonly accepted criteria was established as a quality rule: originality and utility or value. The results fully support the quantity-quality relation (r = .893): the more ideas produced to solve a problem, the better quality of the ideas. The importance of this finding, which supports Osborn's theory, is discussed, and the use of brainstorming is recommended to solve the many open problems faced by our society.

Technical strategies and anatomic considerations for parapedicular access to thoracic and lumbar vertebral bodies

International Nuclear Information System (INIS)

Beall, Douglas P.; Martin, Hal D.; Stapp, Annette M.; Puckett, Timothy A.; Stechison, M.T.; Braswell, John J.

2007-01-01

To investigate and illustrate a variation on the traditional percutaneous access to the vertebral body via a parapedicular approach. An effective parapedicular access technique that could safely and reliably guide the needle tip into the center of the vertebral body was developed from cadaver dissection observations for the purpose of clinical use. A total of 102 vertebral compression fractures from T-4 to L-5 were treated via the parapedicular access at our institution between July 2005 and March 2006. There were 72 patients between the ages of 17 and 96 years (mean age: 68.2 years) who underwent treatment. The cadaver dissection revealed a relatively avascular and aneural portion of the vertebral body along the superior margin of the vertebral body-pedicle junction. A total 102 vertebral fractures were treated using the parapedicular access technique without any recognized clinical complications from the needle access or the instrumentation. The thoracic and lumbar vertebral bodies may be safely, reliably, and reproducibly accessed using a percutaneous parapedicular access technique. The technique presented represents a relatively avascular and aneural approach to vertebral body. (orig.)

Clinical Trials

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Full Text Available ... and useful results, which in turn will improve public health. We offer a variety of funding mechanisms tailored to planning and conducting clinical ... Privacy Policy Freedom of Information Act (FOIA) Accessibility ...

Clinical Trials

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Full Text Available ... medical centers and doctors' offices around the country. Benefits and Risks Possible Benefits Taking part in a clinical trial can have many benefits. For example, you may gain access to new ...

40 CFR 355.12 - What quantities of extremely hazardous substances trigger emergency planning requirements?

Science.gov (United States)

2010-07-01

... EMERGENCY PLANNING AND NOTIFICATION Emergency Planning Who Must Comply § 355.12 What quantities of extremely... 40 Protection of Environment 27 2010-07-01 2010-07-01 false What quantities of extremely hazardous substances trigger emergency planning requirements? 355.12 Section 355.12 Protection of Environment...

AIDS--Challenges to Basic and Clinical Biomedical Research.

Science.gov (United States)

Fauci, Anthony S.

1989-01-01

Clinical trials and access to therapeutic drugs pose dilemmas for researchers, physicians, and AIDS patients. The National Institute of Allergy and Infectious Diseases, recognizing the need for greater access to drugs by a broader spectrum of the infected population, is establishing the Community Programs for Clinical Research on AIDS. (Author/MLW)

The linked medical data access control framework.

Science.gov (United States)

Kamateri, Eleni; Kalampokis, Evangelos; Tambouris, Efthimios; Tarabanis, Konstantinos

2014-08-01

The integration of medical data coming from multiple sources is important in clinical research. Amongst others, it enables the discovery of appropriate subjects in patient-oriented research and the identification of innovative results in epidemiological studies. At the same time, the integration of medical data faces significant ethical and legal challenges that impose access constraints. Some of these issues can be addressed by making available aggregated instead of raw record-level data. In many cases however, there is still a need for controlling access even to the resulting aggregated data, e.g., due to data provider's policies. In this paper we present the Linked Medical Data Access Control (LiMDAC) framework that capitalizes on Linked Data technologies to enable controlling access to medical data across distributed sources with diverse access constraints. The LiMDAC framework consists of three Linked Data models, namely the LiMDAC metadata model, the LiMDAC user profile model, and the LiMDAC access policy model. It also includes an architecture that exploits these models. Based on the framework, a proof-of-concept platform is developed and its performance and functionality are evaluated by employing two usage scenarios. Copyright © 2014 Elsevier Inc. All rights reserved.

41 CFR 101-26.507-4 - Quantities in excess of the maximum order limitation.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Quantities in excess of... Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND PROGRAM 26.5-GSA Procurement Programs § 101-26.507-4 Quantities in...

Insurance + Access ≠ Health Care: Typology of Barriers to Health Care Access for Low-Income Families

Science.gov (United States)

DeVoe, Jennifer E.; Baez, Alia; Angier, Heather; Krois, Lisa; Edlund, Christine; Carney, Patricia A.

2007-01-01

PURPOSE Public health insurance programs have expanded coverage for the poor, and family physicians provide essential services to these vulnerable populations. Despite these efforts, many Americans do not have access to basic medical care. This study was designed to identify barriers faced by low-income parents when accessing health care for their children and how insurance status affects their reporting of these barriers. METHODS A mixed methods analysis was undertaken using 722 responses to an open-ended question on a health care access survey instrument that asked low-income Oregon families, “Is there anything else you would like to tell us?” Themes were identified using immersion/crystallization techniques. Pertinent demographic attributes were used to conduct matrix coded queries. RESULTS Families reported 3 major barriers: lack of insurance coverage, poor access to services, and unaffordable costs. Disproportionate reporting of these themes was most notable based on insurance status. A higher percentage of uninsured parents (87%) reported experiencing difficulties obtaining insurance coverage compared with 40% of those with insurance. Few of the uninsured expressed concerns about access to services or health care costs (19%). Access concerns were the most common among publicly insured families, and costs were more often mentioned by families with private insurance. Families made a clear distinction between insurance and access, and having one or both elements did not assure care. Our analyses uncovered a 3-part typology of barriers to health care for low-income families. CONCLUSIONS Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere. PMID:18025488

Nigerian Journal of Clinical Practice

African Journals Online (AJOL)

PROMOTING ACCESS TO AFRICAN RESEARCH ... The Nigerian Journal of Clinical Practice is the official publication of the Medical ... Its purpose is to promote clinical and academic excellence in Medicine and Dentistry and allied sciences.

Understanding Clinician Information Demands and Synthesis of Clinical Documents in Electronic Health Record Systems

Science.gov (United States)

Farri, Oladimeji Feyisetan

2012-01-01

Large quantities of redundant clinical data are usually transferred from one clinical document to another, making the review of such documents cognitively burdensome and potentially error-prone. Inadequate designs of electronic health record (EHR) clinical document user interfaces probably contribute to the difficulties clinicians experience while…

Quantity, Quality, and Satisfaction with Mentoring: What Matters Most?

Science.gov (United States)

Xu, Xiaohong; Payne, Stephanie C.

2014-01-01

According to Kram's mentor role theory, satisfaction with mentoring and mentorship quality are key indicators of effective and successful mentoring. We contribute to mentoring research by demonstrating the relative importance of mentorship quantity, mentorship quality, and satisfaction with mentoring to the prediction of job satisfaction,…

Pharmaceutical quantities of yohimbine found in dietary supplements in the USA.

Science.gov (United States)

Cohen, Pieter A; Wang, Yan-Hong; Maller, Gregory; DeSouza, Renan; Khan, Ikhlas A

2016-01-01

In the USA, botanical dietary supplements are presumed to be safe, but this is not necessarily always the case. Extracts of the evergreen tree yohimbe, Pausinystalia johimbe, though banned in many countries, are sold in hundreds of dietary supplements in the USA. We analyzed 49 brands of supplements labelled as containing yohimbe or yohimbine available for sale from seven major retailers in the USA. Supplements were analyzed using ultra high-performance liquid chromatography coupled to photodiode and quadrupole time-of-flight mass spectrometry detectors for quantity of three alkaloids found in P. johimbe (yohimbine, rauwolscine, and corynanthine). The alkaloids were confirmed on the basis of retention time, ultraviolet spectra, and mass spectra against reference standards. The quantity of the most active alkaloid, yohimbine, per recommended serving ranged from none detected to 12.1 mg. Thirty-nine percent of the supplements (19/49) did not contain rauwolscine and corynanthine suggesting that the yohimbine was either from highly processed plant extract or synthetic in origin. Only 11 supplement brands (22%, 11/49) listed a specific quantity of yohimbine on the label. Most of these were inaccurately labelled (actual content ranged from 23% to 147% of the content on the label). Eighteen percent (9/49) of the supplements' labels did not provide any information about yohimbine's adverse effects. Of the 49 yohimbine supplement brands sold at seven major retail chains in the USA, only 4.1% (2/49) provided consumers with both accurate information about the quantity of yohimbine as well as information about yohimbine's known adverse effects. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

The estimation of differential counting measurements of possitive quantities with relatively large statistical errors

International Nuclear Information System (INIS)

Vincent, C.H.

1982-01-01

Bayes' principle is applied to the differential counting measurement of a positive quantity in which the statistical errors are not necessarily small in relation to the true value of the quantity. The methods of estimation derived are found to give consistent results and to avoid the anomalous negative estimates sometimes obtained by conventional methods. One of the methods given provides a simple means of deriving the required estimates from conventionally presented results and appears to have wide potential applications. Both methods provide the actual posterior probability distribution of the quantity to be measured. A particularly important potential application is the correction of counts on low radioacitvity samples for background. (orig.)

Estimation of Waste Quantities Using DeCAT-Pro

Energy Technology Data Exchange (ETDEWEB)

Yun, Taesik; Jung, Hyejin; Oh, Jaeyoung; Kim, Younggook [KHNP CRI, Daejeon (Korea, Republic of)

2016-10-15

The D and D (Dismantling and Decontamination) is scheduled to get started in June 2022 elapsing five years of cooling spent fuels down. The final site status is postulated as Brown Field and tentative DCGL of less than 0.1 mSv per year to evaluate waste quantities in a conservative manner. The decommissioning strategy was determined the immediate decommissioning whose whole period would be taken for approximately 15 years; pre-decommissioning for two years, spent fuel cool-down for five years, D and D for six years, site remediation for two years. The assumption to dismantle the underground facilities including SSCs is to one meter beneath the ground level and the other facilities remain intact. In addition, non-radioactive concrete wastes would be used to landfill gaps of the remaining facilities. Although there are many assumptions we applied, the methodologies developed and the data produced by this research will play a meaningful role as a good starting point for the Kori-1 decommissioning after its shutdown to logically and reasonably estimate the waste quantity. However it is clear that tenacious efforts should be taken to successfully perform the decommissioning project.

Mei Symmetry and New Conserved Quantities of Tzénoff Equations for the Variable Mass Higher-Order Nonholonomic System

Institute of Scientific and Technical Information of China (English)

ZHENG Shi-Wang; WANG Jian-Bo; CHEN Xiang-Wei; XIE Jia-Fang

2012-01-01

Operational systems of spacecraft are general variable mass mechanics systems,and their symmetries and conserved quantities imply profound physical rules of the space system.We study the Mei symmetry of Tzénoff equations for a variable mass nonholonomic system and the new conserved quantities derived.The function expression of the new conserved quantities and the criterion equation which deduces these conserved quantities are presented.This result has some theoretical values in further research of conservation laws obeyed by the variable mass system.%Operational systems of spacecraft are general variable mass mechanics systems, and their symmetries and conserved quantities imply profound physical rules of the space system. We study the Mei symmetry of Tzenoff equations for a variable mass nonholonomic system and the new conserved quantities derived. The function expression of the new conserved quantities and the criterion equation which deduces these conserved quantities are presented. This result has some theoretical values in further research of conservation laws obeyed by the variable mass system.

Post-General Anesthesia Ultrasound-Guided Venous Mapping Increases Autogenous Access Placement Rates.

Science.gov (United States)

Png, C Y Maximilian; Korayem, Adam; Finlay, David J

2018-04-18

between the groups in terms of outpatient vein mapping plans (P=0.10), however when comparing the PAUS plans to the outpatient vein mapping plans, there was again a significantly increased proportion of preferred access types in the PAUS group compared to the outpatient group (P<0.001). In the ordinal logit multivariate analysis, the only significant variable was the post-anesthesia ultrasound, which positively correlated with more favorable access configurations (coefficient=2.61, P<0.001). The bivariate logit regression for autogenous access maturation rates found no significant difference between the without-PAUS group and the PAUS group (P=0.13). Introducing a post-anesthesia ultrasound mapping to guide vein-finding significantly increases the quality and quantity of suitable veins found, subsequently leading to increased proportions preferred access placement (autogenous vs. prosthetic and forearm vs. upper extremity). Copyright © 2018 Elsevier Inc. All rights reserved.

DYNAMIC INVESTIGATION OF THE PURCHASE PRICE AND QUANTITY OF MAIZE AND PIG

Directory of Open Access Journals (Sweden)

Judit POÓR

2007-11-01

Full Text Available The aim of our examination was to show the cyclic character in the case of agricultural prices. Beside the investigation of prices the analysis of the purchased quantity is of importance too. We examined the way the prices and quantity exercise mutual influence and the connection between the maize purchase price and the pig purchase price. We compared the Hungarian purchase prices with some international ones, and analyzed the tendencies, the influence of open economies and the approach of the prices.

A note on the expectation and deviation of physical quantities

International Nuclear Information System (INIS)

Nagasawa, Masao

2009-01-01

By using the function representation of self-adjoint operators, the expectation and variance of physical quantities (self-adjoint operators) are defined, and it is shown that the so-called uncertainty principle does not hold.

Effects of DME pilot quantity on the performance of a DME PCCI-DI engine

International Nuclear Information System (INIS)

Wang Ying; He Li; Zhou Longbao; Li Wei

2010-01-01

The combination of premixed charge compression ignition and conventional direct-injection compression ignition combustion is studied in a DME engine. This combustion mode is referred to as PCCI-DI combustion. The pilot quantity is found to be one of main variables affecting the PCCI-DI combustion. So, the main objectives of this paper are to examine the effect of different DME pilot quantities on combustion and emission characteristics in a single-cylinder direct-injection DME engine and to determine whether PCCI-DI is a viable in-cylinder NO x emissions reduction technology. In order to evaluate the characteristics of PCCI-DI combustion, the conventional direct-injection compression-ignition engine performance is supplied to make a comparison with their results. Furthermore, special emphasis is put upon the combined combustion process analysis. Results show that DME engine can operate at a wide range of speeds and loads at PCCI-DI mode. In comparison to the conventional DME CI combustion, the brake thermal efficiency slightly increases for DME PCCI-DI operation. PCCI-DI is capable to decrease NO x effectively for all loads. NO x emission shows an obviously descending tendency with an increase in DME pilot quantity at low loads, while it shows a mildly elevating tendency with an increase in DME pilot quantity at high loads. HC and CO emissions increase for DME PCCI-DI operation under various DME pilot quantities.

Quality versus Quantity Debate in Swimming: Perceptions and Training Practices of Expert Swimming Coaches.

Science.gov (United States)

Nugent, Frank J; Comyns, Thomas M; Warrington, Giles D

2017-06-01

The debate over low-volume, high-intensity training versus high-volume, low-intensity training, commonly known as Quality versus Quantity, respectively, is a frequent topic of discussion among swimming coaches and academics. The aim of this study was to explore expert coaches' perceptions of quality and quantity coaching philosophies in competitive swimming and to investigate their current training practices. A purposeful sample of 11 expert swimming coaches was recruited for this study. The study was a mixed methods design and involved each coach participating in 1 semi-structured interview and completing 1 closed-ended questionnaire. The main findings of this study were that coaches felt quality training programmes would lead to short term results for youth swimmers, but were in many cases more appropriate for senior swimmers. The coaches suggested that quantity training programmes built an aerobic base for youth swimmers, promoted technical development through a focus on slower swimming and helped to enhance recovery from training or competition. However, the coaches continuously suggested that quantity training programmes must be performed with good technique and they felt this was a misunderstood element. This study was a critical step towards gaining a richer and broader understanding on the debate over Quality versus Quantity training from an expert swimming coaches' perspective which was not currently available in the research literature.

Quality Versus Quantity Debate in Swimming: Perceptions and Training Practices of Expert Swimming Coaches

Directory of Open Access Journals (Sweden)

Nugent Frank J.

2017-06-01

Full Text Available The debate over low-volume, high-intensity training versus high-volume, low-intensity training, commonly known as Quality versus Quantity, respectively, is a frequent topic of discussion among swimming coaches and academics. The aim of this study was to explore expert coaches’ perceptions of quality and quantity coaching philosophies in competitive swimming and to investigate their current training practices. A purposeful sample of 11 expert swimming coaches was recruited for this study. The study was a mixed methods design and involved each coach participating in 1 semi-structured interview and completing 1 closed-ended questionnaire. The main findings of this study were that coaches felt quality training programmes would lead to short term results for youth swimmers, but were in many cases more appropriate for senior swimmers. The coaches suggested that quantity training programmes built an aerobic base for youth swimmers, promoted technical development through a focus on slower swimming and helped to enhance recovery from training or competition. However, the coaches continuously suggested that quantity training programmes must be performed with good technique and they felt this was a misunderstood element. This study was a critical step towards gaining a richer and broader understanding on the debate over Quality versus Quantity training from an expert swimming coaches’ perspective which was not currently available in the research literature.

Evaluating Digital PCR for the Quantification of Human Genomic DNA: Accessible Amplifiable Targets.

Science.gov (United States)

Kline, Margaret C; Romsos, Erica L; Duewer, David L

2016-02-16

Polymerase chain reaction (PCR) multiplexed assays perform best when the input quantity of template DNA is controlled to within about a factor of √2. To help ensure that PCR assays yield consistent results over time and place, results from methods used to determine DNA quantity need to be metrologically traceable to a common reference. Many DNA quantitation systems can be accurately calibrated with solutions of DNA in aqueous buffer. Since they do not require external calibration, end-point limiting dilution technologies, collectively termed "digital PCR (dPCR)", have been proposed as suitable for value assigning such DNA calibrants. The performance characteristics of several commercially available dPCR systems have recently been documented using plasmid, viral, or fragmented genomic DNA; dPCR performance with more complex materials, such as human genomic DNA, has been less studied. With the goal of providing a human genomic reference material traceably certified for mass concentration, we are investigating the measurement characteristics of several dPCR systems. We here report results of measurements from multiple PCR assays, on four human genomic DNAs treated with four endonuclease restriction enzymes using both chamber and droplet dPCR platforms. We conclude that dPCR does not estimate the absolute number of PCR targets in a given volume but rather the number of accessible and amplifiable targets. While enzymatic restriction of human genomic DNA increases accessibility for some assays, in well-optimized PCR assays it can reduce the number of amplifiable targets and increase assay variability relative to uncut sample.

Role of Leadership in Transforming the Profession of Quantity Surveying

Directory of Open Access Journals (Sweden)

George Ofori

2012-11-01

Full Text Available The construction industry is facing a period of change. The roles ofthe professions involved in the industry in general, and of quantitysurveyors in particular, are also changing. There are opportunitiesfor surveyors to seize the initiative to broaden their involvement inprojects, and attain strategic positions within the industry. However,they will have to improve upon their skill sets and their knowledgebases. Senior quantity surveyors interviewed in Singapore sharedtheir views on the challenges facing the construction industry,and their profession. They suggested that the quantity surveyingprofession would only be able to address the pressing issues itfaces if it pays more attention to innovation and the development ofits people. It should be able to attract and retain talent. Knowledgemanagement will be of critical importance. This will be enabled andfacilitated by knowledge leadership.

A colorimeter for measurement of picomole quantities of urea.

Science.gov (United States)

Vurek, G G; Knepper, M A

1982-04-01

We described a new colorimeter for the measurement of picomole quantities of urea in nanoliter volume fluid samples. The diacetyl monoxime reaction was used to produce a colored product from urea. The method is capable of resolving differences of 10 pmoles between samples containing 0 to 225 pmoles.

19 CFR 151.47 - Optional entry of net quantity of petroleum or petroleum products.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Optional entry of net quantity of petroleum or petroleum products. 151.47 Section 151.47 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF... Petroleum and Petroleum Products § 151.47 Optional entry of net quantity of petroleum or petroleum products...

Use of online clinical videos for clinical skills training for medical students: benefits and challenges.

Science.gov (United States)

Jang, Hye Won; Kim, Kyong-Jee

2014-03-21

Multimedia learning has been shown effective in clinical skills training. Yet, use of technology presents both opportunities and challenges to learners. The present study investigated student use and perceptions of online clinical videos for learning clinical skills and in preparing for OSCE (Objective Structured Clinical Examination). This study aims to inform us how to make more effective us of these resources. A mixed-methods study was conducted for this study. A 30-items questionnaire was administered to investigate student use and perceptions of OSCE videos. Year 3 and 4 students from 34 Korean medical schools who had access to OSCE videos participated in the online survey. Additionally, a semi-structured interview of a group of Year 3 medical students was conducted for an in-depth understanding of student experience with OSCE videos. 411 students from 31 medical schools returned the questionnaires; a majority of them found OSCE videos effective for their learning of clinical skills and in preparing for OSCE. The number of OSCE videos that the students viewed was moderately associated with their self-efficacy and preparedness for OSCE (p mobile devices; they agreed more with the statement that it was convenient to access the video clips than their peers who accessed the videos using computers (p students reported lack of integration into the curriculum and lack of interaction as barriers to more effective use of OSCE videos. The present study confirms the overall positive impact of OSCE videos on student learning of clinical skills. Having faculty integrate these learning resources into their teaching, integrating interactive tools into this e-learning environment to foster interactions, and using mobile devices for convenient access are recommended to help students make more effective use of these resources.

Solvation quantities from a COSMO-RS equation of state

International Nuclear Information System (INIS)

Panayiotou, C.; Tsivintzelis, I.; Aslanidou, D.; Hatzimanikatis, V.

2015-01-01

Highlights: • Extension of the successful COSMO-RS model to an equation-of-state model. • Two scaling constants, obtained from atom-specific contributions. • Overall estimation of the solvation quantities and contributions. - Abstract: This work focuses on the extension of the successful COSMO-RS model of mixtures into an equation-of-state model of fluids and its application for the estimation of solvation/hydration quantities of a variety of chemical substances. These quantities include free-energies, enthalpies and entropies of hydration as well as the separate contributions to each of them. Emphasis is given on the estimation of contributions from the conformational changes of solutes upon solvation and the associated restructuring of solvent in its immediate neighborhood. COSMO-RS is a quantum-mechanics based group/segment contribution model in which the Quasi-Chemical (QC) approach is used for the description of the non-random distribution of interacting segments in the system. Thus, the equation-of-state development is done through such a QC framework. The new model will not need any adjustable parameters for the strong specific interactions, such as hydrogen bonds, since they will be provided by the quantum-mechanics based cosmo-files – a key feature of COSMO-RS model. It will need, however, one volumetric and one energy parameter per fluid, which are scaling constants or molecular descriptors of the fluid and are obtained from rather easily available data such as densities, boiling points, vapor pressures, heats of vaporization or second virial coefficients. The performance and the potential of the new equation-of-state model to become a fully predictive model are critically discussed

Inequities in access to inpatient rehabilitation after stroke: an international scoping review.

Science.gov (United States)

Lynch, Elizabeth A; Cadilhac, Dominique A; Luker, Julie A; Hillier, Susan L

2017-12-01

Background Inequities in accessing inpatient rehabilitation after stroke have been reported in many countries and impact on patient outcomes. Objective To explore variation in international recommendations regarding which patients should receive inpatient rehabilitation after stroke and to describe reported access to rehabilitation. Methods A scoping review was conducted to identify clinical guidelines with recommendations regarding which patients should access inpatient rehabilitation after stroke, and data regarding the proportion of patients accessing stroke rehabilitation. Four bibliographic databases and grey literature were searched. Results Twenty-eight documents were included. Selection criteria for post-acute inpatient rehabilitation were identified for 14 countries or regions and summary data on the proportion of patients receiving inpatient rehabilitation were identified for 14 countries. In Australia, New Zealand, and the United Kingdom, it is recommended that all patients with stroke symptoms should access rehabilitation, whereas guidelines from the United States, Canada, and Europe did not consistently recommend rehabilitation for people with severe stroke. Access to inpatient rehabilitation ranged from 13% in Sweden to 57% in Israel. Differences in availability of early supported discharge/home rehabilitation programs and variations in reporting methods may influence the ability to reliably compare access to rehabilitation between regions. Conclusion Recommendations regarding which patients with moderate and severe strokes should access ongoing rehabilitation are inconsistent. Clinical practice guidelines from different countries regarding post-stroke rehabilitation do not always reflect the evidence regarding the likely benefits to people with stroke. Inequity in access to rehabilitation after stroke is an international issue.

Clinical Trials

Medline Plus

Full Text Available ... and organizations also sponsor clinical trials. Examples include Government Agencies, such as the U.S. Departments of Defense ... FOIA) Accessibility Copyright and Usage No FEAR Act Grants and Funding Building 31 31 Center Drive Bethesda, ...

MICROMICETES QUANTITY AND BIOMASS IN TECHNOGENIC AND NATURAL SOILS

Directory of Open Access Journals (Sweden)

O. N. Korinovskaya

2014-08-01

Full Text Available It is shown that in edaphotopes around of freight checkpoint of CJSC «Krivorozhskiy Surikovyy Zavod», ore-enrichment factory and fresh-inwashed pool of tailings dam of PJSC «Northern Iron Ore Enrichment Works» there is an increase of heavy metals mobile forms (which are the most dangerous for microorganisms, plants, animals and human: for iron in 310; for zinc - in 4,3-6,5; for lead - in 3.2-5.7; for cadmium - in 5,6-9,8; for copper – 6,8-66,5 and for nickel - in 9 times as compared to zonal soil. Whereas in soils of CJSC «Krivorozhskiy Surikovyy Zavod» sanitary protection zone number of copper, nickel, lead, cadmium and zinc mobile forms exceeded the control values in 2,4-6,6 times. For the first time the features of soil microscopic fungi seasonal dynamics of quantity in industrial disturbed soils of Kryvorizhzhya compared to zonal soil (chernozem usual were registered. Changes in fungal mycelium length and biomass, its spore’s amount and biomass in edaphotopes of ore-enrichment and chemical enterprises and of common chernozem are also presented. It is shown that in edaphotopes of heavy contamination areas of «Krivorozhskiy Surikovyy Zavod» and of «Northern Iron Ore Enrichment Works» in spring, summer, and autumn there was decrease of microscopic fungi quantity in 4-10 times, moreover in tehnozems of «Northern Iron Ore Enrichment Works» fresh-inwashed pool of tailings dam their amount reduces in more than 100 times, compared with common chernozem. In low contamination area of «Krivorozhskiy Surikovyy Zavod» their quantity decreases in 2 times. Also in heavy contamination areas of chemical and ore-enrichment enterprises there is strong decrease in the length of fungal mycelium in 2.7-4.2 times, its biomass in 2,6-4,5 times, the spores amount - in 4,5-7,7 times and their biomass - in 10,5-21 times compared to the natural soil, which could be explained by high contents of toxicants. While in the sanitary protection zone of the �

Evaluation of the challenges faced in increasing contraceptive access within a community college population.

Science.gov (United States)

Lamme, Jacqueline; Edelman, Alison; Padua, Emily; Jensen, Jeffrey T

2017-01-01

Research demonstrates removing barriers to access, decreasing costs and offering same-day placement of long-acting reversible contraception (LARC) increases contraceptive uptake in young women. For those in community college (CC), LARC utilization might reduce the risk of dropout and improve degree completion. We identified a local school who had documented an unmet need for on-campus services through a recent student assessment. We then established an on-campus, same day contraceptive clinic at the CC as part of a clinical trial. We found that students did not use the service even after multiple attempts to increase awareness and we ended the study. Here, we report lessons learned from attempting research in this environment in addition to results from a follow-up survey to determine why students did not access the clinical resource. Students reported that they already had good access to contraception and preferred to get their healthcare off-campus. This study demonstrates the complexities of studying highly focused interventions to influence access to care in the current health care environment with ever changing regulations. NCT02735551 . Registered April 6, 2016.

Terminal illness and access to Phase 1 experimental agents, surgeries and devices: reviewing the ethical arguments.

Science.gov (United States)

Schüklenk, Udo; Lowry, Christopher

2009-01-01

The advent of AIDS brought about a group of patients unwilling to accept crucial aspects of the methodological standards for clinical research investigating Phase 1 drugs, surgeries or devices. Their arguments against placebo controls in trials, which depended--at the time--on the terminal status of patient volunteers led to a renewed discussion of the ethics of denying patients with catastrophic illnesses access to last-chance experimental drugs, surgeries or devices. Existing ethics and health policy literature on the topic of access to experimental drugs. The positions of those arguing for or against free access to experimental drugs for terminally ill patients are irreconcilable. At stake are questions about the kinds of personal sacrifices society can reasonably expect patients in clinical trials to make to ensure statistically predictive results. These would benefit by necessity a much larger number of current and future patients--the conflict is about individual versus public interests. It is also about the question of whether or not the state can legitimately prevent patients with terminal illnesses from unfettered access to experimental drugs, surgeries or devices in order to motivate them to participate in clinical trials. We review the ethical arguments for and against the provision of access to Phase 1 agents for terminally ill patients. Finding a compromise between providing free or no access to Phase 1 drugs for terminally ill patients. We ought to investigate means to increase access to experimental drugs for terminally ill patients without sacrificing necessary clinical trials' sounds scientific methods.

Clarification of the confusion concerning the crystal-field quantities vs the zero-field splitting quantities in magnetism studies: Part II-Survey of literature dealing with model studies of spin systems

International Nuclear Information System (INIS)

Rudowicz, C.

2008-01-01

For respective quantities, i.e., Hamiltonians, parameters, and energy level splittings, related to two physically distinct notions X and Y, various cases of confused terminology have been identified in literature. Referring to a quantity related actually to the notion Y using incorrectly the name of another well-defined notion X constitutes, what may be defined for short as, the type X=Y confusion. An ongoing survey of magnetism literature indicates that quantities related to zero-field splitting (ZFS) or equivalently fine structure (FS) are most often confused with those related to crystal-field (CF) or equivalently ligand field (LF). In this review the CF=ZFS confusion cases, i.e., labelling actual ZFS/FS quantities as purportedly 'CF/LF' ones, appearing in magnetism studies are surveyed and clarified. Part I covers the cases occurring in literature dealing with specific compounds. In this part model studies of spin systems are surveyed. The cases of terminology mixing up actual ZFS/FS quantities with purported CF/LF ones are identified and presented comprehensively in tabular form. To facilitate discussion, problems pertinent for the CF=ZFS confusion are categorized into several groups, including origin of the two notions, physical consequences, usage of specific numerical values, invoking real magnetic spin systems, and properties of spin S=1/2 systems. Physical implications of this confusion for interpretation of model results are also considered. Overall implications of incorrect terminology go beyond simple semantic issues and concern possible misinterpretation of data describing various physical properties of models studied. Such terminology contributes also to misleading keyword classifications of papers in journals and scientific databases. Other types of confusion identified in survey of magnetism literature will be discussed in separate reviews

Is the Quantity Theory of Money Useful in Forecasting U.S. Inflation?

DEFF Research Database (Denmark)

Lanne, Markku; Luoto, Jani; Nyberg, Henri

We propose a new simple model incorporating the implication of the quantity theory of money that money growth and ináation should move one for one in the long run, and, hence, ináation should be predictable by money growth. The model Öts postwar U.S. data well, and beats common univariate benchma...... models in forecasting ináation. Moreover, this evidence is quite robust, and predictability is found also in the Great moderation period. The detected predictability of ináation by money growth lends support to the quantity theory....

Teacher quality and quantity as correlates of secondary school ...

African Journals Online (AJOL)

This study investigated the twin variables of quality and quantity of teachers as correlates of secondary school academic performance in Ogun State of Nigeria between 1997/98 and 2000/2001 academic sessions. The study was conducted ex-post facto under a descriptive survey research design using the proportional to ...

Water quantity and quality at the urban-rural interface

Science.gov (United States)

Ge Sun; B. Graeme Lockaby

2012-01-01

Population growth and urban development dramatically alter natural watershed ecosystem structure and functions and stress water resources. We review studies on the impacts of urbanization on hydrologic and biogeochemical processes underlying stream water quantity and water quality issues, as well as water supply challenges in an urban environment. We conclude that...

Resource rents: The effects of energy taxes and quantity instruments for climate protection

International Nuclear Information System (INIS)

Eisenack, Klaus; Edenhofer, Ottmar; Kalkuhl, Matthias

2012-01-01

Carbon dioxide emissions correspond to fossil resource use. When considering this supply side of climate protection, crucial questions come to fore. It seems likely that owners of fossil resources would object to emission reductions. Moreover, policy instruments such as taxes may not be effective at all: it seems individually rational to leave no fossil resources unused. In this context, it can be expected that economic sectors will react strategically to climate policy, aiming at a re-distribution of rents. To address these questions, we investigate the effectiveness, efficiency, and resource rents for energy taxes, resource taxes, and quantity rationing of emissions. The analysis is based on a game theoretic growth model with explicit factor markets and policy instruments. Market equilibrium depends on a government that acts as a Stackelberg leader with a climate protection goal. We find that resource taxes and quantity rationing achieve this objective efficiently, energy taxation is only second-best. The use of quantity rationing to achieve climate protection generates substantial rents for resource owners. - Highlights: ► Resource taxes and quantity rationing (carbon budgets) are efficient. ► Carbon budgets increase resource rents, while taxes decrease rents. ► Resource owners may support climate protection. ► Climate protection introduces a climate rent.

Supply Chain Coordination under Trade Credit and Quantity Discount with Sales Effort Effects

Directory of Open Access Journals (Sweden)

Zhihong Wang

2018-01-01

Full Text Available The purpose of this paper is to investigate the role of trade credit and quantity discount in supply chain coordination when the sales effort effect on market demand is considered. In this paper, we consider a two-echelon supply chain consisting of a single retailer ordering a single product from a single manufacturer. Market demand is stochastic and is influenced by retailer sales effort. We formulate an analytical model based on a single trade credit and find that the single trade credit cannot achieve the perfect coordination of the supply chain. Then, we develop a hybrid quantitative analytical model for supply chain coordination by coherently integrating incentives of trade credit and quantity discount with sales effort effects. The results demonstrate that, providing that the discount rate satisfies certain conditions, the proposed hybrid model combining trade credit and quantity discount will be able to effectively coordinate the supply chain by motivating retailers to exert their sales effort and increase product order quantity. Furthermore, the hybrid quantitative analytical model can provide great flexibility in coordinating the supply chain to achieve an optimal situation through the adjustment of relevant parameters to resolve conflict of interests from different supply chain members. Numerical examples are provided to demonstrate the effectiveness of the hybrid model.

A framework for improving access and customer service times in health care: application and analysis at the UCLA Medical Center.

Science.gov (United States)

Duda, Catherine; Rajaram, Kumar; Barz, Christiane; Rosenthal, J Thomas

2013-01-01

There has been an increasing emphasis on health care efficiency and costs and on improving quality in health care settings such as hospitals or clinics. However, there has not been sufficient work on methods of improving access and customer service times in health care settings. The study develops a framework for improving access and customer service time for health care settings. In the framework, the operational concept of the bottleneck is synthesized with queuing theory to improve access and reduce customer service times without reduction in clinical quality. The framework is applied at the Ronald Reagan UCLA Medical Center to determine the drivers for access and customer service times and then provides guidelines on how to improve these drivers. Validation using simulation techniques shows significant potential for reducing customer service times and increasing access at this institution. Finally, the study provides several practice implications that could be used to improve access and customer service times without reduction in clinical quality across a range of health care settings from large hospitals to small community clinics.

Instant messaging: The way to improve access for young people to their school nurse.

Science.gov (United States)

Schuller, Lynne; Thaker, Kelly

2015-12-01

Children and young people require ease of access to their school nurse. Alongside this, school nurses are charged with the need to work smarter, being cost-effective and timely in response. School nursing teams across the country provide access through text messaging, however, there is presently no access provided to young people to have a consultation as a web-based chat facility. Using digital media, Doncaster school nurses have worked closely with young people to redesign and launch a totally interactive web- based clinic facility. This allows for improved access, reduction in travel costs and consultations to take place outside of the traditional times for accessing school nurses. This paper discusses a pilot project around the establishment of an e-clinic connecting young people and school nurses. It outlines the journey towards providing this innovative service in an attempt to provide cost-effective, timely services while reducing the barriers for service users.

Thermodynamic quantities for the Klein–Gordon equation with a ...

Indian Academy of Sciences (India)

2017-02-01

Feb 1, 2017 ... Abstract. We study some thermodynamic quantities for the Klein–Gordon equation with a linear plus inverse- linear, scalar potential. We obtain the energy eigenvalues with the help of the quantization rule from the biconfluent Heun's equation. We use a method based on the Euler–MacLaurin formula to ...

Review on evolvement of systems of ionizing radiation quantities and units

International Nuclear Information System (INIS)

Zheng Junzheng; Zeng Zhi

2009-01-01

To scientifically and practically measure the ionizing radiation in unison is an indispensable prerequisite and foundation for the extensive uses of nuclear science and technology, development of radiological protection and safety standards, as well as prevention and treatment of ionizing radiation hazards. Concerning about the quantities and units of ionizing radiation as well as their corresponding measurement and application methods, relevant international organizations and all countries in the world generally adopt the systems proposed by the International Commission on Radiation Units and Measurements (ICRU) which is a well recognized and authoritative academic organization.In the paper,the major evolutions of the systems for ionizing radiation quantities and units in the past decades are summarized. (authors)

On the operational quantity Hp(3) for eye lens dosimetry

International Nuclear Information System (INIS)

Behrens, R

2012-01-01

In the past the operational quantity H p (3) has been defined for calibration purposes in a slab phantom. Recently, an additional phantom in the form of a cylinder was suggested for eye lens dosimetry as a cylinder much better approximates the shape of a head than a slab. Therefore, this work investigates whether the quantity H p (3), when defined in the respective calibration phantom, adequately estimates the eye lens dose (or is at least conservative) depending on the phantom: it turns out that in most cases both calibration phantoms are similarly well suited. Finally, the definition of the eye lens dose is discussed together with possible consequences on the definition of H p (3): the consideration of only the radiation sensitive volume of the lens causes H p (3) not to be conservative in beta radiation fields. (paper)

A Pilot Examination of the Methods Used to Counteract Insider Threat Security Risks Associated with the Use of Radioactive Materials in the Research and Clinical Setting.

Science.gov (United States)

Tsenov, B G; Emery, R J; Whitehead, L W; Gonzalez, J Reingle; Gemeinhardt, G L

2018-03-01

While many organizations maintain multiple layers of security control methodologies to prevent outsiders from gaining unauthorized access, persons such as employees or contractors who have been granted legitimate access can represent an "insider threat" risk. Interestingly, some of the most notable radiological events involving the purposeful contamination or exposure of individuals appear to have been perpetrated by insiders. In the academic and medical settings, radiation safety professionals focus their security efforts on (1) ensuring controls are in place to prevent unauthorized access or removal of sources, and (2) increasing security controls for the unescorted accessing of large sources of radioactivity (known as "quantities of concern"). But these controls may not completely address the threat insiders represent when radioactive materials below these quantities are present. The goal of this research project was to characterize the methodologies currently employed to counteract the insider security threat for the misuse or purposeful divergence of radioactive materials used in the academic and medical settings. A web-based survey was used to assess how practicing radiation safety professionals in academic and medical settings anticipate, evaluate, and control insider threat security risks within their institutions. While all respondents indicated that radioactive sources are being used in amounts below quantities of concern, only 6 % consider insider threat security issues as part of the protocol review for the use of general radioactive materials. The results of this survey identify several opportunities for improvement for institutions to address security gaps.

Clinical and epidemiological features of HIV/AIDS infection among migrants at first access to healthcare services as compared to Italian patients in Italy: a retrospective multicentre study, 2000-2010.

Science.gov (United States)

Sulis, G; El Hamad, I; Fabiani, M; Rusconi, S; Maggiolo, F; Guaraldi, G; Bozzi, G; Bernardini, C; Lichtner, M; Stentarelli, C; Carenzi, L; Francisci, D; Saracino, A; Castelli, F

2014-10-01

Migrants account for approximately 8.7% of the resident population in Italy. The immigration status deeply influences access to prevention and care, thus contributing to increase the burden of HIV/AIDS among such a fragile category. The aim of this study was to investigate socio-demographic and baseline clinical and immunological features of HIV-infected migrants, as compared to Italians. We retrospectively analysed data for all the 1,611 HIV-infected migrant patients and a random sample of 4,230 HIV-infected Italian patients aged 18 or older who first accessed nine Italian clinical centres in 2000-2010 and were followed up at least 1 year. Differences in baseline characteristics between migrants and Italians were evaluated in univariate analysis, while factors associated with late presentation were evaluated in multivariate analysis using logistic regression models. The baseline profile differs between the HIV-infected migrant and Italian patients, substantially reflecting what reported by current statistics in terms of gender, age, risk category as well as clinical features. Late presenters were more frequent among migrants as compared to Italians (53.0 vs 45.8%; adjusted odds ratio [(AOR) = 1.55, 95% confidence interval (CI) 1.34-1.78]. Other factors associated with late presentation included increasing age, as well as undocumented legal status among foreign-born subjects (AOR = 1.41, 95% CI 0.97-2.04), though of borderline significance. Late presentation still represents a relevant problem despite the advances in the management of HIV infection. More efforts are needed to allow early diagnosis and access to care among the most vulnerable, such as undocumented foreign-born subjects in a country where migration flows are on the rise.

Does improved access to water supply by rural households enhance the concept of safe water at the point of use? A case study from deep rural South Africa.

Science.gov (United States)

Jagals, P

2006-01-01

The concept of safe water is defined by three principles: the health-related quality must be suitable, the supply/source must be accessible and the water must constantly be available in quantities sufficient for the intended use. If any one (or more) of these three elements is missing from a water services improvement programme, providing safe water is not successfully achieved. A study in a deep rural area in South Africa showed that providing small communities, using untreated river water as their only water source, with good quality water through a piped distribution system and accessible at communal taps did not fall within our parameters of safe water. The parameters for measuring the three principles were: absence of Escherichia coli in drinking water samples; accessibility by improving tap distances to within 200 m from each household; availability by assessing whether households have at least 25 L per person per day. Results show that although E. coli levels were reduced significantly, households were still consuming water with E. coli numbers at non-compliant levels. Access (distance) was improved from an average of 750 m from households to river source to an average of 120 m to new on-tap source points. This did not result in significant increases in household quantities, which on average remained around 18 L per person per day.

Buyer-vendor coordination for fixed lifetime product with quantity discount under finite production rate

Science.gov (United States)

Zhang, Qinghong; Luo, Jianwen; Duan, Yongrui

2016-03-01

Buyer-vendor coordination has been widely addressed; however, the fixed lifetime of the product is seldom considered. In this paper, we study the coordination of an integrated production-inventory system with quantity discount for a fixed lifetime product under finite production rate and deterministic demand. We first derive the buyer's ordering policy and the vendor's production batch size in decentralised and centralised systems. We then compare the two systems and show the non-coordination of the ordering policies and the production batch sizes. To improve the supply chain efficiency, we propose quantity discount contract and prove that the contract can coordinate the buyer-vendor supply chain. Finally, we present analytically tractable solutions and give a numerical example to illustrate the benefits of the proposed quantity discount strategy.

Are dispensaries indispensable? Patient experiences of access to cannabis from medical cannabis dispensaries in Canada.

Science.gov (United States)

Capler, Rielle; Walsh, Zach; Crosby, Kim; Belle-Isle, Lynne; Holtzman, Susan; Lucas, Philippe; Callaway, Robert

2017-09-01

In 2001, Canada established a federal program for cannabis for therapeutic purposes (CTP). Medical cannabis dispensaries (dispensaries) are widely accessed as a source of CTP despite storefront sales of cannabis being illegal. The discrepancy between legal status and social practice has fuelled active debate regarding the role of dispensaries. The present study aims to inform this debate by analysing CTP user experiences with different CTP sources, and comparing dispensary users to those accessing CTP from other sources. We compared sociodemographic characteristics, health related factors and patterns of cannabis use of 445 respondents, 215 who accessed CTP from dispensaries with 230 who accessed other sources. We compared patients' ratings of CTP sources (dispensaries, Health Canada's supplier, self-production, other producer, friend or acquaintance, street dealer) for quality and availability of product, safety and efficiency of access, cost, and feeling respected while accessing. Patients using dispensaries were older, more likely to have arthritis and HIV/AIDS, and less likely to have mental health conditions than those not using dispensaries. Those accessing dispensaries used larger quantities of cannabis, placed greater value on access to specific strains, and were more likely to have legal authorization for CTP. Dispensaries were rated equally to or more favourably than other sources of CTP for quality, safety, availability, efficiency and feeling respected, and less favourably than self-production and other producer for cost. Given the high endorsement of dispensaries by patients, future regulations should consider including dispensaries as a source of CTP and address known barriers to access such as cost and health care provider support. Further research should assess the impact of the addition of licensed producers on the role and perceived value of dispensaries within the Canadian medical cannabis system. Copyright © 2017 Elsevier B.V. All rights

An accessible four-dimensional treatment of Maxwell's equations in terms of differential forms

International Nuclear Information System (INIS)

Sá, Lucas

2017-01-01

Maxwell’s equations are derived in terms of differential forms in the four-dimensional Minkowski representation, starting from the three-dimensional vector calculus differential version of these equations. Introducing all the mathematical and physical concepts needed (including the tool of differential forms), using only knowledge of elementary vector calculus and the local vector version of Maxwell’s equations, the equations are reduced to a simple and elegant set of two equations for a unified quantity, the electromagnetic field. The treatment should be accessible for students taking a first course on electromagnetism. (paper)

Analysis on Domestic Law and Management Trend Related to Small-Quantity Nuclear Material

International Nuclear Information System (INIS)

Park, Jae Beom; Lee, Kyong Woo; Shim, Hye Won; Min, Gyung Sik

2005-01-01

International Atomic Energy Agency (IAEA) has requested Korea to establish and manage the law ruling all nuclear materials through the INFCIRC/153. Now, it has been 30 years since Korea made the agreement, INFCIRC/153, with IAEA. Korea has tried their best to accomplish the international standard in nuclear control field and it is a fact that Korea finally produced some results in the nuclear control field. Related to nuclear material control, Korea is above the common level appropriately ranked 6th in the world in terms of nuclear power. Before 2000, Korea was making the foundation secure in the nuclear control. IAEA did not urge to establish the law supervising the small-quantity nuclear material and depleted uranium (DU). In a turnaround from early IAEA moderate line to Korea, the situation was changed. Since IAEA brought up the agenda to 2000 Joint Review Meeting between Korea-IAEA, IAEA has asked Korea to establish the control system for smallquantity nuclear material and DU. In 2003, the Korean government set up a project establishing the control system about all nuclear material including small-quantity nuclear material and DU. National Nuclear Management and Control Agency (NNCA), delegating the business relating to international controlling materials from government, developed some modules in nuclear material control system and operated it. The system includes a controlling system for small-quantity nuclear material. NNCA on behalf of government has collected the information and Korea Ministry of Science and Technology (MOST) has reported the information to the IAEA. This paper introduces you the background of controlling the small-quantity nuclear material and the system of controlling nuclear material in Korea. And it will suggest the improvement of the management method in the system for small-quantity nuclear material

Analysis on Domestic Law and Management Trend Related to Small-Quantity Nuclear Material

Energy Technology Data Exchange (ETDEWEB)

Park, Jae Beom; Lee, Kyong Woo; Shim, Hye Won; Min, Gyung Sik [National Nuclear Management and Control Agency, Daejeon (Korea, Republic of)

2005-07-01

International Atomic Energy Agency (IAEA) has requested Korea to establish and manage the law ruling all nuclear materials through the INFCIRC/153. Now, it has been 30 years since Korea made the agreement, INFCIRC/153, with IAEA. Korea has tried their best to accomplish the international standard in nuclear control field and it is a fact that Korea finally produced some results in the nuclear control field. Related to nuclear material control, Korea is above the common level appropriately ranked 6th in the world in terms of nuclear power. Before 2000, Korea was making the foundation secure in the nuclear control. IAEA did not urge to establish the law supervising the small-quantity nuclear material and depleted uranium (DU). In a turnaround from early IAEA moderate line to Korea, the situation was changed. Since IAEA brought up the agenda to 2000 Joint Review Meeting between Korea-IAEA, IAEA has asked Korea to establish the control system for smallquantity nuclear material and DU. In 2003, the Korean government set up a project establishing the control system about all nuclear material including small-quantity nuclear material and DU. National Nuclear Management and Control Agency (NNCA), delegating the business relating to international controlling materials from government, developed some modules in nuclear material control system and operated it. The system includes a controlling system for small-quantity nuclear material. NNCA on behalf of government has collected the information and Korea Ministry of Science and Technology (MOST) has reported the information to the IAEA. This paper introduces you the background of controlling the small-quantity nuclear material and the system of controlling nuclear material in Korea. And it will suggest the improvement of the management method in the system for small-quantity nuclear material.

Highway route controlled quantity shipment routing reports - An overview

International Nuclear Information System (INIS)

Cashwell, J.W.; Welles, B.W.; Welch, M.J.

1989-01-01

US Department of Transportation (DOT) regulations require a postnotification report from the shipper for all shipments of radioactive materials categorized as a Highway Route Controlled Quantity. These postnotification reports, filed in compliance with 49 CFR 172.203(d), have been compiled by the DOT in a database known as the Radioactive Materials Routing Report (RAMRT) since 1982. The data were sorted by each of its elements to establish historical records and trends of Highway Route Controlled Quantity shipments from 1982 through 1987. Approximately 1520 records in the RAMRT database were compiled for this analysis. Approximately half of the shipments reported for the study period were from the US Department of Energy (DOE) and its contractors, with the others being commercial movements. Two DOE installations, EG and G Idaho and Oak Ridge, accounted for nearly half of the DOE activities. Similarly, almost half of the commercial movements were reported by two vendors, Nuclear Assurance Corporation and Transnuclear, Incorporated. Spent fuel from power and research reactors accounted for approximately half of all shipments

Barriers to treatment access for Chagas disease in Mexico.

Science.gov (United States)

Manne, Jennifer M; Snively, Callae S; Ramsey, Janine M; Salgado, Marco Ocampo; Bärnighausen, Till; Reich, Michael R

2013-01-01

According to World Health Organization (WHO) prevalence estimates, 1.1 million people in Mexico are infected with Trypanosoma cruzi, the etiologic agent of Chagas disease (CD). However, limited information is available about access to antitrypanosomal treatment. This study assesses the extent of access in Mexico, analyzes the barriers to access, and suggests strategies to overcome them. Semi-structured in-depth interviews were conducted with 18 key informants and policymakers at the national level in Mexico. Data on CD cases, relevant policy documents and interview data were analyzed using the Flagship Framework for Pharmaceutical Policy Reform policy interventions: regulation, financing, payment, organization, and persuasion. Data showed that 3,013 cases were registered nationally from 2007-2011, representing 0.41% of total expected cases based on Mexico's national prevalence estimate. In four of five years, new registered cases were below national targets by 11-36%. Of 1,329 cases registered nationally in 2010-2011, 834 received treatment, 120 were pending treatment as of January 2012, and the treatment status of 375 was unknown. The analysis revealed that the national program mainly coordinated donation of nifurtimox and that important obstacles to access include the exclusion of antitrypanosomal medicines from the national formulary (regulation), historical exclusion of CD from the social insurance package (organization), absence of national clinical guidelines (organization), and limited provider awareness (persuasion). Efforts to treat CD in Mexico indicate an increased commitment to addressing this disease. Access to treatment could be advanced by improving the importation process for antitrypanosomal medicines and adding them to the national formulary, increasing education for healthcare providers, and strengthening clinical guidelines. These recommendations have important implications for other countries in the region with similar problems in access to

Theory of perceived access to breast health care in African American women.

Science.gov (United States)

Garmon, Sandra C

2012-01-01

The theory presented in this article proposes an alternative view of access to care on the basis of an African American woman's perception of the necessity, availability, and appropriateness of breast health care. The theory of perceived access to breast health care in African American women may also be useful in framing future research studies exploring the relationship between access to care and utilization of primary, secondary, and tertiary clinical preventive services related to breast health care.

ClinicalTrials.gov

Data.gov (United States)

U.S. Department of Health & Human Services — Provides patients, family members, health care professionals, and members of the public easy access to information on clinical trials for a wide range of diseases...

Accessible Knowledge - Knowledge on Accessibility

DEFF Research Database (Denmark)

Kirkeby, Inge Mette

2015-01-01

Although serious efforts are made internationally and nationally, it is a slow process to make our physical environment accessible. In the actual design process, architects play a major role. But what kinds of knowledge, including research-based knowledge, do practicing architects make use of when...... designing accessible environments? The answer to the question is crucially important since it affects how knowledge is distributed and how accessibility can be ensured. In order to get first-hand knowledge about the design process and the sources from which they gain knowledge, 11 qualitative interviews...... were conducted with architects with experience of designing for accessibility. The analysis draws on two theoretical distinctions. The first is research-based knowledge versus knowledge used by architects. The second is context-independent knowledge versus context-dependent knowledge. The practitioners...

Effects of network node consolidation in optical access and aggregation networks on costs and power consumption

Science.gov (United States)

Lange, Christoph; Hülsermann, Ralf; Kosiankowski, Dirk; Geilhardt, Frank; Gladisch, Andreas

2010-01-01

The increasing demand for higher bit rates in access networks requires fiber deployment closer to the subscriber resulting in fiber-to-the-home (FTTH) access networks. Besides higher access bit rates optical access network infrastructure and related technologies enable the network operator to establish larger service areas resulting in a simplified network structure with a lower number of network nodes. By changing the network structure network operators want to benefit from a changed network cost structure by decreasing in short and mid term the upfront investments for network equipment due to concentration effects as well as by reducing the energy costs due to a higher energy efficiency of large network sites housing a high amount of network equipment. In long term also savings in operational expenditures (OpEx) due to the closing of central office (CO) sites are expected. In this paper different architectures for optical access networks basing on state-of-the-art technology are analyzed with respect to network installation costs and power consumption in the context of access node consolidation. Network planning and dimensioning results are calculated for a realistic network scenario of Germany. All node consolidation scenarios are compared against a gigabit capable passive optical network (GPON) based FTTH access network operated from the conventional CO sites. The results show that a moderate reduction of the number of access nodes may be beneficial since in that case the capital expenditures (CapEx) do not rise extraordinarily and savings in OpEx related to the access nodes are expected. The total power consumption does not change significantly with decreasing number of access nodes but clustering effects enable a more energyefficient network operation and optimized power purchase order quantities leading to benefits in energy costs.

Delays by people living with HIV/AIDS in accessing antiretroviral ...

African Journals Online (AJOL)

Objective: To understand, by qualitative enquiry, the underlying reasons and narratives ... denial, practical clinic constraints and appropriate types of health education. Keywords: qualitative research, delays, access, antiretroviral drugs, ARVs ...

Dimensions of Organisational Culture in Quantity Surveying Firms in Nigeria

Directory of Open Access Journals (Sweden)

Ayokunle Olubunmi Olanipekun

2014-12-01

Full Text Available The functionalist paradigm of organisational culture (OC views culture as a variable subject to conscious manipulation and control in order to solve organisational challenges. Therefore, this paper provides information on how OC is a solution to the challenges in Quantity Surveying firms (QSFs.  This was achieved by eliciting the dimensions of OC in forty two QSFs in Lagos, Nigeria, which are the business, people and external environment dimensions. The paper concludes that OC is a relevant solution to the identity and management related challenges in QSFs. Specifically, the paper informs on the implications of business and people dimensions of OC as a solution to the identity challenges, as well as on the implication of the external environment dimension of OC to the management challenges. Based on the findings, practical implications and recommendations were directed at the management and employees QSs in QSFs and Quantity Surveying researchers.

Mobile health clinics in the era of reform.

Science.gov (United States)

Hill, Caterina F; Powers, Brian W; Jain, Sachin H; Bennet, Jennifer; Vavasis, Anthony; Oriol, Nancy E

2014-03-01

Despite the role of mobile clinics in delivering care to the full spectrum of at-risk populations, the collective impact of mobile clinics has never been assessed. This study characterizes the scope of the mobile clinic sector and its impact on access, costs, and quality. It explores the role of mobile clinics in the era of delivery reform and expanded insurance coverage. A synthesis of observational data collected through Mobile Health Map and published literature related to mobile clinics. Analysis of data from the Mobile Health Map Project, an online platform that aggregates data on mobile health clinics in the United States, supplemented by a comprehensive literature review. Mobile clinics represent an integral component of the healthcare system that serves vulnerable populations and promotes high-quality care at low cost. There are an estimated 1500 mobile clinics receiving 5 million visits nationwide per year. Mobile clinics improve access for vulnerable populations, bolster prevention and chronic disease management, and reduce costs. Expanded coverage and delivery reform increase opportunities for mobile clinics to partner with hospitals, health systems, and insurers to improve care and lower costs. Mobile clinics have a critical role to play in providing high-quality, low-cost care to vulnerable populations. The postreform environment, with increasing accountability for population health management and expanded access among historically underserved populations, should strengthen the ability for mobile clinics to partner with hospitals, health systems, and payers to improve care and lower costs.

Clinical skill center: a review of present situation and importance in medical education curriculum

Directory of Open Access Journals (Sweden)

Haleh Talaei

2002-07-01

Full Text Available Clinical skill centers were designed in 1960, offers innovative, more effective clinical health care and treatment curriculum. Clinical skill center (CSC can provide a special facility for clinical and communication skills practice in a setting outside hospital wards in order to train students with enough confidence of confronting real patients. Learning clinical skills in these centers are not patient-dependent and by practicing on manikins and simulated models errors in real patients can be prevented. Moreover, possible feedback of this method can be used for evaluation and can improve quality and quantity of the education. This review intends to determine the purpose, undertaking, and structure of CSC. The study emphasizes the importance of integrating the clinical skill centers into the teaching curriculum of medical universities. Apparently, organizing clinical skill centers can play an important role for improving the quality and quantity of the educational system and consequently post-graduate performance. The authors recommend this program can be a solution for having both the knowledge and skill of diagnosis and treatment seasonal and rare diseases. Key words clinical skill center, medical education, curriculum

Management of Small Quantity of Nuclear Material at Locations Outside Facilities in Korea

Energy Technology Data Exchange (ETDEWEB)

Park, Seung Sik; Kim, Ki Hyun [KAERI, Daejeon (Korea, Republic of)

2016-05-15

Small quantity of nuclear material (SQNM) is prescribed to be less than specified minimum quantities of nuclear material in a facility. SQNM is used at the locations called locations outside facilities (LOFs). LOFs are used to control the locations and installations that store nuclear materials under one effective Kg, respectively. Holders of SQNM don't need to require a license for use or possession of Uranium or Thorium exclusively for non-nuclear activities, or neither report them to the System of Accounting for and Control of nuclear material (SSAC) under specified quantities according to the Atomic Safety Law. Well defined safeguards law is fundamental to the effective control of nuclear material, facilities and nuclear related activities. In the current nuclear safety legislation, there are some exceptive clauses. Users of SQNM don't need to require a license for use or possession of Uranium or Thorium exclusively for non-nuclear activities, or not report them to the national authority below specified amount.

Energy Drinks and Binge Drinking Predict College Students' Sleep Quantity, Quality, and Tiredness.

Science.gov (United States)

Patrick, Megan E; Griffin, Jamie; Huntley, Edward D; Maggs, Jennifer L

2018-01-01

This study examines whether energy drink use and binge drinking predict sleep quantity, sleep quality, and next-day tiredness among college students. Web-based daily data on substance use and sleep were collected across four semesters in 2009 and 2010 from 667 individuals for up to 56 days each, yielding information on 25,616 person-days. Controlling for average levels of energy drink use and binge drinking (i.e., 4+ drinks for women, 5+ drinks for men), on days when students consumed energy drinks, they reported lower sleep quantity and quality that night, and greater next-day tiredness, compared to days they did not use energy drinks. Similarly, on days when students binge drank, they reported lower sleep quantity and quality that night, and greater next-day tiredness, compared to days they did not binge drink. There was no significant interaction effect between binge drinking and energy drink use on the outcomes.

Management of Small Quantity of Nuclear Material at Locations Outside Facilities in Korea

International Nuclear Information System (INIS)

Park, Seung Sik; Kim, Ki Hyun

2016-01-01

Small quantity of nuclear material (SQNM) is prescribed to be less than specified minimum quantities of nuclear material in a facility. SQNM is used at the locations called locations outside facilities (LOFs). LOFs are used to control the locations and installations that store nuclear materials under one effective Kg, respectively. Holders of SQNM don't need to require a license for use or possession of Uranium or Thorium exclusively for non-nuclear activities, or neither report them to the System of Accounting for and Control of nuclear material (SSAC) under specified quantities according to the Atomic Safety Law. Well defined safeguards law is fundamental to the effective control of nuclear material, facilities and nuclear related activities. In the current nuclear safety legislation, there are some exceptive clauses. Users of SQNM don't need to require a license for use or possession of Uranium or Thorium exclusively for non-nuclear activities, or not report them to the national authority below specified amount

THE ANALYSIS OF THE SEWAGE QUANTITY DISCHARGING FROM THE SEWERAGE AGGLOMERATION IN SANOK

Directory of Open Access Journals (Sweden)

Anna Młyńska

2017-06-01

Full Text Available Both too large and too small volume of sewage inflowing to wastewater treatment plant in relation to its volume determined during designing process, can contribute to the reduction of sewage treatment effectiveness. Taking into consideration, in this article, the analysis of the sewage quantity discharging from the Sanok agglomeration and treated in domestic wastewater treatment plant in 2013-2015 was performed. The analysis indicated that in each year of the analyzed period, to the Wastewater Treatment Plant in Trepcza, a similar volumes of sewage was inflowing and the maximum hydraulic capacity of the object was not exceeded, what is evidenced by the average daily sewage flow values. It is noted that in rainless periods, the quantities of inflowing sewage were smaller than during days with wet weather. Despite of periodically situations of the hydraulic overload and hydraulic underload, it can be stated that the effectiveness of the sewage treatment processes is not endangered by the excessive or insufficient quantities of inflowing sewage.

Controlling Access to Suicide Means

Directory of Open Access Journals (Sweden)

Miriam Iosue

2011-12-01

Full Text Available Background: Restricting access to common means of suicide, such as firearms, toxic gas, pesticides and other, has been shown to be effective in reducing rates of death in suicide. In the present review we aimed to summarize the empirical and clinical literature on controlling the access to means of suicide. Methods: This review made use of both MEDLINE, ISI Web of Science and the Cochrane library databases, identifying all English articles with the keywords “suicide means”, “suicide method”, “suicide prediction” or “suicide prevention” and other relevant keywords. Results: A number of factors may influence an individual’s decision regarding method in a suicide act, but there is substantial support that easy access influences the choice of method. In many countries, restrictions of access to common means of suicide has lead to lower overall suicide rates, particularly regarding suicide by firearms in USA, detoxification of domestic and motor vehicle gas in England and other countries, toxic pesticides in rural areas, barriers at jumping sites and hanging, by introducing “safe rooms” in prisons and hospitals. Moreover, decline in prescription of barbiturates and tricyclic antidepressants (TCAs, as well as limitation of drugs pack size for paracetamol and salicylate has reduced suicides by overdose, while increased prescription of SSRIs seems to have lowered suicidal rates. Conclusions: Restriction to means of suicide may be particularly effective in contexts where the method is popular, highly lethal, widely available, and/or not easily substituted by other similar methods. However, since there is some risk of means substitution, restriction of access should be implemented in conjunction with other suicide prevention strategies.

Management of Water Quantity and Quality Based on Copula for a Tributary to Miyun Reservoir, Beijing

Science.gov (United States)

Zang, N.; Wang, X.; Liang, P.

2017-12-01

Due to the complex mutual influence between water quantity and water quality of river, it is difficult to reflect the actual characters of the tributaries to reservoir. In this study, the acceptable marginal probability distributions for water quantity and quality of reservoir inflow were calculated. A bivariate Archimedean copula was further applied to establish the joint distribution function of them. Then multiple combination scenarios of water quantity and water quality were designed to analyze their coexistence relationship and reservoir management strategies. Taking Bai river, an important tributary into the Miyun Reservoir, as a study case. The results showed that it is feasible to apply Frank copula function to describe the jointed distribution function of water quality and water quantity for Bai river. Furthermore, the monitoring of TP concentration needs to be strengthen in Bai river. This methodology can be extended to larger dimensions and is transferable to other reservoirs via establishment of models with relevant data for a particular area. Our findings help better analyzing the coexistence relationship and influence degree of the water quantity and quality of the tributary to reservoir for the purpose of water resources protection.

Insurance + access not equal to health care: typology of barriers to health care access for low-income families.

Science.gov (United States)

Devoe, Jennifer E; Baez, Alia; Angier, Heather; Krois, Lisa; Edlund, Christine; Carney, Patricia A

2007-01-01

Public health insurance programs have expanded coverage for the poor, and family physicians provide essential services to these vulnerable populations. Despite these efforts, many Americans do not have access to basic medical care. This study was designed to identify barriers faced by low-income parents when accessing health care for their children and how insurance status affects their reporting of these barriers. A mixed methods analysis was undertaken using 722 responses to an open-ended question on a health care access survey instrument that asked low-income Oregon families, "Is there anything else you would like to tell us?" Themes were identified using immersion/crystallization techniques. Pertinent demographic attributes were used to conduct matrix coded queries. Families reported 3 major barriers: lack of insurance coverage, poor access to services, and unaffordable costs. Disproportionate reporting of these themes was most notable based on insurance status. A higher percentage of uninsured parents (87%) reported experiencing difficulties obtaining insurance coverage compared with 40% of those with insurance. Few of the uninsured expressed concerns about access to services or health care costs (19%). Access concerns were the most common among publicly insured families, and costs were more often mentioned by families with private insurance. Families made a clear distinction between insurance and access, and having one or both elements did not assure care. Our analyses uncovered a 3-part typology of barriers to health care for low-income families. Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere.

Continuing Need for Sexually Transmitted Disease Clinics After the Affordable Care Act.

Science.gov (United States)

Hoover, Karen W; Parsell, Bradley W; Leichliter, Jami S; Habel, Melissa A; Tao, Guoyu; Pearson, William S; Gift, Thomas L

2015-11-01

We assessed the characteristics of sexually transmitted disease (STD) clinic patients, their reasons for seeking health services in STD clinics, and their access to health care in other venues. In 2013, we surveyed persons who used publicly funded STD clinics in 21 US cities with the highest STD morbidity. Of the 4364 STD clinic patients we surveyed, 58.5% were younger than 30 years, 72.5% were non-White, and 49.9% were uninsured. They visited the clinic for STD symptoms (18.9%), STD screening (33.8%), and HIV testing (13.6%). Patients chose STD clinics because of walk-in, same-day appointments (49.5%), low cost (23.9%), and expert care (8.3%). Among STD clinic patients, 60.4% had access to another type of venue for sick care, and 58.5% had access to another type of venue for preventive care. Most insured patients (51.6%) were willing to use insurance to pay for care at the STD clinic. Despite access to other health care settings, patients chose STD clinics for sexual health care because of convenient, low-cost, and expert care. Policy Implication. STD clinics play an important role in STD prevention by offering walk-in care to uninsured patients.

Determinants of stage at diagnosis of breast cancer in Nigerian women: sociodemographic, breast cancer awareness, health care access and clinical factors.

Science.gov (United States)

Jedy-Agba, Elima; McCormack, Valerie; Olaomi, Oluwole; Badejo, Wunmi; Yilkudi, Monday; Yawe, Terna; Ezeome, Emmanuel; Salu, Iliya; Miner, Elijah; Anosike, Ikechukwu; Adebamowo, Sally N; Achusi, Benjamin; Dos-Santos-Silva, Isabel; Adebamowo, Clement

2017-07-01

Advanced stage at diagnosis is a common feature of breast cancer in Sub-Saharan Africa (SSA), contributing to poor survival rates. Understanding its determinants is key to preventing deaths from this cancer in SSA. Within the Nigerian Integrative Epidemiology of Breast Cancer Study, a multicentred case-control study on breast cancer, we studied factors affecting stage at diagnosis of cases, i.e. women diagnosed with histologically confirmed invasive breast cancer between January 2014 and July 2016 at six secondary and tertiary hospitals in Nigeria. Stage was assessed using clinical and imaging methods. Ordinal logistic regression was used to examine associations of sociodemographic, breast cancer awareness, health care access and clinical factors with odds of later stage (I, II, III or IV) at diagnosis. A total of 316 women were included, with a mean age (SD) of 45.4 (11.4) years. Of these, 94.9% had stage information: 5 (1.7%), 92 (30.7%), 157 (52.4%) and 46 (15.3%) were diagnosed at stages I, II, III and IV, respectively. In multivariate analyses, lower educational level (odds ratio (OR) 2.35, 95% confidence interval: 1.04, 5.29), not believing in a cure for breast cancer (1.81: 1.09, 3.01), and living in a rural area (2.18: 1.05, 4.51) were strongly associated with later stage, whilst age at diagnosis, tumour grade and oestrogen receptor status were not. Being Muslim (vs. Christian) was associated with lower odds of later stage disease (0.46: 0.22, 0.94). Our findings suggest that factors that are amenable to intervention concerning breast cancer awareness and health care access, rather than intrinsic tumour characteristics, are the strongest determinants of stage at diagnosis in Nigerian women.

DETAILED CLINICAL MODELS AND THEIR RELATION WITH ELECTRONIC HEALTH RECORDS.

OpenAIRE

Boscá Tomás, Diego

2016-01-01

[EN] Healthcare domain produces and consumes big quantities of people's health data. Although data exchange is the norm rather than the exception, being able to access to all patient data is still far from achieved. Current developments such as personal health records will introduce even more data and complexity to the Electronic Health Records (EHR). Achieving semantic interoperability is one of the biggest challenges to overcome in order to benefit from all the information contained in the ...

Quantity and quality benefits of in-service invasive cleaning of trunk mains

Directory of Open Access Journals (Sweden)

I. Sunny

2017-07-01

Full Text Available Trunk mains are high risk critical infrastructure where poor performance can impact on large numbers of customers. Both quantity (e.g. hydraulic capacity and quality (e.g. discolouration of trunk main performance are affected by asset deterioration in the form of particle accumulation at the pipe wall. Trunk main cleaning techniques are therefore desirable to remove such material. However, little is quantified regarding the efficacy of different maintenance interventions or longer-term changes following such cleaning. This paper presents an assessment of quantity and quality performance of a trunk main system pre, post and for 12 months following cleaning using pigging with ice slurry. Hydraulic calibration showed a 7 times roughness height reduction after ice slurry pigging, evidencing substantially improved hydraulic capacity and reduced headloss. Turbidity response due to carefully imposed shear stress increase remained significant after the cleaning intervention, showing that relatively loose material had not been fully removed from the pipe wall. Overall the results demonstrate that cleaning by pigging with ice slurry can be beneficial for quantity performance, but care and further assessment may be necessary to realise the full quality benefits.

Quantity and quality benefits of in-service invasive cleaning of trunk mains

Science.gov (United States)

Sunny, Iftekhar; Husband, Stewart; Drake, Nick; Mckenzie, Kevan; Boxall, Joby

2017-07-01

Trunk mains are high risk critical infrastructure where poor performance can impact on large numbers of customers. Both quantity (e.g. hydraulic capacity) and quality (e.g. discolouration) of trunk main performance are affected by asset deterioration in the form of particle accumulation at the pipe wall. Trunk main cleaning techniques are therefore desirable to remove such material. However, little is quantified regarding the efficacy of different maintenance interventions or longer-term changes following such cleaning. This paper presents an assessment of quantity and quality performance of a trunk main system pre, post and for 12 months following cleaning using pigging with ice slurry. Hydraulic calibration showed a 7 times roughness height reduction after ice slurry pigging, evidencing substantially improved hydraulic capacity and reduced headloss. Turbidity response due to carefully imposed shear stress increase remained significant after the cleaning intervention, showing that relatively loose material had not been fully removed from the pipe wall. Overall the results demonstrate that cleaning by pigging with ice slurry can be beneficial for quantity performance, but care and further assessment may be necessary to realise the full quality benefits.

Organizational citizenship behavior and the quantity and quality of work group performance.

Science.gov (United States)

Podsakoff, P M; Ahearne, M; MacKenzie, S B

1997-04-01

Despite the widespread interest in the topic of organizational citizenship behaviors (OCBs), little empirical research has tested the fundamental assumption that these forms of behavior improve the effectiveness of work groups or organizations in which they are exhibited. In the present study, the effects of OCBs on the quantity and quality of the performance of 218 people working in 40 machine crews in a paper mill located in the Northeastern United States were examined. The results indicate that helping behavior and sportsmanship had significant effects on performance quantity and that helping behavior had a significant impact on performance quality. However, civic virtue had no effect on either performance measure.

Calculation of skin dose due to beta contamination using the new quantity of the ICRP 116: the local skin dose

International Nuclear Information System (INIS)

Bourgois, L.; Menard, S.; Comte, N.

2017-01-01

Values of the new protection quantity Local Skin Dose 'LSD', introduced by the International Commission on Radiological Protection (ICRP) Publication 116, were calculated for 134 β - or β + emitting radionuclides, using the Monte Carlo code MCNP6. Two types of source geometry are considered: a point source and disc-type surface contamination (the source is placed in contact with the skin). This new protection quantity is compared with the operational quantity H2 (0.07, 0 deg.), leading us to conclude that, in accordance with the rules of the ICRP, the operational quantity over-estimates the protection quantity to a reasonable extent, except in very rare cases for very low average beta energies. Thus, with the new skin model described in ICRP 116, there are no longer any major differences between the operational quantities and protection quantities estimated with the skin model described in ICRP 74. (authors)

Access to fertility services in Canada for HIV-positive individuals and couples: a comparison between 2007 and 2014.

Science.gov (United States)

Lo, Carson K; Kennedy, V Logan; Yudin, Mark H; Shapiro, Heather M; Loutfy, Mona

2017-11-01

In the modern era of HIV care, a multitude of clinical needs have emerged; one such need is the growing sub-specialty of HIV and reproductive health. In 2007, a study surveying Canadian fertility clinics found limited access to fertility services for HIV-positive patients. Given the extensive efforts made to address this lack of services, a follow-up assessment was warranted. This study aimed to compare the access to Canadian fertility clinics and services for HIV-positive individuals and couples in 2014 and 2007. Surveys were sent to medical or laboratory directors of assisted reproductive technology (ART) clinics in 2014 and results were compared to those sent in 2007. Main outcome measures included: the proportion of fertility clinics willing to provide ART to people with HIV, the specific services offered, and whether the 2012 Canadian HIV Pregnancy Planning Guidelines were implemented to inform practice. Across Canadian provinces, 20/34 (59%) clinics completed the survey. Ninety-five percent (19/20) of clinics accepted HIV-positive patients for consultation. Only 50% (10/20) of clinics in four provinces offered a full range of ART (defined as including in vitro fertilization [IVF]). Ten clinics (50%) in five provinces were aware that guidelines exist; half (n = 5) having read them and four reporting implementation of all the guidelines' recommendations in their practice. Compared to 2007, more clinics had implemented separate facilities (p = 0.028) to treat HIV-positive individuals, offered IVF (p = 0.013) for HIV-positive female partners, sperm washing (p = 0.033) for HIV-positive male partners, and risk reduction techniques to couples with HIV-positive men and women (p = 0.006). Access to fertility clinics for people with HIV has improved over time but is still regionally dependent and access to full ART remains limited. These findings suggest the need for advocacy targeted towards geographical-specific areas and optimizing access to

Limited access atrial septal defect closure and the evolution of minimally invasive surgery.

Science.gov (United States)

Izzat, M B; Yim, A P; El-Zufari, M H

1998-04-01

While minimizing the "invasiveness" in general surgery has been equated with minimizing "access", what constitutes minimally invasive intra-cardiac surgery remains controversial. Many surgeons doubt the benefits of minimizing access when the need for cardiopulmonary bypass cannot be waived. Recognizing that median sternotomy itself does entail significant morbidity, we investigated the value of alternative approaches to median sternotomy using atrial septal defect closure as our investigative model. We believe that some, but not all minimal access approaches are associated with reduced postoperative morbidity and enhanced recovery. Our current strategy is to use a mini-sternotomy approach in adult patients, whereas conventional median sternotomy remains our standard approach in the pediatric population. Considerable clinical experiences coupled with documented clinical benefits are fundamental before a certain approach is adopted in routine practice.

Using QR codes to enable quick access to information in acute cancer care.

Science.gov (United States)

Upton, Joanne; Olsson-Brown, Anna; Marshall, Ernie; Sacco, Joseph

2017-05-25

Quick access to toxicity management information ensures timely access to steroids/immunosuppressive treatment for cancer patients experiencing immune-related adverse events, thus reducing length of hospital stays or avoiding hospital admission entirely. This article discusses a project to add a QR (quick response) code to a patient-held immunotherapy alert card. As QR code generation is free and the immunotherapy clinical management algorithms were already publicly available through the trust's clinical network website, the costs of integrating a QR code into the alert card, after printing, were low, while the potential benefits are numerous. Patient-held alert cards are widely used for patients receiving anti-cancer treatment, and this established standard of care has been modified to enable rapid access of information through the incorporation of a QR code.

Among-species differences in pollen quality and quantity limitation: implications for endemics in biodiverse hotspots.

Science.gov (United States)

Alonso, Conchita; Navarro-Fernández, Carmen M; Arceo-Gómez, Gerardo; Meindl, George A; Parra-Tabla, Víctor; Ashman, Tia-Lynn

2013-11-01

Insufficient pollination is a function of quantity and quality of pollen receipt, and the relative contribution of each to pollen limitation may vary with intrinsic plant traits and extrinsic ecological properties. Community-level studies are essential to evaluate variation across species in quality limitation under common ecological conditions. This study examined whether endemic species are more limited by pollen quantity or quality than non-endemic co-flowering species in three endemic-rich plant communities located in biodiversity hotspots of different continents (Andalusia, California and Yucatan). Natural variations in pollen receipt and pollen tube formation were analysed for 20 insect-pollinated plants. Endemic and non-endemic species that co-flowered were paired in order to estimate and compare the quantity and quality components of pre-zygotic pollination success, obtained through piecewise regression analysis of the relationship between pollen grains and pollen tubes of naturally pollinated wilted flowers. Pollen tubes did not frequently exceed the number of ovules per flower. Only the combination of abundant and good quality pollen and a low number of ovules per flower conferred relief from pre-zygotic pollen limitation in the three stochastic pollination environments studied. Quality of pollen receipt was found to be as variable as quantity among study species. The relative pollination success of endemic and non-endemic species, and its quantity and quality components, was community dependent. Assessing both quality and quantity of pollen receipt is key to determining the ovule fertilization potential of both endemic and widespread plants in biodiverse hotspot regions. Large natural variation among flowers of the same species in the two components and pollen tube formation deserves further analysis in order to estimate the environmental, phenotypic and intraindividual sources of variation that may affect how plants evolve to overcome this limitation in

Color Coding of Circuit Quantities in Introductory Circuit Analysis Instruction

Science.gov (United States)

Reisslein, Jana; Johnson, Amy M.; Reisslein, Martin

2015-01-01

Learning the analysis of electrical circuits represented by circuit diagrams is often challenging for novice students. An open research question in electrical circuit analysis instruction is whether color coding of the mathematical symbols (variables) that denote electrical quantities can improve circuit analysis learning. The present study…

21 CFR 201.62 - Declaration of net quantity of contents.

Science.gov (United States)

2010-04-01

..., 250 milligrams each”: Provided, That: (1) In the case of a firmly established, general consumer usage... firmly established, general consumer usage and trade custom of employing different common fractions in... a declaration of net quantity blown, embossed, or molded on a glass or plastic surface is...

Criterion-based clinical audit in obstetrics: bridging the quality gap?

Science.gov (United States)

Graham, W J

2009-06-01

The Millennium Development Goal 5 - reducing maternal mortality by 75% - is unlikely to be met globally and for the majority of low-income countries. At this time of heightened concern to scale-up services for mothers and babies, it is crucial that not only shortfalls in the quantity of care - in terms of location and financial access - are addressed, but also the quality. Reductions in maternal and perinatal mortality in the immediate term depend in large part on the timely delivery of effective practices in the management of life-threatening complications. Such practices require a functioning health system - including skilled and motivated providers engaged with the women and communities whom they serve. Assuring the quality of this system, the services and the care that women receive requires many inputs, including effective and efficient monitoring mechanisms. The purpose of this article is to summarise the practical steps involved in applying one such mechanism, criterion-based clinical audit (CBCA), and to highlight recent lessons from its application in developing countries. Like all audit tools, the ultimate worth of CBCA relates to the action it stimulates in the health system and among providers.

Clinical applications of measurement of serum immunoreactive levels of erythropoietin

International Nuclear Information System (INIS)

Miller, M.E.; Chandra, M.; Garcia, J.F.

1985-01-01

The purification of erythropoietin (Ep) in 1977 enabled investigators to more clearly define the role of this hormone in erythropoiesis in man. Radioimmunoassays were rapidly developed. Undoubtedly differences between levels of immunoreactive and biologically active Ep will be found but the resolution of these discrepancies will expand our understanding of the erythron. Recently others described a monoclonal antibody against Ep. Because of this breakthrough, large quantities of pure hormone should soon be available to a larger number of investigators than currently have access to it. The major clinical use of this hormone will probably be in the treatment of the anemia of chronic renal disease. In the relatively few years since the radioimmunoassay (RIA) was developed, measurements of the levels of this hormone have been made in several disease states as well as in normal man. Most of the findings to date confirm the predictions that have been made over the years based on studies done using the rather crude bioassay for Ep. In the present study the authors shall review and expand on what is known about subjects with chronic lung and renal disease

Improving access to interventions among mothers screened positive for post-partum depression (PPD) at National Programme on Immunization (NPI) clinics in south-western and south-eastern Nigeria - A service development report.

Science.gov (United States)

Bakare, Muideen O; Bello-Mojeed, Mashudat A; Munir, Kerim M; Duduyemi, Olaniyi O; Orovwigho, Andrew O; Odetunde, Odutola I; Taiwo, Olufemi G; Olofinlade, Jushua A; Omotoso, Olakunle N; Famurewa, Olayinka H; Omolabi, Oladipupo O; Jejeloye, Adebayo O

2017-01-01

We investigate the possibility of improving access to interventions among mothers screened positive for post-partum depression (PPD) at National Programme on Immunization (NPI) clinics randomly selected from Lagos and Enugu States in south-western and south-eastern Nigeria respectively. The principle of human centred design was employed by engaging the mothers screened positive for PPD to be part of the decision making regarding their further assessment and intervention services. The study brought intervention services to primary healthcare centre at the NPI clinics. Improvement in willingness to seek interventions was observed among the mothers screened positive for PPD in this study when compared to our observation in a previous report, where mothers diagnosed with PPD were referred and requested to visit a mental health facility closer to their NPI clinics for further assessment and interventions (95.2% versus 33.7%). Interventional services for the mothers diagnosed with PPD also impact positively on the growth parameters of their infants on follow-up. Principle of human centred design improved access to intervention services among the mothers and infants studied. NPI clinics at primary healthcare level would provide appropriate forum for early screening of mothers for PPD and interventions in low-resource setting like Nigeria. There would be improvement in maternal and child health coverage if the Nigerian Government can adapt human centred design principles employed in this study nationwide.

Skin dose estimation due to a contamination by a radionuclide β emitter: are doses equivalent good estimator of protection quantities?

International Nuclear Information System (INIS)

Bourgois, L.

2011-01-01

When handling radioactive β emitters, measurements in terms of personal dose equivalents H p (0.07) are used to estimate the equivalent dose limit to skin or extremities given by regulations. First of all, analytical expressions for individual dose equivalents H p (0.07) and equivalent doses to the extremities H skin are given for a point source and for contamination with a radionuclide β emitter. Second of all, operational quantities and protection quantities are compared. It is shown that in this case the operational quantities significantly overstate the protection quantities. For a skin contamination the ratio between operational quantities and protection quantities is 2 for a maximum β energy of 3 MeV and 90 for a maximum β energy of 150 keV. (author)

Global Access Programs: A Collaborative Approach for Effective Implementation and Management.

Science.gov (United States)

Ainge, Debra; Aitken, Suzanne; Corbett, Mark; De-Keyzer, David

Global access programs (GAPs) provide access to medicinal products for patients with serious medical conditions and no commercially available treatment options. Providing early access to medicines can be challenging for a pharmaceutical company. The demand for a GAP often occurs at a time when other activities are the prime focus, such as delivery of pivotal clinical trials or gaining of marketing authorization. Furthermore, the skills, experience, and infrastructure necessary to implement and manage a successful GAP vary significantly from those required for regular clinical trial execution, and the regulatory environment presents its own challenges, with regulations often poorly defined and with considerable inter-country variation. This article considers the triggers for early access requests and examines the need for companies to develop a global strategy for GAPs in order to respond appropriately to requests for early access. It also provides a comprehensive overview of the processes for GAP set-up, implementation, management, and closure, along with the considerations affecting the type and scope of GAP, such as demand, regulatory feasibility, license status of the product, drug pricing structure, company strategy, costs, and product supply. Also discussed is the need for appropriate personnel to implement and manage the GAP, and when to consider collaboration with an external GAP provider. In summary, GAPs require careful and efficient planning and management, from set-up to closure. Well-run GAPs provide an ethical and regulatory-compliant pathway for access of new treatments to patients with serious conditions and an unmet medical need.

Peer Assessment for Construction Management and Quantity Surveying Students

Directory of Open Access Journals (Sweden)

Patricia McLaughlin

2012-11-01

Full Text Available Students undertaking the Bachelor of ConstructionManagement degree course at RMIT University, Melbourne,qualify for registration with the Australian Institute ofQuantity Surveyors (AIQS and the Australian Institute ofBuilding (AIB upon graduation. Over the past decade thedegree course has been constantly upgraded and altered inline with recommendations from professional bodies such asthese and other industry partners. In 1994 the Departmentof Building and Construction Economics re-assesseda range of subjects including the first year technologysubjects. Out of the review a problem-based integratedlearning unit was developed and tested. This unit has nowbeen in place for ten years.Quantity surveying and construction management likemost other professions in the construction industryrequire teamwork and advanced consultation skills. Theseskills may be learnt through experience but there isconsiderable evidence that these skills can be taught in theundergraduate years. Therefore in line with team-basedapproaches used in industry and professional constructionsettings, this year a new assessment model - peerassessment - will be applied to the problem-based learningunit. This paper describes the procedures and processesused to introduce the change and examines the theoreticalbase upon which the model was developed.

Transjugular intrahepatic portosystemic stent shunt (TIPSS) with use of Roesch-Uchida transjugular liver access set; Evaluation by CT and its clinical application

Energy Technology Data Exchange (ETDEWEB)

Takahashi, Motoichiro; Okawada, Taketoshi; Kato, Ryoichi; Mochizuki, Takao; Ohkawa, Yoshihisa; Kaneko, Masao [Hamamatsu University School of Medicine, Shizuoka (Japan); Ke, Xu; Hanguo, Zhang; Fangxian, He

1992-12-01

Appropriateness of the Roesch-Uchida transjugular liver access set designed for transjugular intrahepatic portosystemic stent shunt (TIPSS) procedure was confirmed, especially about the catheter angle and effective length of the 20 G puncture needle, by CT analysis on three dimensional vascular anatomy of the liver. Clinically, TIPSS using the set was successfully made for two patients, connecting superior right hepatic vein with right portal vein in one patient and middle hepatic vein with left portal vein in another patient with hypoplastic right portal vein. Prior to TIPSS procedure, verification of vascular anatomy on CT images is the key to success of TIPSS in safe. (author).

Hazardous Waste Management for the Small Quantity Generator. Teacher Edition.

Science.gov (United States)

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This instructional package for teaching about the regulations imposed on small quantity generators by the Environmental Protection Agency (EPA) under the Resource Conservation Recovery Act is organized around ll program objectives: students will be able to (l) determine a hazardous waste from lists or by identifying characteristics; (2) identify…

Single access laparoscopic nephrectomy

Directory of Open Access Journals (Sweden)

Jay D Raman

2008-01-01

Full Text Available Laparoscopic nephrectomy has assumed a central role in the management of benign and malignant kidney diseases. While laparoscopy is less morbid than open surgery, it still requires several incisions each at least 1-2 cm in length. Each incision carries morbidity risks of bleeding, hernia and/or internal organ damage, and incrementally decreases cosmesis. An alternative to conventional laparoscopy is single access or keyhole surgery, which utilizes magnetic anchoring and guidance system (MAGS technology or articulating laparoscopic instruments. These technical innovations obviate the need to externally space trocars for triangulation, thus allowing for the creation of a small, solitary portal of entry into the abdomen. Laboratory and early clinical series demonstrate feasibility as well as safe and successful completion of keyhole nephrectomy. Future work is necessary to improve existing instrumentation, increase clinical experience, assess benefits of this surgical approach, and explore other potential applications for this technique.

Effects of herbivore exclosures on variation in quality and quantity of ...

African Journals Online (AJOL)

Effects of herbivore exclosures on variation in quality and quantity of plants among ... commercial and game) and among habitat types (open savanna, rocky and pan) in a semiarid savanna in South Africa. ... AJOL African Journals Online.

Harvard Aging Brain Study: Dataset and accessibility.

Science.gov (United States)

Dagley, Alexander; LaPoint, Molly; Huijbers, Willem; Hedden, Trey; McLaren, Donald G; Chatwal, Jasmeer P; Papp, Kathryn V; Amariglio, Rebecca E; Blacker, Deborah; Rentz, Dorene M; Johnson, Keith A; Sperling, Reisa A; Schultz, Aaron P

2017-01-01

The Harvard Aging Brain Study is sharing its data with the global research community. The longitudinal dataset consists of a 284-subject cohort with the following modalities acquired: demographics, clinical assessment, comprehensive neuropsychological testing, clinical biomarkers, and neuroimaging. To promote more extensive analyses, imaging data was designed to be compatible with other publicly available datasets. A cloud-based system enables access to interested researchers with blinded data available contingent upon completion of a data usage agreement and administrative approval. Data collection is ongoing and currently in its fifth year. Copyright © 2015 Elsevier Inc. All rights reserved.

Barriers and facilitators to intraosseous access in adult resuscitations when peripheral intravenous access is not achievable.

Science.gov (United States)

James Cheung, Warren; Rosenberg, Hans; Vaillancourt, Christian

2014-03-01

Studies suggest that intraosseous (IO) access is underutilized in adult resuscitations, despite recommendations from advanced trauma and cardiac life support guidelines. The objective was to determine factors associated with IO access use by physicians during adult resuscitations when intravenous (IV) access is not immediately achievable. This study was an online survey among physicians purposefully recruited from various clinical care areas at three teaching hospitals. Questions were generated from the qualitative results of 20 iterative interviews, verified for internal validity, and piloted. The interview guide was based on the constructs of the Theory of Planned Behavior (TPB), which elicits salient attitudes, social influences, and control beliefs that potentially influence intention to use IO access. Recruitment took place in September 2012 until reaching more than 100% of the required sample size (n = 200). Internal consistency was measured using Cronbach's alpha, and the effect of TPB constructs and specific beliefs were assessed with regression analyses. For the 205 respondents, the mean age was 35 years (range = 20 to 66 years), and 53.3% were male. Participants' departmental affiliations were 50.3% emergency medicine (EM), 16.9% internal medicine, 14.9% anesthesia, 10.8% general surgery, and 7.2% critical care. Residents comprised 60.7% of the sample, and 39.3% were attending physicians. Median intention to use IO access when IV is not immediately achievable was 4.67 (interquartile range [IQR] = 4 to 5) out of 5 (5 highest) and predicted by the following TPB constructs: attitudes (AdjCoefficients = 0.504; 95% confidence interval [CI] = 0.334 to 0.673), social influences (AdjCoefficients = 0.285; 95% CI = 0.172 to 0.398), and control beliefs (AdjCoefficients 0.217; 95% CI = 0.113 to 0.320). Physicians were more likely to use IO access if they believed that it provided rapid vascular access for delivering large volumes of fluids, could prevent delays in

Securing water quality and quantity: Research and development perspective

CSIR Research Space (South Africa)

Pienaar, H

2012-10-01

Full Text Available : ? economic growth & development ? human & environmental needs ? meeting international obligations ? energy needs (strategic water users) ? ensuring availability and allocation (all other users) ? CSIR 2012 Slide 3 Background ? SA 30th driest country... and quantity: Research and development perspective 4th Biennial Conference Harrison Pienaar 10 October 2012 Presentation outline ? Introduction and background to water in South Africa ? Transboundary water resource aspects ? Water related challenges...

Archives: South African Journal of Clinical Nutrition

African Journals Online (AJOL)

Items 1 - 50 of 53 ... Archives: South African Journal of Clinical Nutrition. Journal Home > Archives: South African Journal of Clinical Nutrition. Log in or Register to get access to full text downloads.

A randomized controlled pilot trial comparing the impact of access to clinical endocrinology video demonstrations with access to usual revision resources on medical student performance of clinical endocrinology skills.

Science.gov (United States)

Hibbert, Emily J; Lambert, Tim; Carter, John N; Learoyd, Diana L; Twigg, Stephen; Clarke, Stephen

2013-10-03

Demonstrating competence in clinical skills is key to course completion for medical students. Methods of providing clinical instruction that foster immediate learning and potentially serve as longer-term repositories for on-demand revision, such as online videos demonstrating competent performance of clinical skills, are increasingly being used. However, their impact on learning has been little studied. The aim of this study was to determine the value of adjunctive on-demand video-based training for clinical skills acquisition by medical students in endocrinology. Following an endocrinology clinical tutorial program, 2nd year medical students in the pre-assessment revision period were recruited and randomized to either a set of bespoke on-line clinical skills training videos (TV), or to revision as usual (RAU). The skills demonstrated on video were history taking in diabetes mellitus (DMH), examination for diabetes lower limb complications (LLE), and examination for signs of thyroid disease (TE). Students were assessed on these clinical skills in an observed structured clinical examination two weeks after randomization. Assessors were blinded to student randomization status. For both diabetes related clinical skills assessment tasks, students in the TV group performed significantly better than those in the RAU group. There were no between group differences in thyroid examination performance. For the LLE, 91.7% (n = 11/12) of students randomized to the video were rated globally as competent at the skill compared with 40% (n = 4/10) of students not randomized to the video (p = 0.024). For the DMH, 83.3% (n = 10/12) of students randomized to the video were rated globally as competent at the skill compared with 20% (n = 2/10) of students not randomized to the video (p = 0.007). Exposure to high quality videos demonstrating clinical skills can significantly improve medical student skill performance in an observed structured clinical examination of these skills, when

Experiences Accessing Abortion Care in Alabama among Women Traveling for Services.