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Sample records for controlled patient-preference equivalence

  1. Breaking bad news: patients' preferences and health locus of control.

    Science.gov (United States)

    Martins, Raquel Gomes; Carvalho, Irene Palmares

    2013-07-01

    To identify patients' preferences for models of communicating bad news and to explore how such preferences, and the reasons for the preferences, relate with personality characteristics, specifically patients' health locus of control (HLC): internal/external and 'powerful others' (PO). Seventy-two patients from an oncology clinic watched videotaped scenarios of a breaking bad news moment, selected the model they preferred, filled an HLC scale and were interviewed about their choices. Data were analyzed with Chi-square, Kruskal-Wallis and Mann-Whitney tests. Interviews were content-analyzed. 77.8% preferred an "empathic professional", 12.5% a "distanced expert" and 9.7% an "emotionally burdened expert". Preferences varied significantly with HLC scores (patients with higher internal locus of control (ILC) and lower PO preferred the empathic model), presence of cancer, age and education. Patients explained their preferences through aspects of Caring, Professionalism, Wording, Time and Hope. ILC registered significant differences in regards to Wording and Time, whereas PO was associated with Hope and Time. HLC is an important dimension that can help doctors to better know their patients. Knowing whether patients attribute their health to their own behaviors or to chance/others can help tailor the disclosure of bad news to their specific preferences. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. On the equivalence of chaos control systems

    International Nuclear Information System (INIS)

    Wang Xiaofan

    2003-01-01

    For a given chaotic system, different control systems can be constructed depending on which parameter is tuned or where the external input is added. We prove that two different feedback control systems are qualitatively equivalent if they are feedback linearizable

  3. Using a partially randomized patient preference study design to evaluate the therapeutic effect of acupuncture and cupping therapy for fibromyalgia: study protocol for a partially randomized controlled trial.

    Science.gov (United States)

    Cao, Hui-Juan; Liu, Jian-Ping; Hu, Hui; Wang, Nissi S

    2014-07-10

    Conducting randomized controlled trials on traditional Chinese non-drug therapies has been limited by factors such as patient preference to specific treatment modality. The aim of this study is to investigate the feasibility of applying a partially randomized patient preference (PRPP) trial model in evaluating the efficacy of two types of traditional Chinese medicine therapies, acupuncture and cupping, for fibromyalgia while accounting for patients' preference of either therapeutic modality. This protocol was approved by the Institutional Ethics Committee of affiliated Dongfang Hospital, Beijing University of Chinese Medicine (approval number: 2013052104-2). One hundred participants with fibromyalgia will be included in this study. Diagnosis of fibromyalgia will be based on the American College of Rheumatology criteria. Before treatment, participants will be interviewed for their preference toward acupuncture or cupping therapy. Fifty participants with no preference will be randomly assigned to one of the two groups and another 50 participants with strong preference to either acupuncture or cupping will receive what they choose. For acupuncture and cupping therapy, the main acupoints used will be tender points (Ashi). Treatment will be three times a week for 5 consecutive weeks with a follow-up period of 12 weeks. Outcome measures will be qualitative (patient expectation and satisfaction) and quantitative (pain intensity, quality of life, depression assessment). NCT01869712 (in clinicaltrials.gov, on 22nd May 2013).

  4. Patient controlled sedation using a standard protocol for dressing changes in burns: patients' preference, procedural details and a preliminary safety evaluation.

    Science.gov (United States)

    Nilsson, Andreas; Steinvall, Ingrid; Bak, Zoltan; Sjöberg, Folke

    2008-11-01

    Patient controlled sedation (PCS) enables patients to titrate doses of drugs by themselves during different procedures involving pain or discomfort. We studied it in a prospective crossover design using a fixed protocol without lockout time to examine it as an alternative method of sedation for changing dressings in burned patients. Eleven patients with >10% total burn surface area (TBSA) had their dressings changed, starting with sedation by an anaesthetist (ACS). The second dressing change was done with PCS (propofol/alfentanil) and the third time the patients had to choose ACS or PCS. During the procedures, data on cardiopulmonary variables, sedation (bispectral index), pain intensity (VAS), procedural details, doses of drugs, and patients' preferences were collected to compare the two sedation techniques. The study data indicated that wound care in burned patients is feasible with a standardized PCS protocol. The patients preferred PCS to ACS on the basis of self-control, and because they had less discomfort during the recovery period. Wound care was also considered adequate by the staff during PCS. No respiratory (respiratory rate/transcutaneous PCO(2)) or cardiovascular (heart rate/blood pressure) adverse events were recorded at any time during any of the PCS procedures. The doses of propofol and alfentanil and BIS index decrease were less during PCS than ACS. Procedural pain was higher during PCS but lower after the procedure. We suggest that PCS using a standard protocol is an interesting alternative to anaesthetist-provided sedation during dressing changes. It seems effective, saves resources, is safe, and at same time is preferred by the patients. The strength of these conclusions is, however, hampered by the small size of this investigation and therefore further studies are warranted.

  5. On equivalence classes in iterative learning control

    NARCIS (Netherlands)

    Verwoerd, M.H.A.; Meinsma, Gjerrit; de Vries, Theodorus J.A.

    2003-01-01

    This paper advocates a new approach to study the relation between causal iterative learning control (ILC) and conventional feedback control. Central to this approach is the introduction of the set of admissible pairs (of operators) defined with respect to a family of iterations. Considered are two

  6. The transfer of Cfunc contextual control through equivalence relations.

    Science.gov (United States)

    Perez, William F; Fidalgo, Adriana P; Kovac, Roberta; Nico, Yara C

    2015-05-01

    Derived relational responding is affected by contextual stimuli (Cfunc) that select specific stimulus functions. The present study investigated the transfer of Cfunc contextual control through equivalence relations by evaluating both (a) the maintenance of Cfunc contextual control after the expansion of a relational network, and (b) the establishment of novel contextual stimuli by the transfer of Cfunc contextual control through equivalence relations. Initially, equivalence relations were established and contingencies were arranged so that colors functioned as Cfunc stimuli controlling participants' key-pressing responses in the presence of any stimulus from a three-member equivalence network. To investigate the first research question, the three-member equivalence relations were expanded to five members and the novel members were presented with the Cfunc stimuli in the key-pressing task. To address the second goal of this study, the colors (Cfunc) were established as equivalent to certain line patterns. The transfer of contextual cue function (Cfunc) was tested replacing the colored backgrounds with line patterns in the key-pressing task. Results suggest that the Cfunc contextual control was transferred to novel stimuli that were added to the relational network. In addition, the line patterns indirectly acquired the contextual cue function (Cfunc) initially established for the colored backgrounds. The conceptual and applied implications of Cfunc contextual control are discussed. © Society for the Experimental Analysis of Behavior.

  7. Patient preferences for partner notification.

    Science.gov (United States)

    Apoola, A; Radcliffe, K W; Das, S; Robshaw, V; Gilleran, G; Kumari, B S; Boothby, M; Rajakumar, R

    2006-08-01

    To identify patient preferences for notification of sexual contacts when a sexually transmitted infection (STI) is diagnosed. A questionnaire survey of 2544 patients attending three large genitourinary clinics at Derby, Birmingham, and Coventry in the United Kingdom. The median age of the respondents was 24 with 1474 (57.9%) women, 1835 (72.1%) white, 1826 (71.8%) single. The most favoured method of partner notification was patient referral, which was rated a "good" method by 65.8% when they had to be contacted because a sexual partner has an STI. Notifying contacts by letter as a method of provider partner notification is more acceptable than phoning, text messaging, or email. Respondents with access to mobile telephones, private emails, and private letters were more likely to rate a method of partner notification using that mode of communication as "good" compared to those without. With provider referral methods of partner notification respondents preferred to receive a letter, email, or text message asking them to contact the clinic rather than a letter, email or text message informing them that they may have an STI. Most respondents think that being informed directly by a partner is the best method of being notified of the risk of an STI. Some of the newer methods may not be acceptable to all but a significant minority of respondents prefer these methods of partner notification. The wording of letters, emails, or text messages when used for partner notification has an influence on the acceptability of the method and may influence success of the partner notification method. Services should be flexible enough to utilise the patients' preferred method of partner notification.

  8. Patients' preferences for patient-centered communication

    DEFF Research Database (Denmark)

    Lau, Sofie Rosenlund; Christensen, Søren Troels; Andreasen T., Jesper

    2013-01-01

    To investigate patients' preferences for patient-centered communication (PCC) in the encounter with healthcare professionals in an outpatient department in rural Sierra Leone.......To investigate patients' preferences for patient-centered communication (PCC) in the encounter with healthcare professionals in an outpatient department in rural Sierra Leone....

  9. Patients' preferences for nurses' gender in Jordan.

    Science.gov (United States)

    Ahmad, Muayyad M; Alasad, Jafar A

    2007-08-01

    The purpose of the study was to examine patients' preferences for nurses' gender in Jordan. The public, private and university hospitals are represented by selecting one major hospital from each health sector. The sample size was 919 participants. Data were collected by a questionnaire through standardized individual interviews with patients. The findings of the study indicate that gender preferences are stronger among female patients than among male patients. Furthermore, two-thirds of female patients preferred female nurses, whereas only 3.4% preferred male nurses to care for them. In contrast, one-third of male patients' preferred male nurses, and only 10% preferred female nurses. The authors recommend that the high percentage of male nursing students need to be reconsidered by health policy-makers in Jordan.

  10. Equivalent electricity storage capacity of domestic thermostatically controlled loads

    International Nuclear Information System (INIS)

    Sossan, Fabrizio

    2017-01-01

    A method to quantify the equivalent storage capacity inherent the operation of thermostatically controlled loads (TCLs) is developed. Equivalent storage capacity is defined as the amount of power and electricity consumption which can be deferred or anticipated in time with respect to the baseline consumption (i.e. when no demand side event occurs) without violating temperature limits. The analysis is carried out for 4 common domestic TCLs: an electric space heating system, freezer, fridge, and electric water heater. They are simulated by applying grey-box thermal models identified from measurements. They describe the heat transfer of the considered TCLs as a function of the electric power consumption and environment conditions. To represent typical TCLs operating conditions, Monte Carlo simulations are developed, where models inputs and parameters are sampled from relevant statistical distributions. The analysis provides a way to compare flexible demand against competitive storage technologies. It is intended as a tool for system planners to assess the TCLs potential to support electrical grid operation. In the paper, a comparison of the storage capacity per unit of capital investment cost is performed considering the selected TCLs and two grid-connected battery storage systems (a 720 kVA/500 kWh lithium-ion unit and 15 kVA/120 kWh Vanadium flow redox) is performed. - Highlights: • The equivalent storage capacity of domestic TCLs is quantified • A comparison with battery-based storage technologies is performed • We derive metrics for system planners to plan storage in power system networks • Rule-of-thumb cost indicators for flexible demand and battery-based storage

  11. An investigation into the equivalent parameter method for homogeneous transport equivalent parameters for use in fast reactor control assemblies

    International Nuclear Information System (INIS)

    Tullett, J.D.

    1990-01-01

    P Benoist has developed a method for calculating cross-sections for Fast Reactor control rods and their followers described by a single homogenised region (the Equivalent Parameter Method). When used in a diffusion theory calculation, these equivalent cross-sections should give the same rod worth as one would obtain from a transport theory calculation with a heterogeneous description of the control rod and the follower. In this report, Benoist's theory is described, and a comprehensive set of tests is presented. These tests show that the method gives very good results over a range of geometries and control rod positions for a model fast reactor core. (author)

  12. Psychiatric patients' preferences and experiences in clinical decision-making: examining concordance and correlates of patients' preferences.

    Science.gov (United States)

    De las Cuevas, Carlos; Peñate, Wenceslao; de Rivera, Luis

    2014-08-01

    To assess the concordance between patients' preferred role in clinical decision-making and the role they usually experience in their psychiatric consultations and to analyze the influence of socio-demographic, clinical and personality characteristics on patients' preferences. 677 consecutive psychiatric outpatients were invited to participate in a cross-sectional survey and 507 accepted. Patients completed Control Preference Scale twice consecutively before consultation, one for their preferences of participation and another for the style they usually experienced until then, and locus of control and self-efficacy scales. Sixty-three percent of psychiatric outpatients preferred a collaborative role in decision-making, 35% preferred a passive role and only a 2% an active one. A low concordance for preferred and experienced participation in medical decision-making was registered, with more than a half of patients wanting a more active role than they actually had. Age and doctors' health locus of control orientation were found to be the best correlates for participation preferences, while age and gender were for experienced. Psychiatric diagnoses registered significant differences in patients' preferences of participation but no concerning experiences. The limited concordance between preferred and experienced roles in psychiatric patients is indicative that clinicians need to raise their sensitivity regarding patient's participation. The assessment of patient's attribution style should be useful for psychiatrist to set objectives and priority in the communication with their patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Patients' preferences for doctors' attire in Japan.

    Science.gov (United States)

    Yamada, Yasuhiro; Takahashi, Osamu; Ohde, Sachiko; Deshpande, Gautam A; Fukui, Tsuguya

    2010-01-01

    Physicians' attire is one important factor to enhance the physician-patient relationship. However, there are few studies that examine patients' preferences for physicians' attire in Japan. We sought to assess patients' preference regarding doctors' attire and to assess the influence of doctors' attire on patients' confidence in their physician. Furthermore, we examined whether patients' preferences would change among various clinical situations. Employing a cross-sectional design, Japanese outpatients chosen over one week in October 2008 from waiting rooms in various outpatient departments at St. Luke's International Hospital, Tokyo, were given a 10-item questionnaire. A 5-point Likert scale was used to estimate patient preference for four types of attire in both male and female physicians, including semi-formal attire, white coat, surgical scrubs, and casual wear. In addition, a 4-point Likert Scale was used to measure the influence of doctors' attire on patient confidence. Japanese outpatients consecutively chosen from waiting rooms at St. Luke's International Hospital in Tokyo for one week in October 2008. Of 2,272 outpatients enrolled, 1483 (67.1%) of respondents were women. Mean age of subjects was 53.8 years (SD 16.2 years). Respondents most preferred the white coat (mean rank: 4.18, SD: 0.75) and preferred casual attire the least (mean rank: 2.32, SD: 0.81). For female physicians, 1.4% of respondents ranked the white coat little/least preferred while 64.7% of respondents ranked casual wear little/least preferred. Among respondents who most preferred the white coat for physician attire, perceived hygiene (62.7%) and inspiring confidence (59.3%) were important factors for doctor's attire. Around 70% of all respondents reported that physicians' attire has an influence on their confidence in their physician. This study confirms that Japanese outpatients prefer a white coat. Furthermore, this study strongly suggests that wearing a white coat could favorably

  14. Would Your Patient Prefer to Be Considered Your Friend? Patient Preferences in Physician Relationships

    Science.gov (United States)

    Magnezi, Racheli; Bergman, Lisa Carroll; Urowitz, Sara

    2015-01-01

    Objectives. To understand how patient preferences and perceptions of their relationship with their doctor (as patient, friend, partner, client, consumer, or insured) affects confidence in care provided and participation in health care. Methods. Telephone questionnaire to 2,135 households, representative of the population in Israel. Results. A…

  15. Two-group Current-equivalent Parameters for Control Rod Cells. Autocode Programme CRCC

    Energy Technology Data Exchange (ETDEWEB)

    Norinder, O; Nyman, K

    1962-06-15

    In two-group neutron diffusion calculations there is mostly necessary to describe the influence of control rods by equivalent homogeneous two-group parameters in regions about the control rods. The problem is solved for a control rod in a medium characterized by two-group parameters. The property of fast and thermal neutr. on current equivalence is selected to obtain equivalent two-group parameters for a homogeneous cell with the same radius as the control rod cell. For the parameters determined one obtains the same fast and thermal neutron current into the rod cell and the equivalent cell independent of the fast and thermal flux amplitudes on the cell boundaries. The equivalent parameters are obtained as a solution of a system of transcendental equations. A Ferranti Mercury Autocode performing the solution is described. Calculated equivalent parameters for control rods in a heavy water lattice are given for some representative cases.

  16. TOIB Study. Are topical or oral ibuprofen equally effective for the treatment of chronic knee pain presenting in primary care: a randomised controlled trial with patient preference study. [ISRCTN79353052

    Directory of Open Access Journals (Sweden)

    Parsons Suzanne

    2005-11-01

    Full Text Available Abstract Background Many older people have chronic knee pain. Both topical and oral non- steroidal anti-inflammatory drugs (NSAIDs are commonly used to treat this. Oral NSAIDS are effective, at least in the short term, but can have severe adverse effects. Topical NSAIDs also appear to be effective, at least in the short term. One might expect topical NSAIDs both to be less effective and to have fewer adverse effects than oral NSAIDs. If topical NSAIDs have fewer adverse effects this may outweigh both the reduction in effectiveness and the higher cost of topical compared to oral treatment. Patient preferences may influence the comparative effectiveness of drugs delivered via different routes. Methods TOIB is a randomised trial comparing topical and oral ibuprofen, with a parallel patient preference study. We are recruiting people aged 50 or over with chronic knee pain, from 27 MRC General Practice Research Framework practices across the UK. We are seeking to recruit 283 participants to the RCT and 379 to the PPS. Participants will be followed up for up to two years (with the majority reaching one year. Outcomes will be assessed by postal questionnaire, nurse examination, laboratory tests and medical record searches at one and two years or the end of the study. Discussion This study will provide new evidence on the overall costs and benefits of treating chronic knee pain with either oral or topical ibuprofen. The use of a patient preference design is unusual, but will allow us to explore how preference influences response to a medication. In addition, it will provide more information on adverse events. This study will provide evidence to inform primary care practitioners, and possibly influence practice.

  17. Patient controlled analgesia with remifentanil versus epidural analgesia in labour: randomised multicentre equivalence trial

    NARCIS (Netherlands)

    Freeman, Liv M.; Bloemenkamp, Kitty W.; Franssen, Maureen T.; Papatsonis, Dimitri N.; Hajenius, Petra J.; Hollmann, Markus W.; Woiski, Mallory D.; Porath, Martina; van den Berg, Hans J.; van Beek, Erik; Borchert, Odette W. H. M.; Schuitemaker, Nico; Sikkema, J. Marko; Kuipers, A. H. M.; Logtenberg, Sabine L. M.; van der Salm, Paulien C. M.; Oude Rengerink, Katrien; Lopriore, Enrico; van den Akker-van Marle, M. Elske; le Cessie, Saskia; van Lith, Jan M.; Struys, Michel M.; Mol, Ben Willem J.; Dahan, Albert; Middeldorp, Johanna M.

    2015-01-01

    To determine women's satisfaction with pain relief using patient controlled analgesia with remifentanil compared with epidural analgesia during labour. Multicentre randomised controlled equivalence trial. 15 hospitals in the Netherlands. Women with an intermediate to high obstetric risk with an

  18. Labour pain with remifentanil patient-controlled analgesia versus epidural analgesia : a randomised equivalence trial

    NARCIS (Netherlands)

    Logtenberg, Slm; Oude Rengerink, K; Verhoeven, C J; Freeman, L M; van den Akker, Esa; Godfried, M B; van Beek, E; Borchert, Owhm; Schuitemaker, N; van Woerkens, Ecsm; Hostijn, I; Middeldorp, J M; van der Post, J A; Mol, B W

    OBJECTIVE: To distinguish satisfaction with pain relief using remifentanil patient-controlled analgesia (RPCA) compared with epidural analgesia (EA) in low-risk labouring women. DESIGN: Randomised controlled equivalence trial. SETTING: Eighteen midwifery practices and six hospitals in the

  19. Patient controlled analgesia with remifentanil versus epidural analgesia in labour : randomised multicentre equivalence trial

    NARCIS (Netherlands)

    Freeman, Liv M; Bloemenkamp, Kitty W; Franssen, Maureen T; Papatsonis, Dimitri N; Hajenius, Petra J; Hollmann, Markus W; Woiski, Mallory D; Porath, Martina; van den Berg, Hans J; van Beek, Erik; Borchert, Odette W H M; Schuitemaker, Nico; Sikkema, J Marko; Kuipers, A H M; Logtenberg, Sabine L M; van der Salm, Paulien C M; Oude Rengerink, Katrien; Lopriore, Enrico; van den Akker-van Marle, M Elske; le Cessie, Saskia; van Lith, Jan M; Struys, Michel M; Mol, Ben Willem J; Dahan, Albert; Middeldorp, Johanna M; Oude Rengerink, K

    2015-01-01

    OBJECTIVE: To determine women's satisfaction with pain relief using patient controlled analgesia with remifentanil compared with epidural analgesia during labour. DESIGN: Multicentre randomised controlled equivalence trial. SETTING: 15 hospitals in the Netherlands. PARTICIPANTS: Women with an

  20. Patient controlled analgesia with remifentanil versus epidural analgesia in labour : randomised multicentre equivalence trial

    NARCIS (Netherlands)

    Freeman, Liv M.; Bloemenkamp, Kitty W.; Franssen, Maureen T.; Papatsonis, Dimitri N.; Hajenius, Petra J.; Hollmann, Markus W.; Woiski, Mallory D.; Porath, Martina; van den Berg, Hans J.; van Beek, Erik; Borchert, Odette W. H. M.; Schuitemaker, Nico; Sikkema, J. Marko; Kuipers, A. H. M.; Logtenberg, Sabine L. M.; van der Salm, Paulien C. M.; Rengerink, Katrien Oude; Lopriore, Enrico; van den Akker-van Marle, M. Elske; le Cessie, Saskia; van Lith, Jan M.; Struys, Michel M.; Mol, Ben Willem J.; Dahan, Albert; Middeldorp, Johanna M.

    2015-01-01

    Objective To determine women's satisfaction with pain relief using patient controlled analgesia with remifentanil compared with epidural analgesia during labour. Design Multicentre randomised controlled equivalence trial. Setting 15 hospitals in the Netherlands. Participants Women with an

  1. Patient controlled analgesia with remifentanil versus epidural analgesia in labour: randomised multicentre equivalence trial

    NARCIS (Netherlands)

    Freeman, L.M.; Bloemenkamp, K.W.; Franssen, M.T.; Papatsonis, D.N.; Hajenius, P.J.; Hollmann, M.W.; Woiski, M.D.; Porath, M.; Berg, H.J. van den; Beek, E. van; Borchert, O.W.; Schuitemaker, N.; Sikkema, J.M.; Kuipers, A.H.; Logtenberg, S.L.; Salm, P.C. van der; Oude Rengerink, K.; Lopriore, E.; Akker-van Marle, M.E. van den; Cessie, S. le; Lith, J.M. van; Struys, M.M.; Mol, B.W.; Dahan, A; Middeldorp, J.M.

    2015-01-01

    OBJECTIVE: To determine women's satisfaction with pain relief using patient controlled analgesia with remifentanil compared with epidural analgesia during labour. DESIGN: Multicentre randomised controlled equivalence trial. SETTING: 15 hospitals in the Netherlands. PARTICIPANTS: Women with an

  2. Equivalence of Primary Control Strategies for AC and DC Microgrids

    Directory of Open Access Journals (Sweden)

    Eneko Unamuno

    2017-01-01

    Full Text Available Microgrid frequency and voltage regulation is a challenging task, as classical generators with rotational inertia are usually replaced by converter-interfaced systems that inherently do not provide any inertial response. The aim of this paper is to analyse and compare autonomous primary control techniques for alternating current (AC and direct current (DC microgrids that improve this transient behaviour. In this context, a virtual synchronous machine (VSM technique is investigated for AC microgrids, and its behaviour for different values of emulated inertia and droop slopes is tested. Regarding DC microgrids, a virtual-impedance-based algorithm inspired by the operation concept of VSMs is proposed. The results demonstrate that the proposed strategy can be configured to have an analogous behaviour to VSM techniques by varying the control parameters of the integrated virtual-impedances. This means that the steady-state and transient behaviour of converters employing these strategies can be configured independently. As shown in the simulations, this is an interesting feature that could be, for instance, employed for the integration of different dynamic generation or storage systems, such as batteries or supercapacitors.

  3. Controlling Relations in Baseline Conditional Discriminations as Determinants of Stimulus Equivalence

    Science.gov (United States)

    de Rose, Julio C.; Hidalgo, Matheus; Vasconcellos, Mariliz

    2013-01-01

    Variation in baseline controlling relations is suggested as one of the factors determining variability in stimulus equivalence outcomes. This study used single- comparison trials attempting to control such controlling relations. Four children learned AB, BC, and CD conditional discriminations, with 2 samples and 2 comparison stimuli. In Condition…

  4. Periodic equivalence ratio modulation method and apparatus for controlling combustion instability

    Science.gov (United States)

    Richards, George A.; Janus, Michael C.; Griffith, Richard A.

    2000-01-01

    The periodic equivalence ratio modulation (PERM) method and apparatus significantly reduces and/or eliminates unstable conditions within a combustion chamber. The method involves modulating the equivalence ratio for the combustion device, such that the combustion device periodically operates outside of an identified unstable oscillation region. The equivalence ratio is modulated between preselected reference points, according to the shape of the oscillation region and operating parameters of the system. Preferably, the equivalence ratio is modulated from a first stable condition to a second stable condition, and, alternatively, the equivalence ratio is modulated from a stable condition to an unstable condition. The method is further applicable to multi-nozzle combustor designs, whereby individual nozzles are alternately modulated from stable to unstable conditions. Periodic equivalence ratio modulation (PERM) is accomplished by active control involving periodic, low frequency fuel modulation, whereby low frequency fuel pulses are injected into the main fuel delivery. Importantly, the fuel pulses are injected at a rate so as not to affect the desired time-average equivalence ratio for the combustion device.

  5. Calculation of the Reactivity Equivalence of Control Rods in the Second Charge of the HBWR

    International Nuclear Information System (INIS)

    Weissglas, P.

    1960-11-01

    Full text: Using current methods the reactivity equivalence of 19 31 and 37 centrally located control rods in the second charge of the HBWR has been calculated. An estimate of the available excess reactivity with clean cold core has also been made. Insertion depth was taken as 0, l/3, 2/3 and 3/3 of the core length

  6. Calculation of the Reactivity Equivalence of Control Rods in the Second Charge of the HBWR.

    Energy Technology Data Exchange (ETDEWEB)

    Weissglas, P [The Swedish State Power Board, Stockholm (Sweden)

    1960-11-15

    Full text: Using current methods the reactivity equivalence of 19 31 and 37 centrally located control rods in the second charge of the HBWR has been calculated. An estimate of the available excess reactivity with clean cold core has also been made. Insertion depth was taken as 0, l/3, 2/3 and 3/3 of the core length.

  7. Equivalent to Represent Inertial and Primary Frequency Control Effects of an External System

    DEFF Research Database (Denmark)

    Weckesser, Johannes Tilman Gabriel; Van Cutsem, Thierry

    2017-01-01

    This paper presents a novel equivalent, which is suitable for simulation of inertial and primary frequency control effects. In the model reduction procedure, dynamic power injectors are used to replace the external system and to mimic its dynamic behavior. The parameters of the equivalents...... are tuned with a simple approach presented in this paper. The effectiveness of the proposed method is demonstrated on a modified version of the ENTSO-E Dynamic Study Model. The results show that the system frequency response of the unreduced system is retained and a speedup of the simulations of around 4...

  8. Best available technology equivalent controls for B Plant Process Condensate: Tank farm process technology section

    International Nuclear Information System (INIS)

    1988-11-01

    This report evaluates whether proposed controls for the B Plant Process Condensate effluent stream are equivalent to Best Available Technology (BAT) economically achievable. Methods to determine whether the proposed controls for the BCP were equivalent to BAT originated from the Guidance Document for the Hanford Site. The BAT performance standards, which originate from the Clean Water Act, are to be applied to all contaminated liquid effluent discharges currently going to the soil column at the Hanford Site. The B Plant BAT evaluation addressed pollutants that had not been regulated traditionally under Federal or State water-pollution control programs. As a result, only comparisons could be made to existing radiation and water quality standards, and a BAT determination based on the effluent guidelines method (as outlined in the BAT Guidance Document) was not possible. Due to the variability and inconsistency of factors with comparable streams, such as the effluent stream at the Savannah River Plant, a BAT determination by the technology transfer method and treatability studies method was not possible. By using the generic treatment systems method, a one-or two-stage treatment system for dissolved solids removal was concluded to be equivalent to BAT. By performing two economic achievability tests, a one-stage treatment system consisting of mixed bed ion exchange columns was considered to be cost effective and equivalent to BAT. 13 refs., 4 figs., 5 tabs

  9. Determination of equivalent cross sections for representation of control rod regions in diffusion calculations

    International Nuclear Information System (INIS)

    Scherer, W.; Neef, H.J.

    1976-07-01

    The representation of control rod regions in reactor calculations requires a combination of transport and diffusion theory calculations. A method is described which produces equivalent cross sections for a rodded region. These cross sections used in a diffusion theory calcualtion yield the same rod efficiency and reaction rate distribution as the transport theory calculation for the explicit heterogeneous control rod. The description of the method is complemented by sample problems. (orig.) [de

  10. An Equivalent Emission Minimization Strategy for Causal Optimal Control of Diesel Engines

    Directory of Open Access Journals (Sweden)

    Stephan Zentner

    2014-02-01

    Full Text Available One of the main challenges during the development of operating strategies for modern diesel engines is the reduction of the CO2 emissions, while complying with ever more stringent limits for the pollutant emissions. The inherent trade-off between the emissions of CO2 and pollutants renders a simultaneous reduction difficult. Therefore, an optimal operating strategy is sought that yields minimal CO2 emissions, while holding the cumulative pollutant emissions at the allowed level. Such an operating strategy can be obtained offline by solving a constrained optimal control problem. However, the final-value constraint on the cumulated pollutant emissions prevents this approach from being adopted for causal control. This paper proposes a framework for causal optimal control of diesel engines. The optimization problem can be solved online when the constrained minimization of the CO2 emissions is reformulated as an unconstrained minimization of the CO2 emissions and the weighted pollutant emissions (i.e., equivalent emissions. However, the weighting factors are not known a priori. A method for the online calculation of these weighting factors is proposed. It is based on the Hamilton–Jacobi–Bellman (HJB equation and a physically motivated approximation of the optimal cost-to-go. A case study shows that the causal control strategy defined by the online calculation of the equivalence factor and the minimization of the equivalent emissions is only slightly inferior to the non-causal offline optimization, while being applicable to online control.

  11. Preliminary Study on Structural Optimization with Control Variables Using Equivalent Static Loads for Spring-damper Control Systems

    International Nuclear Information System (INIS)

    Yoo, Nam-sun; Jung, Ui-Jin; Park, Gyung-Jin; Kim, Tai-Kyung

    2014-01-01

    An optimization method is proposed for the simultaneous design of structural and control systems using the equivalent static loads. In the past researches, the control parameters of such feedback gains are obtained to improve some performance in the steady-state. However, the actuators which have position and velocity feedback gains should be designed to exhibit a good performance in the time domain. In other words, the system analysis should be conducted for the transient-state in dynamic manner. In this research, a new equivalent static loads method is presented to treat the control variables as the design variables. The equivalent static loads (ESLs) set is defined as a static load set which generates the same displacement field as that from dynamic loads at a certain time. The calculated sets of ESLs are applied as multiple loading conditions in the optimization process. Several examples are solved to validate the proposed method

  12. Patients' preferences for headache acute and preventive treatment.

    Science.gov (United States)

    Mitsikostas, Dimos D; Belesioti, Ioanna; Arvaniti, Chryssa; Mitropoulou, Euthymia; Deligianni, Christina; Kasioti, Elina; Constantinidis, Theodoros; Dermitzakis, Manolis; Vikelis, Michail

    2017-10-06

    We aimed to explore patients' preferences for headache treatments with a self-administered questionnaire including the Q-No questionnaire for nocebo. Questionnaires from 514 outpatients naïve to neurostimulation and monoclonal antibodies were collected. Patients assessed that the efficacy of a treatment is more important than safety or route of administration. They preferred to use an external neurostimulation device for both acute (67.1%) and preventive treatment (62.8%). Most patients preferred to take a pill (86%) than any other drug given parenterally for symptomatic pharmaceutical treatment. For preventive pharmaceutical treatment, most patients preferred to take a pill once per day (52%) compared to an injection either subcutaneously or intravenously each month (9% and 4%), or three months (15% and 11%). 56.6% of all participants scored more than 15 in Q-No questionnaire indicating potential nocebo behaviors that contributed significantly in their choices. These patient preferences along with efficacy and safety data may help physicians better choose the right treatment for the right person.

  13. Assessing patient preferences in heart failure using conjoint methodology

    Directory of Open Access Journals (Sweden)

    Pisa G

    2015-08-01

    Full Text Available Giovanni Pisa,1 Florian Eichmann,1 Stephan Hupfer21Kantar Health GmbH, Munich, Germany; 2Novartis Pharma GmbH, Nuernberg, GermanyAim: The course of heart failure (HF is characterized by frequent hospitalizations, a high mortality rate, as well as a severely impaired health-related quality of life (HRQoL. To optimize disease management, understanding of patient preferences is crucial. We aimed to assess patient preferences using conjoint methodology and HRQoL in patients with HF.Methods: Two modules were applied: an initial qualitative module, consisting of in-depth interviews with 12 HF patients, and the main quantitative module in 300 HF patients from across Germany. Patients were stratified according to the time of their last HF hospitalization. Each patient was presented with ten different scenarios during the conjoint exercise. Additionally, patients completed the generic HRQoL instrument, EuroQol health questionnaire (EQ-5D™.Results: The attribute with the highest relative importance was dyspnea (44%, followed by physical capacity (18%. Of similar importance were exhaustion during mental activities (13%, fear due to HF (13%, and autonomy (12%. The most affected HRQoL dimensions according to the EQ-5D questionnaire were anxiety/depression (23% with severe problems, pain/discomfort (19%, and usual activities (15%. Overall average EQ-5D score was 0.39 with stable, chronic patients (never hospitalized having a significantly better health state vs the rest of the cohort.Conclusion: This paper analyzed patient preference in HF using a conjoint methodology. The preference weights resulting from the conjoint analysis could be used in future to design HRQoL questionnaires which could better assess patient preferences in HF care.Keywords: heart failure, quality of life, conjoint analysis, utility, patient preference

  14. Robust equivalent consumption-based controllers for a dual-mode diesel parallel HEV

    International Nuclear Information System (INIS)

    Finesso, Roberto; Spessa, Ezio; Venditti, Mattia

    2016-01-01

    Highlights: • Non-plug-in dual-mode parallel hybrid architecture. • Cross-validation machine-learning for robust equivalent consumption-based controllers. • Optimal control strategy based on fuel consumption, NOx and battery aging. • Impact of different equivalent consumption definitions on HEV performance. • Correlation between vehicle braking energy and SOC variation in the traction stages. - Abstract: New equivalent consumption minimization strategy (ECMS) tools have been developed and applied to identify the optimal control strategy of a dual-mode parallel hybrid electric vehicle equipped with a compression-ignition engine. In this architecture, the electric machine is coupled to the engine through either a single-speed gearbox (torque-coupling) or a planetary gear set (speed-coupling). One of the main novelties of the present study concerns the definition of the instantaneous equivalent consumption (EC) function, which takes into account not only fuel consumption (FC) and the energy flow through the electric components, but also NO_x emissions, battery aging, and the battery SOC. The EC function has been trained using a cross-validation machine-learning technique, based on a genetic algorithm, where the training data set has been selected in order to maximize performances over a testing data set. The adoption of this technique, in conjunction with the new definition of EC, have led to the identification of very robust controllers, which provide an accurate control for different driving scenarios, even when the EC function is not specifically trained on the same missions over which it is tested. To this aim, a data set of fifty driving cycles and six user-defined missions, which cover a total distance of 70–100 km, has been considered as a training driving set. The ECMS controllers can be implemented in a vehicle control unit, and their performance has resulted to be close to that of a dynamic programming tool, which has here been used as benchmark

  15. Patient Preferences and Physician Practice Patterns Regarding Breast Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Hoopes, David J., E-mail: david.hoopes@wpafb.af.mil [Uniformed Services University of the Health Sciences, Department of Radiology and Radiological Sciences, WPAFB, OH (United States); Kaziska, David; Chapin, Patrick [Air Force Institute of Technology, WPAFB, OH (United States); Weed, Daniel [Clarian Healthcare, Methodist Hospital, Department of Radiation Oncology, Indianapolis, IN (United States); Smith, Benjamin D. [M.D. Anderson Cancer Center, Department of Radiation Oncology, Houston, TX (United States); Hale, E. Ronald [Wright-Patterson Medical Center, Department of Radiation Oncology, WPAFB, OH (United States); Johnstone, Peter A. [Indiana University School of Medicine, Department of Radiation Oncology, Indianapolis, IN (United States)

    2012-02-01

    Purpose: There are multiple current strategies for breast radiotherapy (RT). The alignment of physician practice patterns with best evidence and patient preferences will enhance patient autonomy and improve cancer care. However, there is little information describing patient preferences for breast RT and physician practice patterns. Methods and Materials: Using a reliable and valid instrument, we assessed the preferences of 5,000 randomly selected women (with or without cancer) undergoing mammography. To assess practice patterns, 2,150 randomly selected physician-members of American Society for Radiation Oncology were surveyed. Results: A total of 1,807 women (36%) and 363 physicians (17%) provided usable responses. The 95% confidence interval is < {+-}2.3% for patients and < {+-}5.3% for physicians. Patient preferences were hypofractionated whole breast irradiation (HF-WBI) 62%, partial breast irradiation (PBI) 28%, and conventionally fractionated whole breast irradiation (CF-WBI) 10%. By comparison, 82% of physicians use CF-WBI for more than 2/3 of women and 56% never use HF-WBI. With respect to PBI, 62% of women preferred three-dimensional (3D)-PBI and 38% favor brachytherapy-PBI, whereas 36% of physicians offer 3D-PBI and 66% offer brachytherapy-PBI. 70% of women prefer once-daily RT over 10 days vs. twice-daily RT over 5 days. 55% of physicians who use PBI do not offer PBI on clinical trial. Conclusions: HF-WBI, while preferred by patients and supported by evidence, falls behind the unproven and less preferred strategy of PBI in clinical practice. There is a discrepancy between women's preferences for PBI modality and type of PBI offered by physicians. Further alignment is needed between practice patterns, patient preferences, and clinical evidence.

  16. Patient Preferences and Physician Practice Patterns Regarding Breast Radiotherapy

    International Nuclear Information System (INIS)

    Hoopes, David J.; Kaziska, David; Chapin, Patrick; Weed, Daniel; Smith, Benjamin D.; Hale, E. Ronald; Johnstone, Peter A.

    2012-01-01

    Purpose: There are multiple current strategies for breast radiotherapy (RT). The alignment of physician practice patterns with best evidence and patient preferences will enhance patient autonomy and improve cancer care. However, there is little information describing patient preferences for breast RT and physician practice patterns. Methods and Materials: Using a reliable and valid instrument, we assessed the preferences of 5,000 randomly selected women (with or without cancer) undergoing mammography. To assess practice patterns, 2,150 randomly selected physician-members of American Society for Radiation Oncology were surveyed. Results: A total of 1,807 women (36%) and 363 physicians (17%) provided usable responses. The 95% confidence interval is < ±2.3% for patients and < ±5.3% for physicians. Patient preferences were hypofractionated whole breast irradiation (HF-WBI) 62%, partial breast irradiation (PBI) 28%, and conventionally fractionated whole breast irradiation (CF-WBI) 10%. By comparison, 82% of physicians use CF-WBI for more than 2/3 of women and 56% never use HF-WBI. With respect to PBI, 62% of women preferred three-dimensional (3D)-PBI and 38% favor brachytherapy-PBI, whereas 36% of physicians offer 3D-PBI and 66% offer brachytherapy-PBI. 70% of women prefer once-daily RT over 10 days vs. twice-daily RT over 5 days. 55% of physicians who use PBI do not offer PBI on clinical trial. Conclusions: HF-WBI, while preferred by patients and supported by evidence, falls behind the unproven and less preferred strategy of PBI in clinical practice. There is a discrepancy between women’s preferences for PBI modality and type of PBI offered by physicians. Further alignment is needed between practice patterns, patient preferences, and clinical evidence.

  17. Patient preferences in the treatment of diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Wirostko B

    2011-05-01

    Full Text Available Barbara Wirostko1, Kathleen Beusterien2, Jessica Grinspan2, Thomas Ciulla3, John Gonder4, Alexandra Barsdorf1, Andreas Pleil51Pfizer, New York, NY, USA; 2Oxford Outcomes, Bethesda, MD, USA; 3Midwest Eye Institute, Indianapolis, IN, USA; 4Ivey Eye Institute, London, Ontario, Canada; 5Pfizer Inc, San Diego, CA, USAObjective: Accounting for patient preferences may be especially important in diabetes mellitus, given the challenge in identifying factors associated with treatment adherence. Although preference studies have been performed in diabetes, none have examined treatments used in diabetic retinopathy (DR. The objective of this study was to elicit patient preferences for attributes associated with antivascular endothelial growth factor, focal and panretinal laser, and steroid therapy used in DR management.Methods: A cross-sectional conjoint survey was administered to DR patients at three Canadian eye centers. The survey involved making tradeoffs among 11 DR treatment attributes, including the chance of improving vision and risks of adverse events over a 1-year treatment period. Attribute utilities were summed for each product profile to determine the most preferred treatment.Results: Based on the results from 161 patients, attributes affecting visual functioning, including improving visual acuity and reducing adverse events (eg, chance of cataracts, were more important than those not directly affecting vision (eg, administration. Overall, 52%, 20%, 17%, and 11% preferred the product profiles matching to the antivascular endothelial growth factor, steroid, focal laser, and panretinal laser therapies. Preferences did not vary substantially by previous treatment experience, age, or type of DR (macular edema, proliferative DR, both or neither, with the exception that more macular edema only patients preferred focal laser over steroid treatment (19% versus 14%, respectively.Conclusions: When considering the potential effects of treatment over a 1

  18. Patient Preferences for Managing Insomnia: A Discrete Choice Experiment.

    Science.gov (United States)

    Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Saini, Bandana; Laba, Tracey-Lea

    2018-03-03

    Despite the rapid development of effective treatments, both pharmacological and non-pharmacological, insomnia management remains suboptimal at the practice interface. Patient preferences play a critical role in influencing treatment outcomes. However, there is currently a mismatch between patient preferences and clinician recommendations, partly perpetuated by a limited understanding of the patients' decision-making process. The aim of our study was to empirically quantify patient preferences for treatment attributes common to both pharmacological and non-pharmacological insomnia treatments. An efficient dual-response discrete choice experiment was conducted to evaluate patient treatment preferences for managing insomnia. The sample included 205 patients with self-reported insomnia and an Insomnia Severity Index ≥ 14. Participants were presented with two unlabelled hypothetical scenarios with an opt-out option across 12 choice sets. Data were analyzed using a mixed multinomial logit model to investigate the influence of five attributes (i.e. time, onset of action, maintainability of improved sleep, length of treatment, and monthly cost) on treatment preferences. Treatments were preferentially viewed if they conferred long-term sleep benefits (p managing insomnia.

  19. Tensor Product Model Transformation Based Adaptive Integral-Sliding Mode Controller: Equivalent Control Method

    Directory of Open Access Journals (Sweden)

    Guoliang Zhao

    2013-01-01

    Full Text Available This paper proposes new methodologies for the design of adaptive integral-sliding mode control. A tensor product model transformation based adaptive integral-sliding mode control law with respect to uncertainties and perturbations is studied, while upper bounds on the perturbations and uncertainties are assumed to be unknown. The advantage of proposed controllers consists in having a dynamical adaptive control gain to establish a sliding mode right at the beginning of the process. Gain dynamics ensure a reasonable adaptive gain with respect to the uncertainties. Finally, efficacy of the proposed controller is verified by simulations on an uncertain nonlinear system model.

  20. Factors associated with patient preferences for communication of bad news.

    Science.gov (United States)

    Fujimori, Maiko; Akechi, Tatsuo; Uchitomi, Yosuke

    2017-06-01

    Communication based on patient preferences can alleviate their psychological distress and is an important part of patient-centered care for physicians who have the task of conveying bad news to cancer patients. The present study aimed to explore the demographic, medical, and psychological factors associated with patient preferences with regard to communication of bad news. Outpatients with a variety of cancers were consecutively invited to participate in our study after their follow-up medical visit. A questionnaire assessed their preferences regarding the communication of bad news, covering four factors-(1) how bad news is delivered, (2) reassurance and emotional support, (3) additional information, and (4) setting-as well as on demographic, medical, and psychosocial factors. A total of 529 outpatients with a variety of cancers completed the questionnaire. Multiple regression analyses indicated that patients who were younger, female, had greater faith in their physician, and were more highly educated placed more importance on "how bad news is delivered" than patients who were older, male, had less faith in their physician, and a lower level of education. Female patients and patients without an occupation placed more importance on "reassurance and emotional support." Younger, female, and more highly educated patients placed more importance on "additional information." Younger, female, and more highly educated patients, along with patients who weren't undergoing active treatment placed more importance on "setting." Patient preferences with regard to communication of bad news are associated with factors related to patient background. Physicians should consider these characteristics when delivering bad news and use an appropriate communication style tailored to each patient.

  1. Hemodialysis patients' preferences for the management of secondary hyperparathyroidism.

    Science.gov (United States)

    Hauber, Brett; Caloyeras, John; Posner, Joshua; Brommage, Deborah; Belozeroff, Vasily; Cooper, Kerry

    2017-07-28

    Patient engagement and patient-centered care are critical in optimally managing patients with end-stage renal disease (ESRD). Understanding patient preferences is a key element of patient-centered care and shared decision making. The objective of this study was to elicit patients' preferences for the treatment of secondary hyperparathyroidism (SHPT) associated with ESRD using a discrete-choice experiment survey. Clinical literature, nephrologist input, patient-education resources, and a patient focus group informed development of the survey instrument, which was qualitatively pretested before its administration to a broader sample of patients. The National Kidney Foundation invited individuals in the United States with ESRD who were undergoing hemodialysis to participate in the survey. Respondents chose among three hypothetical SHPT treatment alternatives (two medical alternatives and surgery) in each of a series of questions, which were defined by attributes of efficacy (effect on laboratory values and symptoms), safety, tolerability, mode of administration, and cost. The survey instrument included a best-worst scaling exercise to quantify the relative bother of the individual attributes of surgery. Random-parameters logit models were used to evaluate the conditional relative importance of the attributes. A total of 200 patients with ESRD completed the survey. The treatment attributes that were most important to the respondents were whether a treatment was a medication or surgery and out-of-pocket cost. Patients had statistically significant preferences for efficacy attributes related to symptom management and laboratory values, but placed less importance on the attributes related to mode of administration and side effects. The most bothersome attribute of surgery was the risk of surgical mortality. Patients with ESRD and SHPT who are undergoing hemodialysis understand SHPT and have clear and measurable treatment preferences. These results may help inform

  2. Patients' preference for exercise setting and its influence on the health benefits gained from exercise-based cardiac rehabilitation.

    Science.gov (United States)

    Tang, Lars H; Kikkenborg Berg, Selina; Christensen, Jan; Lawaetz, Jannik; Doherty, Patrick; Taylor, Rod S; Langberg, Henning; Zwisler, Ann-Dorthe

    2017-04-01

    To assess patient preference for exercise setting and examine if choice of setting influences the long-term health benefit of exercise-based cardiac rehabilitation. Patients participating in a randomised controlled trial following either heart valve surgery, or radiofrequency ablation for atrial fibrillation were given the choice to perform a 12-week exercise programme in either a supervised centre-based, or a self-management home-based setting. Exercise capacity and physical and mental health outcomes were assessed for up to 24months after hospital discharge. Outcomes between settings were compared using a time×setting interaction using a mixed effects regression model. Across the 158 included patients, an equivalent proportion preferred to undertake exercise rehabilitation in a centre-based setting (55%, 95% CI: 45% to 63%) compared to a home-based setting (45%, 95% CI: 37% to 53%, p=0.233). At baseline, those who preferred a home-based setting reported better physical health (mean difference in physical component score: 5.0, 95% CI 2.3 to 7.4; p=0.001) and higher exercise capacity (mean between group difference 15.9watts, 95% CI 3.7 to 28.1; p=0.011). With the exception of the depression score in the Hospital Anxiety and Depression Score (F(3.65), p=0.004), there was no evidence of a significant difference in outcomes between settings. The preference of patients to participate in home-based and centre-based exercise programmes appears to be equivalent and provides similar health benefits. Whilst these findings support that patients should be given the choice between exercise-settings when initiating cardiac rehabilitation, further confirmatory evidence is needed. Copyright © 2017. Published by Elsevier B.V.

  3. The voltage—current relationship and equivalent circuit implementation of parallel flux-controlled memristive circuits

    International Nuclear Information System (INIS)

    Bao Bo-Cheng; Feng Fei; Dong Wei; Pan Sai-Hu

    2013-01-01

    A flux-controlled memristor characterized by smooth cubic nonlinearity is taken as an example, upon which the voltage—current relationships (VCRs) between two parallel memristive circuits — a parallel memristor and capacitor circuit (the parallel MC circuit), and a parallel memristor and inductor circuit (the parallel ML circuit) — are investigated. The results indicate that the VCR between these two parallel memristive circuits is closely related to the circuit parameters, and the frequency and amplitude of the sinusoidal voltage stimulus. An equivalent circuit model of the memristor is built, upon which the circuit simulations and experimental measurements of both the parallel MC circuit and the parallel ML circuit are performed, and the results verify the theoretical analysis results

  4. Referral recommendations for osteoarthritis of the knee incorporating patients' preferences

    Science.gov (United States)

    Musila, Nyokabi; Underwood, Martin; McCaskie, Andrew W; Black, Nick; Clarke, Aileen; van der Meulen, Jan H

    2011-01-01

    Background. GPs have to respond to conflicting policy developments. As gatekeeper they are supposed to manage the growing demand for specialist services and as patient advocate they should be responsive to patients' preferences. We used an innovative approach to develop a referral guideline for patients with chronic knee pain that explicitly incorporates patients' preferences. Methods. A guideline development group of 12 members including patients, GPs, orthopaedic surgeons and other health care professionals used formal consensus development informed by systematic evidence reviews. They rated the appropriateness of referral for 108 case scenarios describing patients according to symptom severity, age, body mass, co-morbidity and referral preference. Appropriateness was expressed on scale from 1 (‘strongly disagree’) to 9 (‘strongly agree’). Results. Ratings of referral appropriateness were strongly influenced by symptom severity and patients' referral preferences. The influence of other patient characteristics was small. There was consensus that patients with severe knee symptoms who want to be referred should be referred and that patient with moderate or mild symptoms and strong preference against referral should not be referred. Referral preference had a greater impact on the ratings of referral appropriateness when symptoms were moderate or severe than when symptoms were mild. Conclusions. Referral decisions for patients with osteoarthritis of the knee should only be guided by symptom severity and patients' referral preferences. The guideline development group seemed to have given priority to avoiding inefficient resource use in patients with mild symptoms and to respecting patient autonomy in patients with severe symptoms. PMID:20817791

  5. Magnetic Field Equivalent Current Analysis-Based Radial Force Control for Bearingless Permanent Magnet Synchronous Motors

    Directory of Open Access Journals (Sweden)

    Huangqiu Zhu

    2015-05-01

    Full Text Available Bearingless permanent magnet synchronous motors (BPMSMs, with all advantages of permanent magnet motors (PMSMs and magnetic bearings, have become an important research direction in the bearingless motor field. To realize a stable suspension for the BPMSM, accurate decoupling control between the electromagnetic torque and radial suspension force is indispensable. In this paper, a concise and reliable analysis method based on a magnetic field equivalent current is presented. By this analysis method, the operation principle is analyzed theoretically, and the necessary conditions to produce a stable radial suspension force are confirmed. In addition, mathematical models of the torque and radial suspension force are established which is verified by the finite element analysis (FEA software ANSYS. Finally, an experimental prototype of a 2-4 poles surface-mounted BPMSM is tested with the customized control strategy. The simulation and experimental results have shown that the motor has good rotation and suspension performance, and validated the accuracy of the proposed analysis method and the feasibility of the control strategy.

  6. Equivalent model of a dually-fed machine for electric drive control systems

    Science.gov (United States)

    Ostrovlyanchik, I. Yu; Popolzin, I. Yu

    2018-05-01

    The article shows that the mathematical model of a dually-fed machine is complicated because of the presence of a controlled voltage source in the rotor circuit. As a method of obtaining a mathematical model, the method of a generalized two-phase electric machine is applied and a rotating orthogonal coordinate system is chosen that is associated with the representing vector of a stator current. In the chosen coordinate system in the operator form the differential equations of electric equilibrium for the windings of the generalized machine (the Kirchhoff equation) are written together with the expression for the moment, which determines the electromechanical energy transformation in the machine. Equations are transformed so that they connect the currents of the windings, that determine the moment of the machine, and the voltages on these windings. The structural diagram of the machine is assigned to the written equations. Based on the written equations and accepted assumptions, expressions were obtained for the balancing the EMF of windings, and on the basis of these expressions an equivalent mathematical model of a dually-fed machine is proposed, convenient for use in electric drive control systems.

  7. Approximate dynamic programming approaches for appointment scheduling with patient preferences.

    Science.gov (United States)

    Li, Xin; Wang, Jin; Fung, Richard Y K

    2018-04-01

    During the appointment booking process in out-patient departments, the level of patient satisfaction can be affected by whether or not their preferences can be met, including the choice of physicians and preferred time slot. In addition, because the appointments are sequential, considering future possible requests is also necessary for a successful appointment system. This paper proposes a Markov decision process model for optimizing the scheduling of sequential appointments with patient preferences. In contrast to existing models, the evaluation of a booking decision in this model focuses on the extent to which preferences are satisfied. Characteristics of the model are analysed to develop a system for formulating booking policies. Based on these characteristics, two types of approximate dynamic programming algorithms are developed to avoid the curse of dimensionality. Experimental results suggest directions for further fine-tuning of the model, as well as improving the efficiency of the two proposed algorithms. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Difficult to swallow: patient preferences for alternative valproate pharmaceutical formulations

    Directory of Open Access Journals (Sweden)

    Monali Bhosle

    2009-06-01

    Full Text Available Monali Bhosle,1 Joshua S Benner,1 Mitch DeKoven,1 Jeff Shelton21Health Economics and Outcomes Research, IMS Health Inc, Falls Church, VA, USA; 2Answers and Insights Market Research, Inc, Indianapolis, IN, USAObjective: To determine the degree to which swallowing valproate (VP tablets is an issue, the proportion of patients who would prefer an alternative formulation, and the predictors of preference.Methods: A quantitative telephone survey of eligible adults (n = 400, ≥18 years old who currently take (n = 236 or previously took (n = 164 VP tablets within the past 6 months was conducted.Results: More than half of the patients indicated that VP tablets were ‘uncomfortable to swallow’ (68.5%, n = 274 and were ‘very interested’ (65.8%, n = 263 in medications that were easier to swallow. When choosing conceptually between taking VP tablet once/day or an equally safe and effective but significantly smaller soft gel capsule twice per day, the 82.8%, (n = 331 preferred the soft gel capsule. In the multivariate regression analysis, perceiving soft gel capsules to be easier to swallow (OR = 73.54; 95% CI = 15.01 to 360.40 and taking VP more frequently (OR = 2.02; 95% CI = 1.13 to 3.61 were significant predictors of soft gel capsule treatment preference.Conclusion: VP users would prefer a formulation that is easier to swallow, even if it is needed to be taken twice per day. When choosing between medications with similar efficacy and safety, physicians can consider patient preferences to optimize conditions for medication adherence.Keywords: patient preference, valproate formulations, tablet characteristics

  9. Patient-Centeredness as Physician Behavioral Adaptability to Patient Preferences.

    Science.gov (United States)

    Carrard, Valérie; Schmid Mast, Marianne; Jaunin-Stalder, Nicole; Junod Perron, Noëlle; Sommer, Johanna

    2018-05-01

    A physician who communicates in a patient-centered way is a physician who adapts his or her communication style to what each patient needs. In order to do so, the physician has to (1) accurately assess each patient's states and traits (interpersonal accuracy) and (2) possess a behavioral repertoire to choose from in order to actually adapt his or her behavior to different patients (behavioral adaptability). Physician behavioral adaptability describes the change in verbal or nonverbal behavior a physician shows when interacting with patients who have different preferences in terms of how the physician should interact with them. We hypothesized that physician behavioral adaptability to their patients' preferences would lead to better patient outcomes and that physician interpersonal accuracy was positively related to behavioral adaptability. To test these hypotheses, we recruited 61 physicians who completed an interpersonal accuracy test before being videotaped during four consultations with different patients. The 244 participating patients indicated their preferences for their physician's interaction style prior to the consultation and filled in a consultation outcomes questionnaire directly after the consultation. We coded the physician's verbal and nonverbal behavior for each of the consultations and compared it to the patients' preferences to obtain a measure of physician behavioral adaptability. Results partially confirmed our hypotheses in that female physicians who adapted their nonverbal (but not their verbal) behavior had patients who reported more positive consultation outcomes. Moreover, the more female physicians were accurate interpersonally, the more they showed verbal and nonverbal behavioral adaptability. For male physicians, more interpersonal accuracy was linked to less nonverbal adaptability.

  10. Gyrokinetic equivalence

    International Nuclear Information System (INIS)

    Parra, Felix I; Catto, Peter J

    2009-01-01

    We compare two different derivations of the gyrokinetic equation: the Hamiltonian approach in Dubin D H E et al (1983 Phys. Fluids 26 3524) and the recursive methodology in Parra F I and Catto P J (2008 Plasma Phys. Control. Fusion 50 065014). We prove that both approaches yield the same result at least to second order in a Larmor radius over macroscopic length expansion. There are subtle differences in the definitions of some of the functions that need to be taken into account to prove the equivalence.

  11. Understanding patient preferences and willingness to pay for hemophilia therapies

    Directory of Open Access Journals (Sweden)

    Chaugule SS

    2015-11-01

    Full Text Available Shraddha S Chaugule,1 Joel W Hay,1 Guy Young2 1Department of Clinical Pharmacy, Pharmaceutical Economics and Policy, University of Southern California, 2Hemostasis and Thrombosis Center, Children’s Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA Background: Despite clearly improved clinical outcomes for prophylaxis compared to on-demand therapy, on average only 56% of patients diagnosed with severe hemophilia receive prophylactic factor replacement therapy in the US. Prophylaxis rates generally drop as patients transition from childhood to adulthood, partly due to patients becoming less adherent when they reach adulthood. Assessment of patient preferences is important because these are likely to translate into increased treatment satisfaction and adherence. In this study, we assessed preferences and willingness to pay (WTP for on-demand, prophylaxis, and longer acting prophylaxis therapies in a sample of US hemophilia patients.Methods: Adult US hemophilia patients and caregivers (N=79 completed a discrete-choice survey that presented a series of trade-off questions, each including a pair of hypothetical treatment profiles. Using a mixed logit model for analysis, we compared the relative importance of five treatment characteristics: 1 out-of-pocket treatment costs (paid by patients, 2 factor dose adjustment, 3 treatment side effects, 4 availability of premixed factor, and 5 treatment effectiveness and dosing frequency. Based on these attribute estimates, we calculated patients’ WTP.Results: Out-of-pocket treatment costs (P<0.001, side effects (P<0.001, and treatment effectiveness and dosing frequency (P<0.001 were found to be statistically significant in the model. Patients were willing to pay US $410 (95% confidence interval: $164–$656 out of pocket per month for thrice-weekly prophylaxis therapy compared to on-demand therapy and $360 (95% confidence interval: $145–$575 for a switch

  12. Patient preferences for first-line oral treatment for mild-to-moderate ulcerative colitis: a discrete-choice experiment.

    Science.gov (United States)

    Hodgkins, Paul; Swinburn, Paul; Solomon, Dory; Yen, Linnette; Dewilde, Sarah; Lloyd, Andrew

    2012-01-01

    Patients with ulcerative colitis (UC) frequently require long-term therapy to prevent relapse. Treatments such as 5-aminosalicylic acid (5-ASA [mesalazine]) are efficacious and well tolerated, but adherence to treatment is often poor. This discrete-choice experiment (DCE) was conducted to estimate differences in patient preferences for 5-ASA treatment in mild-to-moderate UC based on levels of self-reported adherence. Inclusion of patients residing in the US, UK, Germany, and Canada allowed for assessment of possible cultural differences in patient preferences. DCE attributes were determined through literature review, clinician consultation, and patient interviews. Six treatment attributes were identified: ease of swallowing, time of day, quantity, extent of flare resolution, likelihood of flare occurrence, and cost. A total of 400 patients in four countries completed the DCE and adherence (Modified Morisky Scale) surveys. Data were analyzed using generalized estimating equations to estimate patient preference and willingness to pay (WTP) by levels of self-reported adherence and country of residence. All attributes had expected polarity and were significant predictors of patient preference. Self-reported 'good' versus 'poor' adherers significantly preferred symptom control (p = 0.0108) and mucosal healing (p = 0.0190) attributes. All patients stated preference for symptom control/mucosal healing and flare risk attributes; the latter attribute was significantly preferred across all countries. Country differences in patient preference for convenience versus clinical attributes were found. Overall, patients were willing to pay £29.24 ($US46.27) per month for symptom control and mucosal healing, and an additional £78.81 ($US124.70) per month for reduction in flare risk to 10% per year (WTP costs were equalized between each country using the published 2008 purchasing power parity). Those with flares in the past year significantly preferred avoiding future

  13. A Technique to Estimate the Equivalent Loss Resistance of Grid-Tied Converters for Current Control Analysis and Design

    DEFF Research Database (Denmark)

    Vidal, Ana; Yepes, Alejandro G.; Fernandez, Francisco Daniel Freijedo

    2015-01-01

    Rigorous analysis and design of the current control loop in voltage source converters (VSCs) requires an accurate modeling. The loop behavior can be significantly influenced by the VSC working conditions. To consider such effect, converter losses should be included in the model, which can be done...... by means of an equivalent series resistance. This paper proposes a method to identify the VSC equivalent loss resistance for the proper tuning of the current control loop. It is based on analysis of the closed-loop transient response provided by a synchronous proportional-integral current controller......, according to the internal model principle. The method gives a set of loss resistance values linked to working conditions, which can be used to improve the tuning of the current controllers, either by online adaptation of the controller gains or by open-loop adaptive adjustment of them according to prestored...

  14. Patient Preferences for Device-Aided Treatments Indicated for Advanced Parkinson Disease.

    Science.gov (United States)

    Marshall, Thomas; Pugh, Amy; Fairchild, Angelyn; Hass, Steven

    2017-12-01

    Effective treatment for advanced Parkinson disease (PD) uncontrolled with oral medication includes device-aided therapies such as deep brain stimulation (DBS) and continuous levodopa-carbidopa infusion to the duodenum via a portable pump. Our objective was to quantify patient preferences for attributes of these device-aided treatments. We administered a Web-enabled survey to 401 patients in the United States. A discrete-choice experiment (DCE) was used to evaluate patients' willingness to accept tradeoffs among efficacy, tolerability, and convenience of alternative treatments. DCE data were analyzed using random-parameters logit. Best-worst scaling (BWS) was used to elicit the relative importance of device-specific attributes. Conditional logit was used to analyze the BWS data. We tested for differences in preferences among subgroups of patients. Improving ability to think clearly was twice as important as a 6-hour-per-day improvement in control of movement symptoms. After controlling for efficacy, treatment delivered via portable infusion pump was preferred over DBS, and both devices were preferred to oral therapy with poor symptom control. Patients were most concerned about device attributes relating to risk of stroke, difficulty thinking, and neurosurgery. Avoiding surgery to insert a wire in the brain was more important than avoiding surgery to insert a tube into the small intestine. Some differences in preferences among subgroups were statistically, but not qualitatively, significant. This study clarifies the patient perspective in therapeutic choices for advanced PD. These findings may help improve communication between patients and providers and also provide evidence on patient preferences to inform regulatory and access decisions. Copyright © 2017. Published by Elsevier Inc.

  15. Dental patient preferences and choice in clinical decision-making.

    Science.gov (United States)

    Fukai, Kakuhiro; Yoshino, Koichi; Ohyama, Atsushi; Takaesu, Yoshinori

    2012-01-01

    In economics, the concept of utility refers to the strength of customer preference. In health care assessment, the visual analogue scale (VAS), the standard gamble, and the time trade-off are used to measure health state utilities. These utility measurements play a key role in promoting shared decision-making in dental care. Individual preference, however, is complex and dynamic. The purpose of this study was to investigate the relationship between patient preference and educational intervention in the field of dental health. The data were collected by distributing questionnaires to employees of two companies in Japan. Participants were aged 18-65 years and consisted of 111 males and 93 females (204 in total). One company (Group A) had a dental program of annual check-ups and health education in the workplace, while the other company (Group B) had no such program. Statistical analyses were performed with the t-test and Chi-square test. The questionnaire items were designed to determine: (1) oral health-related quality of life, (2) dental health state utilities (using VAS), and (3) time trade-off for regular dental check-ups. The percentage of respondents in both groups who were satisfied with chewing function, appearance of teeth, and social function ranged from 23.1 to 42.4%. There were no significant differences between groups A and B in the VAS of decayed, filled, and missing teeth. The VAS of gum bleeding was 42.8 in Group A and 51.3 in Group B (pdecision-making.

  16. [Patients' preferences for information in health care decision-making].

    Science.gov (United States)

    Borracci, Raúl A; Manente, Diego; Giorgi, Mariano A; Calderón, Gustavo; Ciancio, Alejandro; Doval, Hernán C

    2012-01-01

    A survey was carried out among patients who concurred to cardiologic services to know how patients preferred to be informed about their health status, and the demographic characteristics associated to these preferences, considering the following items: knowledge about the disease, information about different therapeutic options and decision-making. From 770 people surveyed, 738 (95.8%) answered the form completely. A trend to trust only in the doctor's knowledge to obtain information (81.7%), in wanting to know the options of treatment and express one's point of view (85.9%), and to involve the family in the decisions (63.2%) was observed. 9.6% preferred to receive the minimum necessary information or "to know nothing" about an alleged serious disease. Males tended less to request options and give opinion on the subject (or: 0.64), giving less freedom to family involvement (or: 1.31). people with a lower social and economical level claim fewer options (or: 0.48) and gave less family participation (or = 1.79). Natives from other South American countries had a minor tendency to demand for options and express their thoughts (or: 0.60); and the ones with lower education level trusted less in the doctor's knowledge (or: 1.81), demanded fewer options (or: 0.45) and chose not to know the severity of the disease (or: 0.56). the analysis of the demographical variables allowed to define preferences associated to age, sex, origin, education, religion and health status. In conclusion, although it is imperative to promote the patient's autonomy, individual preferences must be taken into account before informing and compromising the patient in decision-making about his disease.

  17. Configural frequency analysis as a method of determining patients' preferred decision-making roles in dialysis

    Directory of Open Access Journals (Sweden)

    Loeffert Sabine

    2010-09-01

    Full Text Available Abstract Background Numerous studies examined factors in promoting a patient preference for active participation in treatment decision making with only modest success. The purpose of this study was to identify types of patients wishing to participate in treatment decisions as well as those wishing to play a completely active or passive role based on a Germany-wide survey of dialysis patients; using a prediction typal analysis method that defines types as configurations of categories belonging to different attributes and takes particularly higher order interactions between variables into account. Methods After randomly splitting the original patient sample into two halves, an exploratory prediction configural frequency analysis (CFA was performed on one-half of the sample (n = 1969 and the identified types were considered as hypotheses for an inferential prediction CFA for the second half (n = 1914. 144 possible prediction types were tested by using five predictor variables and control preferences as criterion. An α-adjustment (0.05 for multiple testing was performed by the Holm procedure. Results 21 possible prediction types were identified as hypotheses in the exploratory prediction CFA; four patient types were confirmed in the confirmatory prediction CFA: patients preferring a passive role show low information seeking preference, above average trust in their physician, perceive their physician's participatory decision-making (PDM-style positive, have a lower educational level, and are 56-75 years old (Type 1; p 76 years old (Type 2; p p p Conclusions The method prediction configural frequency analysis was newly introduced to the research field of patient participation and could demonstrate how a particular control preference role is determined by an association of five variables.

  18. Environmental Controls on Snow Cover Thickness and Water Equivalent in Two Sub-Arctic Mountain Catchments

    OpenAIRE

    Cosgrove, Christopher

    2015-01-01

    The spatial variability of snow cover characteristics (depth, density, and snow water equivalent [SWE]) has paramount importance for the management of water resources in mountain environments. Passive microwave (PM) inference of SWE from space-borne instrumentation is increasingly used but the reliability of this technique remains limited in mountainous areas. Complex topography and the transition between forest and alpine tundra vegetation zones create large spatial heterogeneities in the sn...

  19. The control of superluminal group velocity in a system equivalent to the Y-type four-level atomic system

    International Nuclear Information System (INIS)

    Li Luming; Guo Hong; Xiao Feng; Peng Xiang; Chen Xuzong

    2005-01-01

    We study a new way to control the superluminal group velocity of light pulse in hot atomic gases with the five-level atomic configuration. The model of an equivalent Y-type four-level is applied and shows that the light goes faster by using an additional incoherent pumping field. The experiment is performed and shows in good agreement with our theoretical predictions

  20. PATIENT-CENTERED DECISION MAKING: LESSONS FROM MULTI-CRITERIA DECISION ANALYSIS FOR QUANTIFYING PATIENT PREFERENCES.

    Science.gov (United States)

    Marsh, Kevin; Caro, J Jaime; Zaiser, Erica; Heywood, James; Hamed, Alaa

    2018-01-01

    Patient preferences should be a central consideration in healthcare decision making. However, stories of patients challenging regulatory and reimbursement decisions has led to questions on whether patient voices are being considered sufficiently during those decision making processes. This has led some to argue that it is necessary to quantify patient preferences before they can be adequately considered. This study considers the lessons from the use of multi-criteria decision analysis (MCDA) for efforts to quantify patient preferences. It defines MCDA and summarizes the benefits it can provide to decision makers, identifies examples of MCDAs that have involved patients, and summarizes good practice guidelines as they relate to quantifying patient preferences. The guidance developed to support the use of MCDA in healthcare provide some useful considerations for the quantification of patient preferences, namely that researchers should give appropriate consideration to: the heterogeneity of patient preferences, and its relevance to decision makers; the cognitive challenges posed by different elicitation methods; and validity of the results they produce. Furthermore, it is important to consider how the relevance of these considerations varies with the decision being supported. The MCDA literature holds important lessons for how patient preferences should be quantified to support healthcare decision making.

  1. Equivalent Lagrangians

    International Nuclear Information System (INIS)

    Hojman, S.

    1982-01-01

    We present a review of the inverse problem of the Calculus of Variations, emphasizing the ambiguities which appear due to the existence of equivalent Lagrangians for a given classical system. In particular, we analyze the properties of equivalent Lagrangians in the multidimensional case, we study the conditions for the existence of a variational principle for (second as well as first order) equations of motion and their solutions, we consider the inverse problem of the Calculus of Variations for singular systems, we state the ambiguities which emerge in the relationship between symmetries and conserved quantities in the case of equivalent Lagrangians, we discuss the problems which appear in trying to quantize classical systems which have different equivalent Lagrangians, we describe the situation which arises in the study of equivalent Lagrangians in field theory and finally, we present some unsolved problems and discussion topics related to the content of this article. (author)

  2. Chiropractor interaction and treatment equivalence in a pilot randomized controlled trial

    DEFF Research Database (Denmark)

    Salsbury, Stacie A; DeVocht, James W; Hondras, Maria

    2014-01-01

    -parametric statistics were calculated. RESULTS: The trial ran from January 2010 to October 2011. We analyzed 111 complete video-recordings (54 active, 57 sham). Chiropractor interactions differed between the treatment groups in 7 categories. Active participants received more interactions with clinical information (8 vs....... 4) or explanations (3.5 vs. 1) than sham participants within the therapeutic domain. Active participants received more directions (63 vs. 58) and adjusting instrument thrusts (41.5 vs. 23) in the procedural domain and more optimistic (2.5 vs. 0) or neutral (7.5 vs. 5) outcome statements...... aimed to: 1) develop an instrument to assess practitioner-patient interactions; 2) determine the equivalence of a chiropractor's verbal interactions and treatment delivery for participants allocated to active or sham chiropractic groups; and 3) describe the perceptions of a treatment-masked evaluator...

  3. Physician's gender, communication style, patient preferences and patient satisfaction in gynecology and obstetrics: A systematic review

    NARCIS (Netherlands)

    Janssen, S.M.; Lagro-Janssen, A.L.M.

    2012-01-01

    OBJECTIVE: Review of studies published in the last 10 years about women seeking gynecological- or obstetrical care and physician's gender in relation to patient preferences, differences in communication style and patient satisfaction. METHODS: Studies were identified by searching the online

  4. Determining patient preferences for improved chemotoxicity during treatment for advanced bladder cancer

    DEFF Research Database (Denmark)

    Aristides, M.; Maase, Hans von der; Roberts, T.

    2005-01-01

    Determining patient preferences for improved chemotoxicity during treatment for advanced bladder cancer Conventional treatment for advanced bladder cancer is methotrexate, vinblastine, doxorubicin plus cisplatin (MVAC), with a median survival of 1 year but significant toxicity. The newer combinat...

  5. Patient Preferences for Outcomes Associated with Surgical Management of Prostate Cancer

    National Research Council Canada - National Science Library

    Catalona, WIlliam

    2001-01-01

    .... We used utility assessment to quantify patient preferences. We measured preferences in 209 community volunteers enrolled in a prostate cancer screening study who had radical prostatectomies between 1994 and 1998...

  6. Equivalent Consumption Minimization Strategy for the Control of Real Driving NOx Emissions of a Diesel Hybrid Electric Vehicle

    Directory of Open Access Journals (Sweden)

    Tobias Nüesch

    2014-05-01

    Full Text Available Motivated by the fact that the real driving NOx emissions (RDE of conventional diesel vehicles can exceed the legislation norms by far, a concept for the control of RDE with a diesel parallel hybrid electric vehicle (HEV is proposed. By extending the well-known equivalent consumption minimization strategy (ECMS, the power split degree of freedom is used to control the NOx emissions and the battery state of charge (SOC simultaneously. Through an appropriate formulation of the problem, the feedback control is shown to be separable into two dependent PI controllers. By hardware-in-the-loop (HIL experiments, as well as by simulations, the proposed method is shown to minimize the fuel consumption while tracking a given reference trajectory for both the NOx emissions and the battery SOC.

  7. Patients' preference for radiotherapy fractionation schedule in the palliation of symptomatic unresectable lung cancer

    International Nuclear Information System (INIS)

    Tang, J. I.; Lu, J. J.; Wong, L. C.

    2008-01-01

    Full text: The palliative radiotherapeutic management of unresectable non-small-cell lung cancer is controversial, with various fractionation (F x) schedules available. We aimed to determine patient's choice of F x schedule after involvement in a decision-making process using a decision board. A decision board outlining the various advantages and disadvantages apparent in the Medical Research Council study of F x schedules (17 Gy in two fractions vs 39 Gy in 13 fractions) was discussed with patients who met Medical Research Council eligibility criteria. Patients were then asked to indicate their preferred F x schedules, reasons and their level of satisfaction with being involved in the decision making process. Radiation oncologists (R O ) could prescribe radiotherapy schedules irrespective of patients' preferences. Of 92 patients enrolled, 55% chose the longer schedule. English-speaking patients were significantly more likely to choose the longer schedule (P 0.02, 95% confidence interval: 1.2-7.6). Longer F x was chosen because of longer survival (90%) and better local control (12%). Shorter F x was chosen for shorter overall treatment duration (80%), cost (61%) and better symptom control (20%). In all, 56% of patients choosing the shorter schedule had their treatment altered by the treating R O , whereas only 4% of patients choosing longer F x had their treatment altered (P O 's own biases.

  8. Clinical decision making for a tooth with apical periodontitis: the patients' preferred level of participation.

    Science.gov (United States)

    Azarpazhooh, Amir; Dao, Thuan; Ungar, Wendy J; Chaudry, Faiza; Figueiredo, Rafael; Krahn, Murray; Friedman, Shimon

    2014-06-01

    To effectively engage patients in clinical decisions regarding the management of teeth with apical periodontitis (AP), there is a need to explore patients' perspectives on the decision-making process. This study surveyed patients for their preferred level of participation in making treatment decisions for a tooth with AP. Data were collected through a mail-out survey of 800 University of Toronto Faculty of Dentistry patients, complemented by a convenience sample of 200 patients from 10 community practices. The Control Preferences Scale was used to evaluate the patients' preferences for active, collaborative, or passive participation in treatment decisions for a tooth with AP. Using bivariate and logistic regression analyses, the Gelberg-Andersen Behavioral Model for Vulnerable Populations was applied to the Control Preferences Scale questions to understand the influential factors (P ≤ .05). Among 434 of 1,000 respondents, 44%, 40%, and 16% preferred an active, collaborative, and passive participation, respectively. Logistic regression showed a significant association (P ≤ .025) between participants' higher education and preference for active participation compared with a collaborative role. Also, immigrant status was significantly associated with preference for passive participation (P = .025). The majority of patients valued an active or collaborative participation in deciding treatment for a tooth with AP. This pattern implied a preference for a patient-centered practice mode that emphasizes patient autonomy in decision making. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  9. The impact of controlling for extreme responding on measurement equivalence in cross-cultural research

    NARCIS (Netherlands)

    Morren, M.H.; Gelissen, J.P.T.M.; Vermunt, J.K.

    2012-01-01

    Prior research has shown that extreme response style can seriously bias responses to survey questions and that this response style may differ across culturally diverse groups. Consequently, cross-cultural differences in extreme responding may yield incomparable responses when not controlled for. To

  10. A Supervisory Control Algorithm of Hybrid Electric Vehicle Based on Adaptive Equivalent Consumption Minimization Strategy with Fuzzy PI

    Directory of Open Access Journals (Sweden)

    Fengqi Zhang

    2016-11-01

    Full Text Available This paper presents a new energy management system based on equivalent consumption minimization strategy (ECMS for hybrid electric vehicles. The aim is to enhance fuel economy and impose state of charge (SoC charge-sustainability. First, the relationship between the equivalent factor (EF of ECMS and the co-state of pontryagin’s minimum principle (PMP is derived. Second, a new method of implementing the adaptation law using fuzzy proportional plus integral (PI controller is developed to adjust EF for ECMS in real-time. This adaptation law is more robust than one with constant EF due to the variation of EF as well as driving cycle. Finally, simulations for two driving cycles using ECMS are conducted as opposed to the commonly used rule-based (RB control strategy, indicating that the proposed adaptation law can provide a promising blend in terms of fuel economy and charge-sustainability. The results confirm that ECMS with Fuzzy PI adaptation law is more robust than ECMS with constant EF as well as PI adaptation law and it achieves significant improvements compared with RB in terms of fuel economy, which is enhanced by 4.44% and 14.7% for china city bus cycle and economic commission of Europe (ECE cycle, respectively.

  11. Patient preferences versus physicians' judgement: does it make a difference in healthcare decision making?

    Science.gov (United States)

    Mühlbacher, Axel C; Juhnke, Christin

    2013-06-01

    Clinicians and public health experts make evidence-based decisions for individual patients, patient groups and even whole populations. In addition to the principles of internal and external validity (evidence), patient preferences must also influence decision making. Great Britain, Australia and Germany are currently discussing methods and procedures for valuing patient preferences in regulatory (authorization and pricing) and in health policy decision making. However, many questions remain on how to best balance patient and public preferences with physicians' judgement in healthcare and health policy decision making. For example, how to define evaluation criteria regarding the perceived value from a patient's perspective? How do physicians' fact-based opinions also reflect patients' preferences based on personal values? Can empirically grounded theories explain differences between patients and experts-and, if so, how? This article aims to identify and compare studies that used different preference elicitation methods and to highlight differences between patient and physician preferences. Therefore, studies comparing patient preferences and physician judgements were analysed in a review. This review shows a limited amount of literature analysing and comparing patient and physician preferences for healthcare interventions and outcomes. Moreover, it shows that methodology used to compare preferences is diverse. A total of 46 studies used the following methods-discrete-choice experiments, conjoint analyses, standard gamble, time trade-offs and paired comparisons-to compare patient preferences with doctor judgements. All studies were published between 1985 and 2011. Most studies reveal a disparity between the preferences of actual patients and those of physicians. For most conditions, physicians underestimated the impact of intervention characteristics on patients' decision making. Differentiated perceptions may reflect ineffective communication between the provider

  12. Patients' preferences for participation in treatment decision-making at the end of life: qualitative interviews with advanced cancer patients.

    Science.gov (United States)

    Brom, Linda; Pasman, H Roeline W; Widdershoven, Guy A M; van der Vorst, Maurice J D L; Reijneveld, Jaap C; Postma, Tjeerd J; Onwuteaka-Philipsen, Bregje D

    2014-01-01

    Patients are often encouraged to participate in treatment decision-making. Most studies on this subject focus on choosing between different curative treatment types. In the last phase of life treatment decisions differ as they often put more emphasis on weighing quantity against quality of life, such as whether or not to start treatment aimed at life prolongation but with the possibility of side effects. This study aimed to obtain insight into cancer patients' preferences and the reasons for patients' preferred role in treatment decision-making at the end of life. 28 advanced cancer patients were included at the start of their first line treatment. In-depth interviews were held prior to upcoming treatment decisions whether or not to start a life prolonging treatment. The Control Preference Scale was used to start discussing the extent and type of influence patients wanted to have concerning upcoming treatment decision-making. Interviews were audio taped and transcribed. All patients wanted their physician to participate in the treatment decision-making process. The extent to which patients themselves preferred to participate seemed to depend on how patients saw their own role or assessed their own capabilities for participating in treatment decision-making. Patients foresaw a shift in the preferred level of participation to a more active role depending in the later phase of illness when life prolongation would become more limited and quality of life would become more important. Patients vary in how much involvement they would like to have in upcoming treatment decision-making. Individual patients' preferences may change in the course of the illness, with a shift to more active participation in the later phases. Communication about patients' expectations, wishes and preferences for participation in upcoming treatment decisions is of great importance. An approach in which these topics are openly discussed would be beneficial.

  13. An Investigation of Patient Preferences for Music Played Before Electroconvulsive Therapy.

    Science.gov (United States)

    Graff, Veena; Wingfield, Peter; Adams, David; Rabinowitz, Terry

    2016-09-01

    Patients often feel anxious before electroconvulsive therapy (ECT), which can lead to avoidance of treatments. Music is a noninvasive safe option to reduce anxiety in the preoperative setting. Therefore, we examined patients' preferences of listening to music while receiving ECT by providing music-by way of headphones or speakers-to participants before treatment. Patients receiving ECT were recruited for this study. Patients served as their own controls in 3 separate music intervention sessions: 1) randomization to music via headphones or speakers, 2) no music, 3) the remaining music intervention. Patients completed a questionnaire related to satisfaction and preferences of music being played before ECT. Patients received a final questionnaire at the end of the study asking which intervention they preferred. Thirty patients completed the study. Ninety percent enjoyed listening to music through speakers. Eighty percent liked listening to music through headphones. Seventeen percent preferred not having any music. The difference in preference between speakers and headphones was not significant (P = 0.563; McNemar-Bowker test). There was no association between preference at the end of the study and the initial assignment of speakers or headphones (P = 0.542 and P = 0.752, respectively; Pearson χ tests). No adverse events were reported. Music is a low-cost intervention with virtually no side effects that could be offered as an adjunctive therapy for patients receiving ECT. A significant proportion of patients liked hearing music before treatment.

  14. Value redefined for inflammatory bowel disease patients: a choice-based conjoint analysis of patients' preferences.

    Science.gov (United States)

    van Deen, Welmoed K; Nguyen, Dominic; Duran, Natalie E; Kane, Ellen; van Oijen, Martijn G H; Hommes, Daniel W

    2017-02-01

    Value-based healthcare is an upcoming field. The core idea is to evaluate care based on achieved outcomes divided by the costs. Unfortunately, the optimal way to evaluate outcomes is ill-defined. In this study, we aim to develop a single, preference based, outcome metric, which can be used to quantify overall health value in inflammatory bowel disease (IBD). IBD patients filled out a choice-based conjoint (CBC) questionnaire in which patients chose preferable outcome scenarios with different levels of disease control (DC), quality of life (QoL), and productivity (Pr). A CBC analysis was performed to estimate the relative value of DC, QoL, and Pr. A patient-centered composite score was developed which was weighted based on the stated preferences. We included 210 IBD patients. Large differences in stated preferences were observed. Increases from low to intermediate outcome levels were valued more than increases from intermediate to high outcome levels. Overall, QoL was more important to patients than DC or Pr. Individual outcome scores were calculated based on the stated preferences. This score was significantly different from a score not weighted based on patient preferences in patients with active disease. We showed the feasibility of creating a single outcome metric in IBD which incorporates patients' values using a CBC. Because this metric changes significantly when weighted according to patients' values, we propose that success in healthcare should be measured accordingly.

  15. The parental non-equivalence of imprinting control regions during mammalian development and evolution.

    Directory of Open Access Journals (Sweden)

    Reiner Schulz

    2010-11-01

    Full Text Available In mammals, imprinted gene expression results from the sex-specific methylation of imprinted control regions (ICRs in the parental germlines. Imprinting is linked to therian reproduction, that is, the placenta and imprinting emerged at roughly the same time and potentially co-evolved. We assessed the transcriptome-wide and ontology effect of maternally versus paternally methylated ICRs at the developmental stage of setting of the chorioallantoic placenta in the mouse (8.5dpc, using two models of imprinting deficiency including completely imprint-free embryos. Paternal and maternal imprints have a similar quantitative impact on the embryonic transcriptome. However, transcriptional effects of maternal ICRs are qualitatively focused on the fetal-maternal interface, while paternal ICRs weakly affect non-convergent biological processes, with little consequence for viability at 8.5dpc. Moreover, genes regulated by maternal ICRs indirectly influence genes regulated by paternal ICRs, while the reverse is not observed. The functional dominance of maternal imprints over early embryonic development is potentially linked to selection pressures favoring methylation-dependent control of maternal over paternal ICRs. We previously hypothesized that the different methylation histories of ICRs in the maternal versus the paternal germlines may have put paternal ICRs under higher mutational pressure to lose CpGs by deamination. Using comparative genomics of 17 extant mammalian species, we show here that, while ICRs in general have been constrained to maintain more CpGs than non-imprinted sequences, the rate of CpG loss at paternal ICRs has indeed been higher than at maternal ICRs during evolution. In fact, maternal ICRs, which have the characteristics of CpG-rich promoters, have gained CpGs compared to non-imprinted CpG-rich promoters. Thus, the numerical and, during early embryonic development, functional dominance of maternal ICRs can be explained as the

  16. The parental non-equivalence of imprinting control regions during mammalian development and evolution.

    Science.gov (United States)

    Schulz, Reiner; Proudhon, Charlotte; Bestor, Timothy H; Woodfine, Kathryn; Lin, Chyuan-Sheng; Lin, Shau-Ping; Prissette, Marine; Oakey, Rebecca J; Bourc'his, Déborah

    2010-11-18

    In mammals, imprinted gene expression results from the sex-specific methylation of imprinted control regions (ICRs) in the parental germlines. Imprinting is linked to therian reproduction, that is, the placenta and imprinting emerged at roughly the same time and potentially co-evolved. We assessed the transcriptome-wide and ontology effect of maternally versus paternally methylated ICRs at the developmental stage of setting of the chorioallantoic placenta in the mouse (8.5dpc), using two models of imprinting deficiency including completely imprint-free embryos. Paternal and maternal imprints have a similar quantitative impact on the embryonic transcriptome. However, transcriptional effects of maternal ICRs are qualitatively focused on the fetal-maternal interface, while paternal ICRs weakly affect non-convergent biological processes, with little consequence for viability at 8.5dpc. Moreover, genes regulated by maternal ICRs indirectly influence genes regulated by paternal ICRs, while the reverse is not observed. The functional dominance of maternal imprints over early embryonic development is potentially linked to selection pressures favoring methylation-dependent control of maternal over paternal ICRs. We previously hypothesized that the different methylation histories of ICRs in the maternal versus the paternal germlines may have put paternal ICRs under higher mutational pressure to lose CpGs by deamination. Using comparative genomics of 17 extant mammalian species, we show here that, while ICRs in general have been constrained to maintain more CpGs than non-imprinted sequences, the rate of CpG loss at paternal ICRs has indeed been higher than at maternal ICRs during evolution. In fact, maternal ICRs, which have the characteristics of CpG-rich promoters, have gained CpGs compared to non-imprinted CpG-rich promoters. Thus, the numerical and, during early embryonic development, functional dominance of maternal ICRs can be explained as the consequence of two

  17. Managing neurogenic bowel dysfunction: what do patients prefer? A discrete choice experiment of patient preferences for transanal irrigation and standard bowel management

    Directory of Open Access Journals (Sweden)

    Nafees B

    2016-02-01

    . Conclusion: Participants with bowel dysfunction regarded “risk of FI”, “frequency of use”, and “avoiding UTIs” as the most important features of a TAI device. These preferences are valuable in informing decision makers and clinicians regarding different bowel management solutions as well as for development of future devices. Keywords: neurogenic bowel dysfunction, UK, transanal irrigation, patient preference, discrete choice

  18. The development of PubMed search strategies for patient preferences for treatment outcomes.

    Science.gov (United States)

    van Hoorn, Ralph; Kievit, Wietske; Booth, Andrew; Mozygemba, Kati; Lysdahl, Kristin Bakke; Refolo, Pietro; Sacchini, Dario; Gerhardus, Ansgar; van der Wilt, Gert Jan; Tummers, Marcia

    2016-07-29

    The importance of respecting patients' preferences when making treatment decisions is increasingly recognized. Efficiently retrieving papers from the scientific literature reporting on the presence and nature of such preferences can help to achieve this goal. The objective of this study was to create a search filter for PubMed to help retrieve evidence on patient preferences for treatment outcomes. A total of 27 journals were hand-searched for articles on patient preferences for treatment outcomes published in 2011. Selected articles served as a reference set. To develop optimal search strategies to retrieve this set, all articles in the reference set were randomly split into a development and a validation set. MeSH-terms and keywords retrieved using PubReMiner were tested individually and as combinations in PubMed and evaluated for retrieval performance (e.g. sensitivity (Se) and specificity (Sp)). Of 8238 articles, 22 were considered to report empirical evidence on patient preferences for specific treatment outcomes. The best search filters reached Se of 100 % [95 % CI 100-100] with Sp of 95 % [94-95 %] and Sp of 97 % [97-98 %] with 75 % Se [74-76 %]. In the validation set these queries reached values of Se of 90 % [89-91 %] with Sp 94 % [93-95 %] and Se of 80 % [79-81 %] with Sp of 97 % [96-96 %], respectively. Narrow and broad search queries were developed which can help in retrieving literature on patient preferences for treatment outcomes. Identifying such evidence may in turn enhance the incorporation of patient preferences in clinical decision making and health technology assessment.

  19. Measuring Patient Preferences: An Overview of Methods with a Focus on Discrete Choice Experiments.

    Science.gov (United States)

    Hazlewood, Glen S

    2018-05-01

    There is increasing recognition of the importance of patient preferences and methodologies to measure them. In this article, methods to quantify patient preferences are reviewed, with a focus on discrete choice experiments. In a discrete choice experiment, patients are asked to choose between 2 or more treatments. The results can be used to quantify the relative importance of treatment outcomes and/or other considerations relevant to medical decision making. Conducting and interpreting a discrete choice experiment requires multiple steps and an understanding of the potential biases that can arise, which we review in this article with examples in rheumatic diseases. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Immediate versus delayed insertion of an etonogestrel releasing implant at medical abortion-a randomized controlled equivalence trial.

    Science.gov (United States)

    Hognert, Helena; Kopp Kallner, Helena; Cameron, Sharon; Nyrelli, Christina; Jawad, Izabella; Heller, Rebecca; Aronsson, Annette; Lindh, Ingela; Benson, Lina; Gemzell-Danielsson, Kristina

    2016-11-01

    Does a progestin releasing subdermal contraceptive implant affect the efficacy of medical abortion if inserted at the same visit as the progesterone receptor modulator, mifepristone, at medical abortion? A etonogestrel releasing subdermal implant inserted on the day of mifepristone did not impair the efficacy of the medical abortion compared with routine insertion at 2-4 weeks after the abortion. The etonogestrel releasing subdermal implant is one of the most effective long acting reversible contraceptive methods. The effect of timing of placement on the efficacy of mifepristone and impact on prevention of subsequent unintended pregnancy is not known. This multicentre, randomized controlled, equivalence trial with recruitment between 13 October 2013 and 17 October 2015 included a total of 551 women with pregnancies below 64 days gestation opting for the etonogestrel releasing subdermal implant as postabortion contraception. Women were randomized to either insertion at 1 hour after mifepristone intake (immediate) or at follow-up 2-4 weeks later (delayed insertion). An equivalence design was used due to advantages for women such as fewer visits to the clinic with immediate insertion. The primary outcome was the percentage of women with complete abortion not requiring surgical intervention within 1 month. Secondary outcomes included insertion rates, pregnancy and repeat abortion rates during 6 months follow-up. Analysis was per protocol and by intention to treat. Women aged 18 years and older who had requested medical termination of a pregnancy up to 63 days of gestation and opted for an etonogestrel releasing contraceptive implant were recruited in outpatient family planning clinics in six hospitals in Sweden and Scotland. Efficacy of medical abortion was 259/275 (94.2%) in the immediate insertion group and 239/249 (96%) in the routine insertion group with a risk difference of 1.8% (95% CI -0.4 to 4.1%), which was within the ±5% margin of equivalence. The insertion

  1. Relationship between the generalized equivalent uniform dose formulation and the Poisson statistics-based tumor control probability model

    International Nuclear Information System (INIS)

    Zhou Sumin; Das, Shiva; Wang Zhiheng; Marks, Lawrence B.

    2004-01-01

    The generalized equivalent uniform dose (GEUD) model uses a power-law formalism, where the outcome is related to the dose via a power law. We herein investigate the mathematical compatibility between this GEUD model and the Poisson statistics based tumor control probability (TCP) model. The GEUD and TCP formulations are combined and subjected to a compatibility constraint equation. This compatibility constraint equates tumor control probability from the original heterogeneous target dose distribution to that from the homogeneous dose from the GEUD formalism. It is shown that this constraint equation possesses a unique, analytical closed-form solution which relates radiation dose to the tumor cell survival fraction. It is further demonstrated that, when there is no positive threshold or finite critical dose in the tumor response to radiation, this relationship is not bounded within the realistic cell survival limits of 0%-100%. Thus, the GEUD and TCP formalisms are, in general, mathematically inconsistent. However, when a threshold dose or finite critical dose exists in the tumor response to radiation, there is a unique mathematical solution for the tumor cell survival fraction that allows the GEUD and TCP formalisms to coexist, provided that all portions of the tumor are confined within certain specific dose ranges

  2. Patients Prefer Boarding in Inpatient Hallways: Correlation with the National Emergency Department Overcrowding Score

    Directory of Open Access Journals (Sweden)

    John R. Richards

    2011-01-01

    Full Text Available Objective. The boarding of patients in Emergency Department (ED hallways when no inpatient beds are available is a major cause of ED crowding. One solution is to board admitted patients in an inpatient rather than ED hallway. We surveyed patients to determine their preference and correlated their responses to real-time National Emergency Department Overcrowding Score (NEDOCS. Methods. This was a survey of admitted patients in the ED of an urban university level I trauma center serving a community of 5 million about their personal preferences regarding boarding. Real-time NEDOCS was calculated at the time each survey was conducted. Results. 99 total surveys were completed during October 2010, 42 (42% patients preferred to be boarded in an inpatient hallway, 33 (33% preferred the ED hallway, and 24 (24% had no preference. Mean (±SD NEDOCS (range 0–200 was 136±46 for patients preferring inpatient boarding, 112±39 for ED boarding, and 119±43 without preference. Male patients preferred inpatient hallway boarding significantly more than females. Preference for inpatient boarding was associated with a significantly higher NEDOCS. Conclusions. In this survey study, patients prefer inpatient hallway boarding when the hospital is at or above capacity. Males prefer inpatient hallway boarding more than females. The preference for inpatient hallway boarding increases as the ED becomes more crowded.

  3. Patient Preferences for Minimally Invasive and Open Locoregional Treatment for Early-Stage Breast Cancer

    NARCIS (Netherlands)

    Knuttel, Floor; van den Bosch, Maurice A A J; Young-Afat, Danny A.; Emaus, Marleen J.; van den Bongard, Desirée H J G; Witkamp, Arjen J.; Verkooijen, Helena M.

    Background: Noninvasive or minimally invasive treatments are being developed as alternatives to surgery for patients with early-stage breast cancer. Patients' preferences with regard to these new treatments have not been investigated. Objectives: To assess preferences of patients with breast cancer

  4. Patients prefer boarding in inpatient hallways: correlation with the national emergency department overcrowding score.

    Science.gov (United States)

    Richards, John R; Ozery, Gal; Notash, Mark; Sokolove, Peter E; Derlet, Robert W; Panacek, Edward A

    2011-01-01

    Objective. The boarding of patients in Emergency Department (ED) hallways when no inpatient beds are available is a major cause of ED crowding. One solution is to board admitted patients in an inpatient rather than ED hallway. We surveyed patients to determine their preference and correlated their responses to real-time National Emergency Department Overcrowding Score (NEDOCS). Methods. This was a survey of admitted patients in the ED of an urban university level I trauma center serving a community of 5 million about their personal preferences regarding boarding. Real-time NEDOCS was calculated at the time each survey was conducted. Results. 99 total surveys were completed during October 2010, 42 (42%) patients preferred to be boarded in an inpatient hallway, 33 (33%) preferred the ED hallway, and 24 (24%) had no preference. Mean (±SD) NEDOCS (range 0-200) was 136 ± 46 for patients preferring inpatient boarding, 112 ± 39 for ED boarding, and 119 ± 43 without preference. Male patients preferred inpatient hallway boarding significantly more than females. Preference for inpatient boarding was associated with a significantly higher NEDOCS. Conclusions. In this survey study, patients prefer inpatient hallway boarding when the hospital is at or above capacity. Males prefer inpatient hallway boarding more than females. The preference for inpatient hallway boarding increases as the ED becomes more crowded.

  5. Colorectal cancer patients' preferences for type of caregiver during survivorship care

    NARCIS (Netherlands)

    Wieldraaijer, T.; Duineveld, L. A. M.; Donkervoort, S. C.; Busschers, W. B.; van Weert, H. C. P. M.; Wind, J.

    2018-01-01

    Colorectal cancer (CRC) survivors are currently included in a secondary care-led survivorship care programme. Efforts are underway to transfer this survivorship care to primary care, but met with some reluctance by patients and caregivers. This study assesses (1) what caregiver patients prefer to

  6. Do Patients Prefer a Pessary or Surgery as Primary Treatment for Pelvic Organ Prolapse

    NARCIS (Netherlands)

    Thys, S. D.; Roovers, J. P.; Geomini, P. M.; Bongers, M. Y.

    2012-01-01

    Background/Aims: To assess whether patients prefer surgery or a pessary as treatment for pelvic organ prolapse (POP). Methods: A structured interview was performed among treated and untreated women with POP. We conducted fictive scenarios of potential disadvantages of surgery and pessary use. Our

  7. Patients' preferences for adjuvant chemotherapy in early-stage breast cancer: is treatment worthwhile?

    NARCIS (Netherlands)

    Jansen, S. J.; Kievit, J.; Nooij, M. A.; de Haes, J. C.; Overpelt, I. M.; van Slooten, H.; Maartense, E.; Stiggelbout, A. M.

    2001-01-01

    When making decisions about adjuvant chemotherapy for early-stage breast cancer, costs and benefits of treatment should be carefully weighed. In this process, patients' preferences are of major importance. The objectives of the present study were: (1) to determine the minimum benefits that patients

  8. Why consider patients' preferences? A discourse analysis of clinical practice guideline developers.

    Science.gov (United States)

    Boivin, Antoine; Green, Judith; van der Meulen, Jan; Légaré, France; Nolte, Ellen

    2009-08-01

    Several organizations are advocating for patients' preferences to be considered in clinical practice guideline development and implementation. However, lack of agreement on the goal and meaning of this policy curtails evaluation and development of patient involvement programs. To describe guideline developers' discourses on the goal of considering patients' preferences. Qualitative study using discourse analysis. 18 participants (patients, health professionals, and public health experts) from 2 groups of British guideline developers. Template analysis of semi-structured individual interviews was strengthened by active search for deviant cases, team debriefing, and member checking. All respondents supported the idea of taking account of patients' preferences in guidelines. Divergences with the goal and meaning of considering preferences were structured in 4 discourses: (1) The Governance discourse constructs guideline development as a rational process of synthesizing population data-including evidence on patients' preferences-to maximize public health within the constraints of available resources; (2) the Informed Decision discourse aims at fostering patients' choice by providing tailored information on the risks and benefits of interventions; (3) the Professional Care discourse insists on basing professionals' recommendations on the individual characteristics of patients; (4) The Consumer Advocacy discourse argues for greater political power and influence over guideline development and clinical decision making. The identified discourses provide a set of hypothesis on how patient involvement programs are expected to work, which could help clarify the goals pursued by guideline organizations and anchor further evaluation efforts.

  9. Understanding Patient Preference in Female Pelvic Imaging: Transvaginal Ultrasound and MRI.

    Science.gov (United States)

    Sakala, Michelle D; Carlos, Ruth C; Mendiratta-Lala, Mishal; Quint, Elisabeth H; Maturen, Katherine E

    2018-04-01

    Women with pelvic pain or abnormal uterine bleeding may undergo diagnostic imaging. This study evaluates patient experience in transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) and explores correlations between preference and symptom severity. Institutional review board approval was obtained for this Health Insurance Portability and Accountability Act-compliant prospective study. Fifty premenopausal women with pelvic symptoms evaluated by recent TVUS and MRI and without history of gynecologic cancer or hysterectomy were included. A phone questionnaire used validated survey instruments including Uterine Fibroid Symptoms Quality of Life index, Testing Morbidities Index, and Wait Trade Off for TVUS and MRI examinations. Using Wait Trade Off, patients preferred TVUS over MRI (3.58 vs 2.80 weeks, 95% confidence interval [CI] -1.63, 0.12; P = .08). Summary test utility of Testing Morbidities Index for MRI was worse than for TVUS (81.64 vs 87.42, 95%CI 0.41, 11.15; P = .03). Patients reported greater embarrassment during TVUS than during MRI (P MRI, and greater mental (P = .02) and physical (P = .02) problems after MRI versus TVUS. Subscale correlations showed physically inactive women rated TVUS more negatively (R = -0.32, P = .03), whereas women with more severe symptoms of loss of control of health (R = -0.28, P = .04) and sexual dysfunction (R = -0.30, P = .03) rated MRI more negatively. Women with pelvic symptoms had a slight but significant preference for TVUS over MRI. Identifying specific distressing aspects of each test and patient factors contributing to negative perceptions can direct improvement in both test environment and patient preparation. Improved patient experience may increase imaging value. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  10. The development of PubMed search strategies for patient preferences for treatment outcomes

    Directory of Open Access Journals (Sweden)

    Ralph van Hoorn

    2016-07-01

    Full Text Available Abstract Background The importance of respecting patients’ preferences when making treatment decisions is increasingly recognized. Efficiently retrieving papers from the scientific literature reporting on the presence and nature of such preferences can help to achieve this goal. The objective of this study was to create a search filter for PubMed to help retrieve evidence on patient preferences for treatment outcomes. Methods A total of 27 journals were hand-searched for articles on patient preferences for treatment outcomes published in 2011. Selected articles served as a reference set. To develop optimal search strategies to retrieve this set, all articles in the reference set were randomly split into a development and a validation set. MeSH-terms and keywords retrieved using PubReMiner were tested individually and as combinations in PubMed and evaluated for retrieval performance (e.g. sensitivity (Se and specificity (Sp. Results Of 8238 articles, 22 were considered to report empirical evidence on patient preferences for specific treatment outcomes. The best search filters reached Se of 100 % [95 % CI 100-100] with Sp of 95 % [94–95 %] and Sp of 97 % [97–98 %] with 75 % Se [74–76 %]. In the validation set these queries reached values of Se of 90 % [89–91 %] with Sp 94 % [93–95 %] and Se of 80 % [79–81 %] with Sp of 97 % [96–96 %], respectively. Conclusions Narrow and broad search queries were developed which can help in retrieving literature on patient preferences for treatment outcomes. Identifying such evidence may in turn enhance the incorporation of patient preferences in clinical decision making and health technology assessment.

  11. Patients' preferences for adjuvant chemotherapy in early-stage breast cancer: is treatment worthwhile?

    OpenAIRE

    Jansen, S J T; Kievit, J; Nooij, M A; Haes, J C J M de; Overpelt, I M E; Slooten, H van; Maartense, E; Stiggelbout, A M

    2001-01-01

    When making decisions about adjuvant chemotherapy for early-stage breast cancer, costs and benefits of treatment should be carefully weighed. In this process, patients' preferences are of major importance. The objectives of the present study were: (1) to determine the minimum benefits that patients need to find chemotherapy acceptable, and (2) to explore potential preference determinants, namely: positive experience of the treatment, reconciliation with the treatment decision, and demographic...

  12. Patients prefer pictures to numbers to express cardiovascular benefit from treatment.

    Science.gov (United States)

    Goodyear-Smith, Felicity; Arroll, Bruce; Chan, Lydia; Jackson, Rod; Wells, Sue; Kenealy, Timothy

    2008-01-01

    This study aimed to determine which methods of expressing a preventive medication's benefit encourage patients with known cardiovascular disease to decide to take the medication and which methods patients prefer. We identified patients in Auckland, New Zealand, family practices located in areas of differing socioeconomic status who had preexisting heart disease (myocardial infarction, angina, or both) and were taking statins. The patients were interviewed about their preference for methods of expressing the benefit of a hypothetical medication. Benefits were expressed numerically (relative risk, absolute risk, number needed to treat, odds ratio, natural frequency) and graphically. Statistical testing was adjusted for practice. We interviewed 100 eligible patients, representing a 53% response rate. No matter how the risk was expressed, the majority of patients indicated they would be encouraged to take the medication. Two-thirds (68) of the patients preferred 1 method of expressing benefit over others. Of this group, 57% preferred the information presented graphically. This value was significantly greater (P framing preferred positive framing (description of the benefit of treatment) over negative framing (description of the harm of not being treated). Although number needed to treat is a useful tool for communicating risk and benefit to clinicians, this format was the least likely to encourage patients to take medication. As graphical representation of benefit was the method patients preferred most, consideration should be given to developing visual aids to support shared clinical decision making.

  13. Community pharmacy-based asthma services--what do patients prefer?

    Science.gov (United States)

    Naik Panvelkar, Pradnya; Armour, Carol; Saini, Bandana

    2010-12-01

    Patient preferences can influence the outcomes of treatment and so understanding and organizing health-care services around these preferences is vital. To explore patient preferences for types of community pharmacy-based asthma services, to investigate the influence of "experience" in molding preferences for such services, and to identify aspects of the services that patients prefer over others. Semistructured face-to-face interviews were conducted with a convenience sample of two types of asthma patients: (1) those naïve to a specialized asthma service and (2) those who had experienced a specialized asthma service. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Eighteen interviews were conducted (8 experienced patients, 10 naïve patients). The majority of the patients wanted the pharmacist to play a greater role in their asthma management. Patients experiencing increased levels of service had increased levels of expectations as well as more specific preferences for various aspects of the service. The key aspects of an asthma service that all patients wanted their pharmacists to provide were the provision of information about asthma and its medications, lung function testing and monitoring of their asthma, and checking/correcting their inhaler technique. Patients also expressed a desire for skilled communication and behavioral aspects from the pharmacist such as friendliness, empathy, attentiveness, and dedicated time. Patients highlighted the importance of privacy in the pharmacy. There was a high level of satisfaction toward the currently delivered asthma service among both naïve and experienced patients. The provision of the specialized service was associated with increased patient loyalty to the particular pharmacy. All patients indicated a willingness to participate in future pharmacy-delivered specialized asthma services. Elements of the specialized pharmacy-based asthma services important from a patient's perspective were

  14. Establishing Substantial Equivalence: Transcriptomics

    Science.gov (United States)

    Baudo, María Marcela; Powers, Stephen J.; Mitchell, Rowan A. C.; Shewry, Peter R.

    Regulatory authorities in Western Europe require transgenic crops to be substantially equivalent to conventionally bred forms if they are to be approved for commercial production. One way to establish substantial equivalence is to compare the transcript profiles of developing grain and other tissues of transgenic and conventionally bred lines, in order to identify any unintended effects of the transformation process. We present detailed protocols for transcriptomic comparisons of developing wheat grain and leaf material, and illustrate their use by reference to our own studies of lines transformed to express additional gluten protein genes controlled by their own endosperm-specific promoters. The results show that the transgenes present in these lines (which included those encoding marker genes) did not have any significant unpredicted effects on the expression of endogenous genes and that the transgenic plants were therefore substantially equivalent to the corresponding parental lines.

  15. Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial.

    Science.gov (United States)

    Chopra, Arvind; Saluja, Manjit; Tillu, Girish; Sarmukkaddam, Sanjeev; Venugopalan, Anuradha; Narsimulu, Gumdal; Handa, Rohini; Sumantran, Venil; Raut, Ashwinikumar; Bichile, Lata; Joshi, Kalpana; Patwardhan, Bhushan

    2013-08-01

    To demonstrate clinical equivalence between two standardized Ayurveda (India) formulations (SGCG and SGC), glucosamine and celecoxib (NSAID). Ayurvedic formulations (extracts of Tinospora cordifolia, Zingiber officinale, Emblica officinalis, Boswellia serrata), glucosamine sulphate (2 g daily) and celecoxib (200 mg daily) were evaluated in a randomized, double-blind, parallel-efficacy, four-arm, multicentre equivalence drug trial of 24 weeks duration. A total of 440 eligible patients suffering from symptomatic knee OA were enrolled and monitored as per protocol. Primary efficacy variables were active body weight-bearing pain (visual analogue scale) and modified WOMAC pain and functional difficulty Likert score (for knee and hip); the corresponding a priori equivalence ranges were ±1.5 cm, ±2.5 and ±8.5. Differences between the intervention arms for mean changes in primary efficacy variables were within the equivalence range by intent-to-treat and per protocol analysis. Twenty-six patients showed asymptomatic increased serum glutamic pyruvic transaminase (SGPT) with otherwise normal liver function; seven patients (Ayurvedic intervention) were withdrawn and SGPT normalized after stopping the drug. Other adverse events were mild and did not differ by intervention. Overall, 28% of patients withdrew from the study. In this 6-month controlled study of knee OA, Ayurvedic formulations (especially SGCG) significantly reduced knee pain and improved knee function and were equivalent to glucosamine and celecoxib. The unexpected SGPT rise requires further safety assessment. Clinical Drug Trial Registry-India, www.ctri.nic.in, CTRI/2008/091/000063.

  16. A Method for Identification of the Equivalent Inductance and Resistance in the Plant Model of Current-Controlled Grid-Tied Converters

    DEFF Research Database (Denmark)

    Vidal, Ana; Yepes, Alejandro G.; Fernandez, Francisco Daniel Freijedo

    2015-01-01

    Precise knowledge of the plant time constant L=R is essential to perform a thorough analysis and design of the current control loop in voltage source converters (VSCs). From the perspective of the current controller dynamics in the low frequency range, such plant time constant is also suitable...... for most cases in which an LCL filter is used. As the loop behavior can be significantly influenced by the VSC working conditions, the effects associated to converter losses should be included in the model, through an equivalent series resistance. In addition, the plant inductance may also present...... important uncertainties with respect to the value of the VSC L/LCL interface filter measured at rated conditions. Thus, in this work, a method is presented to estimate both parameters of the plant time constant, i.e., the equivalent inductance and resistance in the plant model of current-controlled VSCs...

  17. Do patients prefer mesh or anterior colporrhaphy for primary correction of anterior vaginal wall prolapse: a labelled discrete choice experiment

    NARCIS (Netherlands)

    Notten, K. J. B.; Essers, B. A.; Weemhoff, M.; Rutten, A. G. H.; Donners, J. J. A. E.; van Gestel, I.; Kruitwagen, R. F. M. P.; Roovers, J. P. W. R.; Dirksen, C. D.

    2015-01-01

    We investigated patients' preferences for anterior colporrhaphy or mesh surgery as surgical correction of anterior vaginal wall prolapse. Labelled discrete choice experiment. Three Dutch teaching hospitals. Women with anterior vaginal wall prolapse Pelvic Organ Prolapse Quantification stage 2 or

  18. Economic considerations and patients' preferences affect treatment selection for patients with rheumatoid arthritis: a discrete choice experiment among European rheumatologists

    NARCIS (Netherlands)

    Hifinger, M.; Hiligsmann, M.; Ramiro, S.; Watson, V.; Severens, J. L.; Fautrel, B.; Uhlig, T.; van Vollenhoven, R.; Jacques, P.; Detert, J.; Canas da Silva, J.; Scirè, C. A.; Berghea, F.; Carmona, L.; Péntek, M.; Keat, A.; Boonen, A.

    2017-01-01

    To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis. In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with

  19. Efficacy, safety, and patient preference of monoamine oxidase B inhibitors in the treatment of Parkinson's disease.

    Science.gov (United States)

    Robottom, Bradley J

    2011-01-20

    Parkinson's disease (PD) is the second most common neurodegenerative disease and the most treatable. Treatment of PD is symptomatic and generally focuses on the replacement or augmentation of levodopa. A number of options are available for treatment, both in monotherapy of early PD and to treat complications of advanced PD. This review focuses on rasagiline and selegiline, two medications that belong to a class of antiparkinsonian drugs called monoamine oxidase B (MAO-B) inhibitors. Topics covered in the review include mechanism of action, efficacy in early and advanced PD, effects on disability, the controversy regarding disease modification, safety, and patient preference for MAO-B inhibitors.

  20. Healthcare decision-making in end stage renal disease-patient preferences and clinical correlates.

    Science.gov (United States)

    Jayanti, Anuradha; Neuvonen, Markus; Wearden, Alison; Morris, Julie; Foden, Philip; Brenchley, Paul; Mitra, Sandip

    2015-11-14

    Medical decision-making is critical to patient survival and well-being. Patients with end stage renal disease (ESRD) are faced with incrementally complex decision-making throughout their treatment journey. The extent to which patients seek involvement in the decision-making process and factors which influence these in ESRD need to be understood. 535 ESRD patients were enrolled into the cross-sectional study arm and 30 patients who started dialysis were prospectively evaluated. Patients were enrolled into 3 groups- 'predialysis' (group A), 'in-centre' haemodialysis (HD) (group B) and self-care HD (93 % at home-group C) from across five tertiary UK renal centres. The Autonomy Preference Index (API) has been employed to study patient preferences for information-seeking (IS) and decision-making (DM). Demographic, psychosocial and neuropsychometric assessments are considered for analyses. 458 complete responses were available. API items have high internal consistency in the study population (Cronbach's alpha > 0.70). Overall and across individual study groups, the scores for information-seeking and decision-making are significantly different indicating that although patients had a strong preference to be well informed, they were more neutral in their preference to participate in DM (p gender, marital status; higher API IS scores and white ethnicity background were significant predictors of preference for decision-making. DM scores were subdivided into tertiles to identify variables associated with high (DM > 70: and low DM (≤30) scores. This shows association of higher DM scores with lower age, lower comorbidity index score, higher executive brain function, belonging in the self-caring cohort and being unemployed. In the prospectively studied cohort of predialysis patients, there was no change in decision-making preference scores after commencement of dialysis. ESRD patients prefer to receive information, but this does not always imply active involvement in

  1. The development and initial validation of a clinical tool for patients' preferences on patient participation--The 4Ps.

    OpenAIRE

    Eldh, Ann Catrine; Luhr, Kristina; Ehnfors, Margareta

    2015-01-01

    AIMS: To report on the development and initial testing of a clinical tool, The Patient Preferences for Patient Participation tool (The 4Ps), which will allow patients to depict, prioritize, and evaluate their participation in health care. BACKGROUND: While patient participation is vital for high quality health care, a common definition incorporating all stakeholders' experience is pending. In order to support participation in health care, a tool for determining patients' preferences on partic...

  2. Health literacy, numeracy, and other characteristics associated with hospitalized patients' preferences for involvement in decision-making

    OpenAIRE

    Goggins, KM; Wallston, KA; Nwosu, S; Schildcrout, JS; Castel, L; Kripalani, S

    2014-01-01

    Little research has examined the association of health literacy and numeracy with patients' preferred involvement in the problem-solving and decision-making process in the hospital. Using a sample of 1,249 patients hospitalized with cardiovascular disease from the Vanderbilt Inpatient Cohort Study (VICS), we assessed patients' preferred level of involvement using responses to two scenarios of differing symptom severity from the Problem-Solving Decision-Making (PSDM) Scale. Using multivariable...

  3. Increasing capacity to deliver diabetes self-management education: results of the DESMOND lay educator non-randomized controlled equivalence trial.

    Science.gov (United States)

    Carey, M E; Mandalia, P K; Daly, H; Gray, L J; Hale, R; Martin Stacey, L; Taub, N; Skinner, T C; Stone, M; Heller, S; Khunti, K; Davies, M J

    2014-11-01

    To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators. We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months were referred for self-management education as part of routine care and attended either a control or intervention format DESMOND course. The primary outcome measure was change in illness coherence score (derived from the Diabetes Illness Perception Questionnaire-Revised) between baseline and 4 months after attending education sessions. Secondary outcome measures included change in HbA1c level. The trial was conducted in four primary care organizations across England and Scotland. The 95% CI for the between-group difference in positive change in coherence scores was within the pre-set limits of equivalence (difference = 0.22, 95% CI 1.07 to 1.52). Equivalent changes related to secondary outcome measures were also observed, including equivalent reductions in HbA1c levels. Diabetes education delivered jointly by a trained lay person and a healthcare professional educator with the same educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  4. Multidisciplinary approach in the treatment of T1 glottic cancer. The role of patient preference in an homogenous patient population

    International Nuclear Information System (INIS)

    Dinapoli, Nicola; Parrilla, Claudio; Galli, Jacopo

    2010-01-01

    To compare oncological outcome and voice quality among a uniform and well-defined subset of patients with T1 glottic carcinoma. Patients, affected by laryngeal glottic carcinoma, treated by laser CO 2 surgery or radiotherapy, have been analyzed. Overall survival and disease-free survival were calculated. In order to verify differences in functional outcomes and voice quality, all patients were interviewed during their last follow-up visit during 2009 using the VHI (Voice Handicap Index) questionnaire. The data were analyzed using the MedCalc software. A total of 143 patients were analyzed: 73 underwent surgery and 70 underwent radiotherapy. No statistically significant differences were found between the two groups in terms of overall survival and disease-free survival; dividing patients into stages T1a and T1b also made no difference. In order to evaluate the differences in outcomes for surgery and radiotherapy, patients were interviewed using the VHI questionnaire. Better scores for each category in the VHI were found for patients receiving radiotherapy compared to surgery (physical: p = 0.0023; functional: p < 0.0001; environmental: p < 0.001). The median VHI score for radiotherapy patients was 4, while for surgical patients it was 18 (p < 0.0001). This study confirms the well-known knowledge that results from radiotherapy and surgery in early glottic cancer treatment are equivalent. Furthermore, the role of patient preference in the treatment modality choice and the value of a multidisciplinary approach for a detailed and multi-oriented discussion with the patient are outlined. (orig.)

  5. Multidisciplinary approach in the treatment of T1 glottic cancer. The role of patient preference in an homogenous patient population

    Energy Technology Data Exchange (ETDEWEB)

    Dinapoli, Nicola [Catholic Univ. of the Sacred Heart, Rome (Italy). Dept. of Radiation Oncology; Parrilla, Claudio; Galli, Jacopo [Catholic Univ. of the Sacred Heart, Rome (IT). Dept. of Otorhinolaryngoiatry] (and others)

    2010-11-15

    To compare oncological outcome and voice quality among a uniform and well-defined subset of patients with T1 glottic carcinoma. Patients, affected by laryngeal glottic carcinoma, treated by laser CO{sub 2} surgery or radiotherapy, have been analyzed. Overall survival and disease-free survival were calculated. In order to verify differences in functional outcomes and voice quality, all patients were interviewed during their last follow-up visit during 2009 using the VHI (Voice Handicap Index) questionnaire. The data were analyzed using the MedCalc software. A total of 143 patients were analyzed: 73 underwent surgery and 70 underwent radiotherapy. No statistically significant differences were found between the two groups in terms of overall survival and disease-free survival; dividing patients into stages T1a and T1b also made no difference. In order to evaluate the differences in outcomes for surgery and radiotherapy, patients were interviewed using the VHI questionnaire. Better scores for each category in the VHI were found for patients receiving radiotherapy compared to surgery (physical: p = 0.0023; functional: p < 0.0001; environmental: p < 0.001). The median VHI score for radiotherapy patients was 4, while for surgical patients it was 18 (p < 0.0001). This study confirms the well-known knowledge that results from radiotherapy and surgery in early glottic cancer treatment are equivalent. Furthermore, the role of patient preference in the treatment modality choice and the value of a multidisciplinary approach for a detailed and multi-oriented discussion with the patient are outlined. (orig.)

  6. CMS proposes prioritizing patient preferences, linking patients to follow-up care in discharge planning process.

    Science.gov (United States)

    2016-03-01

    Hospital providers voice concerns about a proposed rule by the Centers for Medicare and Medicaid Services (CMS) that would require providers to devote more resources to discharge planning. The rule would apply to inpatients as well as emergency patients requiring comprehensive discharge plans as opposed to discharge instructions. CMS states that the rule would ensure the prioritization of patient preferences and goals in the discharge planning process, and also would prevent avoidable complications and readmissions. However, hospital and emergency medicine leaders worry that community resources are not yet in place to facilitate the links and follow-up required in the proposed rule, and that the costs associated with implementation would be prohibitive. The proposed rule would apply to acute care hospitals, EDs, long-term care facilities, inpatient rehabilitation centers, and home health agencies. Regardless of the setting, though, CMS is driving home the message that patient preferences should be given more weight during the discharge planning process. Under the rule, hospitals or EDs would need to develop a patient-centered discharge plan within 24 hours of admission or registration, and complete the plan prior to discharge or transfer to another facility. Under the rule, emergency physicians would determine which patients require a comprehensive discharge plan. Both the American Hospital Association and the American College of Emergency Physicians worry that hospitals will have to take on more staff, invest in training, and make changes to their electronic medical record systems to implement the provisions in the proposed rule.

  7. "In the physio we trust": A qualitative study on patients' preferences for physiotherapy.

    Science.gov (United States)

    Bernhardsson, Susanne; Larsson, Maria E H; Johansson, Kajsa; Öberg, Birgitta

    2017-07-01

    Patients' preferences should be integrated in evidence-based practice. This study aimed to explore patients' preferences for physiotherapy treatment and participation in decision making. A qualitative study set in an urban physiotherapy clinic in Gothenburg, Sweden. Individual, semi-structured interviews were conducted with 20 individuals who sought physiotherapy for musculoskeletal disorders. The interviews were recorded, transcribed, and analyzed with qualitative content analysis. An overarching theme, embracing six categories, was conceptualized: Trust in the physiotherapist fosters active engagement in therapy. The participants preferred active treatment strategies such as exercise and advice for self-management, allowing them to actively engage in their therapy. Some preferred passive treatments. Key influencers on treatment preferences were previous experiences and media. All participants wanted to be involved in the clinical decision making, but to varying extents. Some expressed a preference for an active role and wanting to share decisions while others were content with a passive role. Expectations for a professional management were reflected in trust and confidence in physiotherapists' skills and competence, expectations for good outcomes, and believing that treatment methods should be evidence-based. Trust in the physiotherapist's competence, as well as a desire to participate in clinical decision making, fosters active engagement in physiotherapy.

  8. Patient Preferences in Regulatory Benefit-Risk Assessments: A US Perspective.

    Science.gov (United States)

    Johnson, F Reed; Zhou, Mo

    Demands for greater transparency in US regulatory assessments of benefits and risks, together with growing interest in engaging patients in Food and Drug Administration regulatory decision making, have resulted in several recent regulatory developments. Although Food and Drug Administration's Center for Drug Evaluation and Research (CDER) and Center for Devices and Radiological Health (CDRH) have established patient-engagement initiatives, CDRH has proposed guidelines for considering quantitative data on patients' benefit-risk perspectives, while CDER has focused on a more qualitative approach. We summarize two significant studies that were developed in collaboration and consultation with CDER and CDRH. CDER encouraged a patient advocacy group to propose draft guidance on engaging patient and caregiver stakeholders in regulatory decision making for Duchenne muscular dystrophy. CDRH sponsored a discrete-choice experiment case study to quantify obese respondents' perspectives on "meaningful benefits." CDRH and CDER issued draft guidance in May and June 2015, respectively, on including patient-preference data in regulatory submissions. Both organizations face challenges. CDER is working on integrating qualitative data into existing evidence-based review processes and is exploring options for therapeutic areas not included on a priority list. CDRH has adopted an approach that requires patient-preference data to satisfy standards of valid scientific evidence. Although that strategy could facilitate integrating patient perspectives directly with clinical data on benefits and harms, generating such data requires building capacity. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. Identifying patient preferences for communicating risk estimates: A descriptive pilot study

    Directory of Open Access Journals (Sweden)

    O'Connor Annette M

    2001-08-01

    Full Text Available Abstract Background Patients increasingly seek more active involvement in health care decisions, but little is known about how to communicate complex risk information to patients. The objective of this study was to elicit patient preferences for the presentation and framing of complex risk information. Method To accomplish this, eight focus group discussions and 15 one-on-one interviews were conducted, where women were presented with risk data in a variety of different graphical formats, metrics, and time horizons. Risk data were based on a hypothetical woman's risk for coronary heart disease, hip fracture, and breast cancer, with and without hormone replacement therapy. Participants' preferences were assessed using likert scales, ranking, and abstractions of focus group discussions. Results Forty peri- and postmenopausal women were recruited through hospital fliers (n = 25 and a community health fair (n = 15. Mean age was 51 years, 50% were non-Caucasian, and all had completed high school. Bar graphs were preferred by 83% of participants over line graphs, thermometer graphs, 100 representative faces, and survival curves. Lifetime risk estimates were preferred over 10 or 20-year horizons, and absolute risks were preferred over relative risks and number needed to treat. Conclusion Although there are many different formats for presenting and framing risk information, simple bar charts depicting absolute lifetime risk were rated and ranked highest overall for patient preferences for format.

  10. Health literacy, numeracy, and other characteristics associated with hospitalized patients' preferences for involvement in decision making.

    Science.gov (United States)

    Goggins, Kathryn M; Wallston, Kenneth A; Nwosu, Samuel; Schildcrout, Jonathan S; Castel, Liana; Kripalani, Sunil

    2014-01-01

    Little research has examined the association of health literacy and numeracy with patients' preferred involvement in the problem-solving and decision-making process in the hospital. Using a sample of 1,249 patients hospitalized with cardiovascular disease from the Vanderbilt Inpatient Cohort Study (VICS), we assessed patients' preferred level of involvement using responses to two scenarios of differing symptom severity from the Problem-Solving Decision-Making Scale. Using multivariable modeling, we determined the relationship of health literacy, subjective numeracy, and other patient characteristics with preferences for involvement in decisions, and how this differed by scenario. The authors found that patients with higher levels of health literacy desired more participation in the problem-solving and decision-making process, as did patients with higher subjective numeracy skills, greater educational attainment, female gender, less perceived social support, or greater health care system distrust (pparticipate more in the decision-making process when the hypothetical symptom they were experiencing was less severe (i.e., they deferred more to their physician when the hypothetical symptom was more severe). These findings underscore the role that patient characteristics, especially health literacy and numeracy, play in decisional preferences among hospitalized patients.

  11. Orally disintegrating olanzapine review: effectiveness, patient preference, adherence, and other properties

    Directory of Open Access Journals (Sweden)

    Montgomery W

    2012-02-01

    Full Text Available William Montgomery1, Tamas Treuer2, Jamie Karagianis3, Haya Ascher-Svanum4, Gavan Harrison51Global Health Outcomes, Eli Lilly and Company, Sydney, Australia; 2Emerging Markets Business Unit (Neuroscience, Eli Lilly and Company, Budapest, Hungary; 3Eli Lilly and Company, Indianapolis, IN, USA; 4Global Health Outcomes, Eli Lilly and Company, Indianapolis, IN, USA; 5Asia-Pacific Medical Communications, Eli Lilly and Company, Sydney, AustraliaAbstract: Orally disintegrating olanzapine (ODO is a rapid-dissolving formulation of olanzapine which disintegrates in saliva almost immediately, developed as a convenient and adherence-enhancing alternative to the standard olanzapine-coated tablet (SOT. Clinical studies, which form the basis of this review, have shown ODO and SOT to have similar efficacy and tolerability profiles. However, ODO appears to have a number of advantages over SOT in terms of adherence, patient preference, and reduction in nursing burden. Overall, the existing clinical data suggests that compared to SOT, ODO is not only well-suited for difficult-to-treat, agitated, and/or nonadherent patients but, due to its potential ability to improve adherence and greater patient preference, may also be an appropriate formulation for the majority of patients for which olanzapine is the antipsychotic of choice.Keywords: orodispersible formulation, orally disintegrating, olanzapine, atypical antipsychotics, patient adherence, preference, schizophrenia, bipolar disorder

  12. Understanding Patients' Preferences for Referrals to Specialists for an Asymptomatic Condition.

    Science.gov (United States)

    Dunlea, Robert; Lenert, Leslie

    2015-01-14

    A specialty referral is a common but complex decision that often requires a primary care provider to balance his or her own interests with those of the patient. To examine the factors that influence a patient's choice of a specialist for consultation for an asymptomatic condition and better understand the tradeoffs that patients are and are not willing to make in this decision. Stratified cross-sectional convenience sample of subjects selected to parallel US population demographics. Members of an Internet survey panel who reported seeing a physician in the past year whose responses met objective quality metrics for attention. Respondents completed an adaptive conjoint analysis survey comparing specialists regarding eight attributes. The reliability of assessments and the predictive validity of models were measured using holdout samples. The relative importance (RI) of different attributes was computed using paired t tests. The implications of utility values were studied using market simulation methods. Five hundred and thirty subjects completed the survey and had responses that met quality criteria. The reliability of responses was high (86% agreement), and models were predictive of patients' preferences (82.6% agreement with holdout choices). The most important attribute for patients was out-of-pocket cost (RI of 19.5%, P communication" with the primary care provider was the most important attribute (RI of 13.1% P importance was whether the specialist practiced shared decision making (RI of 12.2% P well with their primary care provider and practiced shared decision making. Most patients prefer to wait for a doctor who practices shared decision making: Only one-third (32.3%) of patients preferred a paternalistic doctor who was available in 2 weeks over a doctor who practiced decision making but was available in 4 weeks. In the setting of a referral for an asymptomatic but serious condition, out-of-pocket costs are important to patients; however, they also value

  13. Politico-economic equivalence

    DEFF Research Database (Denmark)

    Gonzalez Eiras, Martin; Niepelt, Dirk

    2015-01-01

    Traditional "economic equivalence'' results, like the Ricardian equivalence proposition, define equivalence classes over exogenous policies. We derive "politico-economic equivalence" conditions that apply in environments where policy is endogenous and chosen sequentially. A policy regime and a st......Traditional "economic equivalence'' results, like the Ricardian equivalence proposition, define equivalence classes over exogenous policies. We derive "politico-economic equivalence" conditions that apply in environments where policy is endogenous and chosen sequentially. A policy regime...... their use in the context of several applications, relating to social security reform, tax-smoothing policies and measures to correct externalities....

  14. Analysis of Washout Filter-Based Power Sharing Strategy—An Equivalent Secondary Controller for Islanded Microgrid without LBC Lines

    DEFF Research Database (Denmark)

    Han, Yang; Li, Hong; Xu, Lin

    2018-01-01

    As a supplement of the droop control, the concept of secondary controlled microgrid (MG) has been extensively studied for voltage and frequency restoration. However, the low band-width communication (LBC) channels are needed to exchange information between the primary and secondary controllers...

  15. Efficacy, safety, and patient preference of monoamine oxidase B inhibitors in the treatment of Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Bradley J Robottom

    2011-01-01

    Full Text Available Bradley J RobottomDepartment of Neurology, University of Maryland School of Medicine, Baltimore, MD, USAAbstract: Parkinson's disease (PD is the second most common neurodegenerative disease and the most treatable. Treatment of PD is symptomatic and generally focuses on the replacement or augmentation of levodopa. A number of options are available for treatment, both in monotherapy of early PD and to treat complications of advanced PD. This review focuses on rasagiline and selegiline, two medications that belong to a class of antiparkinsonian drugs called monoamine oxidase B (MAO-B inhibitors. Topics covered in the review include mechanism of action, efficacy in early and advanced PD, effects on disability, the controversy regarding disease modification, safety, and patient preference for MAO-B inhibitors.Keywords: monoamine oxidase inhibitors, rasagiline, selegiline, Parkinson's disease, efficacy, safety

  16. Antipsychotic drug treatment for patients with schizophrenia: theoretical background, clinical considerations and patients preferences

    DEFF Research Database (Denmark)

    Nielsen, René Ernst; Nielsen, Jimmi

    2009-01-01

      The cornerstone in treatment of psychosis is antipsychotic drugs. Treatment options have increased over the years; newer antipsychotic drugs with a proposed efficacy regarding negative and cognitive symptoms, but also a shift in side-effects from neurological side-effects to metabolic side......-effects have arisen as the new challenge. The basis of successful pharmacological treatment is a fundamental understanding of the mechanisms of action, the desired effects and side-effects of antipsychotic drugs, a good relationship with the patient and a thorough monitoring of the patient before and during...... treatment. The clinically relevant aspects of antipsychotic drug treatment are reviewed; mechanism of antipsychotic drug action, clinical considerations in treatment, switching antipsychotic drugs, polypharmacy, safety and patient preference.  ...

  17. Patient preferences for outcomes of depression treatment in Germany: a choice-based conjoint analysis study.

    Science.gov (United States)

    Zimmermann, Thomas M; Clouth, Johannes; Elosge, Michael; Heurich, Matthias; Schneider, Edith; Wilhelm, Stefan; Wolfrath, Anette

    2013-06-01

    In general, treatment efficacy in depressed patients is evaluated mainly based on the core symptoms of depression. However, patients might consider different outcomes. This study used choice-based conjoint analysis (CBC) to evaluate patient preferences for depression treatment outcomes. Adult subjects from Germany, currently or previously on antidepressant treatment, were presented with 18 pairs of hypothetical treatment outcome scenarios, differing in eight attributes (2-3 factor levels each): depressed mood, loss of interest and enjoyment, loss of energy/fatigue, sleep disturbance, feelings of guilt, depression-related pain, treatment duration, side effects after 2 weeks. Attributes and factor levels were defined by literature review, expert consultations, and in-depth subject interviews. Data were analyzed using multinomial logit modeling; individual part-worth utilities were estimated using hierarchical Bayes routines. Two hundred twenty-seven subjects (89.4% currently treated with antidepressants, 30.0% with depression-related pain) completed the survey. They valued the relative importance of outcomes as follows: loss of energy/fatigue 18.5%, side effects after 2 weeks 14.2%, loss of interest and enjoyment 13.5%, depression-related pain 12.0%, sleep disturbance 12.0%, feelings of guilt 11.5%, treatment duration 9.9%, depressed mood 8.5%. Participants were not required to meet ICD-10 or DSM-IV criteria for depression and had heterogeneous disease severity. CBC analysis was able to reveal patient preferences for outcomes of depression treatment. Subjects valued the ability to cope with activities of everyday living highest. They considered being free of depression-related pain and side effects more important than being free of depressed mood. These findings should be considered when making treatment decisions. Copyright © 2012 Elsevier B.V. All rights reserved.

  18. Patient preferences for important attributes of bipolar depression treatments: a discrete choice experiment

    Directory of Open Access Journals (Sweden)

    Ng-Mak D

    2017-12-01

    Full Text Available Daisy Ng-Mak,1 Jiat-Ling Poon,2 Laurie Roberts,2 Leah Kleinman,2 Dennis A Revicki,2 Krithika Rajagopalan1 1Global Health Economics and Outcomes Research, Sunovion Pharmaceuticals Inc., Marlborough, MA, 2Patient-Centered Research, Evidera, Bethesda, MD, USA Purpose: The purpose of this study was to assess patient preferences regarding pharmacological treatment attributes for bipolar depression using a discrete choice experiment (DCE.Methods: Adult members of an Internet survey panel with a self-reported diagnosis of bipolar depression were invited via e-mail to participate in a web-based DCE survey. Participants were asked to choose between hypothetical medication alternatives defined by attributes and levels that were varied systematically. The six treatment attributes included in the DCE were time to improvement, risk of becoming manic, weight gain, risk of sedation, increased blood sugar, and increased cholesterol. Attributes were supported by literature review, expert input, and results of focus groups with patients. Sawtooth CBC System for Choice-Based Conjoint Analysis was used to estimate the part-worth utilities for the DCE analyses.Results: The analytical sample included 185 participants (50.8% females from a total of 200 participants. The DCE analyses found weight gain to be the most important treatment attribute (relative importance =49.6%, followed by risk of sedation (20.2%, risk of mania (13.0%, increased blood sugar (8.3%, increased cholesterol (5.2%, and time to improvement (3.7%.Conclusion: Results from this DCE suggest that adults with bipolar depression considered risks of weight gain and sedation associated with pharmacotherapy as the most important attributes for the treatment of bipolar depression. Incorporating patient preferences in the treatment decision-making process may potentially have an impact on treatment adherence and satisfaction and, ultimately, patient outcomes. Keywords: bipolar depression, treatment

  19. What Do Patients Prefer? Understanding Patient Perspectives on Receiving a New Breast Cancer Diagnosis.

    Science.gov (United States)

    Attai, Deanna J; Hampton, Regina; Staley, Alicia C; Borgert, Andrew; Landercasper, Jeffrey

    2016-10-01

    There is variability in physician practice regarding delivery method and timeliness of test results to cancer patients. Our aim was to survey patients to determine if there was a difference between actual and preferred care for disclosure of test results. A de-identified survey was distributed to online cancer support groups to query patients about their experience regarding communication of cancer testing and timeliness. Analyses of the differences between actual and preferred communication and wait times were performed. Overall, 1000 patients completed the survey. The analysis herein was restricted to 784 breast cancer survivors. Survey responders were predominately White (non-Hispanic; 89 %), college educated (78 %), and media 'savvy' (online medical media usage; 97 %). Differences between actual and preferred care were identified for the domains of mode of communication and wait times for initial breast cancer diagnostic biopsies and other tests. A total of 309 (39 %) of 784 patients received face-to-face communication for a new cancer diagnosis, with 394 (50 %) patients preferring this option (p cancer biopsy result within 2 days, with 646 (82 %) patients preferring this option (p < 0.0001). Differences were also identified between actual and preferred care for multiple other test types. Actual care for timeliness and modes of communication did not reflect patient-desired care. National and local initiatives to improve performance are needed. As a first step, we recommend that each patient be queried about their preference for mode of communication and timeliness, and efforts made to comply.

  20. Colorectal cancer patients' preferences for type of caregiver during survivorship care.

    Science.gov (United States)

    Wieldraaijer, T; Duineveld, L A M; Donkervoort, S C; Busschers, W B; van Weert, H C P M; Wind, J

    2018-03-01

    Colorectal cancer (CRC) survivors are currently included in a secondary care-led survivorship care programme. Efforts are underway to transfer this survivorship care to primary care, but met with some reluctance by patients and caregivers. This study assesses (1) what caregiver patients prefer to contact for symptoms during survivorship care, (2) what patient factors are associated with a preferred caregiver, and (3) whether the type of symptom is associated with a preferred caregiver. A cross-sectional study of CRC survivors at different time points. For 14 different symptoms, patients reported if they would consult a caregiver, and who they would contact if so. Patient and disease characteristics were retrieved from hospital and general practice records. Two hundred and sixty patients participated (response rate 54%) of whom the average age was 67, 54% were male. The median time after surgery was seven months (range 0-60 months). Patients were divided fairly evenly between tumour stages 1-3, 33% had received chemotherapy. Men, patients older than 65 years, and patients with chronic comorbid conditions preferred to consult their general practitioner (GP). Women, patients with stage 3 disease, and patients that had received chemotherapy preferred to consult their secondary care provider. For all symptoms, patients were more likely to consult their GP, except for (1) rectal blood loss, (2) weight loss, and (3) fear that cancer had recurred, in which case they would consult both their primary and secondary care providers. Patients appreciated all caregivers involved in survivorship care highly; with 8 out of 10 points. CRC survivors frequently consult their GP in the current situation, and for symptoms that could alarm them to a possible recurrent disease consult both their GP and secondary care provider. Patient and tumour characteristics influence patients' preferred caregiver.

  1. Comparative efficacy and patient preference of topical anaesthetics in dermatological laser treatments and skin microneedling

    Directory of Open Access Journals (Sweden)

    Yi Zhen Chiang

    2015-01-01

    Full Text Available Background: Topical anaesthetics are effective for patients undergoing superficial dermatological and laser procedures. Our objective was to compare the efficacy and patient preference of three commonly used topical anaesthetics: (2.5% lidocaine/2.5% prilocaine cream (EMLA ® , 4% tetracaine gel (Ametop TM and 4% liposomal lidocaine gel (LMX4 ® in patients undergoing laser procedures and skin microneedling. Settings and Design: This was a prospective, double-blind study of patients undergoing laser and skin microneedling procedures at a laser unit in a tertiary referral dermatology centre. Materials and Methods: All 29 patients had three topical anaesthetics applied under occlusion for 1 hour prior to the procedure, at different treatment sites within the same anatomical zone. A self-assessment numerical pain rating scale was given to each patient to rate the pain during the procedure and each patient was asked to specify their preferred choice of topical anaesthetic at the end of the procedure. Statistical Analysis: Parametric data (mean pain scores and frequency of topical anaesthetic agent of choice were compared using the paired samples t-test. A P-value of ≤0.05 was considered as statistically significant. Results and Conclusions: Patients reported a mean (±SD; 95% confidence interval pain score of 5 (±2.58; 3.66-6.46 with Ametop TM , 4.38 (±2.53; 2.64-4.89 with EMLA ® and 3.91 (±1.95; 2.65-4.76 with LMX4 ® . There was no statistically significant difference in pain scores between the different topical anaesthetics. The majority of patients preferred LMX4 ® as their choice of topical anaesthetic for dermatological laser and skin microneedling procedures.

  2. Patient preferences for the allocation of deceased donor kidneys for transplantation: a mixed methods study

    Directory of Open Access Journals (Sweden)

    Tong Allison

    2012-04-01

    Full Text Available Abstract Background Deceased donor kidneys are a scarce health resource, yet patient preferences for organ allocation are largely unknown. The aim of this study was to determine patient preferences for how kidneys should be allocated for transplantation. Methods Patients on dialysis and kidney transplant recipients were purposively selected from two centres in Australia to participate in nominal/focus groups in March 2011. Participants identified and ranked criteria they considered important for deceased donor kidney allocation. Transcripts were thematically analysed to identify reasons for their rankings. Results From six groups involving 37 participants, 23 criteria emerged. Most agreed that matching, wait-list time, medical urgency, likelihood of surviving surgery, age, comorbidities, duration of illness, quality of life, number of organs needed and impact on the recipient's life circumstances were important considerations. Underpinning their rankings were four main themes: enhancing life, medical priority, recipient valuation, and deservingness. These were predominantly expressed as achieving equity for all patients, or priority for specific sub-groups of potential recipients regarded as more "deserving". Conclusions Patients believed any wait-listed individual who would gain life expectancy and quality of life compared with dialysis should have access to transplantation. Equity of access to transplantation for all patients and justice for those who would look after their transplant were considered important. A utilitarian rationale based on maximizing health gains from the allocation of a scarce resource to avoid "wastage," were rarely expressed. Organ allocation organisations need to seek input from patients who can articulate preferences for allocation and advocate for equity and justice in organ allocation.

  3. Patient preferences for types of community-based cardiac rehabilitation programme.

    Science.gov (United States)

    Chia, Shermain; Wong, Xin Yi; Toon, Min Li; Seah, Yi; Yap, Angela Frances; Lim, Cindy; Tay, Hung Yong; Fong, Warren; Low, Lian Leng; Kwan, Yu Heng

    2018-01-01

    Cardiac rehabilitation (CR) improves mortality, morbidity and quality of life of cardiovascular patients. However, its uptake is poor especially in the hospitals due to long travel distances and office hours constraints. Community-based CR is a possible solution. To understand the type of community-based CR preferred and identify patient characteristics associated with certain programme combinations. A cross-sectional survey was administered to a randomised list of patients at risk for or with cardiovascular diseases at two community-based CR centres. Participants were presented with nine hypothetical choice sets and asked to choose only one of the two alternative programme combinations in each choice set. Attributes include support group presence, cash incentives, upfront deposit and out-of-pocket cost. The counts for each combination were tallied and corrected for repeats. Chi-square test and logistic regression were performed to understand the characteristics associated with the preferred CR combination. After correcting for repeats, patients most (85.2%) prefer CR programmes with new group activities, support group, cash rewards, deposit and out-of-pocket cost, and few exercise equipment with physiotherapist presence without the need for monitoring equipment. Patients with more than three bedrooms in their house are less likely (OR 0.367; CI 0.17 to 0.80; P=0.011) to choose the choice with no physiotherapist and few equipment available. This is the first study to explore patients' preferences for different types of community CR. Higher income patients prefer physiotherapist presence and are willing to settle for less equipment. Our study serves as a guide for designing future community-based CR programmes.

  4. The best marketing strategy in aesthetic plastic surgery: evaluating patients' preferences by conjoint analysis.

    Science.gov (United States)

    Marsidi, Nick; van den Bergh, Maurice W H M; Luijendijk, Roland W

    2014-01-01

    To provide the best marketing strategy for a private clinic, knowledge of patients' preferences is essential. In marketing, conjoint analysis has been frequently used to calculate which attributes of a product are most valuable to consumers. This study investigates the relative importance of attributes that influence the selection and decision-making process when choosing an aesthetic private clinic, using conjoint analysis. The following attributes were chosen by the senior author (R.W.L.) and a marketing and communications director after a preselection of 25 randomly selected people: relative cost of the procedure, travel time, experience of the plastic surgeon, size of the clinic, method of referral, and online presentation. The attributes were then divided into levels. Using a random factor conducted by SPSS, 18 different scenarios were created and rated online by 150 potential patients before their potential visit or consultation. The patients could rate these scenarios on a scale from 1 to 7 with respect to the likeliness of visiting the clinic. The most important attribute was experience of the surgeon (35.6 percent), followed by method of referral (21.5 percent), travel time (14.2 percent), cost of procedure (12.9 percent), online presentation (9.7 percent), and size of the clinic (6.1 percent). Six of 16 levels gave a negative influence on the decision making. The authors' study shows that the two most important attributes are the experience of the surgeon and the method of referral and that conjoint analysis is effective in determining patients' preferences. It also shows which levels positively or negatively contribute per attribute.

  5. Techniques for enhancing durability and equivalence ratio control in a rich-lean, three-stage ground power gas turbine combustor

    Science.gov (United States)

    Schultz, D. F.

    1982-01-01

    Rig tests of a can-type combustor were performed to demonstrate two advanced ground power engine combustor concepts: steam cooled rich-burn combustor primary zones for enhanced durability; and variable combustor geometry for three stage combustion equivalence ratio control. Both concepts proved to be highly successful in achieving their desired objectives. The steam cooling reduced peak liner temperatures to less than 800 K. This offers the potential of both long life and reduced use of strategic materials for liner fabrication. Three degrees of variable geometry were successfully implemented to control airflow distribution within the combustor. One was a variable blade angle axial flow air swirler to control primary airflow while the other two consisted of rotating bands to control secondary and tertiary or dilution air flow.

  6. Not doing bad things is not equivalent to doing the right thing: distinguishing between inhibitory and initiatory self-control

    NARCIS (Netherlands)

    De Ridder, D.T.D.; de Boer, Benjamin; Lugtig, P.J.; Bakker, A.B.; van Hooft, E.A.J.

    The present study investigated whether a conceptual distinction between two components of self-control (inhibitory and initiatory self-control) is empirically valid. To that purpose, a series of confirmative factor analyses were employed in two samples (total N = 577), providing support for a

  7. Controlling human corneal stromal stem cell contraction to mediate rapid cell and matrix organization of real architecture for 3-dimensional tissue equivalents.

    Science.gov (United States)

    Mukhey, Dev; Phillips, James B; Daniels, Julie T; Kureshi, Alvena K

    2018-02-01

    The architecture of the human corneal stroma consists of a highly organized extracellular matrix (ECM) interspersed with keratocytes. Their progenitor cells; corneal stromal stem cells (CSSC) are located at the periphery, in the limbal stroma. A highly organized corneal ECM is critical for effective transmission of light but this structure may be compromised during injury or disease, resulting in loss of vision. Re-creating normal organization in engineered tissue equivalents for transplantation often involves lengthy culture times that are inappropriate for clinical use or utilisation of synthetic substrates that bring complications such as corneal melting. CSSC have great therapeutic potential owing to their ability to reorganize a disorganized matrix, restoring transparency in scarred corneas. We examined CSSC contractile behavior to assess whether this property could be exploited to rapidly generate cell and ECM organization in Real Architecture For 3D Tissues (RAFT) tissue equivalents (TE) for transplantation. Free-floating collagen gels were characterized to assess contractile behavior of CSSC and establish optimum cell density and culture times. To mediate cell and collagen organization, tethered collagen gels seeded with CSSC were cultured and subsequently stabilized with the RAFT process. We demonstrated rapid creation of biomimetic RAFT TE with tunable structural properties. These displayed three distinct regions of varying degrees of cellular and collagen organization. Interestingly, increased organization coincided with a dramatic loss of PAX6 expression in CSSC, indicating rapid differentiation into keratocytes. The organized RAFT TE system could be a useful bioengineering tool to rapidly create an organized ECM while simultaneously controlling cell phenotype. For the first time, we have demonstrated that human CSSC exhibit the phenomenon of cellular self-alignment in tethered collagen gels. We found this mediated rapid co-alignment of collagen fibrils

  8. Complex antithrombotic therapy: determinants of patient preference and impact on medication adherence

    Directory of Open Access Journals (Sweden)

    Abraham NS

    2015-11-01

    Full Text Available Neena S Abraham,1,2 Aanand D Naik,3,4 Richard L Street Jr,3–5 Diana L Castillo,3 Anita Deswal,6 Peter A Richardson,3,4 Christine M Hartman,3 George Shelton Jr,3,4 Liana Fraenkel7,8 1Division of Gastroenterology, Mayo Clinic, Scottsdale, AZ, USA; 2Divison of Healthcare Policy and Research, Department of Health Services Research, Rochester, MN, USA; 3Center for Innovations in Quality, Effectiveness, and Safety at the Michael E DeBakey VA Medical Center, Houston, TX, USA; 4Department of Medicine, Baylor College of Medicine, Houston, TX, USA; 5Department of Communication, Texas A&M University, College Station, TX, USA; 6Cardiology, Michael E DeBakey VAMC, Houston, TX, USA; 7Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA; 8Department of Medicine, Yale University, New Haven, CT, USA Purpose: For years, older patients have been prescribed multiple blood-thinning medications (complex antithrombotic therapy [CAT] to decrease their risk of cardiovascular events. These therapies, however, increase risk of adverse bleeding events. We assessed patient-reported trade-offs between cardioprotective benefit, gastrointestinal bleeding risk, and burden of self-management using adaptive conjoint analysis (ACA. As ACA could be a clinically useful tool to obtain patient preferences and guide future patient-centered care, we examined the clinical application of ACA to obtain patient preferences and the impact of ACA on medication adherence.Patients and methods: An electronic ACA survey led 201 respondents through medication risk–benefit trade-offs, revealing patients’ preferences for the CAT risk/benefit profile they valued most. The post-ACA prescription regimen was categorized as concordant or discordant with elicited preferences. Adherence was measured using VA pharmacy refill data to measure persistence of use prior to and 1 year following preference-elicitation. Additionally, we analyzed qualitative interviews of 56 respondents

  9. Patient preferences for community pharmacy asthma services: a discrete choice experiment.

    Science.gov (United States)

    Naik-Panvelkar, Pradnya; Armour, Carol; Rose, John M; Saini, Bandana

    2012-10-01

    Specialized community pharmacy services, involving the provision of disease state management and care by pharmacists, have been developed and trialled and have demonstrated very good health outcomes. Most of these services have been developed from a healthcare professional perspective. However, for the future uptake and long-term sustainability of these services as well as for better and sustained health outcomes for patients, it is vital to gain an understanding of patients' preferences. We can then structure healthcare services to match these preferences and needs rather than around clinical viewpoints alone. The aim of this study was to elicit patient preferences for pharmacy-based specialized asthma services using a discrete choice experiment and to explore the value/importance that patients place on the different attributes of the asthma service. The existence of preference heterogeneity in the population was also investigated. The study was conducted with asthma patients who had recently experienced a specialized asthma management service at their pharmacy in New South Wales, Australia. Pharmacists delivering the asthma service mailed out the discrete choice questionnaires to participating patients at the end of 6 months of service provision. A latent class (LC) model was used to investigate each patient's strength of preference and preference heterogeneity for several key attributes related to asthma service provision: frequency of visits, access to pharmacist, interaction with pharmacy staff, availability of a private area for consultation, provision of lung function testing, type and depth of advice provision, number of days with asthma symptoms and cost of service. Eighty useable questionnaires (of 170 questionnaires sent out) were received (response rate 47.1%). The study identified various key elements of asthma services important to patients. Further, the LC analysis revealed three classes with differing patient preferences for levels of asthma service

  10. Impact of Gender on Patient Preferences for Technology-Based Behavioral Interventions

    Directory of Open Access Journals (Sweden)

    David J. Kim

    2014-08-01

    Full Text Available Introduction: Technology-based interventions offer an opportunity to address high-risk behaviors in the emergency department (ED. Prior studies suggest behavioral health strategies are more effective when gender differences are considered. However, the role of gender in ED patient preferences for technology-based interventions has not been examined. The objective was to assess whether patient preferences for technology-based interventions varies by gender. Methods: This was a secondary analysis of data from a systematic survey of adult (18 years of age, English-speaking patients in a large urban academic ED. Subjects were randomly selected during a purposive sample of shifts. The iPad survey included questions on access to technology, preferences for receiving health information, and demographics. We defined ‘‘technology-based’’ as web, text message, e-mail, social networking, or DVD; ‘‘non-technology-based’’ was defined as in-person, written materials, or landline. We calculated descriptive statistics and used univariate tests to compare men and women. Gender-stratified multivariable logistic regression models were used to examine associations between other demographic factors (age, race, ethnicity, income and technology-based preferences for information on specific risky behaviors. Results: Of 417 participants, 45.1% were male. There were no significant demographic differences between men and women. Women were more likely to use computers (90.8% versus 81.9%; p¼0.03, Internet (66.8% versus 59.0%; p¼0.03, and social networks (53.3% versus 42.6%; p¼0.01. 89% of men and 90% of women preferred technology-based formats for at least type of health information; interest in technology-based for individual health topics did not vary by gender. Concern about confidentiality was the most common barrier to technology-based use for both genders. Multivariate analysis showed that for smoking, depression, drug/alcohol use, and injury

  11. 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.)

  12. Congruence between patients' preferred and perceived participation in medical decision-making: a review of the literature.

    Science.gov (United States)

    Brom, Linda; Hopmans, Wendy; Pasman, H Roeline W; Timmermans, Danielle R M; Widdershoven, Guy A M; Onwuteaka-Philipsen, Bregje D

    2014-04-03

    Patients are increasingly expected and asked to be involved in health care decisions. In this decision-making process, preferences for participation are important. In this systematic review we aim to provide an overview the literature related to the congruence between patients' preferences and their perceived participation in medical decision-making. We also explore the direction of mismatched and outline factors associated with congruence. A systematic review was performed on patient participation in medical decision-making. Medline, PsycINFO, CINAHL, EMBASE and the Cochrane Library databases up to September 2012, were searched and all studies were rigorously critically appraised. In total 44 papers were included, they sampled contained 52 different patient samples. Mean of congruence between preference for and perceived participation in decision-making was 60% (49 and 70 representing 25th and 75th percentiles). If no congruence was found, of 36 patient samples most patients preferred more involvement and of 9 patient samples most patients preferred less involvement. Factors associated with preferences the most investigated were age and educational level. Younger patients preferred more often an active or shared role as did higher educated patients. This review suggests that a similar approach to all patients is not likely to meet patients' wishes, since preferences for participation vary among patients. Health care professionals should be sensitive to patients individual preferences and communicate about patients' participation wishes on a regular basis during their illness trajectory.

  13. Patient preference for a long-acting recombinant FSH product in ovarian hyperstimulation in IVF: a discrete choice experiment

    NARCIS (Netherlands)

    van den Wijngaard, L.; Rodijk, I. C. M.; van der Veen, F.; Gooskens-van Erven, M. H. W.; Koks, C. A. M.; Verhoeve, H. R.; Mol, B. W. J.; van Wely, M.; Mochtar, M. H.

    2015-01-01

    What factors or attributes of a long-acting recombinant FSH (rFSH) or daily-administrated rFSH influence women's preferences IVF? Patients' preferences for rFSH products are primary influenced by the attribute 'number of injections', but a low 'number of injections' is exchanged for a high 'number

  14. Precision Oncology and Genetic Risk Information: Exploring Patients' Preferences and Responses

    Science.gov (United States)

    Dr. Jada Hamilton is an Assistant Member at Memorial Sloan Kettering Cancer Center, as well as an Assistant Attending Psychologist in the Behavioral Sciences Service, Department of Psychiatry and Behavioral Sciences and in the Clinical Genetics Service, Department of Medicine at Memorial Hospital in New York, New York.  She leads a program of research at the intersection of behavioral science, cancer prevention, and genomics, with the goal of translating advances in genetic and genomic medicine into improved cancer care that is of high quality, aligned with patient preferences, and ultimately improves public health.  Dr. Hamilton is also currently leading a study to assess how patients and their families respond to inherited risk information that is revealed as part of tumor sequencing (funded through a Mentored Research Scholar Grant from the American Cancer Society), as well as studies to evaluate alternative models for offering genetic counseling and testing to patients with cancer, and to examine the effects of novel breast cancer genetic risk feedback on patients’ decision-making, psychological, and behavioral outcomes. Prior to joining the faculty of Memorial Sloan Kettering, Dr. Hamilton received a BA in Genetics and Psychology from Ohio Wesleyan University (2004), an MA and PhD in Social and Health Psychology from Stony Brook University (2006, 2009), and an MPH from the Mailman School of Public Health at Columbia University (2010).  She also completed a postdoctoral fellowship as part of the National Cancer Institute’s Cancer Prevention Fellowship Program.

  15. Patient Preferences and Surrogate Decision Making in Neuroscience Intensive Care Units

    Science.gov (United States)

    Cai, Xuemei; Robinson, Jennifer; Muehlschlegel, Susanne; White, Douglas B.; Holloway, Robert G.; Sheth, Kevin N.; Fraenkel, Liana; Hwang, David Y.

    2016-01-01

    In the neuroscience intensive care unit (NICU), most patients lack the capacity to make their own preferences known. This fact leads to situations where surrogate decision makers must fill the role of the patient in terms of making preference-based treatment decisions, oftentimes in challenging situations where prognosis is uncertain. The neurointensivist has a large responsibility and role to play in this shared decision making process. This review covers how NICU patient preferences are determined through existing advance care documentation or surrogate decision makers and how the optimum roles of the physician and surrogate decision maker are addressed. We outline the process of reaching a shared decision between family and care team and describe a practice for conducting optimum family meetings based on studies of ICU families in crisis. We review challenges in the decision making process between surrogate decision makers and medical teams in neurocritical care settings, as well as methods to ameliorate conflicts. Ultimately, the goal of shared decision making is to increase knowledge amongst surrogates and care providers, decrease decisional conflict, promote realistic expectations and preference-centered treatment strategies, and lift the emotional burden on families of neurocritical care patients. PMID:25990137

  16. Quality of life and patient preferences: identification of subgroups of multiple sclerosis patients.

    Science.gov (United States)

    Rosato, Rosalba; Testa, Silvia; Oggero, Alessandra; Molinengo, Giorgia; Bertolotto, Antonio

    2015-09-01

    The aim of this study was to estimate preferences related to quality of life attributes in people with multiple sclerosis, by keeping heterogeneity of patient preference in mind, using the latent class approach. A discrete choice experiment survey was developed using the following attributes: activities of daily living, instrumental activities of daily living, pain/fatigue, anxiety/depression and attention/concentration. Choice sets were presented as pairs of hypothetical health status, based upon a fractional factorial design. The latent class logit model estimated on 152 patients identified three subpopulations, which, respectively, attached more importance to: (1) the physical dimension; (2) pain/fatigue and anxiety/depression; and (3) instrumental activities of daily living impairments, anxiety/depression and attention/concentration. A posterior analysis suggests that the latent class membership may be related to an individual's age to some extent, or to diagnosis and treatment, while apart from energy dimension, no significant difference exists between latent groups, with regard to Multiple Sclerosis Quality of Life-54 scales. A quality of life preference-based utility measure for people with multiple sclerosis was developed. These utility values allow identification of a hierarchic priority among different aspects of quality of life and may allow physicians to develop a care programme tailored to patient needs.

  17. Factors affecting direction and strength of patient preferences for treatment of molar teeth with nonvital pulps.

    Science.gov (United States)

    Vernazza, C R; Steele, J G; Whitworth, J M; Wildman, J R; Donaldson, C

    2015-12-01

    To elicit the factors affecting willingness to pay (WTP) values for the preferred options of participants for dealing with a molar tooth with a nonvital pulp, a common but difficult problem. A total of 503 patients were recruited from dental practices in the North East of England and interviewed. Their preferred treatment option for a molar tooth with a nonvital pulp (endodontics, extraction and various prosthetic restorative options) and WTP for this preferred option were elicited. Factors affecting preferred option and WTP were analysed using econometric modelling. Overall, 53% of the sample wished to save the tooth with a mean WTP of £373. The variance in WTP was high. Of those opting for extraction, the majority chose to leave a gap or have an implant. The preferred option was influenced by previous treatment experience. WTP was only influenced by having a low income. The high level of variance in WTP and its relatively unpredictable nature pose difficult questions for policy makers trying to ensure the delivery of an equitable service. For dentists, it is important not to make assumptions about patient preference and strength of preference when making decisions. Ideally, WTP values should be considered alongside effectiveness data, and those on costs, in policy making. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  18. The impact of marketing language on patient preference for robot-assisted surgery.

    Science.gov (United States)

    Dixon, Peter R; Grant, Robert C; Urbach, David R

    2015-02-01

    Robot-assisted surgery is gaining momentum as a new trend in minimally invasive surgery. With limited evidence supporting its use in place of the far less expensive conventional laparoscopic surgery, it has been suggested that marketing pressure is partly responsible for its widespread adoption. The impact of phrases that promote the novelty of robot-assisted surgery on patient decision making has not been investigated. We conducted a discrete choice experiment to elicit preference of partial colectomy technique for a hypothetical diagnosis of colon cancer. A convenience sample of 38 participants in an ambulatory general surgery clinic consented to participate. Each participant made 2 treatment decisions between robot-assisted surgery and conventional laparoscopic surgery, with robot-assisted surgery described as "innovative" and "state-of-the-art" in one of the decisions (marketing frame), and by a disclosure of the uncertainty of available evidence in the other (evidence-based frame). The magnitude of the framing effect was large with 12 of 38 subjects (31.6%, P = .005) selecting robot-assisted surgery in the marketing frame and not the evidence-based frame. This is the first study to our knowledge to demonstrate that words that highlight novelty have an important influence on patient preference for robot-assisted surgery and that use of more neutral language can mitigate this effect. © The Author(s) 2014.

  19. What factors determine patients' preference for tumour necrosis factor inhibitors in ankylosing spondylitis?

    Science.gov (United States)

    Fajri, Dessy W; Brand, Caroline A; Dharmage, Shyamali C; Martin, Belinda J; Buchanan, Russell R C; Schachna, Lionel

    2009-05-01

    Tumour necrosis factor inhibitor (TNFi) therapy, either intravenous (IV) or subcutaneous (SQ), demonstrates similar efficacy in ankylosing spondylitis (AS). The objective of this study was to examine factors influencing patient preference of TNFi. Fifty-nine (79.7%) participants were male with mean age 43.9 years and disease duration of 22.0 years. Fifty-nine patients (79.7%) agreed with the statement 'My doctor gave me a choice and I made a decision based on my personal preference'. Patients commenced first on IV TNFi most commonly cited reduced frequency of injections (96.6%), administration by a trained professional (89.7%) and use of infusion time for leisure activities (86.2%). Patients commenced on SQ TNFi cited flexibility with timing of treatment (80%), shortened administration time (73.3%) and the convenience of home therapy (73.3%). Shared clinical decision-making between clinicians and patients may be desirable for AS patients commencing TNFi therapy.

  20. Discrete-choice modelling of patient preferences for modes of drug administration.

    Science.gov (United States)

    Tetteh, Ebenezer Kwabena; Morris, Steve; Titcheneker-Hooker, Nigel

    2017-12-01

    The administration of (biologically-derived) drugs for various disease conditions involves consumption of resources that constitutes a direct monetary cost to healthcare payers and providers. An often ignored cost relates to a mismatch between patients' preferences and the mode of drug administration. The "intangible" benefits of giving patients what they want in terms of the mode of drug delivery is seldom considered. This study aims to evaluate, in monetary terms, end-user preferences for the non-monetary attributes of different modes of drug administration using a discrete-choice experiment. It provides empirical support to the notion that there are significant benefits from developing patient-friendly approaches to drug delivery. The gross benefits per patient per unit administration is in the same order of magnitude as the savings in resource costs of administering drugs. The study argues that, as long as the underlying manufacturing science is capable, a patient-centred approach to producing drug delivery systems should be encouraged and pursued.

  1. Equivalence principles and electromagnetism

    Science.gov (United States)

    Ni, W.-T.

    1977-01-01

    The implications of the weak equivalence principles are investigated in detail for electromagnetic systems in a general framework. In particular, it is shown that the universality of free-fall trajectories (Galileo weak equivalence principle) does not imply the validity of the Einstein equivalence principle. However, the Galileo principle plus the universality of free-fall rotation states does imply the Einstein principle.

  2. Effect on skin hydration of using baby wipes to clean the napkin area of newborn babies: assessor-blinded randomised controlled equivalence trial

    Directory of Open Access Journals (Sweden)

    Lavender Tina

    2012-06-01

    Full Text Available Abstract Background Some national guidelines recommend the use of water alone for napkin cleansing. Yet, there is a readiness, amongst many parents, to use baby wipes. Evidence from randomised controlled trials, of the effect of baby wipes on newborn skin integrity is lacking. We conducted a study to examine the hypothesis that the use of a specifically formulated cleansing wipe on the napkin area of newborn infants ( Methods A prospective, assessor-blinded, randomised controlled equivalence trial was conducted during 2010. Healthy, term babies (n = 280, recruited within 48 hours of birth, were randomly assigned to have their napkin area cleansed with an alcohol-free baby wipe (140 babies or cotton wool and water (140 babies. Primary outcome was change in hydration from within 48 hours of birth to 4 weeks post-birth. Secondary outcomes comprised changes in trans-epidermal water loss, skin surface pH and erythema, presence of microbial skin contaminants/irritants at 4 weeks and napkin dermatitis reported by midwife at 4 weeks and mother during the 4 weeks. Results Complete hydration data were obtained for 254 (90.7 % babies. Wipes were shown to be equivalent to water and cotton wool in terms of skin hydration (intention-to-treat analysis: wipes 65.4 (SD 12.4 vs. water 63.5 (14.2, p = 0.47, 95 % CI -2.5 to 4.2; per protocol analysis: wipes 64.6 (12.4 vs. water 63.6 (14.3, p = 0.53, 95 % CI -2.4 to 4.2. No significant differences were found in the secondary outcomes, except for maternal-reported napkin dermatitis, which was higher in the water group (p = 0.025 for complete responses. Conclusions Baby wipes had an equivalent effect on skin hydration when compared with cotton wool and water. We found no evidence of any adverse effects of using these wipes. These findings offer reassurance to parents who choose to use baby wipes and to health professionals who support their use. Trial registration Current Controlled

  3. Effect on skin hydration of using baby wipes to clean the napkin area of newborn babies: assessor-blinded randomised controlled equivalence trial.

    Science.gov (United States)

    Lavender, Tina; Furber, Christine; Campbell, Malcolm; Victor, Suresh; Roberts, Ian; Bedwell, Carol; Cork, Michael J

    2012-06-01

    Some national guidelines recommend the use of water alone for napkin cleansing. Yet, there is a readiness, amongst many parents, to use baby wipes. Evidence from randomised controlled trials, of the effect of baby wipes on newborn skin integrity is lacking. We conducted a study to examine the hypothesis that the use of a specifically formulated cleansing wipe on the napkin area of newborn infants (skin hydration when compared with using cotton wool and water (usual care). A prospective, assessor-blinded, randomised controlled equivalence trial was conducted during 2010. Healthy, term babies (n=280), recruited within 48 hours of birth, were randomly assigned to have their napkin area cleansed with an alcohol-free baby wipe (140 babies) or cotton wool and water (140 babies). Primary outcome was change in hydration from within 48 hours of birth to 4 weeks post-birth. Secondary outcomes comprised changes in trans-epidermal water loss, skin surface pH and erythema, presence of microbial skin contaminants/irritants at 4 weeks and napkin dermatitis reported by midwife at 4 weeks and mother during the 4 weeks. Complete hydration data were obtained for 254 (90.7 %) babies. Wipes were shown to be equivalent to water and cotton wool in terms of skin hydration (intention-to-treat analysis: wipes 65.4 (SD 12.4) vs. water 63.5 (14.2), p=0.47, 95% CI -2.5 to 4.2; per protocol analysis: wipes 64.6 (12.4) vs. water 63.6 (14.3), p=0.53, 95% CI -2.4 to 4.2). No significant differences were found in the secondary outcomes, except for maternal-reported napkin dermatitis, which was higher in the water group (p=0.025 for complete responses). Baby wipes had an equivalent effect on skin hydration when compared with cotton wool and water. We found no evidence of any adverse effects of using these wipes. These findings offer reassurance to parents who choose to use baby wipes and to health professionals who support their use. Current Controlled Trials ISRCTN86207019.

  4. Coping-Infused Dialogue through Patient-Preferred Live Music: A Medical Music Therapy Protocol and Randomized Pilot Study for Hospitalized Organ Transplant Patients.

    Science.gov (United States)

    Hogan, Tyler James; Silverman, Michael J

    2015-01-01

    Solid organ transplant patients often experience a variety of psychosocial stressors that can lead to distress and may hinder successful recovery. Using coping-infused dialogue (CID) through patient- preferred live music (PPLM) music therapy sessions may improve mood and decrease pain while also imparting psychoeducational knowledge concerning the identification of local and global problems and coping skills. The purpose of this pilot study was to develop a coping-based medical music therapy protocol that combines coping-infused dialogue (CID) with patient-preferred live music (PPLM) and measure the effects of the resulting CID-PPLM protocol on mood (positive and negative affect) and pain in hospitalized transplant patients. Our study used a pre-/posttest single-session wait-list control design. Participants (N=25) were randomly assigned to experimental (CID-PPLM) or control (usual care) conditions. Participants in the CID-PPLM condition received a single 30-minute session that integrated stressor identification and knowledge of coping skills (CID) with patient-preferred live music (PPLM). Results indicated no between-group differences at pretest and significant correlations between pre- and posttest measures. Concerning posttest ANCOVA analyses, there were significant between-group differences in positive affect, negative affect, and pain, with experimental participants having more favorable posttest scores than control participants. Effect sizes were in the medium-to-large range for positive affect (η2=.198), negative affect (η2=.422), and pain (η2=.303). CID through receptive PPLM may be an effective protocol for improving mood and decreasing pain in organ transplant recipients. MT interventions can be an important tool to develop rapport and enhance outcomes with patients. As greater engagement during interventions may have stronger treatment effects, we recommend future research examining patient engagement as a potential mediator of intervention effects

  5. Female plastic surgery patients prefer mirror-reversed photographs of themselves: A prospective study.

    Science.gov (United States)

    de Runz, Antoine; Boccara, David; Chaouat, Marc; Locatelli, Katia; Bertheuil, Nicolas; Claudot, Frédérique; Bekara, Farid; Mimoun, Maurice

    2016-01-01

    The use of a patient's image in plastic surgery is common today. Thus, plastic surgeons should master the use of the image and be aware of the implications of the patients' perception of themselves. The mere-exposure effect is a psychological phenomenon in which a person tends to rate things more positively merely because (s)he is familiar with them. Faces are asymmetric, so faces in photos are different from those observed in mirrors. The main objective of this study was to assess whether patients within a plastic surgery population, particularly those undergoing facial aesthetic surgery, preferred standard photographs or mirror-reversed photographs of themselves. A prospective study was conducted in a plastic surgery department, which included women who were admitted to the hospital the day before their procedures. The patients were separated into the following two groups: Group 1 was composed of patients who were undergoing facial aesthetic surgeries, and Group 2 consisted of other patients who presented to the plastic surgery department for surgery. The patients were required to rate their appreciation of their own faces and to choose between standard and mirror-reversed photos of themselves. A total of 214 patients participated. The median age was 47.9 years (interquartile range (IQR): 36.4-60.6), and the median face appreciation was 5 (IQR: 5-7). The preference for the mirror-reversed photograph was significantly different from chance (p < 0.001, binomial (214, 156, 0.5)); 73% of the patients preferred the mirror-reversed photographs. The proportions of patients who preferred the mirror-reversed photograph differed significantly (p = 0.047) between Groups 1 (84%) and 2 (70%). Plastic surgery patients have a significant preference for mirror-reversed photographs of themselves over standard photographs. This preference is even more pronounced among patients who are undergoing facial aesthetic surgery. III. Copyright © 2015 British Association of Plastic

  6. Patient preferences toward an interactive e-consent application for research using electronic health records.

    Science.gov (United States)

    Harle, Christopher A; Golembiewski, Elizabeth H; Rahmanian, Kiarash P; Krieger, Janice L; Hagmajer, Dorothy; Mainous, Arch G; Moseley, Ray E

    2017-12-19

    The purpose of this study was to assess patient perceptions of using an interactive electronic consent (e-consent) application when deciding whether or not to grant broad consent for research use of their identifiable electronic health record (EHR) information. For this qualitative study, we conducted a series of 42 think-aloud interviews with 32 adults. Interview transcripts were coded and analyzed using a modified grounded theory approach. We identified themes related to patient preferences, reservations, and mixed attitudes toward consenting electronically; low- and high-information-seeking behavior; and an emphasis on reassuring information, such as data protections and prohibitions against sharing data with pharmaceutical companies. Participants expressed interest in the types of information contained in their EHRs, safeguards protecting EHR data, and specifics on studies that might use their EHR data. This study supports the potential value of interactive e-consent applications that allow patients to customize their consent experience. This study also highlights that some people have concerns about e-consent platforms and desire more detailed information about administrative processes and safeguards that protect EHR data used in research. This study contributes new insights on how e-consent applications could be designed to ensure that patients' information needs are met when seeking consent for research use of health record information. Also, this study offers a potential electronic approach to meeting the new Common Rule requirement that consent documents contain a "concise and focused" presentation of key information followed by more details. © The Author(s) 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  7. Survey of the general public's attitudes toward advance directives in Japan: How to respect patients' preferences

    Directory of Open Access Journals (Sweden)

    Kai Ichiro

    2006-10-01

    Full Text Available Abstract Background Japanese people have become increasingly interested in the expression and enhancement of their individual autonomy in medical decisions made regarding medical treatment at and toward the end of life. However, while many Western countries have implemented legislation that deals with patient autonomy in the case of terminal illness, no such legislation exists in Japan. The rationale for this research is based on the need to investigate patient's preferences regarding treatment at the end of life in order to re-evaluate advance directives policy and practice. Methods We conducted a cross-sectional survey with 418 members of the general middle-aged and senior adults (aged between 40 and 65 in Tokyo, Japan. Respondents were asked about their attitudes toward advance directives, and preferences toward treatment options. Results Over 60% of respondents agreed that it is better to express their wishes regarding advance directives (treatment preferences in writing, appointment of proxy for care decision making, appointment of legal administrator of property, stating preferences regarding disposal of one's property and funeral arrangements but less than 10% of them had already done so. About 60% of respondents in this study preferred to indicate treatment preferences in broad rather than concrete terms. Over 80% would like to decide treatment preferences in consultation with others (22.2% with their proxy, 11.0% with the doctor, and 47.8% with both their proxy and the doctor. Conclusion This study revealed that many Japanese people indicate an interest in undertaking advance directives. This study found that there is a range of preferences regarding how advance directives are undertaken, thus it is important to recognize that any processes put into place should allow flexibility in order to best respect patients' wishes and autonomy.

  8. Understanding HIV-positive patients' preferences for healthcare services: a protocol for a discrete choice experiment

    Science.gov (United States)

    Youssef, Elaney; Cooper, Vanessa; Miners, Alec; Llewellyn, Carrie; Pollard, Alex; Lagarde, Mylene; Sachikonye, Memory; Sabin, Caroline; Foreman, Claire; Perry, Nicky; Nixon, Eileen; Fisher, Martin

    2016-01-01

    Introduction While the care of HIV-positive patients, including the detection and management of comorbidities, has historically been provided in HIV specialist outpatient clinics, recent years have seen a greater involvement of non-HIV specialists and general practitioners (GPs). The aim of this study is to determine whether patients would prefer to see their GP or HIV physician given general symptoms, and to understand what aspects of care influence their preferences. Methods/analysis We have developed and piloted a discrete choice experiment (DCE) to better understand patients' preferences for care of non-HIV-related acute symptoms. The design of the DCE was informed by our exploratory research, including the findings of a systematic literature review and a qualitative study. Additional questionnaire items have been included to measure demographics, service use and experience of non-HIV illnesses and quality of life (EQ5D). We plan to recruit 1000 patients from 14 HIV clinics across South East England. Data will be analysed using random-effects logistic regression and latent class analysis. ORs and 95% CIs will be used to estimate the relative importance of each of the attribute levels. Latent class analysis will identify whether particular groups of people value the service attribute levels differently. Ethics/dissemination Ethical approval for this study was obtained from the Newcastle and North Tyneside Research Ethics Committee (reference number 14/NE/1193). The results will be disseminated at national and international conferences and peer-reviewed publications. A study report, written in plain English, will be made available to all participants. The Patient Advisory Group will develop a strategy for wider dissemination of the findings to patients and the public. PMID:27431895

  9. Contrast-enhanced spectral mammography (CESM) and contrast enhanced MRI (CEMRI): Patient preferences and tolerance.

    Science.gov (United States)

    Hobbs, Max M; Taylor, Donna B; Buzynski, Sebastian; Peake, Rachel E

    2015-06-01

    Contrast-enhanced spectral mammography (CESM) may have similar diagnostic performance to Contrast-enhanced MRI (CEMRI) in the diagnosis and staging of breast cancer. To date, research has focused exclusively on diagnostic performance when comparing these two techniques. Patient experience is also an important factor when comparing and deciding on which of these modalities is preferable. The aim of this study is to compare patient experience of CESM against CEMRI during preoperative breast cancer staging. Forty-nine participants who underwent both CESM and CEMRI, as part of a larger trial, completed a Likert questionnaire about their preference for each modality according to the following criteria: comfort of breast compression, comfort of intravenous (IV) contrast injection, anxiety and overall preference. Participants also reported reasons for preferring one modality to the other. Quantitative data were analysed using a Wilcoxon sign-rank test and chi-squared test. Qualitative data are reported descriptively. A significantly higher overall preference towards CESM was demonstrated (n = 49, P < 0.001), with faster procedure time, greater comfort and lower noise level cited as the commonest reasons. Participants also reported significantly lower rates of anxiety during CESM compared with CEMRI (n = 36, P = 0.009). A significantly higher rate of comfort was reported during CEMRI for measures of breast compression (n = 49, P = 0.001) and the sensation of IV contrast injection (n = 49, P = 0.003). Our data suggest that overall, patients prefer the experience of CESM to CEMRI, adding support for the role of CESM as a possible alternative to CEMRI for breast cancer staging. © 2015 The Royal Australian and New Zealand College of Radiologists.

  10. What drives the prescribing of growth hormone preparations in England? Prices versus patient preferences.

    Science.gov (United States)

    Chapman, Stephen R; Fitzpatrick, Raymond W; Aladul, Mohammed I

    2017-04-11

    The patent expiry of a number of biological medicines and the advent of biosimilars raised the expectations of healthcare commissioners that biosimilars would reduce the high cost of these medicines and produce potential savings to the NHS. We aimed to examine the prescribing pattern of different growth hormone preparations (ready to use and reconstitution requiring) in primary and secondary care in England to determine relative rates of decrease or increase and identify the possible factors influencing prescribing following the introduction of biosimilar growth hormone in 2008. Longitudinal observational study. Primary care prescribing cost and volume data was derived from the NHS business services authority website, and for secondary care from the DEFINE database, between April 2011 and December 2015. Quarterly prescribing analysis to examine trends and measure the relationship between usage and price. Expenditure and usage of growth hormone in primary care decreased by 17.91% and 7.29%, respectively, whereas expenditure and usage in secondary care increased by 68.41% and 100%, respectively, between April 2011 and December 2015. The usage of reconstitution requiring products significantly declined in primary care (R²=0.9292) and slightly increased in use in secondary care (R²=0.139). In contrast, the usage of ready-to-use products significantly increased in use in primary (R²=0.7526) and secondary care (R²=0.9633), respectively. Weak or no correlation existed between the usage and price of growth hormone preparations in primary and secondary care. The price of growth hormone products was not the key factor influencing the prescribing of the biological medicines. The main driver for specific product selection was the ease of use and the number of steps in dose preparation. Prescribers appear to be taking into account patient preferences rather than cost in their prescribing decisions. Published by the BMJ Publishing Group Limited. For permission to use (where

  11. Contrast-enhanced spectral mammography (CESM) and contrast enhanced MRI (CEMRI): Patient preferences and tolerance

    International Nuclear Information System (INIS)

    Hobbs, Max; Buzynski, Sebastian; Taylor, Donna B.; Peake, Rachel E.

    2015-01-01

    Contrast-enhanced spectral mammography (CESM) may have similar diagnostic performance to Contrast-enhanced MRI (CEMRI) in the diagnosis and staging of breast cancer. To date, research has focused exclusively on diagnostic performance when comparing these two techniques. Patient experience is also an important factor when comparing and deciding on which of these modalities is preferable. The aim of this study is to compare patient experience of CESM against CEMRI during preoperative breast cancer staging. Forty-nine participants who underwent both CESM and CEMRI, as part of a larger trial, completed a Likert questionnaire about their preference for each modality according to the following criteria: comfort of breast compression, comfort of intravenous (IV) contrast injection, anxiety and overall preference. Participants also reported reasons for preferring one modality to the other. Quantitative data were analysed using a Wilcoxon sign-rank test and chi-squared test. Qualitative data are reported descriptively. A significantly higher overall preference towards CESM was demonstrated (n = 49, P < 0.001), with faster procedure time, greater comfort and lower noise level cited as the commonest reasons. Participants also reported significantly lower rates of anxiety during CESM compared with CEMRI (n = 36, P = 0.009). A significantly higher rate of comfort was reported during CEMRI for measures of breast compression (n = 49, P = 0.001) and the sensation of IV contrast injection (n = 49, P = 0.003). Our data suggest that overall, patients prefer the experience of CESM to CEMRI, adding support for the role of CESM as a possible alternative to CEMRI for breast cancer staging.

  12. "Is There An App For That?" Orthopaedic Patient Preferences For A Smartphone Application.

    Science.gov (United States)

    Datillo, Jonathan R; Gittings, Daniel J; Sloan, Matthew; Hardaker, William M; Deasey, Matthew J; Sheth, Neil P

    2017-08-16

    Patients are seeking out medical information on the Internet and utilizing smartphone health applications ("apps"). Smartphone use has exponentially increased among orthopaedic surgeons and patients. Despite this increase, patients are rarely directed to specific apps by physicians. No study exists querying patient preferences for a patient-centered, orthopaedic smartphone application. The purpose of this study is to 1) determine Internet use patterns amongst orthopaedic patients; 2) ascertain access to and use of smartphones; and 3) elucidate what features orthopaedic patients find most important in a smartphone application. We surveyed patients in an orthopaedic practice in an urban academic center to assess demographics, access to and patterns of Internet and Smartphone use, and preferences for features in a smartphone app. A total of 310 surveys were completed. Eighty percent of patients reported Internet access, and 62% used the Internet for health information. Seventy-seven percent owned smartphones, 45% used them for health information, and 28% owned health apps. Only 11% were referred to an app by a physician. The highest ranked features were appointment reminders, ability to view test results, communication with physicians, and discharge instructions. General orthopaedic information and pictures or videos explaining surgery were the 2 lowest ranked features. Seventy-one percent of patients felt an app with some of the described features would improve their healthcare experiences, and 40% would pay for the app. The smartphone is an under-utilized tool to enhance patient-physician communication, increase satisfaction, and improve quality of care. Patients were enthusiastic about app features that are often included in patient health portals, but ranked orthopaedic educational features lowest. Further study is required to elucidate how best to use orthopaedic apps as physician-directed educational opportunities to promote patient satisfaction and quality of

  13. Communication of Pulmonary Function Test Results: A Survey of Patient's Preferences.

    Directory of Open Access Journals (Sweden)

    Debbie Zagami

    Full Text Available Physician-patient communication in patients suffering from common chronic respiratory disease should encompass discussion about pulmonary function test (PFT results, diagnosis, disease education, smoking cessation and optimising inhaler technique. Previous studies have identified that patients with chronic respiratory disease/s often express dissatisfaction about physician communication. Currently there is a paucity of data regarding patient awareness of their PFT results (among those who have undergone PFTs previously or patient preferences about PFT result communication.We undertook a three-month prospective study on outpatients referred to two Pulmonary Function Laboratories. If subjects had undergone PFTs previously, the awareness of their previous test results was evaluated. All subjects were asked about their preferences for PFT result communication. Subjects were determined to have chronic respiratory disease based on their past medical history.300 subjects (50% male with a median age (± SD of 65 (± 14 years participated in the study. 99% of the study participants stated that they were at least moderately interested in knowing their PFT results. 72% (217/300 of the subjects had undergone at least one PFT in the past, 48% of whom stated they had not been made aware of their results. Fewer subjects with chronic respiratory disease preferred that only a doctor discuss their PFT results with them (28% vs. 41%, p = 0.021.Our study demonstrates that while almost all subjects want to be informed of their PFT results, this does not occur in a large number of patients. Many subjects are agreeable for their PFT results to be communicated to them by clinicians other than doctors. Further research is required to develop an efficient method of conveying PFT results that will improve patient satisfaction and health outcomes.

  14. Patients' Preferences Related to Benefits, Risks, and Formulations of Schizophrenia Treatment.

    Science.gov (United States)

    Levitan, Bennett; Markowitz, Michael; Mohamed, Ateesha F; Johnson, F Reed; Alphs, Larry; Citrome, Leslie; Bridges, John F P

    2015-07-01

    The objective of this study was to quantify patients' preferences related to benefits and risks of antipsychotic treatments for schizophrenia and to assess the relative importance of treatment attributes and adherence. Treatment-related preferences among U.S. residents with a self-reported physician diagnosis of schizophrenia were assessed via a discrete-choice experiment. Patients chose between competing hypothetical scenarios characterized by improvements in positive symptoms, negative symptoms, and social functioning; incidence of weight gain, extrapyramidal symptoms (EPS), hyperprolactinemia, and hyperglycemia; and medication formulation. Preferences were estimated by using a random-parameters logit model, and the impact of adherence was estimated with conditional logit models. The final sample consisted of 271 patients. Complete improvement in positive symptoms was the most preferred outcome (relative importance score of 10.0), followed by elimination of hyperglycemia (3.6, 95% confidence interval [CI]=2.6-4.6), improvement in negative symptoms (3.0, CI=1.6-4.3), reduced weight gain (2.6, CI=1.2-4.0), avoidance of hyperprolactinemia (1.7, CI=.9-2.6), improved social functioning (1.5, CI=.4-2.5), and avoidance of EPS (1.0, CI=.3-1.8). Patients judged a daily pill superior to monthly injections (p<.01) and monthly injections superior to injections every three months (p<.01) for adherent patients and monthly injections superior to a daily pill for nonadherent patients (p=.01). Persons who self-identified as having schizophrenia judged improvement in positive symptoms as the most important treatment benefit. Hyperglycemia was identified as the most important adverse event. Patients judged oral formulations to be better than monthly injections for adherent patients and monthly injections to be a better choice for nonadherent patients.

  15. The influence of patients' preference/attitude towards psychotherapy and antidepressant medication on the treatment of major depressive disorder.

    Science.gov (United States)

    Moradveisi, Latif; Huibers, Marcus; Renner, Fritz; Arntz, Arnoud

    2014-03-01

    Preferences and attitudes patients hold towards treatment are important, as these can influence treatment outcome. In depression research, the influence of patients' preference/attitudes on outcome and dropout has mainly been studied for antidepressant medication, and less for psychological treatments. We investigated the effects of patients' preference and attitudes towards psychological treatment and antidepressant medication on treatment outcome and dropout, and tested specificity of effects. Data are based on a randomized trial testing the effectiveness of behavioural activation (BA) vs antidepressant medication (ADM) for major depression (MDD) in Iran. Patients with MDD (N = 100) were randomized to BA (N = 50) or ADM (N = 50). Patients' preference/attitudes towards psychotherapy and ADM were assessed at baseline and associated with dropout and treatment outcome using logistic regression and multilevel analysis. High scores on psychotherapy preference/attitude and low scores on ADM preference/attitude predicted dropout from ADM, while no association between dropout and preference/attitude was found in BA. Psychotherapy preference/attitude moderated the differential effect of BA and ADM on one outcome measure, but the association disappeared after one year. Because in Iran most patients have only access to ADM, offering a psychological treatment for depression could attract especially those patients that prefer this newly available treatment. Patients' preferences and attitudes towards depression treatments influence dropout from ADM, and moderate the short-term difference in effectiveness between BA and ADM. The fact that dropout from BA was not affected by preference/attitude speaks for its acceptability among patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Patients' preferences for primary health care - a systematic literature review of discrete choice experiments.

    Science.gov (United States)

    Kleij, Kim-Sarah; Tangermann, Ulla; Amelung, Volker E; Krauth, Christian

    2017-07-11

    Primary care is a key element of health care systems and addresses the main health problems of the population. Due to the demographic change, primary care even gains in importance. The knowledge of the patients' preferences can help policy makers as well as physicians to set priorities in their effort to make health care delivery more responsive to patients' needs. Our objective was to describe which aspects of primary care were included in preference studies and which of them were the most preferred aspects. In order to elicit the preferences for primary care, a systematic literature search was conducted. Two researchers searched three electronic databases (PubMed, Scopus, and PsycINFO) and conducted a narrative synthesis. Inclusion criteria were: focus on primary health care delivery, discrete choice experiment as elicitation method, and studies published between 2006 and 2015 in English language. We identified 18 studies that elicited either the patients' or the population's preferences for primary care based on a discrete choice experiment. Altogether the studies used 16 structure attributes, ten process attributes and four outcome attributes. The most commonly applied structure attribute was "Waiting time till appointment", the most frequently used process attribute was "Shared decision making / professional's attention paid to your views". "Receiving the 'best' treatment" was the most commonly applied outcome attribute. Process attributes were most often the ones of highest importance for patients or the population. The attributes and attribute levels used in the discrete choice experiments were identified by literature research, qualitative research, expert interviews, or the analysis of policy documents. The results of the DCE studies show different preferences for primary health care. The diversity of the results may have several reasons, such as the method of analysis, the selection procedure of the attributes and their levels or the specific research

  17. Patients' preferences for involvement in the decision-making process for treating diabetic retinopathy.

    Science.gov (United States)

    Marahrens, Lydia; Kern, Raimar; Ziemssen, Tjalf; Fritsche, Andreas; Martus, Peter; Ziemssen, Focke; Roeck, Daniel

    2017-08-09

    To assess factors associated with the preferred role of the attending ophthalmologist in the decision-making processes before treating diabetic retinopathy (DR). Cross-sectional study of 810 adults attending secondary diabetes care centers (NCT02311504). Diabetes patients were classified using a validated questionnaire in an ophthalmologist-dominant decision-making (ODM), shared decision-making (SDM) and patient-dominant decision-making (PDM) style. Multivariate logistic regression was performed to determine factors associated with the decision-making process. A majority of 74.3% patients preferred SDM between ophthalmologist and patient, 17.4% patients wanted ODM, delegating the decision-making process to the ophthalmologist, 8.3% preferred the autonomous style of PDM. Patients wanting ODM were older (OR = 1.2 per decade, p = 0.013), had a lower level of education (OR = 1.4, p = 0.001) and had a higher frequency of consultations per year (OR = 1.3, p = 0.022). Patients with better basic knowledge in DR and memorizing their HbA 1 c level showed a higher propensity for SDM (OR = 1.1, p = 0.037). Patients wanting PDM had a significantly higher education (OR = 1.3, p = 0.036) and a greater desire for receiving information from self-help groups (OR = 1.3, p = 0.015). The first evaluation of the general patient wishes for the treatment of DR confirmed the concept of SDM, which was favored by three quarters. In particular, older patients with low educational attainment wanted to delegate the decision-making process to the ophthalmologist. Amelioration of ophthalmologic education in diabetic programs might take up patients' propensity for SDM. Regardless of the decision-making group, nearly all patients wanted the medical and scientific information to be transferred by and shared with the ophthalmologist. The study was registered on www.clinicaltrials.gov (identifier: NCT02311504) on December 4th 2014.

  18. Patient preference and willingness to pay for knee osteoarthritis treatments

    Directory of Open Access Journals (Sweden)

    Posnett J

    2015-06-01

    Full Text Available John Posnett,1 Sanjeev Dixit,2 Brooks Oppenheimer,2 Sven Kili,3 Nazanin Mehin4 1HERONTM Commercialization, PAREXEL® International, London, UK; 2Reason Research, Philadelphia, PA, USA; 3Sanofi Biosurgery, Oxford, UK; 4Sanofi, Paris, France Purpose: To review treatments for osteoarthritis of the knee (OAK received by patients across five European countries, and to obtain patients’ perceptions and willingness to pay for current treatments.Patients and methods: A prospective, internet-based, double-blind survey of adults with OAK was conducted in France, Germany, Italy, Spain, and the United Kingdom. The questionnaire included questions about diagnosis, treatment history, and perceptions of OAK treatments, followed by a discrete choice-based conjoint exercise to identify preferred attributes of OAK treatments, evaluating 14 sets of four unbranded products.Results: Two thousand and seventy-three patients with self-reported OAK completed the survey; 17.4% of patients rated their knee pain as drastically affecting their ability to perform normal daily activities, and 39.3% of employed patients reported that they had lost work time because of OAK. The most common treatments were exercise (69.7%, physical therapy (68.2%, and nonprescription oral pain medication (73.9%. Treatments perceived as most effective were: viscosupplement injections (74.1%, narcotics (67.8%, and steroid injection (67.6%. Patient co-pay, duration of pain relief, and type of therapy exhibited the largest impact on patient preference for OAK treatments. The average patient was willing to pay €35 and €64 more in co-pay for steroid and viscosupplement injections, respectively, over the cost of oral over-the-counter painkillers (per treatment course, per knee (each P<0.05.Conclusion: OAK is a debilitating condition that affects normal daily activities. In general, treatments most commonly offered to patients are not those perceived as being the most effective. Patients are

  19. The development and initial validation of a clinical tool for patients' preferences on patient participation--The 4Ps.

    Science.gov (United States)

    Eldh, Ann Catrine; Luhr, Kristina; Ehnfors, Margareta

    2015-12-01

    To report on the development and initial testing of a clinical tool, The Patient Preferences for Patient Participation tool (The 4Ps), which will allow patients to depict, prioritize, and evaluate their participation in health care. While patient participation is vital for high quality health care, a common definition incorporating all stakeholders' experience is pending. In order to support participation in health care, a tool for determining patients' preferences on participation is proposed, including opportunities to evaluate participation while considering patient preferences. Exploratory mixed methods studies informed the development of the tool, and descriptive design guided its initial testing. The 4Ps tool was tested with 21 Swedish researcher experts (REs) and patient experts (PEs) with experience of patient participation. Individual Think Aloud interviews were employed to capture experiences of content, response process, and acceptability. 'The 4Ps' included three sections for the patient to depict, prioritize, and evaluate participation using 12 items corresponding to 'Having Dialogue', 'Sharing Knowledge', 'Planning', and 'Managing Self-care'. The REs and PEs considered 'The 4Ps' comprehensible, and that all items corresponded to the concept of patient participation. The tool was perceived to facilitate patient participation whilst requiring amendments to content and layout. A tool like The 4Ps provides opportunities for patients to depict participation, and thus supports communication and collaboration. Further patient evaluation is needed to understand the conditions for patient participation. While The 4Ps is promising, revision and testing in clinical practice is required. © 2014 John Wiley & Sons Ltd.

  20. Effective dose equivalent

    International Nuclear Information System (INIS)

    Huyskens, C.J.; Passchier, W.F.

    1988-01-01

    The effective dose equivalent is a quantity which is used in the daily practice of radiation protection as well as in the radiation hygienic rules as measure for the health risks. In this contribution it is worked out upon which assumptions this quantity is based and in which cases the effective dose equivalent can be used more or less well. (H.W.)

  1. Characterization of revenue equivalence

    NARCIS (Netherlands)

    Heydenreich, B.; Müller, R.; Uetz, Marc Jochen; Vohra, R.

    2009-01-01

    The property of an allocation rule to be implementable in dominant strategies by a unique payment scheme is called revenue equivalence. We give a characterization of revenue equivalence based on a graph theoretic interpretation of the incentive compatibility constraints. The characterization holds

  2. Characterization of Revenue Equivalence

    NARCIS (Netherlands)

    Heydenreich, Birgit; Müller, Rudolf; Uetz, Marc Jochen; Vohra, Rakesh

    2008-01-01

    The property of an allocation rule to be implementable in dominant strategies by a unique payment scheme is called \\emph{revenue equivalence}. In this paper we give a characterization of revenue equivalence based on a graph theoretic interpretation of the incentive compatibility constraints. The

  3. On the operator equivalents

    International Nuclear Information System (INIS)

    Grenet, G.; Kibler, M.

    1978-06-01

    A closed polynomial formula for the qth component of the diagonal operator equivalent of order k is derived in terms of angular momentum operators. The interest in various fields of molecular and solid state physics of using such a formula in connection with symmetry adapted operator equivalents is outlined

  4. Equivalent Dynamic Models.

    Science.gov (United States)

    Molenaar, Peter C M

    2017-01-01

    Equivalences of two classes of dynamic models for weakly stationary multivariate time series are discussed: dynamic factor models and autoregressive models. It is shown that exploratory dynamic factor models can be rotated, yielding an infinite set of equivalent solutions for any observed series. It also is shown that dynamic factor models with lagged factor loadings are not equivalent to the currently popular state-space models, and that restriction of attention to the latter type of models may yield invalid results. The known equivalent vector autoregressive model types, standard and structural, are given a new interpretation in which they are conceived of as the extremes of an innovating type of hybrid vector autoregressive models. It is shown that consideration of hybrid models solves many problems, in particular with Granger causality testing.

  5. Valuing the delivery of dental care: Heterogeneity in patients' preferences and willingness-to-pay for dental care attributes.

    Science.gov (United States)

    Sever, Ivan; Verbič, Miroslav; Sever, Eva Klaric

    2018-02-01

    To examine the amount of heterogeneity in patients' preferences for dental care, what factors affect their preferences, and how much they would be willing to pay for improvement in specific dental care attributes. A discrete choice experiment (DCE) was used to elicit patients' preferences. Three alternative dental care services that differed in the type of care provider, treatment explanation, dental staff behavior, waiting time and treatment cost were described to patients. Patients (n=265) were asked to choose their preferred alternative. The study was conducted at a public dental clinic of the School of Dental Medicine, University of Zagreb. Mixed logit and latent class models were used for analysis. On average, the patients would be willing to pay €45 for getting a detailed explanation of treatment over no explanation. This was the most valued attribute of dental care, followed by dental staff behavior with marginal willingness-to-pay (WTP) of €28. Dental care provided by the faculty members and private dental care were valued similarly, while student-provided care was valued €23 less. Patients also disliked longer waiting time in the office, but this was the least important attribute. Four classes of patients with distinct preferences for dental care were identified. Older and/or more educated patients tended to give relatively less importance to treatment explanation. Higher education was also associated with a higher propensity to substitute faculty dental care with the private care providers. Large heterogeneity in patients' preferences was detected. Understanding their preferences may improve the delivery of dental care. Dental care providers should pay particular attention to providing a detailed treatment explanation to their patients. Dental care for older and/or more educated patients should be more attentive to interpersonal characteristics. Faculty dental care provided by faculty members could be price competitive to private care, and student

  6. Economic considerations and patients' preferences affect treatment selection for patients with rheumatoid arthritis: a discrete choice experiment among European rheumatologists.

    Science.gov (United States)

    Hifinger, M; Hiligsmann, M; Ramiro, S; Watson, V; Severens, J L; Fautrel, B; Uhlig, T; van Vollenhoven, R; Jacques, P; Detert, J; Canas da Silva, J; Scirè, C A; Berghea, F; Carmona, L; Péntek, M; Keat, A; Boonen, A

    2017-01-01

    To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis. In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with moderate disease activity. Treatments differed in five attributes: efficacy (improvement and achieved state on disease activity), safety (probability of serious adverse events), patient's preference (level of agreement), medication costs and cost-effectiveness (incremental cost-effectiveness ratio (ICER)). A Bayesian efficient design defined 14 choice sets, and a random parameter logit model was used to estimate relative preferences for rheumatologists across countries. Cluster analyses and latent class models were applied to understand preference patterns across countries and among individual rheumatologists. Responses of 559 rheumatologists from 12 European countries were included in the analysis (49% females, mean age 48 years). In all countries, efficacy dominated treatment decisions followed by economic considerations and patients' preferences. Across countries, rheumatologists avoided selecting a treatment that patients disliked. Latent class models revealed four respondent profiles: one traded off all attributes except safety, and the remaining three classes disregarded ICER. Among individual rheumatologists, 57% disregarded ICER and these were more likely from Italy, Romania, Portugal or France, whereas 43% disregarded uncommon/rare side effects and were more likely from Belgium, Germany, Hungary, the Netherlands, Norway, Spain, Sweden or UK. Overall, European rheumatologists are willing to trade between treatment efficacy, patients' treatment preferences and economic considerations. However, the degree of trade-off differs between countries and among individuals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

  7. Efficacy, safety, and patient preference of monoamine oxidase B inhibitors in the treatment of Parkinson’s disease

    Science.gov (United States)

    Robottom, Bradley J

    2011-01-01

    Parkinson’s disease (PD) is the second most common neurodegenerative disease and the most treatable. Treatment of PD is symptomatic and generally focuses on the replacement or augmentation of levodopa. A number of options are available for treatment, both in monotherapy of early PD and to treat complications of advanced PD. This review focuses on rasagiline and selegiline, two medications that belong to a class of antiparkinsonian drugs called monoamine oxidase B (MAO-B) inhibitors. Topics covered in the review include mechanism of action, efficacy in early and advanced PD, effects on disability, the controversy regarding disease modification, safety, and patient preference for MAO-B inhibitors. PMID:21423589

  8. Contrast-enhanced spectral mammography (CESM) versus MRI in the high-risk screening setting: patient preferences and attitudes.

    Science.gov (United States)

    Phillips, Jordana; Miller, Matthew M; Mehta, Tejas S; Fein-Zachary, Valerie; Nathanson, Audrey; Hori, Wendy; Monahan-Earley, Rita; Slanetz, Priscilla J

    Our study evaluates patient preferences toward screening CESM versus MRI. As part of a prospective study, high-risk patients had breast MRI and CESM. Patients completed an anonymous survey to evaluate preferences regarding the two modalities. 88% of participants completed the survey. 79% preferred CESM over MRI if the exams had equal sensitivity. 89% would be comfortable receiving contrast as part of an annual screening test. High-risk populations may accept CESM as a screening exam and may prefer it over screening MRI if ongoing trials demonstrate screening CESM to be clinically non-inferior MRI. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Equivalent drawbead performance in deep drawing simulations

    NARCIS (Netherlands)

    Meinders, Vincent T.; Geijselaers, Hubertus J.M.; Huetink, Han

    1999-01-01

    Drawbeads are applied in the deep drawing process to improve the control of the material flow during the forming operation. In simulations of the deep drawing process these drawbeads can be replaced by an equivalent drawbead model. In this paper the usage of an equivalent drawbead model in the

  10. Controls on the deposition and preservation of the Cretaceous Mowry Shale and Frontier Formation and equivalents, Rocky Mountain region, Colorado, Utah, and Wyoming

    Science.gov (United States)

    Kirschbaum, Mark A.; Mercier, Tracey J.

    2013-01-01

    Regional variations in thickness and facies of clastic sediments are controlled by geographic location within a foreland basin. Preservation of facies is dependent on the original accommodation space available during deposition and ultimately by tectonic modification of the foreland in its postthrusting stages. The preservation of facies within the foreland basin and during the modification stage affects the kinds of hydrocarbon reservoirs that are present. This is the case for the Cretaceous Mowry Shale and Frontier Formation and equivalent strata in the Rocky Mountain region of Colorado, Utah, and Wyoming. Biostratigraphically constrained isopach maps of three intervals within these formations provide a control on eustatic variations in sea level, which allow depositional patterns across dip and along strike to be interpreted in terms of relationship to thrust progression and depositional topography. The most highly subsiding parts of the Rocky Mountain foreland basin, near the fold and thrust belt to the west, typically contain a low number of coarse-grained sandstone channels but limited sandstone reservoirs. However, where subsidence is greater than sediment supply, the foredeep contains stacked deltaic sandstones, coal, and preserved transgressive marine shales in mainly conformable successions. The main exploration play in this area is currently coalbed gas, but the enhanced coal thickness combined with a Mowry marine shale source rock indicates that a low-permeability, basin-centered play may exist somewhere along strike in a deep part of the basin. In the slower subsiding parts of the foreland basin, marginal marine and fluvial sandstones are amalgamated and compartmentalized by unconformities, providing conditions for the development of stratigraphic and combination traps, especially in areas of repeated reactivation. Areas of medium accommodation in the most distal parts of the foreland contain isolated marginal marine shoreface and deltaic sandstones

  11. Equivalence in Ventilation and Indoor Air Quality

    Energy Technology Data Exchange (ETDEWEB)

    Sherman, Max; Walker, Iain; Logue, Jennifer

    2011-08-01

    We ventilate buildings to provide acceptable indoor air quality (IAQ). Ventilation standards (such as American Society of Heating, Refrigerating, and Air-Conditioning Enginners [ASHRAE] Standard 62) specify minimum ventilation rates without taking into account the impact of those rates on IAQ. Innovative ventilation management is often a desirable element of reducing energy consumption or improving IAQ or comfort. Variable ventilation is one innovative strategy. To use variable ventilation in a way that meets standards, it is necessary to have a method for determining equivalence in terms of either ventilation or indoor air quality. This study develops methods to calculate either equivalent ventilation or equivalent IAQ. We demonstrate that equivalent ventilation can be used as the basis for dynamic ventilation control, reducing peak load and infiltration of outdoor contaminants. We also show that equivalent IAQ could allow some contaminants to exceed current standards if other contaminants are more stringently controlled.

  12. The principle of equivalence

    International Nuclear Information System (INIS)

    Unnikrishnan, C.S.

    1994-01-01

    Principle of equivalence was the fundamental guiding principle in the formulation of the general theory of relativity. What are its key elements? What are the empirical observations which establish it? What is its relevance to some new experiments? These questions are discussed in this article. (author). 11 refs., 5 figs

  13. Radioactive waste equivalence

    International Nuclear Information System (INIS)

    Orlowski, S.; Schaller, K.H.

    1990-01-01

    The report reviews, for the Member States of the European Community, possible situations in which an equivalence concept for radioactive waste may be used, analyses the various factors involved, and suggests guidelines for the implementation of such a concept. Only safety and technical aspects are covered. Other aspects such as commercial ones are excluded. Situations where the need for an equivalence concept has been identified are processes where impurities are added as a consequence of the treatment and conditioning process, the substitution of wastes from similar waste streams due to the treatment process, and exchange of waste belonging to different waste categories. The analysis of factors involved and possible ways for equivalence evaluation, taking into account in particular the chemical, physical and radiological characteristics of the waste package, and the potential risks of the waste form, shows that no simple all-encompassing equivalence formula may be derived. Consequently, a step-by-step approach is suggested, which avoids complex evaluations in the case of simple exchanges

  14. Equivalent Colorings with "Maple"

    Science.gov (United States)

    Cecil, David R.; Wang, Rongdong

    2005-01-01

    Many counting problems can be modeled as "colorings" and solved by considering symmetries and Polya's cycle index polynomial. This paper presents a "Maple 7" program link http://users.tamuk.edu/kfdrc00/ that, given Polya's cycle index polynomial, determines all possible associated colorings and their partitioning into equivalence classes. These…

  15. Correspondences. Equivalence relations

    International Nuclear Information System (INIS)

    Bouligand, G.M.

    1978-03-01

    We comment on sections paragraph 3 'Correspondences' and paragraph 6 'Equivalence Relations' in chapter II of 'Elements de mathematique' by N. Bourbaki in order to simplify their comprehension. Paragraph 3 exposes the ideas of a graph, correspondence and map or of function, and their composition laws. We draw attention to the following points: 1) Adopting the convention of writting from left to right, the composition law for two correspondences (A,F,B), (U,G,V) of graphs F, G is written in full generality (A,F,B)o(U,G,V) = (A,FoG,V). It is not therefore assumed that the co-domain B of the first correspondence is identical to the domain U of the second (EII.13 D.7), (1970). 2) The axiom of choice consists of creating the Hilbert terms from the only relations admitting a graph. 3) The statement of the existence theorem of a function h such that f = goh, where f and g are two given maps having the same domain (of definition), is completed if h is more precisely an injection. Paragraph 6 considers the generalisation of equality: First, by 'the equivalence relation associated with a map f of a set E identical to (x is a member of the set E and y is a member of the set E and x:f = y:f). Consequently, every relation R(x,y) which is equivalent to this is an equivalence relation in E (symmetrical, transitive, reflexive); then R admits a graph included in E x E, etc. Secondly, by means of the Hilbert term of a relation R submitted to the equivalence. In this last case, if R(x,y) is separately collectivizing in x and y, theta(x) is not the class of objects equivalent to x for R (EII.47.9), (1970). The interest of bringing together these two subjects, apart from this logical order, resides also in the fact that the theorem mentioned in 3) can be expressed by means of the equivalence relations associated with the functions f and g. The solutions of the examples proposed reveal their simplicity [fr

  16. Patient preference for a long-acting recombinant FSH product in ovarian hyperstimulation in IVF: a discrete choice experiment.

    Science.gov (United States)

    van den Wijngaard, L; Rodijk, I C M; van der Veen, F; Gooskens-van Erven, M H W; Koks, C A M; Verhoeve, H R; Mol, B W J; van Wely, M; Mochtar, M H

    2015-02-01

    What factors or attributes of a long-acting recombinant FSH (rFSH) or daily-administrated rFSH influence women's preferences IVF? Patients' preferences for rFSH products are primary influenced by the attribute 'number of injections', but a low 'number of injections' is exchanged for a high 'number of injections' at a 6.2% decrease in 'risk of cycle cancellation due to low response' and at a 4.5% decrease in 'chance of OHSS'. Injections of long-acting rFSH have been claimed to be preferred over daily-administrated rFSH injections, but patient preference studies to underpin this assumption have not been performed. A discrete choice experiment (DCE) was created to assess women's preference for long-acting or daily-administrated rFSH under varying attributes of efficiency, safety and burden. The selected attributes were the 'total number of injections', 'chance of ovarian hyperstimulation syndrome (OHSS)' and the 'risk of cycle cancellation due to low response'. Questionnaires were handed out during information gathering sessions in one academic hospital and two teaching hospitals in The Netherlands between April 2011 and April 2012. Women at the start of their first IVF treatment were asked to participate in this patient preference study. Participation was voluntary. We analysed the data by using mixed logit models to estimate the utility of each attribute. Questionnaires (n = 125) were handed out with a response rate of 77% (97/125). Four respondents did not complete the questionnaire. Hence, there were 93 questionnaires available for analysis. All attributes significantly influenced women's preference. Overall, the lower 'number of injections' was preferred above the higher 'number of injections' (mean coefficient 1.25; P lower 'number of injections' for a higher 'number of injections' when gaining a 6.2% reduction in 'cycle cancellation due to low response', or a 4.5% reduction in 'chance of OHSS'. The generalizability of this DCE is limited in time-span. Women may

  17. The equivalence theorem

    International Nuclear Information System (INIS)

    Veltman, H.

    1990-01-01

    The equivalence theorem states that, at an energy E much larger than the vector-boson mass M, the leading order of the amplitude with longitudinally polarized vector bosons on mass shell is given by the amplitude in which these vector bosons are replaced by the corresponding Higgs ghosts. We prove the equivalence theorem and show its validity in every order in perturbation theory. We first derive the renormalized Ward identities by using the diagrammatic method. Only the Feynman-- 't Hooft gauge is discussed. The last step of the proof includes the power-counting method evaluated in the large-Higgs-boson-mass limit, needed to estimate the leading energy behavior of the amplitudes involved. We derive expressions for the amplitudes involving longitudinally polarized vector bosons for all orders in perturbation theory. The fermion mass has not been neglected and everything is evaluated in the region m f ∼M much-lt E much-lt m Higgs

  18. Veda-scope: More comfortable than the bivalve speculum and cytologically equivalent.

    Science.gov (United States)

    Longmore, Peter G

    2004-04-01

    The aim of the present study was to confirm that the Veda-scope is equivalent to the bivalve speculum in the collection of endocervical cells, as confirmation of adequate cervical sampling for Pap smear testing. The study also aimed to assess the comfort level of the Veda-scope compared to the traditional bivalve speculum and the patient preference of the Veda-scope compared to the bivalve speculum. Multicentre, randomised, controlled crossover, cytologist blinded study. The total number of subjects enrolled in the study were 250. The number of evaluable subjects were 210. In primary efficacy analysis, no significant difference was seen between the presence or absence of endocervical cells in the smears using either the Veda-scope or the bivalve speculum. There was a high concordance level between the diagnosis assigned to each specimen of a paired sample, the diagnosis agreeing in 97.6% cases. The primary reason given by many women for avoidance of regular Pap smear examinations is the discomfort or pain experienced with sample collection with the bivalve speculum. In the present study, 92% of subjects indicated a preference for the Veda-scope for Pap smear collection, while only 8.4% preferred the bivalve speculum. Subject preference was also assessed with respect to how the subject rated the comfort level of her previous Pap smear. In subjects who rated their previous Pap smear as very comfortable or comfortable, 86% expressed a preference for the Veda-scope. This rose to 93% in subjects who rated their previous Pap smear as only tolerable. The results of the present study show that Pap smear collections with the Veda-scope are of equal quality to those collected with the bivalve speculum, with an equivalent diagnostic outcome. A very strong preference for the Veda-scope was shown by the women enrolled in the present study based on the comfort levels experienced with the two devices.

  19. Patient Preferences for Pain Management in Advanced Cancer: Results from a Discrete Choice Experiment.

    Science.gov (United States)

    Meads, David M; O'Dwyer, John L; Hulme, Claire T; Chintakayala, Phani; Vinall-Collier, Karen; Bennett, Michael I

    2017-10-01

    Pain from advanced cancer remains prevalent, severe and often under-treated. The aim of this study was to conduct a discrete choice experiment with patients to understand their preferences for pain management services and inform service development. Focus groups were used to develop the attributes and levels of the discrete choice experiment. The attributes were: waiting time, type of healthcare professional, out-of-pocket costs, side-effect control, quality of communication, quality of information and pain control. Patients completed the discrete choice experiment along with clinical and health-related quality of life questions. Conditional and mixed logit models were used to analyse the data. Patients with cancer pain (n = 221) and within palliative care services completed the survey (45% were female, mean age 64.6 years; age range 21-92 years). The most important aspects of pain management were: good pain control, zero out-of-pocket costs and good side-effect control. Poor or moderate pain control and £30 costs drew the highest negative preferences. Respondents preferred control of side effects and provision of better information and communication, over access to certain healthcare professionals. Those with lower health-related quality of life were less willing to wait for treatment and willing to incur higher costs. The presence of a carer influenced preferences. Outcome attributes were more important than process attributes but the latter were still valued. Thus, supporting self-management, for example by providing better information on pain may be a worthwhile endeavour. However, service provision may need to account for individual characteristics given the heterogeneity in preferences.

  20. On uncertainties in definition of dose equivalent

    International Nuclear Information System (INIS)

    Oda, Keiji

    1995-01-01

    The author has entertained always the doubt that in a neutron field, if the measured value of the absorbed dose with a tissue equivalent ionization chamber is 1.02±0.01 mGy, may the dose equivalent be taken as 10.2±0.1 mSv. Should it be 10.2 or 11, but the author considers it is 10 or 20. Even if effort is exerted for the precision measurement of absorbed dose, if the coefficient being multiplied to it is not precise, it is meaningless. [Absorbed dose] x [Radiation quality fctor] = [Dose equivalent] seems peculiar. How accurately can dose equivalent be evaluated ? The descriptions related to uncertainties in the publications of ICRU and ICRP are introduced, which are related to radiation quality factor, the accuracy of measuring dose equivalent and so on. Dose equivalent shows the criterion for the degree of risk, or it is considered only as a controlling quantity. The description in the ICRU report 1973 related to dose equivalent and its unit is cited. It was concluded that dose equivalent can be considered only as the absorbed dose being multiplied by a dimensionless factor. The author presented the questions. (K.I.)

  1. Do patients prefer optimistic or cautious psychiatrists? An experimental study with new and long-term patients.

    Science.gov (United States)

    Priebe, Stefan; Ramjaun, Gonca; Strappelli, Nadia; Arcidiacono, Eleonora; Aguglia, Eugenio; Greenberg, Lauren

    2017-01-17

    Patients seeking treatment may be assumed to prefer a psychiatrist who suggests a new treatment with confidence and optimism. Yet, this might not apply uniformly to all patients. In this study, we tested the hypothesis that new patients prefer psychiatrists who present treatments optimistically, whilst patients with longer-term experience of mental health care may rather prefer more cautious psychiatrists. In an experimental study, we produced video-clips of four psychiatrists, each suggesting a pharmacological and a psychological treatment once with optimism and once with caution. 100 'new' patients with less than 3 months experience of mental health care and 100 'long-term' patients with more than one year of experience were shown a random selection of one video-clip from each psychiatrist, always including an optimistic and a cautious suggestion of each treatment. Patients rated their preferences for psychiatrists on Likert type scales. Differences in subgroups with different age (18-40 vs. 41-65 years), gender, school leaving age (≤16 vs. >16 years), and diagnosis (ICD 10 F2 vs. others) were explored. New patients preferred more optimistic treatment suggestions, whilst there was no preference among long-term patients. The interaction effect between preference for treatment presentations and experience of patients was significant (interaction p-value = 0.003). Findings in subgroups were similar. In line with the hypothesis, psychiatrists should suggest treatments with optimism to patients with little experience of mental health care. However, this rule does not apply to longer-term patients, who may have experienced treatment failures in the past.

  2. Discrepancies between Patients' Preferences and Educational Programs on Oral Anticoagulant Therapy: A Survey in Community Pharmacies and Hospital Consultations.

    Directory of Open Access Journals (Sweden)

    Diane Macquart de Terline

    Full Text Available Oral anticoagulation therapy is increasingly used for the prevention and treatment of thromboembolic complications in various clinical situations. Nowadays, education programs for patients treated with anticoagulants constitute an integrated component of their management. However, such programs are usually based on the healthcare providers' perceptions of what patients should know, rather than on patients' preferences.To investigate patients' viewpoints on educational needs and preferred modalities of information delivery.We conducted an observational study based on a self-administered questionnaire. To explore several profiles of patients, the study was designed for enrolling patients in two settings: during outpatient consultations in a cardiology department (Saint Antoine Hospital, Paris, France and in community pharmacies throughout France.Of the 371 patients who completed the questionnaire, 187 (50.4% were recruited during an outpatient consultation and 184 (49.6% were recruited in community pharmacies. 84.1% of patients were receiving a vitamin K antagonist and 15.6% a direct oral anticoagulant. Patients ranked 16 of 21 (76.2% questionnaire items on information about their treatment as important or essential; information on adverse effects of treatment was the highest ranked domain (mean score 2.38, 95% CI 2.30-2.46. Pharmacists (1.69, 1.58-1.80, nurses (1.05, 0.95-1.16, and patient associations (0.36, 0.29-0.44, along with group sessions (0.85, 0.75-0.95, the internet (0.77, 0.67-0.88, and delivery of material at the patient's home (1.26, 1.14-1.38, were ranked poorly in terms of delivering educational material.This study revealed substantial discrepancies between patient preferences and current educational programs. These findings should be useful for tailoring future educational programs that are better adapted to patients, with a potential associated enhancement of their effectiveness.

  3. Patient preference and satisfaction with implant-supported mandibular overdentures retained with ball or locator attachments: a crossover clinical trial.

    Science.gov (United States)

    Krennmair, Gerald; Seemann, Rudolf; Fazekas, Andres; Ewers, Rolf; Piehslinger, Eva

    2012-01-01

    To determine patient satisfaction and preference for implant-supported mandibular overdentures (IOD) retained with ball or Locator attachments. In addition, peri-implant conditions and prosthodontic maintenance efforts for the final attachments were evaluated after 1 year of function. In this crossover clinical trial, 20 edentulous patients were recruited to receive two mandibular implants in the canine region and were provided with implant-retained mandibular overdentures and new complete maxillary dentures. Implant-retained mandibular overdentures were stabilized with either ball attachments or Locator attachments, in random order. After 3 months of function, the attachments in the existing denture were changed. Questionnaires on satisfaction/complaints with the prostheses were administered at baseline (with the old dentures) and after 3 months of function with each attachment, thus providing for an intraindividual comparison. The decision for the final attachment chosen was based on the patient's preference. For the definitive attachment, peri-implant conditions (peri-implant marginal bone resorption, pocket depth, and Plaque Index, Gingival Index, and Bleeding Index) as well as prosthodontic maintenance efforts and satisfaction score were evaluated after an insertion period of 1 year. Nineteen (95%) patients completed the study (1 dropout). Patient satisfaction improved significantly (P<.05) from baseline (old dentures) to the new prostheses retained with each of the two attachment types for all domains of satisfaction. However, there were no differences between ball or Locator attachment for any items of satisfaction evaluated and neither attachment had a significant patient preference. No differences for peri-implant parameters or for patient satisfaction were noted between the definitive attachments (ball, n=10; Locator, n=9) after 1 year. Although the overall incidence rate of prosthodontic maintenance did not significantly differ between both retention

  4. Clinical marginal fit of zirconia crowns and patients' preferences for impression techniques using intraoral digital scanner versus polyvinyl siloxane material.

    Science.gov (United States)

    Sakornwimon, Nawapat; Leevailoj, Chalermpol

    2017-09-01

    The use of digital intraoral scanners is increasing; however, evidence of its precision in making crown impressions clinically remains scarce. Patients should also feel more comfortable with digital impressions, but only a few studies evaluating this subject have been performed. The purpose of this clinical study was to evaluate the marginal fit of monolithic zirconia crowns and patients' preferences for digital impressions versus polyvinyl siloxane (PVS) impressions. Sixteen participants with indications for single molar crowns were included. After crown preparation, digital impressions by intraoral scanner and PVS impressions were made. The participants were asked to complete a 6-item questionnaire with a visual analog scale related to perceptions of each of the following topics: time involved, taste/smell, occlusal registration, size of impression tray/scanner, gag reflex, and overall preference. Computer-aided design and computer-aided manufacturing monolithic zirconia crowns were fabricated from both impressions. The crowns were evaluated intraorally, and a blinded examiner measured the marginal discrepancy of silicone replicas under a stereomicroscope. Intraexaminer reliability was evaluated by calculating the intraclass correlation coefficient. Data for patients' preferences and marginal discrepancies were analyzed using the paired t test (α=.05). Visual analog scale scores for digital impressions were statistically significantly higher than those for PVS impressions in every topic (Pdigital group on all sides (P>.05). No differences were found in the clinical marginal fit of zirconia crowns fabricated from either digital impressions compared with PVS impressions. Furthermore, patients' satisfaction with digital impressions was significantly higher than with conventional impressions. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  5. Depressed patients' preferences for education about medications by pharmacists in Kuwait.

    Science.gov (United States)

    Al-Saffar, Nabeel; Abdulkareem, Abdulraheem; Abdulhakeem, Alsughayer; Salah, Al-Qattan; Heba, Metwalli

    2008-07-01

    To assess patients' opinion toward receiving written or specialized verbal pharmacists' interventions and to determine the effect of these interventions on patients' medication knowledge. 150 newly diagnosed patients with unipolar depression and initiated with a single antidepressant were randomized into 3 groups: control, leaflet and counselling, and interviewed at initiation and after 6-8 weeks of treatment at the outpatient department of the Psychiatric Hospital in Kuwait. 50% of respondents asserted that clinicians did not give them sufficient information while 90% favoured the idea of receiving further information about therapy. Forty seven percent of participants failed to return for the second follow-up appointment. The drop-out rate was 66% in the control, 42% in the Leaflet and only 34% in the counselling groups (P=0.004). A broad support for receiving leaflets and drug counselling (97%) was found among attendees. Moreover, 94% of the counselling and 79% of the leaflets group affirmed that they received adequate information compared to 47% of the control (P=0.001). Counselling was found to be significantly associated with a much higher recall of medicine name (OR=9.6, P=0.01), how to manage missed doses (OR=8.9, P=0.007), and correct use of medication (OR=31.3, Peducational material. However, both interventions were more informative than the control in conveying elemental drug information to patients. In contrast with the lack of enthusiasm that some clinicians express, the affirmativeness that was expressed by patients towards receiving written or verbal specialized educational interventions by pharmacists may support the psychiatric hospital pharmacists' stands in providing them for all patients which may aid in improving patients compliance and probably treatment outcome.

  6. Equivalence, commensurability, value

    DEFF Research Database (Denmark)

    Albertsen, Niels

    2017-01-01

    Deriving value in Capital Marx uses three commensurability arguments (CA1-3). CA1 establishes equivalence in exchange as exchangeability with the same third commodity. CA2 establishes value as common denominator in commodities: embodied abstract labour. CA3 establishes value substance...... as commonality of labour: physiological labour. Tensions between these logics have permeated Marxist interpretations of value. Some have supported value as embodied labour (CA2, 3), others a monetary theory of value and value as ‘pure’ societal abstraction (ultimately CA1). They all are grounded in Marx....

  7. Improving inhaler use in COPD and the role of patient preference

    Directory of Open Access Journals (Sweden)

    E. D. Bateman

    2005-12-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a difficult disease to manage, but recent research focusing on its pathophysiology has provided direction for the development of new treatments and improved management strategies. COPD differs substantially from asthma, both in its pathophysiology and its treatment. Unlike asthma, COPD cannot be fully controlled or "reversed"; it is progressive and responses to anti-inflammatory drugs, including corticosteroids, have been disappointing, suggesting the presence of a unique, persistent form of inflammation. The current main emphasis in the treatment of COPD is therefore to minimise airflow obstruction using regular bronchodilator therapy. Apparently small improvements in traditional measures of airflow obstruction, such as functional residual capacity, may produce significant improvements in other measures, resulting in clinical benefit. Ensuring efficient delivery of bronchodilators is vital to treatment success but has received little attention in guidelines to date. Inhaler technique, adherence rates and levels of satisfaction with therapy are all far from ideal. Improvements in these areas require more detailed consideration of the interactions between the patient, the healthcare provider and the inhaler device, and an examination of how inhaler choices are currently made by both healthcare provider and patient.

  8. Colorectal surgery patients prefer simple solid foods to clear fluids as the first postoperative meal.

    Science.gov (United States)

    Yeung, Sophia E; Fenton, Tanis R

    2009-09-01

    Randomized controlled trials have established that there is no benefit to withholding oral food and fluids from colorectal surgery patients postoperatively. The aim of this survey was to determine food preferences for the first postoperative meal and compare these with a traditional clear-fluid diet. One hundred forty-five elective colorectal surgery patients were surveyed about their preferences for 35 common foods within 72 hours of surgery and their levels of nausea, hunger, and pain. Preferences were examined by postoperative day (one vs. two) and levels of nausea, hunger, and pain. The survey showed that patients significantly preferred solid foods as early as the first postoperative day and their preferences had little congruency with the traditional clear-fluid diet. Foods highest in preference, such as eggs, regular broth soup (e.g., chicken noodle soup), toast, and potatoes, were significantly more preferred than common clear-fluid diet items such as gelatin, clear broth, and carbonated beverages (P clear-fluid diet as their first postoperative meal.

  9. Waste Determination Equivalency - 12172

    Energy Technology Data Exchange (ETDEWEB)

    Freeman, Rebecca D. [Savannah River Remediation (United States)

    2012-07-01

    by the Secretary of Energy in January of 2006 based on proposed processing techniques with the expectation that it could be revised as new processing capabilities became viable. Once signed, however, it became evident that any changes would require lengthy review and another determination signed by the Secretary of Energy. With the maturation of additional salt removal technologies and the extension of the SWPF start-up date, it becomes necessary to define 'equivalency' to the processes laid out in the original determination. For the purposes of SRS, any waste not processed through Interim Salt Processing must be processed through SWPF or an equivalent process, and therefore a clear statement of the requirements for a process to be equivalent to SWPF becomes necessary. (authors)

  10. Establishing Substantial Equivalence: Proteomics

    Science.gov (United States)

    Lovegrove, Alison; Salt, Louise; Shewry, Peter R.

    Wheat is a major crop in world agriculture and is consumed after processing into a range of food products. It is therefore of great importance to determine the consequences (intended and unintended) of transgenesis in wheat and whether genetically modified lines are substantially equivalent to those produced by conventional plant breeding. Proteomic analysis is one of several approaches which can be used to address these questions. Two-dimensional PAGE (2D PAGE) remains the most widely available method for proteomic analysis, but is notoriously difficult to reproduce between laboratories. We therefore describe methods which have been developed as standard operating procedures in our laboratory to ensure the reproducibility of proteomic analyses of wheat using 2D PAGE analysis of grain proteins.

  11. 161: BRIDGING BETWEEN PATIENTS PREFERENCE AND EVIDENCE BASED PRACTICE ACCORDING TO GUIDELINES IN OSTEOARTHRITIS MANAGEMENT: A QUALITATIVE STUDY

    Science.gov (United States)

    Behshid, Mozhgan; Zamanzadeh, Vahid; Ahmadi, Fazlollah; Irajpoor, Alireza

    2017-01-01

    Background and aims Osteoarthritis is the major cause of disability worldwide that causes significant problems in activities of daily living and deeply affects the quality of life. Osteoarthritis is predicted to become one of the major causes of disability in future that necessitates comprehensive global plans for resolving this health issue in accordance with patients' local culture, beliefs and attitudes. This study was a part of PhD dissertation that was conducted to carry out an in-depth examination of the experiences of patients with OA about their use of strategies for the OA self-management and compare them with scientific evidences. Methods The present qualitative study was conducted using a conventional content analysis approach on 33participantincluding patients with OA, their family members and healthcare personnel who were selected by purposive sampling. Data were collected through unstructured and semi-structured interviews and continued until data saturation occurred. Data analysis was carried out simultaneously. Guba and Lincoln's standards of rigor and trustworthiness were respected including the credibility, transferability, dependability and conformability of the data. A narrative systematic review was conducted on osteoarthritis care guidelines and algorithms in order to compare patients' preference with scientific evidences. Results The analysis of the data revealed four main categories, including: Conservative approach in selecting treatment modalities, trend toward traditional treatment, Preferring complementary and alternative medicine, and concerns and barriers treatment modalities. The review of literature demonstrated little attention by professionals to the patients' values or priorities. Comparing of the modalities that were preferred by patients with scientific guidelines indicated some inconsistencies. Conclusion Patient's perceptions, preference, and adherence to treatment, play an essential role in relieving nagging symptoms and

  12. Equivalence relations and the reinforcement contingency.

    Science.gov (United States)

    Sidman, M

    2000-07-01

    Where do equivalence relations come from? One possible answer is that they arise directly from the reinforcement contingency. That is to say, a reinforcement contingency produces two types of outcome: (a) 2-, 3-, 4-, 5-, or n-term units of analysis that are known, respectively, as operant reinforcement, simple discrimination, conditional discrimination, second-order conditional discrimination, and so on; and (b) equivalence relations that consist of ordered pairs of all positive elements that participate in the contingency. This conception of the origin of equivalence relations leads to a number of new and verifiable ways of conceptualizing equivalence relations and, more generally, the stimulus control of operant behavior. The theory is also capable of experimental disproof.

  13. Quantification of the equivalence principle

    International Nuclear Information System (INIS)

    Epstein, K.J.

    1978-01-01

    Quantitative relationships illustrate Einstein's equivalence principle, relating it to Newton's ''fictitious'' forces arising from the use of noninertial frames, and to the form of the relativistic time dilatation in local Lorentz frames. The equivalence principle can be interpreted as the equivalence of general covariance to local Lorentz covariance, in a manner which is characteristic of Riemannian and pseudo-Riemannian geometries

  14. Patient preferences for clean intermittent catheterisation and transurethral indwelling catheterisation for treatment of abnormal post-void residual bladder volume after vaginal prolapse surgery

    NARCIS (Netherlands)

    Hakvoort, R. A.; Nieuwkerk, P. T.; Burger, M. P.; Emanuel, M. H.; Roovers, J. P.

    2011-01-01

    To determine patient preferences for clean intermittent catheterisation (CIC) relative to transurethral indwelling catheterisation (TIC) as the treatment of abnormal post-void residual bladder volume (PVR) following vaginal prolapse surgery. Scenario-based preference assessment during face-to-face

  15. Using frequency equivalency in stability calculations

    Energy Technology Data Exchange (ETDEWEB)

    Gruzdev, I.A.; Temirbulatov, R.A.; Tereshko, L.A.

    1981-01-01

    A methodology for calculating oscillatory instability that involves using frequency equivalency is employed in carrying out the following proceedures: dividing an electric power system into subgroups; determining the adjustments to the automatic excitation control in each subsystem; simplifying the mathematical definition of the separate subsystems by using frequency equivalency; gradually re-tuning the automatic excitation control in the separate subsystems to account for neighboring subsystems by using their equivalent frequency characteristics. The methodology is to be used with a computer program to determine the gain in the stabilization channels of the automatic excitation control unit in which static stability of the entire aggregate of normal and post-breakdown conditions acceptable damping of transient processes are provided. The possibility of reducing the equation series to apply to chosen regions of the existing range of frequencies is demonstrated. The use of the methodology is illustrated in a sample study on stability in a Siberian unified power system.

  16. Patient preference and satisfaction in erectile dysfunction therapy: a comparison of the three phosphodiesterase-5 inhibitors sildenafil, vardenafil and tadalafil

    Directory of Open Access Journals (Sweden)

    Amr Abdel Raheem

    2009-04-01

    Full Text Available Amr Abdel Raheem1, Philip Kell21St. Peter’s Andrology Department, The Institute of Urology, London, and Cairo University, Egypt; 2St. Peter’s Andrology Department, The Institute of Urology, London, UKAbstract: Erectile dysfunction (ED is a problem that may affect up to 52% of men between the ages of 40 and 70. It can be distressing because of its negative effect on self-esteem, quality of life, and interpersonal relationships. Oral phosphodiesterase-5 inhibitors (PDE5 inhibitors are now the first choice of treatment in ED. The availability of three (sildenafil citrate, tadalafil, and vardenafil well tolerated and effective oral PDE5 inhibitors gives treatment options for men with ED. Although the mechanism of action is the same for the three drugs, they differ in their pharmacokinetics. Several preference studies were conducted between the three PDE5 inhibitors but they were not free from bias. Because of the lack of overwhelming reliable data showing that one PDE5 inhibitor is superior to another, current opinion is that the individual patient should have the opportunity to test all three drugs and then select the one that best suits him and his partner.Keywords: erectile dysfunction, PDE5 inhibitors, patient preference

  17. What patients look for when choosing a plastic surgeon: an assessment of patient preference by conjoint analysis.

    Science.gov (United States)

    Waltzman, Joshua T; Scholz, Thomas; Evans, Gregory R D

    2011-06-01

    The knowledge of patient preference is crucial for plastic surgeons to determine optimal marketing strategies. Conjoint analysis is a statistical technique whereby research participants make a series of trade-offs. Analysis of these trade-offs reveals the relative importance of component attributes. This study will evaluate the relative importance of attributes that influence the selection and decision-making process when choosing a plastic surgeon. A questionnaire consisting of 18 plastic surgeon profiles was rated by 111 patients. Attributes analyzed were as follows: travel distance, number of years in practice, board certification status, method of referral, office décor, and procedure cost. A traditional full-profile conjoint analysis was performed. Subjects consisted of 10 men and 101 women (n = 111). Median age was 51 years (range, 19-72). The "mean importance" of the attributes are as follows: board certification status, 39.7%; method of referral, 23.5%; distance from home to office, 13.2%; office décor, 9.0%; number of years in practice, 7.5%; and cost of procedure, 7.2%. Internal validity checks showed a high correlation (Pearson ρ = 0.995; P market research in the health care system. The level of importance for each attribute reliably helps plastic surgeons to understand the preferences of their patients, thus being able to improve marketing strategies for private practices and institutions. The present study indicates that the most important attributes were board certification and method of referral.

  18. A patient-preference cohort study of office versus inpatient uterine polyp treatment for abnormal uterine bleeding.

    Science.gov (United States)

    Cooper, Natalie A M; Middleton, Lee; Smith, Paul; Denny, Elaine; Stobert, Lynda; Daniels, Jane; Clark, T Justin

    2016-01-01

    Uterine polyps can cause abnormal bleeding in women. Conventional practise is to remove them under general anaesthesia but advances in technology have made it possible to perform polypectomy in the office setting. We conducted a patient-preference study to explore women's preferences for treatment setting and to evaluate the effectiveness and treatment experience of women undergoing uterine polypectomy. Three hundred ninety-nine women with abnormal uterine bleeding who were found to have uterine polyps at diagnostic hysteroscopy were recruited. Office polypectomies were performed in office hysteroscopy clinics, and inpatient procedures were undertaken in operating theatres. Three hundred twenty-four of 399 (81 %) expressed a preference for office treatment. There was no difference found between office treatment and inpatient treatment in terms of alleviating abnormal uterine bleeding as assessed by patients and in improving disease-specific quality of life. Acceptability was lower and patient pain scores were significantly higher in the office group. When offered a choice of treatment setting for uterine polypectomy, patients have a preference for office over inpatient treatment. Ambulatory gynaecology services should be available within healthcare systems to meet patient demand.

  19. An equivalence evaluation of a nurse-moderated group-based internet support program for new mothers versus standard care: a pragmatic preference randomised controlled trial

    Science.gov (United States)

    2014-01-01

    Background All mothers in South Australia are offered a clinic or home-visit by a Child and Family Health community nurse in the initial postnatal weeks. Subsequent support is available on request from staff in community clinics and from a telephone helpline. The aim of the present study is to compare equivalence of a single clinic-based appointment plus a nurse-moderated group-based internet intervention when infants were aged 0–6 months versus a single home-visit together with subsequent standard services (the latter support was available to mothers in both study groups). Methods/Design The evaluation utilised a pragmatic preference randomised trial comparing the equivalence of outcomes for mothers and infants across the two study groups. Eligible mothers were those whose services were provided by nurses working in one of six community clinics in the metropolitan region of Adelaide. Mothers were excluded if they did not have internet access, required an interpreter, or their nurse clinician recommended that they not participate due to issues such as domestic violence or substance abuse. Randomisation was based on the service identification number sequentially assigned to infants when referred to the Child and Family Health Services from birthing units (this was done by administrative staff who had no involvement in recruiting mothers, delivering the intervention, or analyzing results for the study). Consistent with design and power calculations, 819 mothers were recruited to the trial. The primary outcomes for the trial are parents’ sense of competence and self-efficacy measured using standard self-report questionnaires. Secondary outcomes include the quality of mother-infant relationships, maternal social support, role satisfaction and maternal mental health, infant social-emotional and language development, and patterns of service utilisation. Maternal and infant outcomes will be evaluated using age-appropriate questionnaires when infants are aged <2 months

  20. Patients' preference in migraine

    NARCIS (Netherlands)

    Dekker, François (Frans)

    2014-01-01

    This thesis is about migraine. Three elements are discussed. First element is preventive treatment, second element is attack treatment and the third part focuses on medication overuse headache. The preventive treatment of migraine is a valuable intervention in primary care. If preventive treatment

  1. New recommendations for dose equivalent

    International Nuclear Information System (INIS)

    Bengtsson, G.

    1985-01-01

    In its report 39, the International Commission on Radiation Units and Measurements (ICRU), has defined four new quantities for the determination of dose equivalents from external sources: the ambient dose equivalent, the directional dose equivalent, the individual dose equivalent, penetrating and the individual dose equivalent, superficial. The rationale behind these concepts and their practical application are discussed. Reference is made to numerical values of these quantities which will be the subject of a coming publication from the International Commission on Radiological Protection, ICRP. (Author)

  2. Use of the Concept of Equivalent Biologically Effective Dose (BED) to Quantify the Contribution of Hyperthermia to Local Tumor Control in Radiohyperthermia Cervical Cancer Trials, and Comparison With Radiochemotherapy Results

    International Nuclear Information System (INIS)

    Plataniotis, George A.; Dale, Roger G.

    2009-01-01

    Purpose: To express the magnitude of contribution of hyperthermia to local tumor control in radiohyperthermia (RT/HT) cervical cancer trials, in terms of the radiation-equivalent biologically effective dose (BED) and to explore the potential of the combined modalities in the treatment of this neoplasm. Materials and Methods: Local control rates of both arms of each study (RT vs. RT+HT) reported from randomized controlled trials (RCT) on concurrent RT/HT for cervical cancer were reviewed. By comparing the two tumor control probabilities (TCPs) from each study, we calculated the HT-related log cell-kill and then expressed it in terms of the number of 2 Gy fraction equivalents, for a range of tumor volumes and radiosensitivities. We have compared the contribution of each modality and made some exploratory calculations on the TCPs that might be expected from a combined trimodality treatment (RT+CT+HT). Results: The HT-equivalent number of 2-Gy fractions ranges from 0.6 to 4.8 depending on radiosensitivity. Opportunities for clinically detectable improvement by the addition of HT are only available in tumors with an alpha value in the approximate range of 0.22-0.28 Gy -1 . A combined treatment (RT+CT+HT) is not expected to improve prognosis in radioresistant tumors. Conclusion: The most significant improvements in TCP, which may result from the combination of RT/CT/HT for locally advanced cervical carcinomas, are likely to be limited only to those patients with tumors of relatively low-intermediate radiosensitivity.

  3. The importance of good death components among cancer patients, the general population, oncologists, and oncology nurses in Japan: patients prefer "fighting against cancer".

    Science.gov (United States)

    Miyashita, Mitsunori; Kawakami, Sachiko; Kato, Daiki; Yamashita, Hideomi; Igaki, Hiroshi; Nakano, Kimiko; Kuroda, Yujiro; Nakagawa, Keiichi

    2015-01-01

    The objectives of this study were to compare the importance of components of a good death among cancer patients, the general population, oncologists, and oncology nurses, and explore which patients preferred "fighting against cancer." We conducted a cross-sectional anonymous self-reported survey of cancer patients who visited a radiation oncology outpatient clinic, oncologists, and oncology nurses at the Tokyo University Hospital and a random sample of the general population in the Tokyo metropolitan area. The outcomes were 18 previously developed components of a good death in Japanese cancer care consisting of 57 attributes. Three hundred ten patients, 353 subjects from the general population, 109 oncologists, and 366 oncology nurses participated. The desire to "fight against cancer" was highly significantly different between patients and oncologists (effect size [ES] = -1.40; P = 0.001) and patients and oncology nurses (ES = -1.12; P = 0.001). "Physical and cognitive control" was, similarly, highly significantly different between patients and oncologists (ES = -1.30; P = 0.001) and patients and oncology nurses (ES = -1.06; P = 0.001). Patients who emphasized "maintaining hope and pleasure" (P = 0.0001), "unawareness of death" (P = 0.0001), and "good relationship with family" (P = 0.004) favored "fighting against cancer." The patients, however, who emphasized "physical and psychological comfort" did not significantly favor "fighting against cancer" (P = 0.004). The importance of good death components differed between groups. Medical professionals should be aware of the diversity of values surrounding death and assess the patient's values and discuss them to support his or her quality of life. In addition, the development of care and a medical/social system to maintain hope and pleasure after failure of anticancer treatment is necessary.

  4. Evaluation of patient preferences towards treatment during extended hours for patients receiving radiation therapy for the treatment of cancer: A time trade-off study

    International Nuclear Information System (INIS)

    Brown, Alison M.; Atyeo, John; Field, Nikki; Cox, Jennifer; Bull, Colin; Gebski, Val J.

    2009-01-01

    Background: To reduce the waiting time between diagnosis and the start of radiation therapy, some departments have introduced appointments outside of conventional working hours, but the inconvenience this may cause to patients is unknown. We examined, from the patient's perspective, whether reduced waiting times to treatment would be sufficient to trade off against potentially inconvenient appointment times. Method: We interviewed patients receiving radiation therapy at a major teaching hospital between January and May 2005. Two patient groups were considered: those treated during conventional working hours (8.30 am to 4.30 pm), and those treated outside these hours. Patients were asked to trade a reduction in waiting time to the start of treatment against treatment outside conventional working hours. Results: Of 129 patients interviewed, 77 were treated during conventional working hours and 52 outside these hours. Fifty-seven (44%) were male and 52 (40%) were aged over 60 years. To prefer treatment out of working hours, patients being treated during conventional working hours required a larger reduction in waiting time (odds ratio 2.36, 95% CI 0.97-5.76). Patients with curable disease and those who had made few changes in their lifestyle throughout the treatment were more likely to accept treatment outside of conventional working hours. Conclusion: It is impractical to satisfy the treatment-time preferences of all patients. However, many patients prefer treatment outside of normal treatment times if this would reduce the time until the start of radiation therapy. Evaluating the effect of waiting times on patients' perceptions of their disease control provides important information in allocating treatment hours and appointment times

  5. System equivalent model mixing

    Science.gov (United States)

    Klaassen, Steven W. B.; van der Seijs, Maarten V.; de Klerk, Dennis

    2018-05-01

    This paper introduces SEMM: a method based on Frequency Based Substructuring (FBS) techniques that enables the construction of hybrid dynamic models. With System Equivalent Model Mixing (SEMM) frequency based models, either of numerical or experimental nature, can be mixed to form a hybrid model. This model follows the dynamic behaviour of a predefined weighted master model. A large variety of applications can be thought of, such as the DoF-space expansion of relatively small experimental models using numerical models, or the blending of different models in the frequency spectrum. SEMM is outlined, both mathematically and conceptually, based on a notation commonly used in FBS. A critical physical interpretation of the theory is provided next, along with a comparison to similar techniques; namely DoF expansion techniques. SEMM's concept is further illustrated by means of a numerical example. It will become apparent that the basic method of SEMM has some shortcomings which warrant a few extensions to the method. One of the main applications is tested in a practical case, performed on a validated benchmark structure; it will emphasize the practicality of the method.

  6. Examining chronic care patient preferences for involvement in health-care decision making: the case of Parkinson's disease patients in a patient-centred clinic.

    Science.gov (United States)

    Zizzo, Natalie; Bell, Emily; Lafontaine, Anne-Louise; Racine, Eric

    2017-08-01

    Patient-centred care is a recommended model of care for Parkinson's disease (PD). It aims to provide care that is respectful and responsive to patient preferences, values and perspectives. Provision of patient-centred care should entail considering how patients want to be involved in their care. To understand the participation preferences of patients with PD from a patient-centred care clinic in health-care decision-making processes. Mixed-methods study with early-stage Parkinson's disease patients from a patient-centred care clinic. Study involved a modified Autonomy Preference Index survey (N=65) and qualitative, semi-structured in-depth interviews, analysed using thematic qualitative content analysis (N=20, purposefully selected from survey participants). Interviews examined (i) the patient preferences for involvement in health-care decision making; (ii) patient perspectives on the patient-physician relationship; and (iii) patient preferences for communication of information relevant to decision making. Preferences for participation in decision making varied between individuals and also within individuals depending on decision type, relational and contextual factors. Patients had high preferences for communication of information, but with acknowledged limits. The importance of communication in the patient-physician relationship was emphasized. Patient preferences for involvement in decision making are dynamic and support shared decision making. Relational autonomy corresponds to how patients envision their participation in decision making. Clinicians may need to assess patient preferences on an on-going basis. Our results highlight the complexities of decision-making processes. Improved understanding of individual preferences could enhance respect for persons and make for patient-centred care that is truly respectful of individual patients' wants, needs and values. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  7. Topological equivalence of nonlinear autonomous dynamical systems

    International Nuclear Information System (INIS)

    Nguyen Huynh Phan; Tran Van Nhung

    1995-12-01

    We show in this paper that the autonomous nonlinear dynamical system Σ(A,B,F): x' = Ax+Bu+F(x) is topologically equivalent to the linear dynamical system Σ(A,B,O): x' = Ax+Bu if the projection of A on the complement in R n of the controllable vectorial subspace is hyperbolic and if lipschitz constant of F is sufficiently small ( * ) and F(x) = 0 when parallel x parallel is sufficiently large ( ** ). In particular, if Σ(A,B,O) is controllable, it is topologically equivalent to Σ(A,B,F) when it is only that F satisfy ( ** ). (author). 18 refs

  8. The equivalence principle

    International Nuclear Information System (INIS)

    Smorodinskij, Ya.A.

    1980-01-01

    The prerelativistic history of the equivalence principle (EP) is presented briefly. Its role in history of the general relativity theory (G.R.T.) discovery is elucidated. A modern idea states that the ratio of inert and gravitational masses does not differ from 1 at least up to the 12 sign after comma. Attention is paid to the difference of the gravitational field from electromagnetic one. The difference is as follows, the energy of the gravitational field distributed in space is the source of the field. These fields always interact at superposition. Electromagnetic fields from different sources are put together. On the basis of EP it is established the Sun field interact with the Earth gravitational energy in the same way as with any other one. The latter proves the existence of gravitation of the very gravitational field to a heavy body. A problem on gyroscope movement in the Earth gravitational field is presented as a paradox. The calculation has shown that gyroscope at satellite makes a positive precession, and its axis turns in an angle equal to α during a turn of the satellite round the Earth, but because of the space curvature - into the angle two times larger than α. A resulting turn is equal to 3α. It is shown on the EP basis that the polarization plane in any coordinate system does not turn when the ray of light passes in the gravitational field. Together with the historical value of EP noted is the necessity to take into account the requirements claimed by the EP at description of the physical world

  9. Patient Preference Before and After Arthroscopic Rotator Cuff Repair: Which Is More Important, Pain Relief or Strength Return?

    Science.gov (United States)

    Virk, Mandeep S; Levy, David M; Kuhns, Benjamin D; Krecher, James S; Parsley, Billy K; Burkhart, Stephen S; Romeo, Anthony A; Verma, Nikhil N; Cole, Brian J

    Our understanding of patients' desired outcomes and expectations of arthroscopic rotator cuff repair (ARCR) is limited, particularly regarding the importance of pain relief and strength return relative to each other. We conducted a study of patient's ratings of the importance of pain relief and strength return after ARCR. Before undergoing surgery, 60 patients completed a shoulder questionnaire on which they assessed severity of symptoms and rated, on a 10-point scale, the importance of postoperative improvements in pain relief and strength return. After surgery, they completed the same questionnaire, again rating the importance of pain relief and strength return. About 50% of the patients valued pain relief and strength return equally before and after ARCR. However, overall patient ratings were higher for strength return over pain relief, both before surgery, mean (SD), 9.2 (2.1) vs 8.6 (2.3) (P = .02), and afterward, at a follow-up of 5.2 (0.2) years, 8.9 (1.9) vs 8.2 (3.1) (P = .03). This significant preference for strength return held irrespective of sex, age, active sports involvement, preoperative self-assessed pain score, and subjective shoulder weakness. Before surgery, increasing age was associated with a stronger preference for pain relief (r = 0.33, P = .01), and retirees preferred pain relief over strength return. These results show the patterns of patient preference for pain relief and strength return after ARCR. Improved understanding of these patients' expectations will allow meaningful changes in patient satisfaction.

  10. Patient preferences and extended-release naltrexone: A new opportunity to treat opioid use disorders in Ukraine.

    Science.gov (United States)

    Marcus, Ruthanne; Makarenko, Iuliia; Mazhnaya, Alyona; Zelenev, Alexei; Polonsky, Maxim; Madden, Lynn; Filippovych, Sergii; Dvoriak, Sergii; Springer, Sandra A; Altice, Frederick L

    2017-10-01

    Scaling up HIV prevention for people who inject drugs (PWID) using opioid agonist therapies (OAT) in Ukraine has been restricted by individual and structural factors. Extended-release naltrexone (XR-NTX), however, provides new opportunities for treating opioid use disorders (OUDs) in this region, where both HIV incidence and mortality continue to increase. Survey results from 1613 randomly selected PWID from 5 regions in Ukraine who were currently, previously or never on OAT were analyzed for their preference of pharmacological therapies for treating OUDs. For those preferring XR-NTX, independent correlates of their willingness to initiate XR-NTX were examined. Among the 1613 PWID, 449 (27.8%) were interested in initiating XR-NTX. Independent correlates associated with interest in XR-NTX included: being from Mykolaiv (AOR=3.7, 95% CI=2.3-6.1) or Dnipro (AOR=1.8, 95% CI=1.1-2.9); never having been on OAT (AOR=3.4, 95% CI=2.1-5.4); shorter-term injectors (AOR=0.9, 95% CI 0.9-0.98); and inversely for both positive (AOR=0.8, CI=0.8-0.9), and negative attitudes toward OAT (AOR=1.3, CI=1.2-1.4), respectively. In the context of Eastern Europe and Central Asia where HIV is concentrated in PWID and where HIV prevention with OAT is under-scaled, new options for treating OUDs are urgently needed. here suggest that XR-NTX could become an option for addiction treatment and HIV prevention especially for PWID who have shorter duration of injection and who harbor negative attitudes to OAT. Decision aids that inform patient preferences with accurate information about the various treatment options are likely to guide patients toward better, patient-centered treatments and improve treatment entry and retention. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Logically automorphically equivalent knowledge bases

    OpenAIRE

    Aladova, Elena; Plotkin, Tatjana

    2017-01-01

    Knowledge bases theory provide an important example of the field where applications of universal algebra and algebraic logic look very natural, and their interaction with practical problems arising in computer science might be very productive. In this paper we study the equivalence problem for knowledge bases. Our interest is to find out how the informational equivalence is related to the logical description of knowledge. Studying various equivalences of knowledge bases allows us to compare d...

  12. Testing statistical hypotheses of equivalence

    CERN Document Server

    Wellek, Stefan

    2010-01-01

    Equivalence testing has grown significantly in importance over the last two decades, especially as its relevance to a variety of applications has become understood. Yet published work on the general methodology remains scattered in specialists' journals, and for the most part, it focuses on the relatively narrow topic of bioequivalence assessment.With a far broader perspective, Testing Statistical Hypotheses of Equivalence provides the first comprehensive treatment of statistical equivalence testing. The author addresses a spectrum of specific, two-sided equivalence testing problems, from the

  13. Occupational dose equivalent limits

    International Nuclear Information System (INIS)

    Goldfinch, E.P.

    1980-01-01

    This paper considers methods of limiting individual radiation risks by recognizing the variation of risk with age at exposure, taking into account both somatic and genetic risks and proposes a simple formula for controlling individual cumulative exposure and hence risk. (Author)

  14. Patients' preference for exercise setting and its influence on the health benefits gained from exercise-based cardiac rehabilitation

    DEFF Research Database (Denmark)

    Tang, Lars H.; Kikkenborg Berg, Selina; Christensen, Jan

    2017-01-01

    .011). With the exception of the depression score in the Hospital Anxiety and Depression Score (F(3.65), p=0.004), there was no evidence of a significant difference in outcomes between settings. CONCLUSION: The preference of patients to participate in home-based and centre-based exercise programmes appears to be equivalent...

  15. Effect on skin hydration of using baby wipes to clean the napkin area of newborn babies: assessor-blinded randomised controlled equivalence trial

    OpenAIRE

    Lavender, Tina; Furber, Christine; Campbell, Malcolm; Victor, Suresh; Roberts, Ian; Bedwell, Carol; Cork, Michael J

    2012-01-01

    Abstract Background Some national guidelines recommend the use of water alone for napkin cleansing. Yet, there is a readiness, amongst many parents, to use baby wipes. Evidence from randomised controlled trials, of the effect of baby wipes on newborn skin integrity is lacking. We conducted a study to examine the hypothesis that the use of a specifically formulated cleansing wipe on the napkin area of newborn infants (

  16. SAPONIFICATION EQUIVALENT OF DASAMULA TAILA

    OpenAIRE

    Saxena, R. B.

    1994-01-01

    Saponification equivalent values of Dasamula taila are very useful for the technical and analytical work. It gives the mean molecular weight of the glycerides and acids present in Dasamula Taila. Saponification equivalent values of Dasamula taila are reported in different packings.

  17. Saponification equivalent of dasamula taila.

    Science.gov (United States)

    Saxena, R B

    1994-07-01

    Saponification equivalent values of Dasamula taila are very useful for the technical and analytical work. It gives the mean molecular weight of the glycerides and acids present in Dasamula Taila. Saponification equivalent values of Dasamula taila are reported in different packings.

  18. A study on lead equivalent

    International Nuclear Information System (INIS)

    Lin Guanxin

    1991-01-01

    A study on the rules in which the lead equivalent of lead glass changes with the energy of X rays or γ ray is described. The reason of this change is discussed and a new testing method of lead equivalent is suggested

  19. Long-acting reversible contraceptive acceptability and unintended pregnancy among women presenting for short-acting methods: a randomized patient preference trial.

    Science.gov (United States)

    Hubacher, David; Spector, Hannah; Monteith, Charles; Chen, Pai-Lien; Hart, Catherine

    2017-02-01

    Measures of contraceptive effectiveness combine technology and user-related factors. Observational studies show higher effectiveness of long-acting reversible contraception compared with short-acting reversible contraception. Women who choose long-acting reversible contraception may differ in key ways from women who choose short-acting reversible contraception, and it may be these differences that are responsible for the high effectiveness of long-acting reversible contraception. Wider use of long-acting reversible contraception is recommended, but scientific evidence of acceptability and successful use is lacking in a population that typically opts for short-acting methods. The objective of the study was to reduce bias in measuring contraceptive effectiveness and better isolate the independent role that long-acting reversible contraception has in preventing unintended pregnancy relative to short-acting reversible contraception. We conducted a partially randomized patient preference trial and recruited women aged 18-29 years who were seeking a short-acting method (pills or injectable). Participants who agreed to randomization were assigned to 1 of 2 categories: long-acting reversible contraception or short-acting reversible contraception. Women who declined randomization but agreed to follow-up in the observational cohort chose their preferred method. Under randomization, participants chose a specific method in the category and received it for free, whereas participants in the preference cohort paid for the contraception in their usual fashion. Participants were followed up prospectively to measure primary outcomes of method continuation and unintended pregnancy at 12 months. Kaplan-Meier techniques were used to estimate method continuation probabilities. Intent-to-treat principles were applied after method initiation for comparing incidence of unintended pregnancy. We also measured acceptability in terms of level of happiness with the products. Of the 916

  20. Family preference for place of death mediates the relationship between patient preference and actual place of death: a nationwide retrospective cross-sectional study.

    Science.gov (United States)

    Ishikawa, Yoshiki; Fukui, Sakiko; Saito, Toshiya; Fujita, Junko; Watanabe, Minako; Yoshiuchi, Kazuhiro

    2013-01-01

    Discrepancy between preferred and actual place of death is common in cancer patients. While previous research has elucidated the factors associated with congruence between patients' preferred and actual place of death, it is not known how the perspective of the family influences the place of death. This study examined whether family preference for place of death mediates the relationship between patient preference and actual place of death. A total of 258 cancer patients (home death, n = 142; hospital death, n = 116) who had received terminal care in Japan were analyzed. Measures included patients' demographic variables, patient and family preferences for place for death, actual place of death, patients' functional status, use and intensity of home care, availability of inpatient bed, living arrangement, and amount of extended family support. Patient-family congruence on preferred place of death was 66% in patients who died at home and 47% in patients who died at other places (kappa coefficient: 0.20 and 0.25, respectively). In a multiple logistic regression model, patients were more likely to die at home when patients were male (odds ratio [OR], 95% confidence interval [CI]: 2.53, 1.06-6.05) and when their family preferred death at home (OR, 95% CI: 37.37, 13.82-101.03). A Sobel test revealed that family preference mediated the relationship between patient preference and place of death (pfamily in the relationship between patient preference and place of death in Japan. In order to honor patients' wishes to die at home, supporting caregivers in the family may be an essential component of terminal care.

  1. Ego mechanisms of defense are associated with patients? preference of treatment modality independent of psychological distress in end-stage renal disease

    OpenAIRE

    Hyphantis, Thomas; Katsoudas, Spiros; Voudiclari, Sonia

    2010-01-01

    Several parameters mediate the selection of treatment modality in end-stage renal disease (ESRD). The nephrology community suggests that patient preference should be the prime determinant of modality choice. We aimed to test whether ego mechanisms of defense are associated with patients? treatment modality preferences, independent of psychological distress. In 58 eligible ESRD patients who had themselves chosen their treatment modality, we administered the Symptom Distress Checklist-90-R and ...

  2. Internet Use Frequency and Patient-Centered Care: Measuring Patient Preferences for Participation Using the Health Information Wants Questionnaire

    Science.gov (United States)

    Wang, Mo; Feldman, Robert; Zhou, Le

    2013-01-01

    Background The Internet is bringing fundamental changes to medical practice through improved access to health information and participation in decision making. However, patient preferences for participation in health care vary greatly. Promoting patient-centered health care requires an understanding of the relationship between Internet use and a broader range of preferences for participation than previously measured. Objective To explore (1) whether there is a significant relationship between Internet use frequency and patients’ overall preferences for obtaining health information and decision-making autonomy, and (2) whether the relationships between Internet use frequency and information and decision-making preferences differ with respect to different aspects of health conditions. Methods The Health Information Wants Questionnaire (HIWQ) was administered to gather data about patients’ preferences for the (1) amount of information desired about different aspects of a health condition, and (2) level of decision-making autonomy desired across those same aspects. Results The study sample included 438 individuals: 226 undergraduates (mean age 20; SD 2.15) and 212 community-dwelling older adults (mean age 72; SD 9.00). A significant difference was found between the younger and older age groups’ Internet use frequencies, with the younger age group having significantly more frequent Internet use than the older age group (younger age group mean 5.98, SD 0.33; older age group mean 3.50, SD 2.00; t 436=17.42, PInternet use frequency was positively related to the overall preference rating (γ=.15, PInternet users preferred significantly more information and decision making than infrequent Internet users. The relationships between Internet use frequency and different types of preferences varied: compared with infrequent Internet users, frequent Internet users preferred more information but less decision making for diagnosis (γ=.57, PInternet users in their preferences

  3. Multinational Internet-based survey of patient preference for newer oral or injectable Type 2 diabetes medication

    Directory of Open Access Journals (Sweden)

    Marco daCosta DiBonaventura

    2010-11-01

    Full Text Available Marco daCosta DiBonaventura1, Jan-Samuel Wagner1, Cynthia J Girman2, Kimberly Brodovicz2, Qiaoyi Zhang3, Ying Qiu3, Sri-Ram Pentakota3, Larry Radican31Health Sciences Practice, Kantar Health, New York; 2Epidemiology, 3Global Health Outcomes, Merck, Whitehouse Station, New Jersey, USABackground: The prevalence of Type 2 diabetes mellitus continues to rise. Although glucagon-like peptide-1 (GLP-1 analog and dipeptidyl peptidase-4 (DPP-4 inhibitor medications are effective, there are differences between these products, including method of administration (injectable versus oral. The objective of this study was to examine patient preferences (and predictors of preferences for two different medication profiles, one similar to a GLP-1 analog (liraglutide and another similar to a DPP-4 inhibitor (sitagliptin.Methods: Internet survey data were collected in two waves (wave 1, n = 2402; wave 2, n = 1340 using patients from the US and Europe. Patients were presented with two hypothetical medication profiles (“drug A” and “drug B”, resembling sitagliptin and liraglutide, respectively and asked to report their preferences.Results: Most patients in wave 1 and wave 2 reported that overall they would prefer a drug with the sitagliptin-like profile (81.9% and 84.4%, respectively over a drug with the liraglutide-like profile (18.1% and 15.6%, respectively, and >80% of patients reported that they would be able to take a drug with the sitagliptin-like profile as directed by their physician for a longer period. The likelihood of preferring the sitagliptin-like profile significantly increased as age (odds ratio [OR] = 1.02 and importance placed on method of administration (OR = 1.32 increased (P < 0.05. Although the sitagliptin-like profile was preferred by the majority of patients in all subgroups, a lower proportion of patients with obesity, with weight gain, with A1C values above target, and who exercised preferred the sitagliptin-like profile compared with

  4. A Prospective Comparison of Younger and Older Patients' Preferences for Adjuvant Chemotherapy and Hormonal Therapy in Early Breast Cancer.

    Science.gov (United States)

    Hamelinck, Victoria C; Bastiaannet, Esther; Pieterse, Arwen H; de Glas, Nienke A; Portielje, Johanneke E A; Merkus, Jos W S; den Hoed, Irma D M; van de Velde, Cornelis J H; Liefers, Gerrit-Jan; Stiggelbout, Anne M

    2016-10-01

    It is unknown what minimal benefit in disease-free survival older patients with breast cancer require from adjuvant systemic therapy, and if this differs from that required by younger patients. We prospectively examined patients' preferences for adjuvant chemotherapy (aCT) and adjuvant hormonal therapy (aHT), factors related to minimally-required benefit, and patients' self-reported motivations. Fifty-two younger (40-64 years) and 29 older (≥ 65 years) women with a first primary, invasive tumor were interviewed post-surgery, prior to receiving aCT/aHT recommendation. The proportions of younger versus older participants who would accept, refuse, or were undecided about therapy were 92% versus 62%, 4% versus 24%, and 4% versus 14% for aCT, and 92% versus 59%, 8% versus 17%, and 0% versus 24% for aHT. The proportion of older participants who would refuse rather than accept aCT was larger than that of younger participants (P = .005). No significant difference was found for aHT (P = .12). Younger and older participants' minimally-required benefit, in terms of additional 10-year disease-free survival, to accept aCT (median, 5% vs. 4%; P = .13) or aHT (median, 10% vs. 8%; P = .15) did not differ. Being single/divorced/widowed (odds ratio [OR], 0.16; P = .005), presence of geriatric condition (inability to perform daily activities, incontinence, severe sensory impairment, depression, polypharmacy, difficulties with walking; OR, 0.27; P = .047), and having a preference to make the treatment decision either alone or after considering the clinician's opinion (active role; OR, 0.15; P = .012) were independently related to requiring larger benefits from aCT. The most frequent motivations for/against therapy included the wish to survive/avoid recurrence, clinician's recommendation, side effects, and treatment duration (only aHT). Whereas older participants were less willing to accept aCT than younger participants, no significant difference was found for aHT. However, a

  5. Do not judge according to appearance: patients' preference of a doctor's face does not influence their assessment of the patient-doctor relationship.

    Science.gov (United States)

    Lee, Soon-Ho; Chang, Dong-Seon; Kang, O-Seok; Kim, Hwa-Hyun; Kim, Hackjin; Lee, Hyejung; Park, Hi-Joon; Chae, Younbyoung

    2012-12-01

    The aim of this study was to investigate whether a patient's preference for a doctor's face is associated with better assessments of relational empathy in the patient-doctor relationship after the first clinical consultation. A total of 110 patients enrolled in a traditional Korean medical clinic participated in the study. Patients' preference for doctors' faces was assessed by a two alternative forced choice (2AFC) task, with 60 different pairs of six different Asian male doctors' faces. One of the six doctors then carried out the initial clinical consultation for these patients. The patient-doctor relationship was assessed using the Consultation and Relational Empathy (CARE) measure. The data of all patients' simulated preferences for a doctor's face and their assessment values of a doctor's relational empathy was compared, and no significant correlation was found between both values (r=-0.024, p>0.809). These findings suggest that the perceived empathy in the patient-doctor relationship is not influenced by the patient's preference for a certain doctor's face. The first impression of a doctor is often determined by his appearance and look. However, whether or not the patient particularly prefers a doctor's face does not seem to matter in developing a good patient-doctor relationship.

  6. Is single room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure ulcers or medication errors? A natural experiment with non-equivalent controls.

    Science.gov (United States)

    Simon, Michael; Maben, Jill; Murrells, Trevor; Griffiths, Peter

    2016-07-01

    A wide range of patient benefits have been attributed to single room hospital accommodation including a reduction in adverse patient safety events. However, studies have been limited to the US with limited evidence from elsewhere. The aim of this study was to assess the impact on safety outcomes of the move to a newly built all single room acute hospital. A natural experiment investigating the move to 100% single room accommodation in acute assessment, surgical and older people's wards. Move to 100% single room accommodation compared to 'steady state' and 'new build' control hospitals. Falls, pressure ulcer, medication error, meticillin-resistant Staphylococcus aureus and Clostridium difficile rates from routine data sources were measured over 36 months. Five of 15 time series in the wards that moved to single room accommodation revealed changes that coincided with the move to the new all single room hospital: specifically, increased fall, pressure ulcer and Clostridium difficile rates in the older people's ward, and temporary increases in falls and medication errors in the acute assessment unit. However, because the case mix of the older people's ward changed, and because the increase in falls and medication errors on the acute assessment ward did not last longer than six months, no clear effect of single rooms on the safety outcomes was demonstrated. There were no changes to safety events coinciding with the move at the new build control site. For all changes in patient safety events that coincided with the move to single rooms, we found plausible alternative explanations such as case-mix change or disruption as a result of the re-organization of services after the move. The results provide no evidence of either benefit or harm from all single room accommodation in terms of safety-related outcomes, although there may be short-term risks associated with a move to single rooms. © The Author(s) 2016.

  7. Determination of dose equivalent with tissue-equivalent proportional counters

    International Nuclear Information System (INIS)

    Dietze, G.; Schuhmacher, H.; Menzel, H.G.

    1989-01-01

    Low pressure tissue-equivalent proportional counters (TEPC) are instruments based on the cavity chamber principle and provide spectral information on the energy loss of single charged particles crossing the cavity. Hence such detectors measure absorbed dose or kerma and are able to provide estimates on radiation quality. During recent years TEPC based instruments have been developed for radiation protection applications in photon and neutron fields. This was mainly based on the expectation that the energy dependence of their dose equivalent response is smaller than that of other instruments in use. Recently, such instruments have been investigated by intercomparison measurements in various neutron and photon fields. Although their principles of measurements are more closely related to the definition of dose equivalent quantities than those of other existing dosemeters, there are distinct differences and limitations with respect to the irradiation geometry and the determination of the quality factor. The application of such instruments for measuring ambient dose equivalent is discussed. (author)

  8. Comparing the Efficacy, Mask Leak, Patient Adherence, and Patient Preference of Three Different CPAP Interfaces to Treat Moderate-Severe Obstructive Sleep Apnea.

    Science.gov (United States)

    Rowland, Sharn; Aiyappan, Vinod; Hennessy, Cathy; Catcheside, Peter; Chai-Coezter, Ching Li; McEvoy, R Doug; Antic, Nick A

    2018-01-15

    To determine if the type of continuous positive airway pressure (CPAP) mask interface influences CPAP treatment efficacy, adherence, side effects, comfort and sleep quality in patients with moderate-severe obstructive sleep apnea (OSA). This took place in a hospital-based tertiary sleep disorders unit. It is a prospective, randomized, crossover trial comparing three CPAP interfaces: nasal mask (NM), nasal mask plus chinstrap (NM-CS) and oronasal mask (ONM) each tried in random order, for 4 weeks. After each 4-week period, patient outcomes were assessed. Participants had a new diagnosis of obstructive sleep apneas. Forty-eight patients with moderate-severe OSA (32 males, mean ± standard deviation apnea-hypopnea index (AHI) 55.6 ± 21.1 events/h, age 54.9 ± 13.1 years, body mass index 35.8 ± 7.2 kg/m 2 ) were randomized. Thirty-five participants completed the full study, with complete data available for 34 patients. There was no statistically significant difference in CPAP adherence; however, residual AHI was higher with ONM than NM and NM-CS (residual AHI 7.1 ± 7.7, 4.0 ± 3.1, 4.2 ± 3.7 events/h respectively, main effect P = .001). Patient satisfaction and quality of sleep were higher with the NM and NM-CS than the ONM. Fewer leak and mask fit problems were reported with NM (all chi-square P CPAP adherence did not differ between the three different mask interfaces but the residual AHI was lower with NM than ONM and patients reported greater mask comfort, better sleep, and overall preference for a NM. A nasal mask with or without chinstrap should be the first choice for patients with OSA referred for CPAP treatment. Registry: Australian and New Zealand Clinical Trials Registry, URL: https://www.anzctr.org.au, title: A comparison of continuous positive airway pressure (CPAP) interface in the control of leak, patient compliance and patient preference: nasal CPAP mask and chinstrap versus full face mask in patients with obstructive sleep apnoea (OSA), identifier

  9. What is correct: equivalent dose or dose equivalent

    International Nuclear Information System (INIS)

    Franic, Z.

    1994-01-01

    In Croatian language some physical quantities in radiation protection dosimetry have not precise names. Consequently, in practice either terms in English or mathematical formulas are used. The situation is even worse since the Croatian language only a limited number of textbooks, reference books and other papers are available. This paper compares the concept of ''dose equivalent'' as outlined in International Commission on Radiological Protection (ICRP) recommendations No. 26 and newest, conceptually different concept of ''equivalent dose'' which is introduced in ICRP 60. It was found out that Croatian terminology is both not uniform and unprecise. For the term ''dose equivalent'' was, under influence of Russian and Serbian languages, often used as term ''equivalent dose'' even from the point of view of ICRP 26 recommendations, which was not justified. Unfortunately, even now, in Croatia the legal unit still ''dose equivalent'' defined as in ICRP 26, but the term used for it is ''equivalent dose''. Therefore, in Croatian legislation a modified set of quantities introduced in ICRP 60, should be incorporated as soon as possible

  10. Can Arthroplasty Stem INfluence Outcome? (CASINO): a randomized controlled equivalence trial of 125 mm versus 150 mm Exeter V40 stems in total hip arthroplasty.

    Science.gov (United States)

    Hamilton, David F; Ohly, Nicholas E; Gaston, Paul

    2018-04-16

    The use of shorter length femoral stems during total hip arthroplasty has been suggested to accommodate wider patient femoral geometry and offer maximal bone preservation. However, cemented short-stem designs may increase the risk of varus stem malalignment and influence patient outcomes. CASINO is a multi-centre randomised equivalence trial that will recruit 220 patients undergoing total hip arthroplasty for osteoarthritis at two NHS hospitals in Scotland. Patients will be aged 45-80, undergoing unilateral primary hip arthroplasty, with no plan for contralateral procedure within the study timeframe, and able to comply with the protocol. Participants will be randomised to receive either a short (125 mm) or a standard (150 mm) Exeter V40 stem. The Contemporary acetabular component will be used in all cases. All implants will be cemented. Patient pain, function and satisfaction will be assessed using change from baseline measurement in Oxford Hip Score, Forgotten Joint Score, EQ-5D, pain numerical rating scores, and patient satisfaction questionnaire at baseline and at 1 and 2 years following surgery. Radiographic assessment will evaluate stem position and will be appraised by independent reviewers. Patients will be blind to implant allocation. Stem length may be associated with outcome; however, we can find no randomised trial in which researchers investigated the effect of stem length on patient outcome following cemented total hip arthroplasty. The aim of this trial is to determine if the use of short cemented stems offers equivalent patient outcomes to those achieved following surgery with standard length stems. International Standard Randomised Controlled Trial Number, ISRCTN13154542 , Registered on 30 June 2017.

  11. Symmetries of dynamically equivalent theories

    Energy Technology Data Exchange (ETDEWEB)

    Gitman, D.M.; Tyutin, I.V. [Sao Paulo Univ., SP (Brazil). Inst. de Fisica; Lebedev Physics Institute, Moscow (Russian Federation)

    2006-03-15

    A natural and very important development of constrained system theory is a detail study of the relation between the constraint structure in the Hamiltonian formulation with specific features of the theory in the Lagrangian formulation, especially the relation between the constraint structure with the symmetries of the Lagrangian action. An important preliminary step in this direction is a strict demonstration, and this is the aim of the present article, that the symmetry structures of the Hamiltonian action and of the Lagrangian action are the same. This proved, it is sufficient to consider the symmetry structure of the Hamiltonian action. The latter problem is, in some sense, simpler because the Hamiltonian action is a first-order action. At the same time, the study of the symmetry of the Hamiltonian action naturally involves Hamiltonian constraints as basic objects. One can see that the Lagrangian and Hamiltonian actions are dynamically equivalent. This is why, in the present article, we consider from the very beginning a more general problem: how the symmetry structures of dynamically equivalent actions are related. First, we present some necessary notions and relations concerning infinitesimal symmetries in general, as well as a strict definition of dynamically equivalent actions. Finally, we demonstrate that there exists an isomorphism between classes of equivalent symmetries of dynamically equivalent actions. (author)

  12. Matching of equivalent field regions

    DEFF Research Database (Denmark)

    Appel-Hansen, Jørgen; Rengarajan, S.B.

    2005-01-01

    In aperture problems, integral equations for equivalent currents are often found by enforcing matching of equivalent fields. The enforcement is made in the aperture surface region adjoining the two volumes on each side of the aperture. In the case of an aperture in a planar perfectly conducting...... screen, having the same homogeneous medium on both sides and an impressed current on one aide, an alternative procedure is relevant. We make use of the fact that in the aperture the tangential component of the magnetic field due to the induced currents in the screen is zero. The use of such a procedure...... shows that equivalent currents can be found by a consideration of only one of the two volumes into which the aperture plane divides the space. Furthermore, from a consideration of an automatic matching at the aperture, additional information about tangential as well as normal field components...

  13. Teleparallel equivalent of Lovelock gravity

    Science.gov (United States)

    González, P. A.; Vásquez, Yerko

    2015-12-01

    There is a growing interest in modified gravity theories based on torsion, as these theories exhibit interesting cosmological implications. In this work inspired by the teleparallel formulation of general relativity, we present its extension to Lovelock gravity known as the most natural extension of general relativity in higher-dimensional space-times. First, we review the teleparallel equivalent of general relativity and Gauss-Bonnet gravity, and then we construct the teleparallel equivalent of Lovelock gravity. In order to achieve this goal, we use the vielbein and the connection without imposing the Weitzenböck connection. Then, we extract the teleparallel formulation of the theory by setting the curvature to null.

  14. Attainment of radiation equivalency principle

    International Nuclear Information System (INIS)

    Shmelev, A.N.; Apseh, V.A.

    2004-01-01

    Problems connected with the prospects for long-term development of the nuclear energetics are discussed. Basic principles of the future large-scale nuclear energetics are listed, primary attention is the safety of radioactive waste management of nuclear energetics. The radiation equivalence principle means close of fuel cycle and management of nuclear materials transportation with low losses on spent fuel and waste processing. Two aspects are considered: radiation equivalence in global and local aspects. The necessity of looking for other strategies of fuel cycle management in full-scale nuclear energy on radioactive waste management is supported [ru

  15. Comments on field equivalence principles

    DEFF Research Database (Denmark)

    Appel-Hansen, Jørgen

    1987-01-01

    It is pointed Out that often-used arguments based on a short-circuit concept in presentations of field equivalence principles are not correct. An alternative presentation based on the uniqueness theorem is given. It does not contradict the results obtained by using the short-circuit concept...

  16. Cryogenic test of the equivalence principle

    International Nuclear Information System (INIS)

    Worden, P.W. Jr.

    1976-01-01

    The weak equivalence principle is the hypothesis that the ratio of internal and passive gravitational mass is the same for all bodies. A greatly improved test of this principle is possible in an orbiting satellite. The most promising experiments for an orbital test are adaptations of the Galilean free-fall experiment and the Eotvos balance. Sensitivity to gravity gradient noise, both from the earth and from the spacecraft, defines a limit to the sensitivity in each case. This limit is generally much worse for an Eotvos balance than for a properly designed free-fall experiment. The difference is related to the difficulty of making a balance sufficiently isoinertial. Cryogenic technology is desirable to take full advantage of the potential sensitivity, but tides in the liquid helium refrigerant may produce a gravity gradient that seriously degrades the ultimate sensitivity. The Eotvos balance appears to have a limiting sensitivity to relative difference of rate of fall of about 2 x 10 -14 in orbit. The free-fall experiment is limited by helium tide to about 10 -15 ; if the tide can be controlled or eliminated the limit may approach 10 -18 . Other limitations to equivalence principle experiments are discussed. An experimental test of some of the concepts involved in the orbital free-fall experiment is continuing. The experiment consists in comparing the motions of test masses levitated in a superconducting magnetic bearing, and is itself a sensitive test of the equivalence principle. At present the levitation magnets, position monitors and control coils have been tested and major noise sources identified. A measurement of the equivalence principle is postponed pending development of a system for digitizing data. The experiment and preliminary results are described

  17. Comparison between neurostimulation techniques repetitive transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression: patient preference and cost-effectiveness.

    Science.gov (United States)

    Magnezi, Racheli; Aminov, Emanuel; Shmuel, Dikla; Dreifuss, Merav; Dannon, Pinhas

    2016-01-01

    Major depressive disorder (MDD) is a common disorder, widely distributed in the population, and is often associated with severe symptoms and functional impairment. It has been estimated that 30% of MDD patients do not benefit adequately from therapeutic interventions, including pharmacotherapy and psychotherapy. Treatment-resistant depression (TRD) is generally defined as a failure to achieve remission, despite therapeutic interventions. The most effective treatment alternatives for TRD are hospitalization, electroconvulsive therapy (ECT), and transcranial magnetic stimulation (TMS). Here we compared the clinical effectiveness of ECT and TMS, including success rates, patient responses, side-effect profiles, and financial worthiness. We found that ECT (P<0.0001) was more effective than TMS (P<0.012) (not statistically significant in group effect) in TRD patients. However, ECT patients reported a higher percentage of side effects (P<0.01) and the TMS treatment scored better in terms of patient preference. The cost benefit of ECT was higher than that of TMS (US$2075 vs US$814). Patient's preferences for treatment could be more intense in the TMS, if the TMS is included in the Health Maintenance Organization's service list. We propose that both of these treatment options should be available in psychiatric wards, thus expanding the therapeutic toolkit for TRD.

  18. Deciding Type Equivalence in a Language with Singleton Kinds

    National Research Council Canada - National Science Library

    Stone, Christopher

    1999-01-01

    ...: S(A) is the kind of all types provably equivalent to the type A. Singletons are interesting because they provide a very general form of definitions for type variables and allow fine-grained control of type computations...

  19. EQUIVALENCE VERSUS NON-EQUIVALENCE IN ECONOMIC TRANSLATION

    Directory of Open Access Journals (Sweden)

    Cristina, Chifane

    2012-01-01

    Full Text Available This paper aims at highlighting the fact that “equivalence” represents a concept worth revisiting and detailing upon when tackling the translation process of economic texts both from English into Romanian and from Romanian into English. Far from being exhaustive, our analysis will focus upon the problems arising from the lack of equivalence at the word level. Consequently, relevant examples from the economic field will be provided to account for the following types of non-equivalence at word level: culturespecific concepts; the source language concept is not lexicalised in the target language; the source language word is semantically complex; differences in physical and interpersonal perspective; differences in expressive meaning; differences in form; differences in frequency and purpose of using specific forms and the use of loan words in the source text. Likewise, we shall illustrate a number of translation strategies necessary to deal with the afore-mentioned cases of non-equivalence: translation by a more general word (superordinate; translation by a more neutral/less expressive word; translation by cultural substitution; translation using a loan word or loan word plus explanation; translation by paraphrase using a related word; translation by paraphrase using unrelated words; translation by omission and translation by illustration.

  20. The Source Equivalence Acceleration Method

    International Nuclear Information System (INIS)

    Everson, Matthew S.; Forget, Benoit

    2015-01-01

    Highlights: • We present a new acceleration method, the Source Equivalence Acceleration Method. • SEAM forms an equivalent coarse group problem for any spatial method. • Equivalence is also formed across different spatial methods and angular quadratures. • Testing is conducted using OpenMOC and performance is compared with CMFD. • Results show that SEAM is preferable for very expensive transport calculations. - Abstract: Fine-group whole-core reactor analysis remains one of the long sought goals of the reactor physics community. Such a detailed analysis is typically too computationally expensive to be realized on anything except the largest of supercomputers. Recondensation using the Discrete Generalized Multigroup (DGM) method, though, offers a relatively cheap alternative to solving the fine group transport problem. DGM, however, suffered from inconsistencies when applied to high-order spatial methods. While an exact spatial recondensation method was developed and provided full spatial consistency with the fine group problem, this approach substantially increased memory requirements for realistic problems. The method described in this paper, called the Source Equivalence Acceleration Method (SEAM), forms a coarse-group problem which preserves the fine-group problem even when using higher order spatial methods. SEAM allows recondensation to converge to the fine-group solution with minimal memory requirements and little additional overhead. This method also provides for consistency when using different spatial methods and angular quadratures between the coarse group and fine group problems. SEAM was implemented in OpenMOC, a 2D MOC code developed at MIT, and its performance tested against Coarse Mesh Finite Difference (CMFD) acceleration on the C5G7 benchmark problem and on a 361 group version of the problem. For extremely expensive transport calculations, SEAM was able to outperform CMFD, resulting in speed-ups of 20–45 relative to the normal power

  1. Equivalent statistics and data interpretation.

    Science.gov (United States)

    Francis, Gregory

    2017-08-01

    Recent reform efforts in psychological science have led to a plethora of choices for scientists to analyze their data. A scientist making an inference about their data must now decide whether to report a p value, summarize the data with a standardized effect size and its confidence interval, report a Bayes Factor, or use other model comparison methods. To make good choices among these options, it is necessary for researchers to understand the characteristics of the various statistics used by the different analysis frameworks. Toward that end, this paper makes two contributions. First, it shows that for the case of a two-sample t test with known sample sizes, many different summary statistics are mathematically equivalent in the sense that they are based on the very same information in the data set. When the sample sizes are known, the p value provides as much information about a data set as the confidence interval of Cohen's d or a JZS Bayes factor. Second, this equivalence means that different analysis methods differ only in their interpretation of the empirical data. At first glance, it might seem that mathematical equivalence of the statistics suggests that it does not matter much which statistic is reported, but the opposite is true because the appropriateness of a reported statistic is relative to the inference it promotes. Accordingly, scientists should choose an analysis method appropriate for their scientific investigation. A direct comparison of the different inferential frameworks provides some guidance for scientists to make good choices and improve scientific practice.

  2. Equivalent nozzle in thermomechanical problems

    International Nuclear Information System (INIS)

    Cesari, F.

    1977-01-01

    When analyzing nuclear vessels, it is most important to study the behavior of the nozzle cylinder-cylinder intersection. For the elastic field, this analysis in three dimensions is quite easy using the method of finite elements. The same analysis in the non-linear field becomes difficult for designs in 3-D. It is therefore necessary to resolve a nozzle in two dimensions equivalent to a 3-D nozzle. The purpose of the present work is to find an equivalent nozzle both with a mechanical and thermal load. This has been achieved by the analysis in three dimensions of a nozzle and a nozzle cylinder-sphere intersection, of a different radius. The equivalent nozzle will be a nozzle with a sphere radius in a given ratio to the radius of a cylinder; thus, the maximum equivalent stress is the same in both 2-D and 3-D. The nozzle examined derived from the intersection of a cylindrical vessel of radius R=191.4 mm and thickness T=6.7 mm with a cylindrical nozzle of radius r=24.675 mm and thickness t=1.350 mm, for which the experimental results for an internal pressure load are known. The structure was subdivided into 96 finite, three-dimensional and isoparametric elements with 60 degrees of freedom and 661 total nodes. Both the analysis with a mechanical load as well as the analysis with a thermal load were carried out on this structure according to the Bersafe system. The thermal load consisted of a transient typical of an accident occurring in a sodium-cooled fast reactor, with a peak of the temperature (540 0 C) for the sodium inside the vessel with an insulating argon temperature constant at 525 0 C. The maximum value of the equivalent tension was found in the internal area at the union towards the vessel side. The analysis of the nozzle in 2-D consists in schematizing the structure as a cylinder-sphere intersection, where the sphere has a given relation to the

  3. 21 CFR 26.9 - Equivalence determination.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Equivalence determination. 26.9 Section 26.9 Food... Specific Sector Provisions for Pharmaceutical Good Manufacturing Practices § 26.9 Equivalence determination... document insufficient evidence of equivalence, lack of opportunity to assess equivalence or a determination...

  4. Information Leakage from Logically Equivalent Frames

    Science.gov (United States)

    Sher, Shlomi; McKenzie, Craig R. M.

    2006-01-01

    Framing effects are said to occur when equivalent frames lead to different choices. However, the equivalence in question has been incompletely conceptualized. In a new normative analysis of framing effects, we complete the conceptualization by introducing the notion of information equivalence. Information equivalence obtains when no…

  5. Wijsman Orlicz Asymptotically Ideal -Statistical Equivalent Sequences

    Directory of Open Access Journals (Sweden)

    Bipan Hazarika

    2013-01-01

    in Wijsman sense and present some definitions which are the natural combination of the definition of asymptotic equivalence, statistical equivalent, -statistical equivalent sequences in Wijsman sense. Finally, we introduce the notion of Cesaro Orlicz asymptotically -equivalent sequences in Wijsman sense and establish their relationship with other classes.

  6. Equivalence relations of AF-algebra extensions

    Indian Academy of Sciences (India)

    In this paper, we consider equivalence relations of *-algebra extensions and describe the relationship between the isomorphism equivalence and the unitary equivalence. We also show that a certain group homomorphism is the obstruction for these equivalence relations to be the same.

  7. Mixed field dose equivalent measuring instruments

    International Nuclear Information System (INIS)

    Brackenbush, L.W.; McDonald, J.C.; Endres, G.W.R.; Quam, W.

    1985-01-01

    In the past, separate instruments have been used to monitor dose equivalent from neutrons and gamma rays. It has been demonstrated that it is now possible to measure simultaneously neutron and gamma dose with a single instrument, the tissue equivalent proportional counter (TEPC). With appropriate algorithms dose equivalent can also be determined from the TEPC. A simple ''pocket rem meter'' for measuring neutron dose equivalent has already been developed. Improved algorithms for determining dose equivalent for mixed fields are presented. (author)

  8. Comparison between neurostimulation techniques rapid transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression: patient preference and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Magnezi R

    2016-08-01

    Full Text Available Racheli Magnezi,1 Emanuel Aminov,1 Dikla Shmuel,2 Merav Dreifuss,1 Pinhas Dannon1,2 1Public Health and Health Systems Management Program, Department of Management, Bar-Ilan University, Ramat Gan, 2Beer Yaakov Mental Health Center affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Objectives: Major depressive disorder (MDD is a common disorder, widely distributed in the population, and is often associated with severe symptoms and functional impairment. It has been estimated that 30% of MDD patients do not benefit adequately from therapeutic interventions, including pharmacotherapy and psychotherapy. Treatment-resistant depression (TRD is generally defined as a failure to achieve remission, despite therapeutic interventions. Aim: The most effective treatment alternatives for TRD are hospitalization, electroconvulsive therapy (ECT, and transcranial magnetic stimulation (TMS. Here we compared the clinical effectiveness of ECT and TMS, including success rates, patient responses, side-effect profiles, and financial worthiness. Results: We found that ECT (P<0.0001 was more effective than TMS (P<0.012 (not statistically significant in group effect in TRD patients. However, ECT patients reported a higher percentage of side effects (P<0.01 and the TMS treatment scored better in terms of patient preference. The cost benefit of ECT was higher than that of TMS (US$2075 vs US$814. Patient’s preferences for treatment could be more intense in the TMS, if the TMS is included in the Health Maintenance Organization’s service list. Conclusion: We propose that both of these treatment options should be available in psychiatric wards, thus expanding the therapeutic toolkit for TRD. Keywords: ECT, TMS, treatment-resistant depression, cost benefit, patient preference

  9. Derived equivalences for group rings

    CERN Document Server

    König, Steffen

    1998-01-01

    A self-contained introduction is given to J. Rickard's Morita theory for derived module categories and its recent applications in representation theory of finite groups. In particular, Broué's conjecture is discussed, giving a structural explanation for relations between the p-modular character table of a finite group and that of its "p-local structure". The book is addressed to researchers or graduate students and can serve as material for a seminar. It surveys the current state of the field, and it also provides a "user's guide" to derived equivalences and tilting complexes. Results and proofs are presented in the generality needed for group theoretic applications.

  10. Generating carbyne equivalents with photoredox catalysis

    Science.gov (United States)

    Wang, Zhaofeng; Herraiz, Ana G.; Del Hoyo, Ana M.; Suero, Marcos G.

    2018-02-01

    Carbon has the unique ability to bind four atoms and form stable tetravalent structures that are prevalent in nature. The lack of one or two valences leads to a set of species—carbocations, carbanions, radicals and carbenes—that is fundamental to our understanding of chemical reactivity. In contrast, the carbyne—a monovalent carbon with three non-bonded electrons—is a relatively unexplored reactive intermediate; the design of reactions involving a carbyne is limited by challenges associated with controlling its extreme reactivity and the lack of efficient sources. Given the innate ability of carbynes to form three new covalent bonds sequentially, we anticipated that a catalytic method of generating carbynes or related stabilized species would allow what we term an ‘assembly point’ disconnection approach for the construction of chiral centres. Here we describe a catalytic strategy that generates diazomethyl radicals as direct equivalents of carbyne species using visible-light photoredox catalysis. The ability of these carbyne equivalents to induce site-selective carbon-hydrogen bond cleavage in aromatic rings enables a useful diazomethylation reaction, which underpins sequencing control for the late-stage assembly-point functionalization of medically relevant agents. Our strategy provides an efficient route to libraries of potentially bioactive molecules through the installation of tailored chiral centres at carbon-hydrogen bonds, while complementing current translational late-stage functionalization processes. Furthermore, we exploit the dual radical and carbene character of the generated carbyne equivalent in the direct transformation of abundant chemical feedstocks into valuable chiral molecules.

  11. Calculation methods for determining dose equivalent

    International Nuclear Information System (INIS)

    Endres, G.W.R.; Tanner, J.E.; Scherpelz, R.I.; Hadlock, D.E.

    1987-11-01

    A series of calculations of neutron fluence as a function of energy in an anthropomorphic phantom was performed to develop a system for determining effective dose equivalent for external radiation sources. Critical organ dose equivalents are calculated and effective dose equivalents are determined using ICRP-26 [1] methods. Quality factors based on both present definitions and ICRP-40 definitions are used in the analysis. The results of these calculations are presented and discussed. The effective dose equivalent determined using ICRP-26 methods is significantly smaller than the dose equivalent determined by traditional methods. No existing personnel dosimeter or health physics instrument can determine effective dose equivalent. At the present time, the conversion of dosimeter response to dose equivalent is based on calculations for maximal or ''cap'' values using homogeneous spherical or cylindrical phantoms. The evaluated dose equivalent is, therefore, a poor approximation of the effective dose equivalent as defined by ICRP Publication 26. 3 refs., 2 figs., 1 tab

  12. Foreword: Biomonitoring Equivalents special issue.

    Science.gov (United States)

    Meek, M E; Sonawane, B; Becker, R A

    2008-08-01

    The challenge of interpreting results of biomonitoring for environmental chemicals in humans is highlighted in this Foreword to the Biomonitoring Equivalents (BEs) special issue of Regulatory Toxicology and Pharmacology. There is a pressing need to develop risk-based tools in order to empower scientists and health professionals to interpret and communicate the significance of human biomonitoring data. The BE approach, which integrates dosimetry and risk assessment methods, represents an important advancement on the path toward achieving this objective. The articles in this issue, developed as a result of an expert panel meeting, present guidelines for derivation of BEs, guidelines for communication using BEs and several case studies illustrating application of the BE approach for specific substances.

  13. Radiological equivalent of chemical pollutants

    International Nuclear Information System (INIS)

    Medina, V.O.

    1982-01-01

    The development of the peaceful uses of nuclear energy has caused continued effort toward public safety through radiation health protection measures and nuclear management practices. However, concern has not been focused on the development specifically in the operation of chemical pestrochemical industries as well as other industrial processes brought about by technological advancements. This article presents the comparison of the risk of radiation and chemicals. The methods used for comparing the risks of late effects of radiation and chemicals are considered at three levels. (a) as a frame of reference to give an impression of resolving power of biological tests; (b) as methods to quantify risks; (c) as instruments for an epidemiological survey of human populations. There are marked dissimilarities between chemicals and radiation and efforts to interpret chemical activity may not be achieved. Applicability of the concept of rad equivalence has many restrictions and as pointed out this approach is not an established one. (RTD)

  14. Tissue equivalence in neutron dosimetry

    International Nuclear Information System (INIS)

    Nutton, D.H.; Harris, S.J.

    1980-01-01

    A brief review is presented of the essential features of neutron tissue equivalence for radiotherapy and gives the results of a computation of relative absorbed dose for 14 MeV neutrons, using various tissue models. It is concluded that for the Bragg-Gray equation for ionometric dosimetry it is not sufficient to define the value of W to high accuracy and that it is essential that, for dosimetric measurements to be applicable to real body tissue to an accuracy of better than several per cent, a correction to the total absorbed dose must be made according to the test and tissue atomic composition, although variations in patient anatomy and other radiotherapy parameters will often limit the benefits of such detailed dosimetry. (U.K.)

  15. Expanding the Interaction Equivalency Theorem

    Directory of Open Access Journals (Sweden)

    Brenda Cecilia Padilla Rodriguez

    2015-06-01

    Full Text Available Although interaction is recognised as a key element for learning, its incorporation in online courses can be challenging. The interaction equivalency theorem provides guidelines: Meaningful learning can be supported as long as one of three types of interactions (learner-content, learner-teacher and learner-learner is present at a high level. This study sought to apply this theorem to the corporate sector, and to expand it to include other indicators of course effectiveness: satisfaction, knowledge transfer, business results and return on expectations. A large Mexican organisation participated in this research, with 146 learners, 30 teachers and 3 academic assistants. Three versions of an online course were designed, each emphasising a different type of interaction. Data were collected through surveys, exams, observations, activity logs, think aloud protocols and sales records. All course versions yielded high levels of effectiveness, in terms of satisfaction, learning and return on expectations. Yet, course design did not dictate the types of interactions in which students engaged within the courses. Findings suggest that the interaction equivalency theorem can be reformulated as follows: In corporate settings, an online course can be effective in terms of satisfaction, learning, knowledge transfer, business results and return on expectations, as long as (a at least one of three types of interaction (learner-content, learner-teacher or learner-learner features prominently in the design of the course, and (b course delivery is consistent with the chosen type of interaction. Focusing on only one type of interaction carries a high risk of confusion, disengagement or missed learning opportunities, which can be managed by incorporating other forms of interactions.

  16. Non-invasive prenatal diagnosis for cystic fibrosis: detection of paternal mutations, exploration of patient preferences and cost analysis.

    Science.gov (United States)

    Hill, Melissa; Twiss, Philip; Verhoef, Talitha I; Drury, Suzanne; McKay, Fiona; Mason, Sarah; Jenkins, Lucy; Morris, Stephen; Chitty, Lyn S

    2015-10-01

    We aim to develop non-invasive prenatal diagnosis (NIPD) for cystic fibrosis (CF) and determine costs and implications for implementation. A next-generation sequencing assay was developed to detect ten common CF mutations for exclusion of the paternal mutation in maternal plasma. Using uptake data from a study exploring views on NIPD for CF, total test-related costs were estimated for the current care pathway and compared with those incorporating NIPD. The assay reliably predicted mutation status in all control and maternal plasma samples. Of carrier or affected adults with CF (n = 142) surveyed, only 43.5% reported willingness to have invasive testing for CF with 94.4% saying they would have NIPD. Using these potential uptake data, the incremental costs of NIPD over invasive testing per 100 pregnancies at risk of CF are £9025 for paternal mutation exclusion, and £26,510 for direct diagnosis. We have developed NIPD for risk stratification in around a third of CF families. There are economic implications due to potential increased test demand to inform postnatal management rather than to inform decisions around termination of an affected pregnancy. © 2015 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.

  17. Equivalent damage of loads on pavements

    CSIR Research Space (South Africa)

    Prozzi, JA

    2009-05-26

    Full Text Available This report describes a new methodology for the determination of Equivalent Damage Factors (EDFs) of vehicles with multiple axle and wheel configurations on pavements. The basic premise of this new procedure is that "equivalent pavement response...

  18. Investigation of Equivalent Circuit for PEMFC Assessment

    International Nuclear Information System (INIS)

    Myong, Kwang Jae

    2011-01-01

    Chemical reactions occurring in a PEMFC are dominated by the physical conditions and interface properties, and the reactions are expressed in terms of impedance. The performance of a PEMFC can be simply diagnosed by examining the impedance because impedance characteristics can be expressed by an equivalent electrical circuit. In this study, the characteristics of a PEMFC are assessed using the AC impedance and various equivalent circuits such as a simple equivalent circuit, equivalent circuit with a CPE, equivalent circuit with two RCs, and equivalent circuit with two CPEs. It was found in this study that the characteristics of a PEMFC could be assessed using impedance and an equivalent circuit, and the accuracy was highest for an equivalent circuit with two CPEs

  19. 46 CFR 175.540 - Equivalents.

    Science.gov (United States)

    2010-10-01

    ... Safety Management (ISM) Code (IMO Resolution A.741(18)) for the purpose of determining that an equivalent... Organization (IMO) “Code of Safety for High Speed Craft” as an equivalent to compliance with applicable...

  20. Patient Preferences regarding Shared Decision-making in the Emergency Department: Findings from a multi-site survey.

    Science.gov (United States)

    Schoenfeld, Elizabeth M; Kanzaria, Hemal K; Quigley, Denise D; Marie, Peter St; Nayyar, Nikita; Sabbagh, Sarah H; Gress, Kyle L; Probst, Marc A

    2018-06-13

    As Shared Decision-Making (SDM) has received increased attention as a method to improve the patient-centeredness of emergency department (ED) care, we sought to determine patients' desired level of involvement in medical decisions and their perceptions of potential barriers and facilitators to SDM in the ED. We surveyed a cross-sectional sample of adult ED patients at three academic medical centers across the United States. The survey included 32 items regarding patient involvement in medical decisions including a modified Control Preference Scale (CPS) and questions about barriers and facilitators to SDM in the ED. Items were developed and refined based on prior literature and qualitative interviews with ED patients. Research assistants administered the survey in person. Of 797 patients approached, 661 (83%) agreed to participate. Participants were 52% female, 45% white, and 30% Hispanic. The majority of respondents (85-92%, depending on decision type) expressed a desire for some degree of involvement in decision-making in the ED, while 8-15% preferred to leave decision-making to their physician alone. Ninety-eight percent wanted to be involved with decisions when "something serious is going on." The majority of patients (94%) indicated that self-efficacy was not a barrier to SDM in the ED. However, most patients (55%) reported a tendency to defer to the physician's decision-making during an ED visit, with about half reporting they would wait for a physician to ask them to be involved. We found the majority of ED patients in our large, diverse sample wanted to be involved in medical decisions, especially in the case of a "serious" medical problem, and felt that they had the ability to do so. Nevertheless, many patients were unlikely to actively seek involvement and defaulted to allowing the physician to make decisions during the ED visit. After fully explaining the consequences of a decision, clinicians should make an effort to explicitly ascertain patients

  1. Individualized determination of lower margin in pelvic radiation field after low anterior resection for rectal cancer resulted in equivalent local control and radiation volume reduction compared with traditional method

    International Nuclear Information System (INIS)

    Park, Suk Won; Ahn, Yong Chan; Huh, Seung Jae; Chun, Ho Kyung; Kang, Won Ki; Kim, Dae Yong; Lim, Do Hoon; Noh, Young Ju; Lee, Jung Eun

    2000-01-01

    . There was no significant difference with respect to local control and disease-free survival rates (p=0.42, p=0.68) between two groups of different lower margin determination policies. The new concept in the individualized determination of the lower margin depending on the anastomotic site has led to the equivalent local control and disease-free survival rates, and is expected to contribute to the reduction of unnecessary radiation-related morbidity by reduction of radiation volume, compared with the traditional method of lower margin determination

  2. Thévenin equivalent based static contingency assessment

    DEFF Research Database (Denmark)

    2015-01-01

    of the determined present state of the power system and determining a first representation of the network based on the determined Thevenin equivalents, determining a modified representation of the network, wherein the modified representation is a representation of the network having at least one contingency......, wherein at least one Thevenin equivalent of at least one voltage controlled node is modified due to the at least one contingency, the modified network representation being determined on the basis of the modified Thevenin equivalents, calculating voltage angles of the modified Thevenin equivalents......, and evaluating the voltage angles to determine whether the network having at least one contingency admit a steady state. Also a method of providing information on a real time static security assessment of a power system is disclosed....

  3. Equivalence ratio and constriction effects on RBCC thrust augmentation

    Science.gov (United States)

    Koupriyanov, M.; Etele, J.

    2011-06-01

    A theoretical analysis of a variable area rocket based combined cycle engine with and without simultaneous mixing and combustion is presented. The flowfield is solved using a steady, quasi-one-dimensional, inviscid control volume formulation with combustion effects included via a generalized equilibrium calculation. Compression augmentation is shown to be sensitive to the equivalence ratio within the primary rocket chamber, where ejector section performance is greatest at both low and high equivalence ratios but near a minimum at stoichiometric conditions. The thrust generated by the RBCC engine compared to that generated by the same rocket in isolation can be increased by as much as 12% at constriction ratios of between 45% and 50%. Thrust augmentation is also shown to vary with equivalence ratio, where for a fixed geometry the maximum thrust is generated at equivalence ratios slightly below unity.

  4. Some spectral equivalences between Schroedinger operators

    International Nuclear Information System (INIS)

    Dunning, C; Hibberd, K E; Links, J

    2008-01-01

    Spectral equivalences of the quasi-exactly solvable sectors of two classes of Schroedinger operators are established, using Gaudin-type Bethe ansatz equations. In some instances the results can be extended leading to full isospectrality. In this manner we obtain equivalences between PT-symmetric problems and Hermitian problems. We also find equivalences between some classes of Hermitian operators

  5. The definition of the individual dose equivalent

    International Nuclear Information System (INIS)

    Ehrlich, Margarete

    1986-01-01

    A brief note examines the choice of the present definition of the individual dose equivalent, the new operational dosimetry quantity for external exposure. The consequences of the use of the individual dose equivalent and the danger facing the individual dose equivalent, as currently defined, are briefly discussed. (UK)

  6. Are patients' preferences regarding the place of treatment heard and addressed at the point of referral: an exploratory study based on observations of GP-patient consultations.

    Science.gov (United States)

    Victoor, Aafke; Noordman, Janneke; Sonderkamp, Johan A; Delnoij, Diana M J; Friele, Roland D; van Dulmen, Sandra; Rademakers, Jany J D J M

    2013-12-10

    Today, in several north-western European countries, patients are encouraged to choose, actively, a healthcare provider. However, patients often visit the provider that is recommended by their general practitioner (GP). The introduction of patient choice requires GPs to support patients to be involved, actively, in the choice of a healthcare provider. We aim to investigate whether policy on patient choice is reflected in practice, i.e. what the role of the patient is in their choices of healthcare providers at the point of referral and to what extent GPs' and patients' healthcare paths influence the role that patients play in the referral decision. In 2007-2008, we videotaped Dutch GP-patient consultations. For this study, we selected, at random, 72 videotaped consultations between 72 patients and 39 GPs in which the patient was referred to a healthcare provider. These were analysed using an observation protocol developed by the researchers. The majority of the patients had little or no input into the choice of a healthcare provider at the point of referral by their GP. Their GPs did not support them in actively choosing a provider and the patients often agreed with the provider that the GP proposed. Patients who were referred for diagnostic purposes seem to have had even less input into their choice of a provider than patients who were referred for treatment. We found that the GP chooses a healthcare provider on behalf of the patient in most consultations, even though policy on patient choice expects from patients that they choose, actively, a provider. On the one hand, this could indicate that the policy needs adjustments. On the other hand, adjustments may be needed to practice. For instance, GPs could help patients to make an active choice of provider. However, certain patients prefer to let their GP decide as their agent. Even then, GPs need to know patients' preferences, because in a principal-agent relationship, it is necessary that the agent is fully

  7. Patient preference and ease of use for different coagulation factor VIII reconstitution device scenarios: a cross-sectional survey in five European countries

    Directory of Open Access Journals (Sweden)

    Cimino E

    2014-12-01

    Full Text Available Ernesto Cimino,1 Silvia Linari,2 Mara Malerba,3 Susan Halimeh,4 Francesca Biondo,5 Martina Westfeld5 1Dipartimento Medicina Clinica e Sperimentale, Universita’ degli Studi di Napoli Federico II, Naples, Italy; 2Agenzia per l’ Emofilia, AOU Careggi di Firenze, Florence, Italy; 3Fondazione Cà Granda Ospedale Maggiore Policlinico, Centro Emofilia e Trombosi “A Bianchi Bonomi”, Milan, Italy; 4CRC Coagulation Research Centre GmbH, Duisburg, Germany; 5Pfizer Italia, Rome, Italy Introduction: Hemophilia A treatment involves replacing the deficient coagulation factor VIII. This process may involve multiple steps that might create a barrier to adherence. A new dual-chamber syringe (DCS; FuseNGo® was recently introduced with the aim of simplifying reconstitution. Aim: This study aimed to identify factors associated with adult patients’ preferences for different coagulation factor VIII reconstitution systems and to test ease of use and patient preference for the DCS. Methods: A cross-sectional survey of adults with hemophilia A in five European countries was conducted; a subset of subjects also participated in a practical testing session of the DCS. Results: Among the 299 survey participants, the device scenario requiring the least equipment and reconstitution steps (the DCS received a median preference rating of 71 out of 100 (0 being “the least desirable” and 100 “the most desirable” rating. This was significantly higher than the other scenarios (the next highest achieved a median of 50 points; P<0.001. Participants would be more likely to use this device prophylactically (P<0.001. Among the 98 participants who tested the DCS, 57% preferred this device over their current device, 26% preferred their current device, and 17% had no preference. The DCS was rated as easier to use than current treatment devices (median score 9/10 versus 7/10 for current treatment, P=0.001. Conclusion: The survey indicates that the prefilled DCS, Fuse

  8. [Physician perspectives on the impact of patient preferences and the role of next-of-kin of patients in evidence-based decision-making: A qualitative interview study from oncology].

    Science.gov (United States)

    Salloch, Sabine; Otte, Ina C; Reinacher-Schick, Anke; Vollmann, Jochen

    2018-04-01

    The impact of patient preferences in evidence-based medicine is a complex issue which touches on theoretical questions as well as medical practice in the clinical context. The interaction between evidence-based recommendations and value-related patient preferences in clinical practice is, however, highly complex and requires not only medical knowledge but social, psychological and communicative competencies on the side of the physician. The multi-layered process of oncology physicians' clinical decision-making was explored in 14 semi-structured interviews with respect to a first diagnosis of a pancreatic adenocarcinoma. A case vignette was used and the Q method ("card sorting") was applied to analyze the influence of different factors (such as evidence, patient preferences and the role of relatives) on physicians' deliberations. Content analysis (Mayring) was performed. The results show that the participating oncologists consider patient preferences as an important guidance which, however, is limited on certain occasions where the physicians assume a leadership role in decision-making. From the interviewees' perspectives, the preferences of the patients' relatives are likewise of high importance because debilitating oncologic treatments can only be carried out if patients have both social and psychological support. There is a need for an ongoing reflection of the physicians' own values and due consideration of the patients' social role within the context of shared decision-making. Copyright © 2018. Published by Elsevier GmbH.

  9. Patient preferences for medicine administration for acute agitation: results from an internet-based survey of patients diagnosed with bipolar disorder or schizophrenia in two Nordic countries.

    Science.gov (United States)

    Jørgensen, Tine Rikke; Emborg, Charlotte; Dahlen, Karianne; Bøgelund, Mette; Carlborg, Andreas

    2018-01-01

    The objective was to elicit patient preferences for medicine administration method in the management of acute agitation episodes among patients diagnosed with bipolar disorder or schizophrenia. The patients' experiences of acute agitation episodes and their management of episodes were also explored. Data were collected via an anonymous, internet-based survey of residents in Denmark or Sweden with schizophrenia or bipolar disorder (October 2014 to December 2014). Inclusion criteria were having a diagnosis of schizophrenia or bipolar disorder, and being above 18 years of age. The questionnaire included questions about preferences for medication attributes, experiences with pharmacological treatment for agitation and involvement in treatment plans. A total of 237 diagnosed patients (61 with schizophrenia; 176 with bipolar disorder) completed the questionnaire. Agitation episodes were experienced by 90% of the respondents. In total, 83% of the respondents reported having received treatment with tablets. When patients were presented with the attributes of an inhalation method, respondents stated that the fast onset of action, low risk of adverse reactions and least invasive form of drug delivery were positive attributes of treatment with inhalation. Inhalation is a new delivery route for treatment of acute agitation in patients diagnosed with bipolar disorder or schizophrenia. Inhalation is the preferred treatment method for acute agitation among Danish and Swedish patients with bipolar disorder or schizophrenia.

  10. Editorial Commentary: Graft Removal Versus Retention for Septic Arthritis After Anterior Cruciate Ligament Reconstruction: Accounting for Patient Preference Flips the Script on Current Practice.

    Science.gov (United States)

    Cote, Mark P

    2018-03-01

    Septic arthritis is a rare but potentially devastating complication after anterior cruciate ligament (ACL) reconstruction. Studies examining surgical treatment options including graft retention and removal are largely inconclusive. Although the literature indicated that 43.8% of patients who have the graft removed later go on to have a revision ACL reconstruction compared with only 6.5% among those whose graft is retained, this expected-value decision analysis found removal to be the optimal treatment for patients with septic arthritis after ACL reconstruction. This is largely based on patient preference to avoid a late reoperation for residual knee infection. These findings support the concept of utility when considering treatment options for patients with a septic knee. For some, avoiding a late reoperation for a persistent infection is the most important factor and as such graft removal may be the most appropriate treatment to produce a positive outcome among these patients despite the fact that currently, an attempt at graft retention could represent the generally preferred treatment option among practicing surgeons. Copyright © 2017. Published by Elsevier Inc.

  11. Ego mechanisms of defense are associated with patients' preference of treatment modality independent of psychological distress in end-stage renal disease.

    Science.gov (United States)

    Hyphantis, Thomas; Katsoudas, Spiros; Voudiclari, Sonia

    2010-03-24

    Several parameters mediate the selection of treatment modality in end-stage renal disease (ESRD). The nephrology community suggests that patient preference should be the prime determinant of modality choice. We aimed to test whether ego mechanisms of defense are associated with patients' treatment modality preferences, independent of psychological distress. In 58 eligible ESRD patients who had themselves chosen their treatment modality, we administered the Symptom Distress Checklist-90-R and the Defense Style Questionnaire. Thirty-seven patients (53.4%) had chosen hemodialysis and 21 (46.6%) peritoneal dialysis. Patients who preferred peritoneal dialysis were younger (odds ratio [OR], 0.89; 95% confidence interval [CI]: 0.804-0.988), had received more education (OR, 8.84; 95% CI: 1.301-60.161), and were twice as likely to adopt an adaptive defense style as compared to patients who preferred hemodialysis (57.1% vs 27.0%, respectively; P psychological distress. Our findings indicate that the patient's personality should be taken into account, if we are to better define which modalities are best suited to which patients. Also, physicians should bear in mind passive-aggressive behaviors that warrant attention and intervention in patients who preferred hemodialysis.

  12. A new concept of equivalent homogenization method

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Jin; Pogoskekyan, Leonid; Kim, Young Il; Ju, Hyung Kook; Chang, Moon Hee [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1996-07-01

    A new concept of equivalent homogenization is proposed. The concept employs new set of homogenized parameters: homogenized cross sections (XS) and interface matrix (IM), which relates partial currents at the cell interfaces. The idea of interface matrix generalizes the idea of discontinuity factors (DFs), proposed and developed by K. Koebke and K. Smith. The offered concept covers both those of K. Koebke and K. Smith; both of them can be simulated within framework of new concept. Also, the offered concept covers Siemens KWU approach for baffle/reflector simulation, where the equivalent homogenized reflector XS are derived from the conservation of response matrix at the interface in 1D simi-infinite slab geometry. The IM and XS of new concept satisfy the same assumption about response matrix conservation in 1D semi-infinite slab geometry. It is expected that the new concept provides more accurate approximation of heterogeneous cell, especially in case of the steep flux gradients at the cell interfaces. The attractive shapes of new concept are: improved accuracy, simplicity of incorporation in the existing codes, equal numerical expenses in comparison to the K. Smith`s approach. The new concept is useful for: (a) explicit reflector/baffle simulation; (b) control blades simulation; (c) mixed UO{sub 2}/MOX core simulation. The offered model has been incorporated in the finite difference code and in the nodal code PANDOX. The numerical results show good accuracy of core calculations and insensitivity of homogenized parameters with respect to in-core conditions. 9 figs., 7 refs. (Author).

  13. Equivalence principle implications of modified gravity models

    International Nuclear Information System (INIS)

    Hui, Lam; Nicolis, Alberto; Stubbs, Christopher W.

    2009-01-01

    Theories that attempt to explain the observed cosmic acceleration by modifying general relativity all introduce a new scalar degree of freedom that is active on large scales, but is screened on small scales to match experiments. We demonstrate that if such screening occurs via the chameleon mechanism, such as in f(R) theory, it is possible to have order unity violation of the equivalence principle, despite the absence of explicit violation in the microscopic action. Namely, extended objects such as galaxies or constituents thereof do not all fall at the same rate. The chameleon mechanism can screen the scalar charge for large objects but not for small ones (large/small is defined by the depth of the gravitational potential and is controlled by the scalar coupling). This leads to order one fluctuations in the ratio of the inertial mass to gravitational mass. We provide derivations in both Einstein and Jordan frames. In Jordan frame, it is no longer true that all objects move on geodesics; only unscreened ones, such as test particles, do. In contrast, if the scalar screening occurs via strong coupling, such as in the Dvali-Gabadadze-Porrati braneworld model, equivalence principle violation occurs at a much reduced level. We propose several observational tests of the chameleon mechanism: 1. small galaxies should accelerate faster than large galaxies, even in environments where dynamical friction is negligible; 2. voids defined by small galaxies would appear larger compared to standard expectations; 3. stars and diffuse gas in small galaxies should have different velocities, even if they are on the same orbits; 4. lensing and dynamical mass estimates should agree for large galaxies but disagree for small ones. We discuss possible pitfalls in some of these tests. The cleanest is the third one where the mass estimate from HI rotational velocity could exceed that from stars by 30% or more. To avoid blanket screening of all objects, the most promising place to look is in

  14. The Complexity of Identifying Large Equivalence Classes

    DEFF Research Database (Denmark)

    Skyum, Sven; Frandsen, Gudmund Skovbjerg; Miltersen, Peter Bro

    1999-01-01

    We prove that at least 3k−4/k(2k−3)(n/2) – O(k)equivalence tests and no more than 2/k (n/2) + O(n) equivalence tests are needed in the worst case to identify the equivalence classes with at least k members in set of n elements. The upper bound is an improvement by a factor 2 compared to known res...

  15. Equivalent Simplification Method of Micro-Grid

    OpenAIRE

    Cai Changchun; Cao Xiangqin

    2013-01-01

    The paper concentrates on the equivalent simplification method for the micro-grid system connection into distributed network. The equivalent simplification method proposed for interaction study between micro-grid and distributed network. Micro-grid network, composite load, gas turbine synchronous generation, wind generation are equivalent simplification and parallel connect into the point of common coupling. A micro-grid system is built and three phase and single phase grounded faults are per...

  16. Calculation methods for determining dose equivalent

    International Nuclear Information System (INIS)

    Endres, G.W.R.; Tanner, J.E.; Scherpelz, R.I.; Hadlock, D.E.

    1988-01-01

    A series of calculations of neutron fluence as a function of energy in an anthropomorphic phantom was performed to develop a system for determining effective dose equivalent for external radiation sources. critical organ dose equivalents are calculated and effective dose equivalents are determined using ICRP-26 methods. Quality factors based on both present definitions and ICRP-40 definitions are used in the analysis. The results of these calculations are presented and discussed

  17. Equivalences of real submanifolds in complex space.

    OpenAIRE

    ZAITSEV, DMITRI

    2001-01-01

    PUBLISHED We show that for any real-analytic submanifold M in CN there is a proper real-analytic subvariety V contained in M such that for any p ? M \\ V , any real-analytic submanifold M? in CN, and any p? ? M?, the germs of the submanifolds M and M? at p and p? respectively are formally equivalent if and only if they are biholomorphically equivalent. More general results for k-equivalences are also stated and proved.

  18. Relations of equivalence of conditioned radioactive waste

    International Nuclear Information System (INIS)

    Kumer, L.; Szeless, A.; Oszuszky, F.

    1982-01-01

    A compensation for the wastes remaining with the operator of a waste management center, to be given by the agent having caused the waste, may be assured by effecting a financial valuation (equivalence) of wastes. Technically and logically, this equivalence between wastes (or specifically between different waste categories) and financial valuation has been established as reasonable. In this paper, the possibility of establishing such equivalences are developed, and their suitability for waste management concepts is quantitatively expressed

  19. Behavioural equivalence for infinite systems - Partially decidable!

    DEFF Research Database (Denmark)

    Sunesen, Kim; Nielsen, Mogens

    1996-01-01

    languages with two generalizations based on traditional approaches capturing non-interleaving behaviour, pomsets representing global causal dependency, and locality representing spatial distribution of events. We first study equivalences on Basic Parallel Processes, BPP, a process calculus equivalent...... of processes between BPP and TCSP, not only are the two equivalences different, but one (locality) is decidable whereas the other (pomsets) is not. The decidability result for locality is proved by a reduction to the reachability problem for Petri nets....

  20. Equivalence in Bilingual Lexicography: Criticism and Suggestions*

    Directory of Open Access Journals (Sweden)

    Herbert Ernst Wiegand

    2011-10-01

    Full Text Available

    Abstract: A reminder of general problems in the formation of terminology, as illustrated by theGerman Äquivalence (Eng. equivalence and äquivalent (Eng. equivalent, is followed by a critical discussionof the concept of equivalence in contrastive lexicology. It is shown that especially the conceptof partial equivalence is contradictory in its different manifestations. Consequently attemptsare made to give a more precise indication of the concept of equivalence in the metalexicography,with regard to the domain of the nominal lexicon. The problems of especially the metalexicographicconcept of partial equivalence as well as that of divergence are fundamentally expounded.In conclusion the direction is indicated to find more appropriate metalexicographic versions of theconcept of equivalence.

    Keywords: EQUIVALENCE, LEXICOGRAPHIC EQUIVALENT, PARTIAL EQUIVALENCE,CONGRUENCE, DIVERGENCE, CONVERGENCE, POLYDIVERGENCE, SYNTAGM-EQUIVALENCE,ZERO EQUIVALENCE, CORRESPONDENCE

    Abstrakt: Äquivalenz in der zweisprachigen Lexikographie: Kritik und Vorschläge.Nachdem an allgemeine Probleme der Begriffsbildung am Beispiel von dt. Äquivalenzund dt. äquivalent erinnert wurde, wird zunächst auf Äquivalenzbegriffe in der kontrastiven Lexikologiekritisch eingegangen. Es wird gezeigt, dass insbesondere der Begriff der partiellen Äquivalenzin seinen verschiedenen Ausprägungen widersprüchlich ist. Sodann werden Präzisierungenzu den Äquivalenzbegriffen in der Metalexikographie versucht, die sich auf den Bereich der Nennlexikbeziehen. Insbesondere der metalexikographische Begriff der partiellen Äquivalenz sowie derder Divergenz werden grundsätzlich problematisiert. In welche Richtung man gehen kann, umangemessenere metalexikographische Fassungen des Äquivalenzbegriffs zu finden, wird abschließendangedeutet.

    Stichwörter: ÄQUIVALENZ, LEXIKOGRAPHISCHES ÄQUIVALENT, PARTIELLE ÄQUIVALENZ,KONGRUENZ, DIVERGENZ, KONVERGENZ, POLYDIVERGENZ

  1. Xpand chest drain: assessing equivalence to current standard ...

    African Journals Online (AJOL)

    leakage from 'open to air' system or breakage of glass bottle (with associated risk to ... and an air-leak detection system. It is connected to a ... need to add water. Xpand chest drain: assessing equivalence to current standard therapy – a randomised controlled trial. CHARL COOPER, M.B. CH.B. TIMOTHY HARDCASTLE ...

  2. Conducting a Discrete-Choice Experiment Study Following Recommendations for Good Research Practices: An Application for Eliciting Patient Preferences for Diabetes Treatments.

    Science.gov (United States)

    Janssen, Ellen M; Hauber, A Brett; Bridges, John F P

    2018-01-01

    To consolidate and illustrate good research practices in health care to the application and reporting of a study measuring patient preferences for type 2 diabetes mellitus medications, given recent methodological advances in stated-preference methods. The International Society for Pharmacoeconomics and Outcomes Research good research practices and other recommendations were used to conduct a discrete-choice experiment. Members of a US online panel with type 2 diabetes mellitus completed a Web-enabled, self-administered survey that elicited choices between treatment pairs with six attributes at three possible levels each. A D-efficient experimental design blocked 48 choice tasks into three 16-task surveys. Preference estimates were obtained using mixed logit estimation and were used to calculate choice probabilities. A total of 552 participants (51% males) completed the survey. Avoiding 90 minutes of nausea was valued the highest (mean -10.00; 95% confidence interval [CI] -10.53 to -9.47). Participants wanted to avoid low blood glucose during the day and/or night (mean -3.87; 95% CI -4.32 to -3.42) or one pill and one injection per day (mean -7.04; 95% CI -7.63 to -6.45). Participants preferred stable blood glucose 6 d/wk (mean 4.63; 95% CI 4.15 to 5.12) and a 1% decrease in glycated hemoglobin (mean 5.74; 95% CI 5.22 to 6.25). If cost increased by $1, the probability that a treatment profile would be chosen decreased by 1%. These results are consistent with the idea that people have strong preferences for immediate consequences of medication. Despite efforts to produce recommendations, ambiguity surrounding good practices remains and various judgments need to be made when conducting stated-preference studies. To ensure transparency, these judgments should be described and justified. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  3. McMaster-Toronto Arthritis Patient Preference Disability Questionnaire sensitivity to change in low back pain: influence of shifts in priorities.

    Directory of Open Access Journals (Sweden)

    Katherine Sanchez

    Full Text Available OBJECTIVE: To assess the sensitivity to change of the McMaster Toronto Arthritis Patient Preference Disability Questionnaire (MACTAR in chronic low back pain (CLBP and shifts in patients' priorities of disabling activities over time. METHODS: A prospective longitudinal survey of 100 patients (38 males with CLBP in a tertiary care teaching hospital. Evaluation at baseline and 6 months by the MACTAR, Quebec Back Pain Disability Questionnaire (QUEBEC, Hospital Anxiety and Depression scale (HAD, Fear-Avoidance Beliefs Questionnaire (FABQ, Coping Strategies Questionnaire (CSQ, and pain and handicap visual analogue scales (VASs. Patients' perceived improvement or worsening of condition was assessed at 6 months. Effect size (ES and Standardized response mean (SRM and effect size (ES were used to evaluate sensitivity to change of the MACTAR. RESULTS: The MACTAR SRM and ES values (SRM = 0.25; ES = 0.37 were among the highest for the instruments evaluated. For patients considering their condition as improved, the SRM was 0.66 and the ES 1. The 3 disability domains, classified by the International Classification of Functioning, Disability and Health (ICF, most often cited as priorities at baseline remained the most cited at follow-up: mobility (40.9% of patients; community, social and civic life (22.7%; and domestic life (22.4%. At 6 months, 48 patients shifted their priorities, for a decrease in MACTAR SRM and ES values for patients considering their condition improved and an increase in these values for those considering their condition deteriorated. CONCLUSIONS: Although the MACTAR has similar sensitivity to change as other outcome measures widely used in CLBP, shifts in patient priorities over time are common and influence scores and sensitivity to change.

  4. Orientifold Planar Equivalence: The Chiral Condensate

    DEFF Research Database (Denmark)

    Armoni, Adi; Lucini, Biagio; Patella, Agostino

    2008-01-01

    The recently introduced orientifold planar equivalence is a promising tool for solving non-perturbative problems in QCD. One of the predictions of orientifold planar equivalence is that the chiral condensates of a theory with $N_f$ flavours of Dirac fermions in the symmetric (or antisymmetric...

  5. 7 CFR 1005.54 - Equivalent price.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1005.54 Section 1005.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1005.54 Equivalent price. See § 1000.54. Uniform Prices ...

  6. 7 CFR 1126.54 - Equivalent price.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1126.54 Section 1126.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1126.54 Equivalent price. See § 1000.54. Producer Price Differential ...

  7. 7 CFR 1001.54 - Equivalent price.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1001.54 Section 1001.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1001.54 Equivalent price. See § 1000.54. Producer Price Differential ...

  8. 7 CFR 1032.54 - Equivalent price.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1032.54 Section 1032.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1032.54 Equivalent price. See § 1000.54. Producer Price Differential ...

  9. 7 CFR 1124.54 - Equivalent price.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1124.54 Section 1124.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Class Prices § 1124.54 Equivalent price. See § 1000.54. Producer Price Differential ...

  10. 7 CFR 1030.54 - Equivalent price.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1030.54 Section 1030.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1030.54 Equivalent price. See § 1000.54. ...

  11. 7 CFR 1033.54 - Equivalent price.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1033.54 Section 1033.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1033.54 Equivalent price. See § 1000.54. Producer Price Differential ...

  12. 7 CFR 1131.54 - Equivalent price.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1131.54 Section 1131.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1131.54 Equivalent price. See § 1000.54. Uniform Prices ...

  13. 7 CFR 1006.54 - Equivalent price.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1006.54 Section 1006.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1006.54 Equivalent price. See § 1000.54. Uniform Prices ...

  14. 7 CFR 1007.54 - Equivalent price.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1007.54 Section 1007.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Handling Class Prices § 1007.54 Equivalent price. See § 1000.54. Uniform Prices ...

  15. 7 CFR 1000.54 - Equivalent price.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Equivalent price. 1000.54 Section 1000.54 Agriculture... Prices § 1000.54 Equivalent price. If for any reason a price or pricing constituent required for computing the prices described in § 1000.50 is not available, the market administrator shall use a price or...

  16. Finding small equivalent decision trees is hard

    NARCIS (Netherlands)

    Zantema, H.; Bodlaender, H.L.

    2000-01-01

    Two decision trees are called decision equivalent if they represent the same function, i.e., they yield the same result for every possible input. We prove that given a decision tree and a number, to decide if there is a decision equivalent decision tree of size at most that number is NPcomplete. As

  17. What is Metaphysical Equivalence? | Miller | Philosophical Papers

    African Journals Online (AJOL)

    Theories are metaphysically equivalent just if there is no fact of the matter that could render one theory true and the other false. In this paper I argue that if we are judiciously to resolve disputes about whether theories are equivalent or not, we need to develop testable criteria that will give us epistemic access to the obtaining ...

  18. EQUIVALENT MODELS IN COVARIANCE STRUCTURE-ANALYSIS

    NARCIS (Netherlands)

    LUIJBEN, TCW

    1991-01-01

    Defining equivalent models as those that reproduce the same set of covariance matrices, necessary and sufficient conditions are stated for the local equivalence of two expanded identified models M1 and M2 when fitting the more restricted model M0. Assuming several regularity conditions, the rank

  19. A Model for Semantic Equivalence Discovery for Harmonizing Master Data

    Science.gov (United States)

    Piprani, Baba

    IT projects often face the challenge of harmonizing metadata and data so as to have a "single" version of the truth. Determining equivalency of multiple data instances against the given type, or set of types, is mandatory in establishing master data legitimacy in a data set that contains multiple incarnations of instances belonging to the same semantic data record . The results of a real-life application define how measuring criteria and equivalence path determination were established via a set of "probes" in conjunction with a score-card approach. There is a need for a suite of supporting models to help determine master data equivalency towards entity resolution—including mapping models, transform models, selection models, match models, an audit and control model, a scorecard model, a rating model. An ORM schema defines the set of supporting models along with their incarnation into an attribute based model as implemented in an RDBMS.

  20. Beyond Language Equivalence on Visibly Pushdown Automata

    DEFF Research Database (Denmark)

    Srba, Jiri

    2009-01-01

    We study (bi)simulation-like preorder/equivalence checking on the class of visibly pushdown automata and its natural subclasses visibly BPA (Basic Process Algebra) and visibly one-counter automata. We describe generic methods for proving complexity upper and lower bounds for a number of studied...... preorders and equivalences like simulation, completed simulation, ready simulation, 2-nested simulation preorders/equivalences and bisimulation equivalence. Our main results are that all the mentioned equivalences and preorders are EXPTIME-complete on visibly pushdown automata, PSPACE-complete on visibly...... one-counter automata and P-complete on visibly BPA. Our PSPACE lower bound for visibly one-counter automata improves also the previously known DP-hardness results for ordinary one-counter automata and one-counter nets. Finally, we study regularity checking problems for visibly pushdown automata...

  1. Equivalence of a single dose (1200 mg) compared to a three-time a day dose (400 mg) of chondroitin 4&6 sulfate in patients with knee osteoarthritis. Results of a randomized double blind placebo controlled study.

    Science.gov (United States)

    Zegels, B; Crozes, P; Uebelhart, D; Bruyère, O; Reginster, J Y

    2013-01-01

    Evaluation of the efficacy and safety of a single oral dose of a 1200 mg sachet of chondroitin 4&6 sulfate (CS 1200) vs three daily capsules of chondroitin 4&6 sulfate 400 mg (CS 3*400) (equivalence study) and vs placebo (superiority study) during 3 months, in patients with knee osteoarthritis (OA). Comparative, double-blind, randomized, multicenter study, including 353 patients of both genders over 45 years with knee OA. Minimum inclusion criteria were a Lequesne index (LI) ≥ 7 and pain ≥ 40 mm on a visual analogue scale (VAS). LI and VAS were assessed at baseline and after 1-3 months. Equivalence between CS was tested using the per-protocol procedure and superiority of CS vs placebo was tested using an intent-to-treat procedure. After 3 months of follow-up, no significant difference was demonstrated between the oral daily single dose of CS 1200 formulation and the three daily capsules of CS 400. Patients treated with CS 1200 or CS 3*400 were significantly improved compared to placebo after 3 months of follow-up in terms of LI (security and tolerability was observed between the three groups. This study suggests that a daily administration of an oral sachet of 1200 mg of chondroitin 4&6 sulfate allows a significant clinical improvement compared to a placebo, and a similar improvement when compared to a regimen of three daily capsules of 400 mg of the same active ingredient. Copyright © 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  2. Certainty Equivalence M-MRAC for Systems with Unmatched Uncertainties

    Science.gov (United States)

    Stepanyan, Vahram; Krishnakumar, Kalmanje

    2012-01-01

    The paper presents a certainty equivalence state feedback indirect adaptive control design method for the systems of any relative degree with unmatched uncertainties. The approach is based on the parameter identification (estimation) model, which is completely separated from the control design and is capable of producing parameter estimates as fast as the computing power allows without generating high frequency oscillations. It is shown that the system's input and output tracking errors can be systematically decreased by the proper choice of the design parameters.

  3. 78 FR 67360 - Ambient Air Monitoring Reference and Equivalent Methods: Designation of Five New Equivalent Methods

    Science.gov (United States)

    2013-11-12

    ... Methods: Designation of Five New Equivalent Methods AGENCY: Office of Research and Development; Environmental Protection Agency (EPA). ACTION: Notice of the designation of five new equivalent methods for...) has designated, in accordance with 40 CFR Part 53, five new equivalent methods, one for measuring...

  4. 77 FR 60985 - Ambient Air Monitoring Reference and Equivalent Methods: Designation of Three New Equivalent Methods

    Science.gov (United States)

    2012-10-05

    ... Methods: Designation of Three New Equivalent Methods AGENCY: Environmental Protection Agency. ACTION: Notice of the designation of three new equivalent methods for monitoring ambient air quality. SUMMARY... equivalent methods, one for measuring concentrations of PM 2.5 , one for measuring concentrations of PM 10...

  5. Analytical and numerical construction of equivalent cables.

    Science.gov (United States)

    Lindsay, K A; Rosenberg, J R; Tucker, G

    2003-08-01

    The mathematical complexity experienced when applying cable theory to arbitrarily branched dendrites has lead to the development of a simple representation of any branched dendrite called the equivalent cable. The equivalent cable is an unbranched model of a dendrite and a one-to-one mapping of potentials and currents on the branched model to those on the unbranched model, and vice versa. The piecewise uniform cable, with a symmetrised tri-diagonal system matrix, is shown to represent the canonical form for an equivalent cable. Through a novel application of the Laplace transform it is demonstrated that an arbitrary branched model of a dendrite can be transformed to the canonical form of an equivalent cable. The characteristic properties of the equivalent cable are extracted from the matrix for the transformed branched model. The one-to-one mapping follows automatically from the construction of the equivalent cable. The equivalent cable is used to provide a new procedure for characterising the location of synaptic contacts on spinal interneurons.

  6. Efficiency, safety, and patient preference of switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5% while maintaining the prostaglandin F2α analog

    OpenAIRE

    Shimizu, Yoshie; Nakakura,Shunsuke; Nishiyama,Makiko; Tabuchi,Hitoshi; Kiuchi,Yoshiaki

    2015-01-01

    Yoshie Shimizu,1 Shunsuke Nakakura,1 Makiko Nishiyama,1 Hitoshi Tabuchi,1 Yoshiaki Kiuchi2 1Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, 2Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan Background: We investigated the efficiency, safety and patient preference of switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5% while maintaining the prostaglandin F2α analog...

  7. VERSE - Virtual Equivalent Real-time Simulation

    Science.gov (United States)

    Zheng, Yang; Martin, Bryan J.; Villaume, Nathaniel

    2005-01-01

    Distributed real-time simulations provide important timing validation and hardware in the- loop results for the spacecraft flight software development cycle. Occasionally, the need for higher fidelity modeling and more comprehensive debugging capabilities - combined with a limited amount of computational resources - calls for a non real-time simulation environment that mimics the real-time environment. By creating a non real-time environment that accommodates simulations and flight software designed for a multi-CPU real-time system, we can save development time, cut mission costs, and reduce the likelihood of errors. This paper presents such a solution: Virtual Equivalent Real-time Simulation Environment (VERSE). VERSE turns the real-time operating system RTAI (Real-time Application Interface) into an event driven simulator that runs in virtual real time. Designed to keep the original RTAI architecture as intact as possible, and therefore inheriting RTAI's many capabilities, VERSE was implemented with remarkably little change to the RTAI source code. This small footprint together with use of the same API allows users to easily run the same application in both real-time and virtual time environments. VERSE has been used to build a workstation testbed for NASA's Space Interferometry Mission (SIM PlanetQuest) instrument flight software. With its flexible simulation controls and inexpensive setup and replication costs, VERSE will become an invaluable tool in future mission development.

  8. Patient-provider communication styles in HIV treatment programs in Bamako, Mali: A mixed-methods study to define dimensions and measure patient preferences

    Directory of Open Access Journals (Sweden)

    Emily A. Hurley

    2017-12-01

    Full Text Available Effective patient-provider communication (PPC promotes patient adherence and retention in long-term care. Sub-Saharan Africa faces unprecedented demand for chronic care for HIV patients on antiretroviral therapy (ART, yet adherence and retention remain challenging. In high-income countries, research describing patient preferences for different PPC styles has guided interventions to improve PPC and patient outcomes. However, research on PPC preferences in sub-Saharan Africa is limited. We sought to define PPC dimensions relevant to ART programs in Bamako, Mali through recordings of clinical interactions, in-depth interviews and focus-group discussions with 69 patients and 17 providers. To assess preferences toward contrasting PPC styles within dimensions, we conducted a vignette-based survey with 141 patients across five ART facilities. Qualitative analysis revealed two PPC dimensions similar to those described in the literature on patient-centered communication (level of psychosocial regard, balance of power, and one unique dimension that emerged from the data (guiding patient behavior: easy/tough/sharp. Significantly more survey participants chose the vignette demonstrating high psychosocial regard (52.2% compared to a biomedical style (22.5% (p<0.001. Within balance of power, a statistically similar proportion of participants chose the vignette demonstrating shared power (40.2% compared to a provider-dominated style (35.8%. In guiding patient behavior, a similar proportion of participants preferred the vignette depicting the “easy” (38.4% and/or “tough” style (40.6%, but significantly fewer preferred the “sharp” style (14.5% (p<0.001. Highly educated participants chose biomedical and shared power styles more frequently, while less educated participants more frequently indicated “no preference”. Working to understand, develop, and tailor PPC styles to patients in chronic care may help support patient retention and ultimately

  9. Geometry of the local equivalence of states

    Energy Technology Data Exchange (ETDEWEB)

    Sawicki, A; Kus, M, E-mail: assawi@cft.edu.pl, E-mail: marek.kus@cft.edu.pl [Center for Theoretical Physics, Polish Academy of Sciences, Al Lotnikow 32/46, 02-668 Warszawa (Poland)

    2011-12-09

    We present a description of locally equivalent states in terms of symplectic geometry. Using the moment map between local orbits in the space of states and coadjoint orbits of the local unitary group, we reduce the problem of local unitary equivalence to an easy part consisting of identifying the proper coadjoint orbit and a harder problem of the geometry of fibers of the moment map. We give a detailed analysis of the properties of orbits of 'equally entangled states'. In particular, we show connections between certain symplectic properties of orbits such as their isotropy and coisotropy with effective criteria of local unitary equivalence. (paper)

  10. Quantum equivalence principle without mass superselection

    International Nuclear Information System (INIS)

    Hernandez-Coronado, H.; Okon, E.

    2013-01-01

    The standard argument for the validity of Einstein's equivalence principle in a non-relativistic quantum context involves the application of a mass superselection rule. The objective of this work is to show that, contrary to widespread opinion, the compatibility between the equivalence principle and quantum mechanics does not depend on the introduction of such a restriction. For this purpose, we develop a formalism based on the extended Galileo group, which allows for a consistent handling of superpositions of different masses, and show that, within such scheme, mass superpositions behave as they should in order to obey the equivalence principle. - Highlights: • We propose a formalism for consistently handling, within a non-relativistic quantum context, superpositions of states with different masses. • The formalism utilizes the extended Galileo group, in which mass is a generator. • The proposed formalism allows for the equivalence principle to be satisfied without the need of imposing a mass superselection rule

  11. REFractions: The Representing Equivalent Fractions Game

    Science.gov (United States)

    Tucker, Stephen I.

    2014-01-01

    Stephen Tucker presents a fractions game that addresses a range of fraction concepts including equivalence and computation. The REFractions game also improves students' fluency with representing, comparing and adding fractions.

  12. ON THE EQUIVALENCE OF THE ABEL EQUATION

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    This article uses the reflecting function of Mironenko to study some complicated differential equations which are equivalent to the Abel equation. The results are applied to discuss the behavior of solutions of these complicated differential equations.

  13. interpratation: of equivalences and cultural untranslatability

    African Journals Online (AJOL)

    jgmweri

    translatability in cultural diversity in terms equivalences such as –Vocabulary or lexical ..... A KSL interpreter who does not understand this English idiom may literally interpret it .... Nida, E.A. (1958) Analysis of meaning and dictionary making.

  14. Equivalence Principle, Higgs Boson and Cosmology

    Directory of Open Access Journals (Sweden)

    Mauro Francaviglia

    2013-05-01

    Full Text Available We discuss here possible tests for Palatini f(R-theories together with their implications for different formulations of the Equivalence Principle. We shall show that Palatini f(R-theories obey the Weak Equivalence Principle and violate the Strong Equivalence Principle. The violations of the Strong Equivalence Principle vanish in vacuum (and purely electromagnetic solutions as well as on short time scales with respect to the age of the universe. However, we suggest that a framework based on Palatini f(R-theories is more general than standard General Relativity (GR and it sheds light on the interpretation of data and results in a way which is more model independent than standard GR itself.

  15. The gauge principle vs. the equivalence principle

    International Nuclear Information System (INIS)

    Gates, S.J. Jr.

    1984-01-01

    Within the context of field theory, it is argued that the role of the equivalence principle may be replaced by the principle of gauge invariance to provide a logical framework for theories of gravitation

  16. Dark matter and the equivalence principle

    Science.gov (United States)

    Frieman, Joshua A.; Gradwohl, Ben-Ami

    1993-01-01

    A survey is presented of the current understanding of dark matter invoked by astrophysical theory and cosmology. Einstein's equivalence principle asserts that local measurements cannot distinguish a system at rest in a gravitational field from one that is in uniform acceleration in empty space. Recent test-methods for the equivalence principle are presently discussed as bases for testing of dark matter scenarios involving the long-range forces between either baryonic or nonbaryonic dark matter and ordinary matter.

  17. S-equivalents lagrangians in generalized mechanics

    International Nuclear Information System (INIS)

    Negri, L.J.; Silva, Edna G. da.

    1985-01-01

    The problem of s-equivalent lagrangians is considered in the realm of generalized mechanics. Some results corresponding to the ordinary (non-generalized) mechanics are extended to the generalized case. A theorem for the reduction of the higher order lagrangian description to the usual order is found to be useful for the analysis of generalized mechanical systems and leads to a new class of equivalence between lagrangian functions. Some new perspectives are pointed out. (Author) [pt

  18. Social participation of diabetes and ex-leprosy patients in the Netherlands and patient preference for combined self-care groups.

    Science.gov (United States)

    de Vries, Henry J C; de Groot, Roos; van Brakel, Wim H

    2014-01-01

    their neuropathic complaints concerned. Yet only 17% showed interest in combined self-care groups. The majority preferred disease-specific self-care groups only focused on diabetic patients. This might have been caused partly by the perception that a self-care group is yet another disease-related demand on their time, rather than an opportunity to become less dependent on health care services. The physical complications and social problems in ex-leprosy and diabetic patients with neuropathy are similar. Both groups show social participation limitations, yet in contrast to diabetic patients, ex-leprosy patients perceive stigma in more domains in life. Despite the fact that diabetic patients preferred disease-specific, homogeneous self-care groups, we believe that the option of combined groups with ex-leprosy patients and possibly even other people needing chronic wound care is a promising strategy. Therefore, further research is warranted into the acceptance and impact of self-care groups as a strategy to reduce social constraints by diseases causing neuropathy.

  19. The principle of equivalence reconsidered: assessing the relevance of the principle of equivalence in prison medicine.

    Science.gov (United States)

    Jotterand, Fabrice; Wangmo, Tenzin

    2014-01-01

    In this article we critically examine the principle of equivalence of care in prison medicine. First, we provide an overview of how the principle of equivalence is utilized in various national and international guidelines on health care provision to prisoners. Second, we outline some of the problems associated with its applications, and argue that the principle of equivalence should go beyond equivalence to access and include equivalence of outcomes. However, because of the particular context of the prison environment, third, we contend that the concept of "health" in equivalence of health outcomes needs conceptual clarity; otherwise, it fails to provide a threshold for healthy states among inmates. We accomplish this by examining common understandings of the concepts of health and disease. We conclude our article by showing why the conceptualization of diseases as clinical problems provides a helpful approach in the delivery of health care in prison.

  20. A method to obtain new cross-sections transport equivalent

    International Nuclear Information System (INIS)

    Palmiotti, G.

    1988-01-01

    We present a method, that allows the calculation, by the mean of variational principle, of equivalent cross-sections in order to take into account the transport and mesh size effects on reactivity variation calculations. The method validation has been made in two and three dimensions geometries. The reactivity variations calculated in three dimensional hexagonal geometry with seven points by subassembly using two sets of equivalent cross-sections for control rods are in a very good agreement with the ones of a transport, extrapolated to zero mesh size, calculation. The difficulty encountered in obtaining a good flux distribution has lead to the utilisation of a single set of equivalent cross-sections calculated by starting from an appropriated R-Z model that allows to take into account also the axial transport effects for the control rod followers. The global results in reactivity variations are still satisfactory with a good performance for the flux distribution. The main interest of the proposed method is the possibility to simulate a full 3D transport calculation, with fine mesh size, using a 3D diffusion code, with a larger mesh size. The results obtained should be affected by uncertainties, which do not exceed ± 4% for a large LMFBR control rod worth and for very different rod configurations. This uncertainty is by far smaller than the experimental uncertainties. (author). 5 refs, 8 figs, 9 tabs

  1. Equivalence of Szegedy's and coined quantum walks

    Science.gov (United States)

    Wong, Thomas G.

    2017-09-01

    Szegedy's quantum walk is a quantization of a classical random walk or Markov chain, where the walk occurs on the edges of the bipartite double cover of the original graph. To search, one can simply quantize a Markov chain with absorbing vertices. Recently, Santos proposed two alternative search algorithms that instead utilize the sign-flip oracle in Grover's algorithm rather than absorbing vertices. In this paper, we show that these two algorithms are exactly equivalent to two algorithms involving coined quantum walks, which are walks on the vertices of the original graph with an internal degree of freedom. The first scheme is equivalent to a coined quantum walk with one walk step per query of Grover's oracle, and the second is equivalent to a coined quantum walk with two walk steps per query of Grover's oracle. These equivalences lie outside the previously known equivalence of Szegedy's quantum walk with absorbing vertices and the coined quantum walk with the negative identity operator as the coin for marked vertices, whose precise relationships we also investigate.

  2. Quantum mechanics and the equivalence principle

    International Nuclear Information System (INIS)

    Davies, P C W

    2004-01-01

    A quantum particle moving in a gravitational field may penetrate the classically forbidden region of the gravitational potential. This raises the question of whether the time of flight of a quantum particle in a gravitational field might deviate systematically from that of a classical particle due to tunnelling delay, representing a violation of the weak equivalence principle. I investigate this using a model quantum clock to measure the time of flight of a quantum particle in a uniform gravitational field, and show that a violation of the equivalence principle does not occur when the measurement is made far from the turning point of the classical trajectory. The results are then confirmed using the so-called dwell time definition of quantum tunnelling. I conclude with some remarks about the strong equivalence principle in quantum mechanics

  3. Water equivalence of polymer gel dosimeters

    International Nuclear Information System (INIS)

    Sellakumar, P.; James Jebaseelan Samuel, E.; Supe, Sanjay S.

    2007-01-01

    To evaluate the water equivalence and radiation transport properties of polymer gel dosimeters over the wide range of photon and electron energies 14 different types of polymer gels were considered. Their water equivalence was evaluated in terms of effective atomic number (Z eff ), electron density (ρ e ), photon mass attenuation coefficient (μ/ρ), photon mass energy absorption coefficient (μ en /ρ) and total stopping power (S/ρ) tot of electrons using the XCOM and the ESTAR database. The study showed that the effective atomic number of polymer gels were very close ( en /ρ for all polymer gels were in close agreement ( tot of electrons in polymer gel dosimeters were within 1% agreement with that of water. From the study we conclude that at lower energy (<80keV) the polymer gel dosimeters cannot be considered water equivalent and study has to be carried out before using the polymer gel for clinical application

  4. The equivalence problem for LL- and LR-regular grammars

    NARCIS (Netherlands)

    Nijholt, Antinus; Gecsec, F.

    It will be shown that the equivalence problem for LL-regular grammars is decidable. Apart from extending the known result for LL(k) grammar equivalence to LLregular grammar equivalence, we obtain an alternative proof of the decidability of LL(k) equivalence. The equivalence prob]em for LL-regular

  5. Fiscal adjustments in Europe and Ricardian equivalence

    Directory of Open Access Journals (Sweden)

    V. DE BONIS

    1998-09-01

    Full Text Available According to the ‘Ricardian’ equivalence hypothesis, consumption is dependent on permanent disposable income and current deficits are equivalent to future tax payments. This hypothesis is tested on 14 European countries in the 1990s. The relationships between private sector savings and general government deficit, and the GDP growth rate and the unemployment rate are determined. The results show the change in consumers' behaviour with respect to government deficit, and that expectations of an increase in future wealth are no longer associated with a decrease in deficit.

  6. Equivalent circuit analysis of terahertz metamaterial filters

    KAUST Repository

    Zhang, Xueqian

    2011-01-01

    An equivalent circuit model for the analysis and design of terahertz (THz) metamaterial filters is presented. The proposed model, derived based on LMC equivalent circuits, takes into account the detailed geometrical parameters and the presence of a dielectric substrate with the existing analytic expressions for self-inductance, mutual inductance, and capacitance. The model is in good agreement with the experimental measurements and full-wave simulations. Exploiting the circuit model has made it possible to predict accurately the resonance frequency of the proposed structures and thus, quick and accurate process of designing THz device from artificial metamaterials is offered. ©2011 Chinese Optics Letters.

  7. A neutron dose equivalent meter at CAEP

    International Nuclear Information System (INIS)

    Tian Shihai; Lu Yan; Wang Heyi; Yuan Yonggang; Chen Xu

    2012-01-01

    The measurement of neutron dose equivalent has been a widespread need in industry and research. In this paper, aimed at improving the accuracy of neutron dose equivalent meter: a neutron dose counter is simulated with MCNP5, and the energy response curve is optimized. The results show that the energy response factor is from 0.2 to 1.8 for neutrons in the energy range of 2.53×10 -8 MeV to 10 MeV Compared with other related meters, it turns that the design of this meter is right. (authors)

  8. Measurements of the personal dose equivalent

    International Nuclear Information System (INIS)

    Scarlat, F.; Scarisoreanu, A.; Badita, E.; Oane, M.; Mitru, E.

    2008-01-01

    Full text: The paper presents the results of measurements related to the personal dose equivalent in the rooms adjacent to NILPRP 7 MeV linear accelerator, by means of the secondary standard chamber T34035 Hp(10). The chamber was calibrated by PTB at S- 137 Cs (E av = 661.6 keV, T 1/2 11050 days) and has N H = 3.17x10 6 Sv/C calibration factor for the personal dose equivalent, Hp(10), at a depth of 10 mm in climatic reference conditions. The measurements were made for the two operation mode of the 7 MeV linac: electrons and bremsstrahlung

  9. 77 FR 32632 - Ambient Air Monitoring Reference and Equivalent Methods: Designation of Three New Equivalent Methods

    Science.gov (United States)

    2012-06-01

    ... Methods: Designation of Three New Equivalent Methods AGENCY: Environmental Protection Agency. ACTION... accordance with 40 CFR Part 53, three new equivalent methods: One for measuring concentrations of nitrogen... INFORMATION: In accordance with regulations at 40 CFR Part 53, the EPA evaluates various methods for...

  10. Efficiency, safety, and patient preference of switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5% while maintaining the prostaglandin F2α analog.

    Science.gov (United States)

    Shimizu, Yoshie; Nakakura, Shunsuke; Nishiyama, Makiko; Tabuchi, Hitoshi; Kiuchi, Yoshiaki

    2015-01-01

    We investigated the efficiency, safety and patient preference of switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5% while maintaining the prostaglandin F2α analog. We initially enrolled 44 eyes from 44 primary open angle glaucoma patients, and a total of 42 patients completed the study. All patients were under treatment with various prostaglandin F2α analogs and dorzolamide 1%/timolol 0.5%. While maintaining the prostaglandin F2α analog, dorzolamide 1%/timolol 0.5% was switched to brinzolamide 1%/timolol 0.5%. Conjunctival hyperemia, superficial punctate keratopathy, and intraocular pressure (IOP) were evaluated at baseline and at 4, 12, and 24 weeks. Adverse events and patient preferences, measured using a questionnaire at study initiation and at 24 weeks, were also noted. The IOP was 17.7±1.7, 16.8±2.6, 16.7±2.2, and 16.7±2.4 mmHg at baseline and at 4, 12, and 24 weeks, respectively, with no significant differences in IOP values at any time point (P=0.117, one-way analysis of variance). In addition, no significant differences were found in the incidence of conjunctival hyperemia or SPK score at any time point (all P>0.5, by Kruskal-Wallis test). Based on the evaluation of side effects using the questionnaire, stinging/burning was less common (P=0.042), while blurred vision was more common (P=0.003), after switching to brinzolamide 1%/timolol 0.5%. Regarding patient preferences, 13 patients (31%) preferred dorzolamide 1%/timolol 0.5%, 12 patients (29%) preferred brinzolamide 1%/timolol 0.5%, and 17 patients (40%) preferred neither. When switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5%, the IOP values and incidence of superficial punctate keratopathy and conjunctival hyperemia were sustained throughout the 24-week observation period, and the patient preferences were similar for the two regimens. However, differences were observed in the ocular sensations of stinging/burning with dorzolamide 1%/timolol 0

  11. Efficiency, safety, and patient preference of switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5% while maintaining the prostaglandin F2α analog

    Directory of Open Access Journals (Sweden)

    Shimizu Y

    2015-03-01

    Full Text Available Yoshie Shimizu,1 Shunsuke Nakakura,1 Makiko Nishiyama,1 Hitoshi Tabuchi,1 Yoshiaki Kiuchi2 1Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, 2Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan Background: We investigated the efficiency, safety and patient preference of switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1%/timolol 0.5% while maintaining the prostaglandin F2α analog.Methods: We initially enrolled 44 eyes from 44 primary open angle glaucoma patients, and a total of 42 patients completed the study. All patients were under treatment with various prostaglandin F2α analogs and dorzolamide 1%/timolol 0.5%. While maintaining the prostaglandin F2α analog, dorzolamide 1%/timolol 0.5% was switched to brinzolamide 1%/timolol 0.5%. Conjunctival hyperemia, superficial punctate keratopathy, and intraocular pressure (IOP were evaluated at baseline and at 4, 12, and 24 weeks. Adverse events and patient preferences, measured using a questionnaire at study initiation and at 24 weeks, were also noted.Results: The IOP was 17.7±1.7, 16.8±2.6, 16.7±2.2, and 16.7±2.4 mmHg at baseline and at 4, 12, and 24 weeks, respectively, with no significant differences in IOP values at any time point (P=0.117, one-way analysis of variance. In addition, no significant differences were found in the incidence of conjunctival hyperemia or SPK score at any time point (all P>0.5, by Kruskal–Wallis test. Based on the evaluation of side effects using the questionnaire, stinging/burning was less common (P=0.042, while blurred vision was more common (P=0.003, after switching to brinzolamide 1%/timolol 0.5%. Regarding patient preferences, 13 patients (31% preferred dorzolamide 1%/timolol 0.5%, 12 patients (29% preferred brinzolamide 1%/timolol 0.5%, and 17 patients (40% preferred neither.Conclusion: When switching from dorzolamide 1%/timolol 0.5% to brinzolamide 1

  12. Preferencias de los pacientes sobre la información de su enfermedad Patients' preferences for information in health care decision-making

    Directory of Open Access Journals (Sweden)

    Raúl A Borracci

    2012-10-01

    Full Text Available Se realizó una encuesta a pacientes que concurrían a servicios de cardiología para conocer cómo preferían ser informados sobre su estado de salud, y las características sociodemográficas asociadas con estas preferencias, considerando los siguientes ítems: conocimiento sobre la enfermedad, información sobre opciones terapéuticas y toma de decisiones. De 770 encuestados, 738 (95.8% respondieron completamente el formulario. Se observó una tendencia a confiar sólo en el médico para obtener información (81.7%, a querer conocer las opciones de tratamiento y poder opinar (85.9% y en menor medida, a la participación de la familia en las decisiones (63.2%. El 9.6% deseaba recibir la información mínima necesaria o "no saber nada" sobre una presunta enfermedad grave. Los varones fueron menos proclives a solicitar opciones y dar opinión (OR: 0.64, dando menos libertad a la participación familiar (OR: 1.31. Los de menor nivel socioeconómico reclamaron menos opciones (OR: 0.48 y dieron menor participación familiar (OR: 1.79. Los provenientes de otros países de Sudamérica tuvieron una menor tendencia a reclamar opciones y manifestar opinión (OR: 0.60; y los de menor nivel educativo confiaron menos en el conocimiento del médico (OR: 1.81, exigieron menos opciones (OR: 0.45 y prefirieron no conocer la gravedad de la enfermedad (OR: 0.56. El análisis de las variables demográficas permitió definir distintas preferencias de información asociadas a la edad, sexo, procedencia, educación, religión y estado de salud. Se concluye que, aunque es imperativo promover la autonomía del paciente, se deben conocer las preferencias individuales antes de informar y comprometer al paciente en el proceso de toma de decisiones sobre su enfermedad.A survey was carried out among patients who concurred to cardiologic services to know how patients preferred to be informed about their health status, and the demographic characteristics associated to these

  13. Confluence Modulo Equivalence in Constraint Handling Rules

    DEFF Research Database (Denmark)

    Christiansen, Henning; Kirkeby, Maja Hanne

    2015-01-01

    Previous results on confluence for Constraint Handling Rules, CHR, are generalized to take into account user-defined state equivalence relations. This allows a much larger class of programs to enjoy the advantages of confluence, which include various optimization techniques and simplified...

  14. Free Fall and the Equivalence Principle Revisited

    Science.gov (United States)

    Pendrill, Ann-Marie

    2017-01-01

    Free fall is commonly discussed as an example of the equivalence principle, in the context of a homogeneous gravitational field, which is a reasonable approximation for small test masses falling moderate distances. Newton's law of gravity provides a generalisation to larger distances, and also brings in an inhomogeneity in the gravitational field.…

  15. Estimation of Toxicity Equivalent Concentration (TEQ) of ...

    African Journals Online (AJOL)

    Estimation of Toxicity Equivalent Concentration (TEQ) of carcinogenic polycyclic aromatic hydrocarbons in soils from Idu Ekpeye playground and University of Port ... Effective soil remediation and detoxification method like Dispersion by chemical reaction technology should be deployed to clean-up sites to avoid soil toxicity ...

  16. Chemical equivalence assessment of three brands of ...

    African Journals Online (AJOL)

    Assay for content of active ingredients is a critical test of drug quality; failure to meet up the standard for content of active ingredients will result to sub therapeutic quantities. Three brands (A, B and C) of carbamazepine were assayed to determine their chemical equivalence as well as their anticonvulsant activities. This was ...

  17. On Behavioral Equivalence of Rational Representations

    NARCIS (Netherlands)

    Trentelman, Harry L.; Willems, JC; Hara, S; Ohta, Y; Fujioka, H

    2010-01-01

    This article deals with the equivalence of representations of behaviors of linear differential systems In general. the behavior of a given linear differential system has many different representations. In this paper we restrict ourselves to kernel representations and image representations Two kernel

  18. Visual Equivalence and Amodal Completion in Cuttlefish.

    Science.gov (United States)

    Lin, I-Rong; Chiao, Chuan-Chin

    2017-01-01

    Modern cephalopods are notably the most intelligent invertebrates and this is accompanied by keen vision. Despite extensive studies investigating the visual systems of cephalopods, little is known about their visual perception and object recognition. In the present study, we investigated the visual processing of the cuttlefish Sepia pharaonis , including visual equivalence and amodal completion. Cuttlefish were trained to discriminate images of shrimp and fish using the operant conditioning paradigm. After cuttlefish reached the learning criteria, a series of discrimination tasks were conducted. In the visual equivalence experiment, several transformed versions of the training images, such as images reduced in size, images reduced in contrast, sketches of the images, the contours of the images, and silhouettes of the images, were used. In the amodal completion experiment, partially occluded views of the original images were used. The results showed that cuttlefish were able to treat the training images of reduced size and sketches as the visual equivalence. Cuttlefish were also capable of recognizing partially occluded versions of the training image. Furthermore, individual differences in performance suggest that some cuttlefish may be able to recognize objects when visual information was partly removed. These findings support the hypothesis that the visual perception of cuttlefish involves both visual equivalence and amodal completion. The results from this research also provide insights into the visual processing mechanisms used by cephalopods.

  19. Possibility and necessity measures and integral equivalence

    Czech Academy of Sciences Publication Activity Database

    Chen, T.; Mesiar, Radko; Li, J.; Stupňanová, A.

    2017-01-01

    Roč. 86, č. 1 (2017), s. 62-72 ISSN 0888-613X Institutional support: RVO:67985556 Keywords : Integral equivalence * Necessity measure * Possibility measure * Survival function * Universal integral Subject RIV: BA - General Mathematics OBOR OECD: Statistics and probability Impact factor: 2.845, year: 2016 http://library.utia.cas.cz/separaty/2017/E/mesiar-0477092.pdf

  20. Fuel Cell Equivalent Electric Circuit Parameter Mapping

    DEFF Research Database (Denmark)

    Jeppesen, Christian; Zhou, Fan; Andreasen, Søren Juhl

    In this work a simple model for a fuel cell is investigated for diagnostic purpose. The fuel cell is characterized, with respect to the electrical impedance of the fuel cell at non-faulty conditions and under variations in load current. Based on this the equivalent electrical circuit parameters can...

  1. Weak equivalence classes of complex vector bundles

    Czech Academy of Sciences Publication Activity Database

    Le, Hong-Van

    LXXVII, č. 1 (2008), s. 23-30 ISSN 0862-9544 R&D Projects: GA AV ČR IAA100190701 Institutional research plan: CEZ:AV0Z10190503 Keywords : chern classes * complex Grassmannians weak equivalence Subject RIV: BA - General Mathematics

  2. Violation of Equivalence Principle and Solar Neutrinos

    International Nuclear Information System (INIS)

    Gago, A.M.; Nunokawa, H.; Zukanovich Funchal, R.

    2001-01-01

    We have updated the analysis for the solution to the solar neutrino problem by the long-wavelength neutrino oscillations induced by a tiny breakdown of the weak equivalence principle of general relativity, and obtained a very good fit to all the solar neutrino data

  3. Bilingual Dictionaries and Communicative Equivalence for a ...

    African Journals Online (AJOL)

    This implies that a bilingual dictionary becomes a poly functional instrument, presenting more information than just translation equivalents. ... With the emphasis on the user perspective, metalexicographical criteria are used to investigate problems regarding the access structure and the addressing procedures in Afrikaans ...

  4. Equivalent operator preconditioning for elliptic problems

    Czech Academy of Sciences Publication Activity Database

    Axelsson, Owe; Karátson, J.

    2009-01-01

    Roč. 50, č. 3 (2009), s. 297-380 ISSN 1017-1398 Institutional research plan: CEZ:AV0Z30860518 Keywords : Elliptic problem * Conjugate gradient method * preconditioning * equivalent operators * compact operators Subject RIV: BA - General Mathematics Impact factor: 0.716, year: 2009 http://en.scientificcommons.org/42514649

  5. Superstring field theory equivalence: Ramond sector

    International Nuclear Information System (INIS)

    Kroyter, Michael

    2009-01-01

    We prove that the finite gauge transformation of the Ramond sector of the modified cubic superstring field theory is ill-defined due to collisions of picture changing operators. Despite this problem we study to what extent could a bijective classical correspondence between this theory and the (presumably consistent) non-polynomial theory exist. We find that the classical equivalence between these two theories can almost be extended to the Ramond sector: We construct mappings between the string fields (NS and Ramond, including Chan-Paton factors and the various GSO sectors) of the two theories that send solutions to solutions in a way that respects the linearized gauge symmetries in both sides and keeps the action of the solutions invariant. The perturbative spectrum around equivalent solutions is also isomorphic. The problem with the cubic theory implies that the correspondence of the linearized gauge symmetries cannot be extended to a correspondence of the finite gauge symmetries. Hence, our equivalence is only formal, since it relates a consistent theory to an inconsistent one. Nonetheless, we believe that the fact that the equivalence formally works suggests that a consistent modification of the cubic theory exists. We construct a theory that can be considered as a first step towards a consistent RNS cubic theory.

  6. Equivalence Scales for the Former West Germany

    NARCIS (Netherlands)

    Charlier, E.

    1997-01-01

    Equivalence scales provide answers to questions like how much a household with four children needs to spend compared to a household with two children or how much a childless couple needs to spend compared to a single person household to attain the same welfare level. These are important questions

  7. Confluence Modulo Equivalence in Constraint Handling Rules

    DEFF Research Database (Denmark)

    Christiansen, Henning; Kirkeby, Maja Hanne

    2014-01-01

    Previous results on confluence for Constraint Handling Rules, CHR, are generalized to take into account user-defined state equivalence relations. This allows a much larger class of programs to enjoy the ad- vantages of confluence, which include various optimization techniques and simplified...

  8. Equivalence of rational representations of behaviors

    NARCIS (Netherlands)

    Gottimukkala, Sasanka; Fiaz, Shaik; Trentelman, H.L.

    This article deals with the equivalence of representations of behaviors of linear differential systems. In general, the behavior of a given linear differential system has many different representations. In this paper we restrict ourselves to kernel and image representations. Two kernel

  9. Equivalent physical models and formulation of equivalent source layer in high-resolution EEG imaging

    International Nuclear Information System (INIS)

    Yao Dezhong; He Bin

    2003-01-01

    In high-resolution EEG imaging, both equivalent dipole layer (EDL) and equivalent charge layer (ECL) assumed to be located just above the cortical surface have been proposed as high-resolution imaging modalities or as intermediate steps to estimate the epicortical potential. Presented here are the equivalent physical models of these two equivalent source layers (ESL) which show that the strength of EDL is proportional to the surface potential of the layer when the outside of the layer is filled with an insulator, and that the strength of ECL is the normal current of the layer when the outside is filled with a perfect conductor. Based on these equivalent physical models, closed solutions of ECL and EDL corresponding to a dipole enclosed by a spherical layer are given. These results provide the theoretical basis of ESL applications in high-resolution EEG mapping

  10. Equivalent physical models and formulation of equivalent source layer in high-resolution EEG imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yao Dezhong [School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu City, 610054, Sichuan Province (China); He Bin [The University of Illinois at Chicago, IL (United States)

    2003-11-07

    In high-resolution EEG imaging, both equivalent dipole layer (EDL) and equivalent charge layer (ECL) assumed to be located just above the cortical surface have been proposed as high-resolution imaging modalities or as intermediate steps to estimate the epicortical potential. Presented here are the equivalent physical models of these two equivalent source layers (ESL) which show that the strength of EDL is proportional to the surface potential of the layer when the outside of the layer is filled with an insulator, and that the strength of ECL is the normal current of the layer when the outside is filled with a perfect conductor. Based on these equivalent physical models, closed solutions of ECL and EDL corresponding to a dipole enclosed by a spherical layer are given. These results provide the theoretical basis of ESL applications in high-resolution EEG mapping.

  11. "I don't need my patients' opinion to withdraw treatment": patient preferences at the end-of-life and physician attitudes towards advance directives in England and France.

    Science.gov (United States)

    Horn, Ruth

    2014-08-01

    This paper presents the results of a qualitative interview study exploring English and French physicians' moral perspectives and attitudes towards end-of-life decisions when patients lack capacity to make decisions for themselves. The paper aims to examine the importance physicians from different contexts accord to patient preferences and to explore the (potential) role of advance directives (ADs) in each context. The interviews focus on (1) problems that emerge when deciding to withdraw/-hold life-sustaining treatment from both conscious and unconscious patients; (2) decision-making procedures and the participation of proxies/relatives; (3) previous experience with ADs and views on their usefulness; and (4) perspectives on ways in which the decision-making processes in question might be improved. The analysis reveals differences in the way patient preferences are taken into consideration and shows how these differences influence the reasons physicians in each country invoke to justify their reluctance to adhering to ADs. Identifying cultural differences that complicate efforts to develop the practical implementation of ADs can help to inform national policies governing ADs and to better adapt them to practice.

  12. On the equivalence of GPD representations

    International Nuclear Information System (INIS)

    Müller, Dieter; Semenov-Tian-Shansky, Kirill

    2016-01-01

    Phenomenological representations of generalized parton distributions (GPDs) implementing the non-trivial field theoretical requirements are employed in the present day strategies for extracting of hadron structure information encoded in GPDs from the observables of hard exclusive reactions. Showing out the equivalence of various GPD representations can help to get more insight into GPD properties and allow to build up flexible GPD models capable of satisfactory description of the whole set of available experimental data. Below we review the mathematical aspects of establishing equivalence between the the double partial wave expansion of GPDs in the conformal partial waves and in the t-channel SO(3) partial waves and the double distribution representation of GPDs

  13. Developing equivalent circuits for radial distribution networks

    Energy Technology Data Exchange (ETDEWEB)

    Prada, Ricardo; Coelho, Agnelo; Rodrigues, Anselmo [Catholic University of Rio de Janeiro (PUC-Rio), RJ (Brazil). Dept. of Electrical Engineering], Emails: prada@ele.puc-rio.br, agnelo@ele.puc-rio.br, nebulok_99@yahoo.com; Silva, Maria da Guia da [Federal University of Maranhao, Sao Luiz, MA (Brazil). Dept. of Electrical Engineering

    2009-07-01

    This paper presents a method for evaluating External Equivalent in Electric Distribution Networks (EDN).The proposed method has as its main objectives the reduction of the computational costs in distribution network reconfiguration, investigation of the optimal allocation of banks of capacitors, investigation of the allocation of distributed generation, etc. In these sorts of problems a large number of alternative projects must be assessed in order to identify the optimal solution. The optimal solution comes up with the voltage level in the load points within specified limits. Consequently, the EDN must retain the external network load points but without major increasing in the dimension of the equivalent circuit. The proposed method has been tested and validated in a substation of the Electricity Utility of Maranhao - CEMAR, in Brazil. (author)

  14. Thermoluminescence dosemeter for personal dose equivalent assessment

    International Nuclear Information System (INIS)

    Silva, T.A. da; Rosa, L.A.R. da; Campos, L.L.

    1995-01-01

    The possibility was investigated of utilising a Brazilian thermoluminescence individual dosemeter, usually calibrated in terms of photon dose equivalent, for the assessment of the personal dose equivalent, H p (d), at depths of 0.07 and 10 mm. The dosemeter uses four CaSO 4 :Dy thermoluminescent detectors, between different filters, as the sensitive materials. It was calibrated in gamma and X radiation fields in the energy range from 17 to 1250 keV. Linear combinations of the responses of three detectors, in this energy range, allow the evaluation of H p (0.07) and H p (10), for radiation incidence angles varying from 0 to 60 degrees, with an accuracy better than 35%. The method is not applicable to mixed photon-beta fields. (author)

  15. Thevenin Equivalent Method for Dynamic Contingency Assessment

    DEFF Research Database (Denmark)

    Møller, Jakob Glarbo; Jóhannsson, Hjörtur; Østergaard, Jacob

    2015-01-01

    A method that exploits Thevenin equivalent representation for obtaining post-contingency steady-state nodal voltages is integrated with a method of detecting post-contingency aperiodic small-signal instability. The task of integrating stability assessment with contingency assessment is challenged...... by the cases of unstable post-contingency conditions. For unstable postcontingency conditions there exists no credible steady-state which can be used for basis of a stability assessment. This paper demonstrates how Thevenin Equivalent methods can be applied in algebraic representation of such bifurcation...... points which may be used in assessment of post-contingency aperiodic small-signal stability. The assessment method is introduced with a numeric example....

  16. The Logic of Equivalence in Academic Discourse?

    DEFF Research Database (Denmark)

    Madsen, Dorte

    2017-01-01

    of discourse to distinguish between the scientific field, where interrelationships among academic disciplines are taken as an object of research, and the widespread uses of ‘interdisciplinary’ and ‘interdisciplinarity’ in academic discourse more generally, typically for legitimation purposes. The assumption......-discourses meet. It is suggested that the logics of signification, and the tension between difference and equivalence, may be important tools for theorizing this borderland. It is argued that whereas the logic of equivalence and the production of empty signifiers appears to be of marginal interest...... to the scientific field, the logic of difference as a more complex articulation of elements, seems to be more in line with the ideals of academic discourse....

  17. On equivalent resistance of electrical circuits

    Science.gov (United States)

    Kagan, Mikhail

    2015-01-01

    While the standard (introductory physics) way of computing the equivalent resistance of nontrivial electrical circuits is based on Kirchhoff's rules, there is a mathematically and conceptually simpler approach, called the method of nodal potentials, whose basic variables are the values of the electric potential at the circuit's nodes. In this paper, we review the method of nodal potentials and illustrate it using the Wheatstone bridge as an example. We then derive a closed-form expression for the equivalent resistance of a generic circuit, which we apply to a few sample circuits. The result unveils a curious interplay between electrical circuits, matrix algebra, and graph theory and its applications to computer science. The paper is written at a level accessible by undergraduate students who are familiar with matrix arithmetic. Additional proofs and technical details are provided in appendices.

  18. Symmetry adaptation, operator equivalents and magnetic resonance

    International Nuclear Information System (INIS)

    Kibler, M.; Chatterjee, R.

    1977-12-01

    Basic quantities for symmetry adaptation are discussed in connection with molecular and solid state physics. This gives rise to a formalism whose the central elements are operator equivalents adapted to a point group. Such symmetry adapted operator equivalents are defined in terms of Schwinger operators so that they cover the off-diagonal and diagonal cases. Special emphasis is put on the applications of the formalism to magnetic resonance. More specifically, it is shown how to apply the formalism to the construction, the study of the transformation properties, and the determination of the eigenstates of a generalized spin hamiltonian. Numerous examples are given as well as key tables relative to the chain SO(3) for making easy the application of the formalism to electron paramagnetic resonance [fr

  19. Determination of equivalent copper thickness of patient equivalent phantoms in terms of attenuation, used in radiology

    International Nuclear Information System (INIS)

    Jansen, J.Th.M.; Suliman, I.I.; Zoetelief, J.

    2002-01-01

    aluminium filtration. The Monte Carlo N-Particle transport code (MCNP) is used to calculate the attenuation in the different geometries with the PMMA or copper or no filters applied. In all these cases the detector is placed at 1.0005 m distance from the focus on the central beam axis, with all filters between the detector and the focus. No anti-scatter grid is used in these calculations. With different thickness of the PMMA phantom and appropriate tube voltage the attenuation is calculated. The copper filter thickness is adjusted to get the same attenuation as obtained with the relevant PMMA phantoms. This match is made for the PMMA-phantom in front of the image intensifier and the copper filter in front of the image intensifier or attached to the X-ray tube diaphragm. In addition a match is made with both the PMMA and copper filter attached to the X-ray tube diaphragm. The image intensifier is simulated by a CsI plate 0.5 mm thickness, placed at 1.001 m from the focus. The front filters are placed 0.15 m from the focus and the back filters are ending 1.00 m from the focus. The results will be presented as the copper equivalent filter thickness for the PMMA phantom thicknesses mentioned above for different tube voltages and both beam geometries. The situation with both the PMMA phantom and copper filter in the back position is used to estimate the patient entrance surface dose rates. The equivalent copper filter calculation is based on the detector behind the attenuators to simulate the performance of an Automatic Exposure Controller (AEC). In addition detectors are placed 0.5 mm in front of the PMMA phantom and the copper filter and corrected by the inverse square law to a focus detector distance of 0.50 m. Comparison between both situations is made to estimate the uncertainty in the ionisation chamber measurement. The equivalent copper filter is based on equal attenuation therefore the beam quality will, in general, be different. In order to characterise these

  20. A Logical Characterisation of Static Equivalence

    DEFF Research Database (Denmark)

    Hüttel, Hans; Pedersen, Michael D.

    2007-01-01

    -order logic for frames with quantification over environment knowledge which, under certain general conditions, characterizes static equivalence and is amenable to construction of characteristic formulae. The logic can be used to reason about environment knowledge and can be adapted to a particular application...... by defining a suitable signature and associated equational theory. The logic can furthermore be extended with modalities to yield a modal logic for e.g. the Applied Pi calculus....

  1. Global equivalent magnetization of the oceanic lithosphere

    Science.gov (United States)

    Dyment, J.; Choi, Y.; Hamoudi, M.; Lesur, V.; Thebault, E.

    2015-11-01

    As a by-product of the construction of a new World Digital Magnetic Anomaly Map over oceanic areas, we use an original approach based on the global forward modeling of seafloor spreading magnetic anomalies and their comparison to the available marine magnetic data to derive the first map of the equivalent magnetization over the World's ocean. This map reveals consistent patterns related to the age of the oceanic lithosphere, the spreading rate at which it was formed, and the presence of mantle thermal anomalies which affects seafloor spreading and the resulting lithosphere. As for the age, the equivalent magnetization decreases significantly during the first 10-15 Myr after its formation, probably due to the alteration of crustal magnetic minerals under pervasive hydrothermal alteration, then increases regularly between 20 and 70 Ma, reflecting variations in the field strength or source effects such as the acquisition of a secondary magnetization. As for the spreading rate, the equivalent magnetization is twice as strong in areas formed at fast rate than in those formed at slow rate, with a threshold at ∼40 km/Myr, in agreement with an independent global analysis of the amplitude of Anomaly 25. This result, combined with those from the study of the anomalous skewness of marine magnetic anomalies, allows building a unified model for the magnetic structure of normal oceanic lithosphere as a function of spreading rate. Finally, specific areas affected by thermal mantle anomalies at the time of their formation exhibit peculiar equivalent magnetization signatures, such as the cold Australian-Antarctic Discordance, marked by a lower magnetization, and several hotspots, marked by a high magnetization.

  2. Visual Equivalence and Amodal Completion in Cuttlefish

    OpenAIRE

    Lin, I-Rong; Chiao, Chuan-Chin

    2017-01-01

    Modern cephalopods are notably the most intelligent invertebrates and this is accompanied by keen vision. Despite extensive studies investigating the visual systems of cephalopods, little is known about their visual perception and object recognition. In the present study, we investigated the visual processing of the cuttlefish Sepia pharaonis, including visual equivalence and amodal completion. Cuttlefish were trained to discriminate images of shrimp and fish using the operant conditioning pa...

  3. Canonizing certain Borel equivalences for Silver forcing

    Czech Academy of Sciences Publication Activity Database

    Doucha, Michal

    2012-01-01

    Roč. 159, č. 13 (2012), s. 2973-2979 ISSN 0166-8641. [Prague Symposium on General Topology and its Relations to Modern Analysis and Algebra /11./. Prague, 07.08.2011-12.08.2011] Institutional research plan: CEZ:AV0Z10190503 Keywords : Borel equivalence relations * silver ideal * canonical Ramsey theorem Subject RIV: BA - General Mathematics Impact factor: 0.562, year: 2012 http://www.sciencedirect.com/science/article/pii/S0166864112002180#

  4. Quantum mechanics from an equivalence principle

    International Nuclear Information System (INIS)

    Faraggi, A.E.

    1997-01-01

    The authors show that requiring diffeomorphic equivalence for one-dimensional stationary states implies that the reduced action S 0 satisfies the quantum Hamilton-Jacobi equation with the Planck constant playing the role of a covariantizing parameter. The construction shows the existence of a fundamental initial condition which is strictly related to the Moebius symmetry of the Legendre transform and to its involutive character. The universal nature of the initial condition implies the Schroedinger equation in any dimension

  5. Equivalency of two-dimensional algebras

    International Nuclear Information System (INIS)

    Santos, Gildemar Carneiro dos; Pomponet Filho, Balbino Jose S.

    2011-01-01

    Full text: Let us consider a vector z = xi + yj over the field of real numbers, whose basis (i,j) satisfy a given algebra. Any property of this algebra will be reflected in any function of z, so we can state that the knowledge of the properties of an algebra leads to more general conclusions than the knowledge of the properties of a function. However structural properties of an algebra do not change when this algebra suffers a linear transformation, though the structural constants defining this algebra do change. We say that two algebras are equivalent to each other whenever they are related by a linear transformation. In this case, we have found that some relations between the structural constants are sufficient to recognize whether or not an algebra is equivalent to another. In spite that the basis transform linearly, the structural constants change like a third order tensor, but some combinations of these tensors result in a linear transformation, allowing to write the entries of the transformation matrix as function of the structural constants. Eventually, a systematic way to find the transformation matrix between these equivalent algebras is obtained. In this sense, we have performed the thorough classification of associative commutative two-dimensional algebras, and find that even non-division algebra may be helpful in solving non-linear dynamic systems. The Mandelbrot set was used to have a pictorial view of each algebra, since equivalent algebras result in the same pattern. Presently we have succeeded in classifying some non-associative two-dimensional algebras, a task more difficult than for associative one. (author)

  6. Extended equivalent dipole model for radiated emissions

    OpenAIRE

    Obiekezie, Chijioke S.

    2016-01-01

    This work is on the characterisation of radiated fields from electronic devices. An equivalent dipole approach is used. Previous work showed that this was an effective approach for single layer printed circuit boards where an infinite ground plane can be assumed. In this work, this approach is extended for the characterisation of more complex circuit boards or electronic systems.\\ud For complex electronic radiators with finite ground planes, the main challenge is characterising field diffract...

  7. Equivalence of Lagrangian and Hamiltonian BRST quantizations

    International Nuclear Information System (INIS)

    Grigoryan, G.V.; Grigoryan, R.P.; Tyutin, I.V.

    1992-01-01

    Two approaches to the quantization of gauge theories using BRST symmetry are widely used nowadays: the Lagrangian quantization, developed in (BV-quantization) and Hamiltonian quantization, formulated in (BFV-quantization). For all known examples of field theory (Yang-Mills theory, gravitation etc.) both schemes give equivalent results. However the equivalence of these approaches in general wasn't proved. The main obstacle in comparing of these formulations consists in the fact, that in Hamiltonian approach the number of ghost fields is equal to the number of all first-class constraints, while in the Lagrangian approach the number of ghosts is equal to the number of independent gauge symmetries, which is equal to the number of primary first-class constraints only. This paper is devoted to the proof of the equivalence of Lagrangian and Hamiltonian quantizations for the systems with first-class constraints only. This is achieved by a choice of special gauge in the Hamiltonian approach. It's shown, that after integration over redundant variables on the functional integral we come to effective action which is constructed according to rules for construction of the effective action in Lagrangian quantization scheme

  8. Energy conservation and the principle of equivalence

    International Nuclear Information System (INIS)

    Haugan, M.P.

    1979-01-01

    If the equivalence principle is violated, then observers performing local experiments can detect effects due to their position in an external gravitational environment (preferred-location effects) or can detect effects due to their velocity through some preferred frame (preferred frame effects). We show that the principle of energy conservation implies a quantitative connection between such effects and structure-dependence of the gravitational acceleration of test bodies (violation of the Weak Equivalence Principle). We analyze this connection within a general theoretical framework that encompasses both non-gravitational local experiments and test bodies as well as gravitational experiments and test bodies, and we use it to discuss specific experimental tests of the equivalence principle, including non-gravitational tests such as gravitational redshift experiments, Eoetvoes experiments, the Hughes-Drever experiment, and the Turner-Hill experiment, and gravitational tests such as the lunar-laser-ranging ''Eoetvoes'' experiment, and measurements of anisotropies and variations in the gravitational constant. This framework is illustrated by analyses within two theoretical formalisms for studying gravitational theories: the PPN formalism, which deals with the motion of gravitating bodies within metric theories of gravity, and the THepsilonμ formalism that deals with the motion of charged particles within all metric theories and a broad class of non-metric theories of gravity

  9. Gauge equivalence of the Gross Pitaevskii equation and the equivalent Heisenberg spin chain

    Science.gov (United States)

    Radha, R.; Kumar, V. Ramesh

    2007-11-01

    In this paper, we construct an equivalent spin chain for the Gross-Pitaevskii equation with quadratic potential and exponentially varying scattering lengths using gauge equivalence. We have then generated the soliton solutions for the spin components S3 and S-. We find that the spin solitons for S3 and S- can be compressed for exponentially growing eigenvalues while they broaden out for decaying eigenvalues.

  10. Equivalent models of wind farms by using aggregated wind turbines and equivalent winds

    International Nuclear Information System (INIS)

    Fernandez, L.M.; Garcia, C.A.; Saenz, J.R.; Jurado, F.

    2009-01-01

    As a result of the increasing wind farms penetration on power systems, the wind farms begin to influence power system, and therefore the modeling of wind farms has become an interesting research topic. In this paper, new equivalent models of wind farms equipped with wind turbines based on squirrel-cage induction generators and doubly-fed induction generators are proposed to represent the collective behavior on large power systems simulations, instead of using a complete model of wind farms where all the wind turbines are modeled. The models proposed here are based on aggregating wind turbines into an equivalent wind turbine which receives an equivalent wind of the ones incident on the aggregated wind turbines. The equivalent wind turbine presents re-scaled power capacity and the same complete model as the individual wind turbines, which supposes the main feature of the present equivalent models. Two equivalent winds are evaluated in this work: (1) the average wind from the ones incident on the aggregated wind turbines with similar winds, and (2) an equivalent incoming wind derived from the power curve and the wind incident on each wind turbine. The effectiveness of the equivalent models to represent the collective response of the wind farm at the point of common coupling to grid is demonstrated by comparison with the wind farm response obtained from the detailed model during power system dynamic simulations, such as wind fluctuations and a grid disturbance. The present models can be used for grid integration studies of large power system with an important reduction of the model order and the computation time

  11. Total effective dose equivalent associated with fixed uranium surface contamination

    International Nuclear Information System (INIS)

    Bogard, J.S.; Hamm, R.N.; Ashley, J.C.; Turner, J.E.; England, C.A.; Swenson, D.E.; Brown, K.S.

    1997-04-01

    This report provides the technical basis for establishing a uranium fixed-contamination action level, a fixed uranium surface contamination level exceeding the total radioactivity values of Appendix D of Title 10, Code of Federal Regulations, part 835 (10CFR835), but below which the monitoring, posting, and control requirements for Radiological Areas are not required for the area of the contamination. An area of fixed uranium contamination between 1,000 dpm/100 cm 2 and that level corresponding to an annual total effective dose equivalent (TEDE) of 100 mrem requires only routine monitoring, posting to alert personnel of the contamination, and administrative control. The more extensive requirements for monitoring, posting, and control designated by 10CFR835 for Radiological Areas do not have to be applied for these intermediate fixed-contamination levels

  12. Physical Sciences Facility Air Emission Control Equivalency Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Brown, David M.; Belew, Shan T.

    2008-10-17

    This document presents the adequacy evaluation for the application of technology standards during design, fabrication, installation and testing of radioactive air exhaust systems at the Physical Sciences Facility (PSF), located on the Horn Rapids Triangle north of the Pacific Northwest National Laboratory (PNNL) complex. The analysis specifically covers the exhaust portion of the heating, ventilation and air conditioning (HVAC) systems associated with emission units EP-3410-01-S, EP-3420-01-S and EP 3430-01-S.

  13. A prospective, double-blind, randomized, two-period crossover, multicenter study to evaluate tolerability and patient preference between mirabegron and tolterodine in patients with overactive bladder (PREFER study).

    Science.gov (United States)

    Staskin, David; Herschorn, Sender; Fialkov, Jonathan; Tu, Le Mai; Walsh, Terry; Schermer, Carol R

    2018-02-01

    The objective of this study was to assess the tolerability and treatment preference in patients with overactive bladder (OAB) treated with mirabegron or tolterodine. This was a two-period, 8-week crossover, double-blind, phase IV study (PREFER; NCT02138747) in treatment-naive adults with OAB for 3 months or longer randomized to one of four treatment sequences in a 5:5:1:1 ratio (mirabegron/tolterodine, tolterodine/mirabegron, mirabegron/mirabegron, or tolterodine/tolterodine), separated by a washout period of 2 weeks. The primary endpoint was drug tolerability using the Medication Tolerability scale of the OAB Treatment Satisfaction (OAB-S) questionnaire at end of treatment (EoT). Period-by-treatment interactions were analyzed to determine any effect of drug order. Patient preference, change from baseline in OAB symptoms, and treatment-emergent adverse events (TEAEs) were assessed. A total of 358 randomized patients completed the OAB-S Medication Tolerability scale questionnaire at one or more visits after the baseline evaluation. The mean (95% CI) OAB-S Medication Tolerability scores were significantly higher (better tolerability) for mirabegron (86.29 [83.50, 89.08]) than for tolterodine (83.40 [80.59, 86.20]; p = 0.004). The period-by-treatment interaction was not significant (p = 0.955). Improvements in OAB-S Medication Tolerability scores at EoT were more evident in women, patients aged ≥65 years, and in patients without baseline incontinence, and were greater with mirabegron than with tolterodine extended release. There were no significant differences in patient preference or improvements in OAB symptoms. Significant differences in favor of mirabegron were observed for anticholinergic TEAEs (20.4% vs. 27.4%; p = 0.042) and specifically for gastrointestinal disorders (14.7% vs. 22.5%; p = 0.015). Tolerability of mirabegron was significantly higher than that of tolterodine, and patient preference and improvements in OAB symptoms were comparable

  14. Equivalent conserved currents and generalized Noether's theorem

    International Nuclear Information System (INIS)

    Gordon, T.J.

    1984-01-01

    A generalized Noether theorem is presented, relating symmetries and equivalence classes of local) conservation laws in classical field theories; this is contrasted with the standard theorem. The concept of a ''Noether'' field theory is introduced, being a theory for which the generalized theorem applies; not only does this include the cases of Lagrangian and Hamiltonian field theories, these structures are ''derived'' from the Noether property in a natural way. The generalized theorem applies to currents and symmetries that contain derivatives of the fields up to an arbitrarily high order

  15. Gravitational leptogenesis, C, CP and strong equivalence

    International Nuclear Information System (INIS)

    McDonald, Jamie I.; Shore, Graham M.

    2015-01-01

    The origin of matter-antimatter asymmetry is one of the most important outstanding problems at the interface of particle physics and cosmology. Gravitational leptogenesis (baryogenesis) provides a possible mechanism through explicit couplings of spacetime curvature to appropriate lepton (or baryon) currents. In this paper, the idea that these strong equivalence principle violating interactions could be generated automatically through quantum loop effects in curved spacetime is explored, focusing on the realisation of the discrete symmetries C, CP and CPT which must be broken to induce matter-antimatter asymmetry. The related issue of quantum corrections to the dispersion relation for neutrino propagation in curved spacetime is considered within a fully covariant framework.

  16. European Equivalencies in Legal Interpreting and Translation

    DEFF Research Database (Denmark)

    Corsellis, Ann; Hertog, Erik; Martinsen, Bodil

    2002-01-01

    Within Europe there is increasing freedom of movement between countries and increasing inward migration. As a result, equivalent standards of legl interpreting and translation are required to allow reliable communication for judicial cooperation between member states, for criminal and civil matters...... which cross national borders and for the needs of multilingual populations. The European Convention of Human Rights (article 6, paragrph 3) is one of the main planks of relevant legislation. This international, two year project has been funded by the EU Grotius programme to set out what is required...

  17. Testing efficiency transfer codes for equivalence

    International Nuclear Information System (INIS)

    Vidmar, T.; Celik, N.; Cornejo Diaz, N.; Dlabac, A.; Ewa, I.O.B.; Carrazana Gonzalez, J.A.; Hult, M.; Jovanovic, S.; Lepy, M.-C.; Mihaljevic, N.; Sima, O.; Tzika, F.; Jurado Vargas, M.; Vasilopoulou, T.; Vidmar, G.

    2010-01-01

    Four general Monte Carlo codes (GEANT3, PENELOPE, MCNP and EGS4) and five dedicated packages for efficiency determination in gamma-ray spectrometry (ANGLE, DETEFF, GESPECOR, ETNA and EFFTRAN) were checked for equivalence by applying them to the calculation of efficiency transfer (ET) factors for a set of well-defined sample parameters, detector parameters and energies typically encountered in environmental radioactivity measurements. The differences between the results of the different codes never exceeded a few percent and were lower than 2% in the majority of cases.

  18. The equivalence principle in a quantum world

    DEFF Research Database (Denmark)

    Bjerrum-Bohr, N. Emil J.; Donoghue, John F.; El-Menoufi, Basem Kamal

    2015-01-01

    the energy is small, we now have the tools to address this conflict explicitly. Despite the violation of some classical concepts, the EP continues to provide the core of the quantum gravity framework through the symmetry - general coordinate invariance - that is used to organize the effective field theory......We show how modern methods can be applied to quantum gravity at low energy. We test how quantum corrections challenge the classical framework behind the equivalence principle (EP), for instance through introduction of nonlocality from quantum physics, embodied in the uncertainty principle. When...

  19. Equivalent Circuit Modeling of Hysteresis Motors

    Energy Technology Data Exchange (ETDEWEB)

    Nitao, J J; Scharlemann, E T; Kirkendall, B A

    2009-08-31

    We performed a literature review and found that many equivalent circuit models of hysteresis motors in use today are incorrect. The model by Miyairi and Kataoka (1965) is the correct one. We extended the model by transforming it to quadrature coordinates, amenable to circuit or digital simulation. 'Hunting' is an oscillatory phenomenon often observed in hysteresis motors. While several works have attempted to model the phenomenon with some partial success, we present a new complete model that predicts hunting from first principles.

  20. Money and bonds: an equivalence theorem

    OpenAIRE

    Narayana R. Kocherlakota

    2007-01-01

    This paper considers four models in which immortal agents face idiosyncratic shocks and trade only a single risk-free asset over time. The four models specify this single asset to be private bonds, public bonds, public money, or private money respectively. I prove that, given an equilibrium in one of these economies, it is possible to pick the exogenous elements in the other three economies so that there is an outcome-equivalent equilibrium in each of them. (The term ?exogenous variables? ref...

  1. Gravitational leptogenesis, C, CP and strong equivalence

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, Jamie I.; Shore, Graham M. [Department of Physics, Swansea University,Swansea, SA2 8PP (United Kingdom)

    2015-02-12

    The origin of matter-antimatter asymmetry is one of the most important outstanding problems at the interface of particle physics and cosmology. Gravitational leptogenesis (baryogenesis) provides a possible mechanism through explicit couplings of spacetime curvature to appropriate lepton (or baryon) currents. In this paper, the idea that these strong equivalence principle violating interactions could be generated automatically through quantum loop effects in curved spacetime is explored, focusing on the realisation of the discrete symmetries C, CP and CPT which must be broken to induce matter-antimatter asymmetry. The related issue of quantum corrections to the dispersion relation for neutrino propagation in curved spacetime is considered within a fully covariant framework.

  2. Integrable topological billiards and equivalent dynamical systems

    Science.gov (United States)

    Vedyushkina, V. V.; Fomenko, A. T.

    2017-08-01

    We consider several topological integrable billiards and prove that they are Liouville equivalent to many systems of rigid body dynamics. The proof uses the Fomenko-Zieschang theory of invariants of integrable systems. We study billiards bounded by arcs of confocal quadrics and their generalizations, generalized billiards, where the motion occurs on a locally planar surface obtained by gluing several planar domains isometrically along their boundaries, which are arcs of confocal quadrics. We describe two new classes of integrable billiards bounded by arcs of confocal quadrics, namely, non-compact billiards and generalized billiards obtained by gluing planar billiards along non-convex parts of their boundaries. We completely classify non-compact billiards bounded by arcs of confocal quadrics and study their topology using the Fomenko invariants that describe the bifurcations of singular leaves of the additional integral. We study the topology of isoenergy surfaces for some non-convex generalized billiards. It turns out that they possess exotic Liouville foliations: the integral trajectories of the billiard that lie on some singular leaves admit no continuous extension. Such billiards appear to be leafwise equivalent to billiards bounded by arcs of confocal quadrics in the Minkowski metric.

  3. Twisted conformal field theories and Morita equivalence

    Energy Technology Data Exchange (ETDEWEB)

    Marotta, Vincenzo [Dipartimento di Scienze Fisiche, Universita di Napoli ' Federico II' and INFN, Sezione di Napoli, Compl. universitario M. Sant' Angelo, Via Cinthia, 80126 Napoli (Italy); Naddeo, Adele [CNISM, Unita di Ricerca di Salerno and Dipartimento di Fisica ' E.R. Caianiello' , Universita degli Studi di Salerno, Via Salvador Allende, 84081 Baronissi (Italy); Dipartimento di Scienze Fisiche, Universita di Napoli ' Federico II' , Compl. universitario M. Sant' Angelo, Via Cinthia, 80126 Napoli (Italy)], E-mail: adelenaddeo@yahoo.it

    2009-04-01

    The Morita equivalence for field theories on noncommutative two-tori is analysed in detail for rational values of the noncommutativity parameter {theta} (in appropriate units): an isomorphism is established between an Abelian noncommutative field theory (NCFT) and a non-Abelian theory of twisted fields on ordinary space. We focus on a particular conformal field theory (CFT), the one obtained by means of the m-reduction procedure [V. Marotta, J. Phys. A 26 (1993) 3481; V. Marotta, Mod. Phys. Lett. A 13 (1998) 853; V. Marotta, Nucl. Phys. B 527 (1998) 717; V. Marotta, A. Sciarrino, Mod. Phys. Lett. A 13 (1998) 2863], and show that it is the Morita equivalent of a NCFT. Finally, the whole m-reduction procedure is shown to be the image in the ordinary space of the Morita duality. An application to the physics of a quantum Hall fluid at Jain fillings {nu}=m/(2pm+1) is explicitly discussed in order to further elucidate such a correspondence and to clarify its role in the physics of strongly correlated systems. A new picture emerges, which is very different from the existing relationships between noncommutativity and many body systems [A.P. Polychronakos, arXiv: 0706.1095].

  4. Planck Constant Determination from Power Equivalence

    Science.gov (United States)

    Newell, David B.

    2000-04-01

    Equating mechanical to electrical power links the kilogram, the meter, and the second to the practical realizations of the ohm and the volt derived from the quantum Hall and the Josephson effects, yielding an SI determination of the Planck constant. The NIST watt balance uses this power equivalence principle, and in 1998 measured the Planck constant with a combined relative standard uncertainty of 8.7 x 10-8, the most accurate determination to date. The next generation of the NIST watt balance is now being assembled. Modification to the experimental facilities have been made to reduce the uncertainty components from vibrations and electromagnetic interference. A vacuum chamber has been installed to reduce the uncertainty components associated with performing the experiment in air. Most of the apparatus is in place and diagnostic testing of the balance should begin this year. Once a combined relative standard uncertainty of one part in 10-8 has been reached, the power equivalence principle can be used to monitor the possible drift in the artifact mass standard, the kilogram, and provide an accurate alternative definition of mass in terms of fundamental constants. *Electricity Division, Electronics and Electrical Engineering Laboratory, Technology Administration, U.S. Department of Commerce. Contribution of the National Institute of Standards and Technology, not subject to copyright in the U.S.

  5. Apoios de decisão: instrumento de auxílio à medicina baseada em preferências. Uma revisão conceitual Decision aids: an instrument to eliciting patient preference. Current concepts

    Directory of Open Access Journals (Sweden)

    Mirhelen Mendes de Abreu

    2006-08-01

    Full Text Available A necessidade da incorporação das preferências dos pacientes nas tomadas de decisão é uma realidade da assistência médica contemporânea, que caracteriza a medicina baseada em preferências. Os apoios de decisão são instrumentos que surgem como mecanismos de auxílio ao médico a expor riscos e benefícios de uma determinada tomada de decisão, sendo um mecanismo facilitador para a decisão compartilhada. Na literatura médica, particularmente em reumatologia, nota-se um emergente interesse pelo estudo das preferências dos pacientes nos ensaios clínicos. Este artigo de revisão tem por objetivo conceituar e caracterizar os apoios de decisão e suas implicações na pesquisa e prática clínicas, bem como ressaltar os princípios metodológicos necessários para a sua utilização e desenvolvimento.Patient preferences in decision making is one reality of the medical assistance, which characterizes the value based medicine. The decision aids are instruments that appear as support mechanisms for the doctor to exercise this model of decision making. In medical literature, particularly in rheumatology, an emergent interest on patient's preference study is noticed in clinical trials. The aim of this article is to appraise and to characterize the decision aids and its implications in the practical research and clinics, as well as standing out the necessary methodology principles for its use and development.

  6. Borel equivalence relations structure and classification

    CERN Document Server

    Kanovei, Vladimir

    2008-01-01

    Over the last 20 years, the theory of Borel equivalence relations and related topics have been very active areas of research in set theory and have important interactions with other fields of mathematics, like ergodic theory and topological dynamics, group theory, combinatorics, functional analysis, and model theory. The book presents, for the first time in mathematical literature, all major aspects of this theory and its applications. This book should be of interest to a wide spectrum of mathematicians working in set theory as well as the other areas mentioned. It provides a systematic exposition of results that so far have been only available in journals or are even unpublished. The book presents unified and in some cases significantly streamlined proofs of several difficult results, especially dichotomy theorems. It has rather minimal overlap with other books published in this subject.

  7. Characterization of Destrins with Different Dextrose Equivalents

    Directory of Open Access Journals (Sweden)

    Guanglei Li

    2010-07-01

    Full Text Available Dextrins are widely used for their functional properties and prepared by partial hydrolysis of starch using acid, enzymes, or combinations of both. The physiochemical properties of dextrins are dependent on their molecular distribution and oligosaccharide profiles. In this study, scanning electron microscopy (SEM, X-ray diffractometry (XRD, rapid viscoanalysis (RVA, high-performance Liquid Chromatography (HPLC and gel permeation chromatography (GPC were used to characterize dextrins prepared by common neutral and thermostable α-amylase hydrolysis. The dextrin granules displayed irregular surfaces and were badly damaged by the enzyme treatment. They displayed A-type X-ray diffraction patterns with a decrease of intensity of the characteristic diffraction peaks. The RVA profiles showed that the viscosity of dextrin decreased with the increase of its Dextrose Equivalent (DE value. According to HPLC analysis, the molecular weight, degree of polymerization and the composition of oligosaccharides in dextrins were different.

  8. Multiplicities of states od equivalent fermion shells

    International Nuclear Information System (INIS)

    Savukinas, A.Yu.; Glembotskij, I.I.

    1980-01-01

    Classification of states of three or four equivalent fermions has been studied, i.e. possible terms and their multiplicities have been determined. For this purpose either the group theory or evident expressions for the fractional-parentage coefficients have been used. In the first approach the formulas obtained by other authors for the multiplicities of terms through the characters of the transformation matrices of bond moments have been used. This approach happens to be more general as compared with the second one, as expressions for the fractional-parentage coefficients in many cases are not known. The multiplicities of separate terms have been determined. It has been shown that the number of terms of any multiplicity becomes constant when l or j is increased [ru

  9. Sample size allocation in multiregional equivalence studies.

    Science.gov (United States)

    Liao, Jason J Z; Yu, Ziji; Li, Yulan

    2018-06-17

    With the increasing globalization of drug development, the multiregional clinical trial (MRCT) has gained extensive use. The data from MRCTs could be accepted by regulatory authorities across regions and countries as the primary sources of evidence to support global marketing drug approval simultaneously. The MRCT can speed up patient enrollment and drug approval, and it makes the effective therapies available to patients all over the world simultaneously. However, there are many challenges both operationally and scientifically in conducting a drug development globally. One of many important questions to answer for the design of a multiregional study is how to partition sample size into each individual region. In this paper, two systematic approaches are proposed for the sample size allocation in a multiregional equivalence trial. A numerical evaluation and a biosimilar trial are used to illustrate the characteristics of the proposed approaches. Copyright © 2018 John Wiley & Sons, Ltd.

  10. Equivalence principle and the baryon acoustic peak

    Science.gov (United States)

    Baldauf, Tobias; Mirbabayi, Mehrdad; Simonović, Marko; Zaldarriaga, Matias

    2015-08-01

    We study the dominant effect of a long wavelength density perturbation δ (λL) on short distance physics. In the nonrelativistic limit, the result is a uniform acceleration, fixed by the equivalence principle, and typically has no effect on statistical averages due to translational invariance. This same reasoning has been formalized to obtain a "consistency condition" on the cosmological correlation functions. In the presence of a feature, such as the acoustic peak at ℓBAO, this naive expectation breaks down for λLexplicitly applied to the one-loop calculation of the power spectrum. Finally, the success of baryon acoustic oscillation reconstruction schemes is argued to be another empirical evidence for the validity of the results.

  11. Development of air equivalent gamma dose monitor

    International Nuclear Information System (INIS)

    Alex, Mary; Bhattacharya, Sadhana; Karpagam, R.; Prasad, D.N.; Jakati, R.K.; Mukhopadhyay, P.K.; Patil, R.K.

    2010-01-01

    The paper describes design and development of air equivalent gamma absorbed dose monitor. The monitor has gamma sensitivity of 84 pA/R/h for 60 Co source. The characterization of the monitor has been done to get energy dependence on gamma sensitivity and response to gamma radiation field from 1 R/hr to 5000 R/hr. The gamma sensitivity in the energy range of 0.06 to 1.25MeV relative to 137 Cs nuclide was within 2.5%. The linearity of the monitor response as a function of gamma field from 10 R/h to 3.8 kR/h was within 6%. The monitor has been designed for its application in harsh environment. It has been successfully qualified to meet environmental requirements of shock. (author)

  12. 49 CFR 391.33 - Equivalent of road test.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false Equivalent of road test. 391.33 Section 391.33... AND LONGER COMBINATION VEHICLE (LCV) DRIVER INSTRUCTORS Tests § 391.33 Equivalent of road test. (a) In place of, and as equivalent to, the road test required by § 391.31, a person who seeks to drive a...

  13. A bicategorical approach to Morita equivalence for Von Neumann algebras

    NARCIS (Netherlands)

    R.M. Brouwer (Rachel)

    2003-01-01

    textabstractWe relate Morita equivalence for von Neumann algebras to the ``Connes fusion'' tensor product between correspondences. In the purely algebraic setting, it is well known that rings are Morita equivalent if and only if they are equivalent objects in a bicategory whose 1-cells are

  14. Problems of Equivalence in Shona- English Bilingual Dictionaries

    African Journals Online (AJOL)

    rbr

    Page 1 ... translation equivalents in Shona-English dictionaries where lexicographers will be dealing with divergent languages and cultures, traditional practices of lexicography and the absence of reliable ... ideal in translation is to achieve structural and semantic equivalence. Absolute equivalence between any two ...

  15. The equivalence principle in classical mechanics and quantum mechanics

    OpenAIRE

    Mannheim, Philip D.

    1998-01-01

    We discuss our understanding of the equivalence principle in both classical mechanics and quantum mechanics. We show that not only does the equivalence principle hold for the trajectories of quantum particles in a background gravitational field, but also that it is only because of this that the equivalence principle is even to be expected to hold for classical particles at all.

  16. Regret about surgical decisions among early-stage breast cancer patients: Effects of the congruence between patients' preferred and actual decision-making roles.

    Science.gov (United States)

    Wang, Ashley Wei-Ting; Chang, Su-Mei; Chang, Cheng-Shyong; Chen, Shou-Tung; Chen, Dar-Ren; Fan, Fang; Antoni, Michael H; Hsu, Wen-Yau

    2018-02-01

    Early-stage breast cancer patients generally receive either a mastectomy or a lumpectomy, either by their own choice or that of their surgeon. Sometimes, there is regret about the decision afterward. To better understand regret about surgical decisions, this study examined 2 possibilities: The first is that women who take a dominant or collaborative role in decision making about the surgery express less regret afterward. The second is that congruence between preferred role and actual role predicts less regret. We also explored whether disease stage moderates the relationship between role congruence and decisional regret. In a cross-sectional design, 154 women diagnosed with breast cancer completed a survey assessing decisional role preference and actual decisional role, a measure of post-decision regret, and a measure of disturbances related to breast cancer treatment. Hierarchical regression was used to investigate prediction of decisional regret. Role congruence, not actual decisional role, was significantly associated with less decisional regret, independent of all the control variables. The interaction between disease stage and role congruence was also significant, showing that mismatch relates to regret only in women with more advanced disease. Our findings suggest that cancer patients could benefit from tailored decision support concerning their decisional role preferences in the complex scenario of medical and personal factors during the surgical decision. Copyright © 2017 John Wiley & Sons, Ltd.

  17. The one-dimensional normalised generalised equivalence theory (NGET) for generating equivalent diffusion theory group constants for PWR reflector regions

    International Nuclear Information System (INIS)

    Mueller, E.Z.

    1991-01-01

    An equivalent diffusion theory PWR reflector model is presented, which has as its basis Smith's generalisation of Koebke's Equivalent Theory. This method is an adaptation, in one-dimensional slab geometry, of the Generalised Equivalence Theory (GET). Since the method involves the renormalisation of the GET discontinuity factors at nodal interfaces, it is called the Normalised Generalised Equivalence Theory (NGET) method. The advantages of the NGET method for modelling the ex-core nodes of a PWR are summarized. 23 refs

  18. A bicategorical approach to Morita equivalence for von Neumann algebras

    International Nuclear Information System (INIS)

    Brouwer, R. M.

    2003-01-01

    We relate Morita equivalence for von Neumann algebras to the ''Connes fusion'' tensor product between correspondences. In the purely algebraic setting, it is well known that rings are Morita equivalent if they are equivalent objects in a bicategory whose 1-cells are bimodules. We present a similar result for von Neumann algebras. We show that von Neumann algebras form a bicategory, having Connes's correspondences as 1-morphisms, and (bounded) intertwiners as 2-morphisms. Further, we prove that two von Neumann algebras are Morita equivalent iff they are equivalent objects in the bicategory. The proofs make extensive use of the Tomita-Takesaki modular theory

  19. Theoretical aspects of the equivalence principle

    International Nuclear Information System (INIS)

    Damour, Thibault

    2012-01-01

    We review several theoretical aspects of the equivalence principle (EP). We emphasize the unsatisfactory fact that the EP maintains the absolute character of the coupling constants of physics, while general relativity and its generalizations (Kaluza–Klein, …, string theory) suggest that all absolute structures should be replaced by dynamical entities. We discuss the EP-violation phenomenology of dilaton-like models, which is likely to be dominated by the linear superposition of two effects: a signal proportional to the nuclear Coulomb energy, related to the variation of the fine-structure constant, and a signal proportional to the surface nuclear binding energy, related to the variation of the light quark masses. We recall various theoretical arguments (including a recently proposed anthropic argument) suggesting that the EP be violated at a small, but not unmeasurably small level. This motivates the need for improved tests of the EP. These tests are probing new territories in physics that are related to deep, and mysterious, issues in fundamental physics. (paper)

  20. Biomonitoring Equivalents for interpretation of urinary fluoride.

    Science.gov (United States)

    Aylward, L L; Hays, S M; Vezina, A; Deveau, M; St-Amand, A; Nong, A

    2015-06-01

    Exposure to fluoride is widespread due to its natural occurrence in the environment and addition to drinking water and dental products for the prevention of dental caries. The potential health risks of excess fluoride exposure include aesthetically unacceptable dental fluorosis (tooth mottling) and increased skeletal fragility. Numerous organizations have conducted risk assessments and set guidance values to represent maximum recommended exposure levels as well as recommended adequate intake levels based on potential public health benefits of fluoride exposure. Biomonitoring Equivalents (BEs) are estimates of the average biomarker concentrations corresponding to such exposure guidance values. The literature on daily urinary fluoride excretion rates as a function of daily fluoride exposure was reviewed and BE values corresponding to the available US and Canadian exposure guidance values were derived for fluoride in urine. The derived BE values range from 1.1 to 2.1mg/L (1.2-2.5μg/g creatinine). Concentrations of fluoride in single urinary spot samples from individuals, even under exposure conditions consistent with the exposure guidance values, may vary from the predicted average concentrations by several-fold due to within- and across-individual variation in urinary flow and creatinine excretion rates and due to the rapid elimination kinetics of fluoride. Thus, the BE values are most appropriately applied to screen population central tendency estimates for biomarker concentrations rather than interpretation of individual spot sample concentrations. Copyright © 2015. Published by Elsevier Inc.

  1. Challenging a culture of racial equivalence.

    Science.gov (United States)

    Song, Miri

    2014-03-01

    We live at a time when our understandings and conceptualizations of 'racism' are often highly imprecise, broad, and used to describe a wide range of racialized phenomena. In this article, I raise some important questions about how the term racism is used and understood in contemporary British society by drawing on some recent cases of alleged racism in football and politics, many of which have been played out via new media technologies. A broader understanding of racism, through the use of the term 'racialization', has been helpful in articulating a more nuanced and complex understanding of racial incidents, especially of people's (often ambivalent) beliefs and behaviours. However, the growing emphasis upon 'racialization' has led to a conceptualization of racism which increasingly involves multiple perpetrators, victims, and practices without enough consideration of how and why particular interactions and practices constitute racism as such. The trend toward a growing culture of racial equivalence is worrying, as it denudes the idea of racism of its historical basis, severity and power. These frequent and commonplace assertions of racism in the public sphere paradoxically end up trivializing and homogenizing quite different forms of racialized interactions. I conclude that we need to retain the term 'racism', but we need to differentiate more clearly between 'racism' (as an historical and structured system of domination) from the broader notion of 'racialization'. © London School of Economics and Political Science 2014.

  2. Testing the equivalence principle on a trampoline

    Science.gov (United States)

    Reasenberg, Robert D.; Phillips, James D.

    2001-07-01

    We are developing a Galilean test of the equivalence principle in which two pairs of test mass assemblies (TMA) are in free fall in a comoving vacuum chamber for about 0.9 s. The TMA are tossed upward, and the process repeats at 1.2 s intervals. Each TMA carries a solid quartz retroreflector and a payload mass of about one-third of the total TMA mass. The relative vertical motion of the TMA of each pair is monitored by a laser gauge working in an optical cavity formed by the retroreflectors. Single-toss precision of the relative acceleration of a single pair of TMA is 3.5×10-12 g. The project goal of Δg/g = 10-13 can be reached in a single night's run, but repetition with altered configurations will be required to ensure the correction of systematic error to the nominal accuracy level. Because the measurements can be made quickly, we plan to study several pairs of materials.

  3. Testing the equivalence principle on cosmological scales

    Science.gov (United States)

    Bonvin, Camille; Fleury, Pierre

    2018-05-01

    The equivalence principle, that is one of the main pillars of general relativity, is very well tested in the Solar system; however, its validity is more uncertain on cosmological scales, or when dark matter is concerned. This article shows that relativistic effects in the large-scale structure can be used to directly test whether dark matter satisfies Euler's equation, i.e. whether its free fall is characterised by geodesic motion, just like baryons and light. After having proposed a general parametrisation for deviations from Euler's equation, we perform Fisher-matrix forecasts for future surveys like DESI and the SKA, and show that such deviations can be constrained with a precision of order 10%. Deviations from Euler's equation cannot be tested directly with standard methods like redshift-space distortions and gravitational lensing, since these observables are not sensitive to the time component of the metric. Our analysis shows therefore that relativistic effects bring new and complementary constraints to alternative theories of gravity.

  4. A Bayesian equivalency test for two independent binomial proportions.

    Science.gov (United States)

    Kawasaki, Yohei; Shimokawa, Asanao; Yamada, Hiroshi; Miyaoka, Etsuo

    2016-01-01

    In clinical trials, it is often necessary to perform an equivalence study. The equivalence study requires actively denoting equivalence between two different drugs or treatments. Since it is not possible to assert equivalence that is not rejected by a superiority test, statistical methods known as equivalency tests have been suggested. These methods for equivalency tests are based on the frequency framework; however, there are few such methods in the Bayesian framework. Hence, this article proposes a new index that suggests the equivalency of binomial proportions, which is constructed based on the Bayesian framework. In this study, we provide two methods for calculating the index and compare the probabilities that have been calculated by these two calculation methods. Moreover, we apply this index to the results of actual clinical trials to demonstrate the utility of the index.

  5. Experimental Evaluation of Equivalent-Fluid Models for Melamine Foam

    Science.gov (United States)

    Allen, Albert R.; Schiller, Noah H.

    2016-01-01

    Melamine foam is a soft porous material commonly used in noise control applications. Many models exist to represent porous materials at various levels of fidelity. This work focuses on rigid frame equivalent fluid models, which represent the foam as a fluid with a complex speed of sound and density. There are several empirical models available to determine these frequency dependent parameters based on an estimate of the material flow resistivity. Alternatively, these properties can be experimentally educed using an impedance tube setup. Since vibroacoustic models are generally sensitive to these properties, this paper assesses the accuracy of several empirical models relative to impedance tube measurements collected with melamine foam samples. Diffuse field sound absorption measurements collected using large test articles in a laboratory are also compared with absorption predictions determined using model-based and measured foam properties. Melamine foam slabs of various thicknesses are considered.

  6. Equivalent Gene Expression Profiles between Glatopa™ and Copaxone®.

    Directory of Open Access Journals (Sweden)

    Josephine S D'Alessandro

    Full Text Available Glatopa™ is a generic glatiramer acetate recently approved for the treatment of patients with relapsing forms of multiple sclerosis. Gene expression profiling was performed as a means to evaluate equivalence of Glatopa and Copaxone®. Microarray analysis containing 39,429 unique probes across the entire genome was performed in murine glatiramer acetate--responsive Th2-polarized T cells, a test system highly relevant to the biology of glatiramer acetate. A closely related but nonequivalent glatiramoid molecule was used as a control to establish assay sensitivity. Multiple probe-level (Student's t-test and sample-level (principal component analysis, multidimensional scaling, and hierarchical clustering statistical analyses were utilized to look for differences in gene expression induced by the test articles. The analyses were conducted across all genes measured, as well as across a subset of genes that were shown to be modulated by Copaxone. The following observations were made across multiple statistical analyses: the expression of numerous genes was significantly changed by treatment with Copaxone when compared against media-only control; gene expression profiles induced by Copaxone and Glatopa were not significantly different; and gene expression profiles induced by Copaxone and the nonequivalent glatiramoid were significantly different, underscoring the sensitivity of the test system and the multiple analysis methods. Comparative analysis was also performed on sets of transcripts relevant to T-cell biology and antigen presentation, among others that are known to be modulated by glatiramer acetate. No statistically significant differences were observed between Copaxone and Glatopa in the expression levels (magnitude and direction of these glatiramer acetate-regulated genes. In conclusion, multiple methods consistently supported equivalent gene expression profiles between Copaxone and Glatopa.

  7. Radiation equivalency: For the radiation recall phenomenon

    International Nuclear Information System (INIS)

    Stevens, R.H.; Cole, D.A.

    1983-01-01

    Experimental and clinico-epidemiological investigations have unequivocally established the risk of an offspring in later years developing cancer after experiencing an in utero carcinogenic insult. The present studies have focused upon identifying whether the biological effects of iodine-131 and the colon carcinogen 1,2-dimethylhydrazine (DMH) when administered during pregnancy in the Fischer F344 inbred rat are remembered in the offsprings at a later age. The investigations have been based upon the premise that after exposure to a carcinogen ''foreign-like'' tumor cells develop which result in the host mounting active antitumor immune responses. The authors have now measured at 2 to 3 months post-exposure, the antitumor cell-mediated immunity (CMI) induced by intraperitoneal administration of the radionuclide or chemical at 16-18 days of gestation. Their findings indicate a positive sex relationship existing in those offsprings exposed to the radioiodine with the female being much less sensitive. In contrast, no such difference was observed between responsiveness of the males and females born from dams exposed to the DMH. Significantly, the dams exposed to either the radionuclide or DMH expressed no measurable CMI suggesting that either the fetus acted as a carcinogen trap or else the state of pregnancy altered the mother's immune system in such a fashion to no longer respond to the insult. A Radiation Equivalency value has now been determined for the transplacental DMH exposures with the calculations suggesting the fetus is significantly more sensitive (over 10 times) than the adult animals. The results of this study now demonstrate that carcinogenic memory remains for exposures to both the iodine-131 and DMH in the first offspring generation and suggest that the effects may be recalled at a later age with the expected overt results being the development of cancer

  8. Biomonitoring Equivalents for bisphenol A (BPA).

    Science.gov (United States)

    Krishnan, Kannan; Gagné, Michelle; Nong, Andy; Aylward, Lesa L; Hays, Sean M

    2010-10-01

    Recent efforts worldwide have resulted in a growing database of measured concentrations of chemicals in blood and urine samples taken from the general population. However, few tools exist to assist in the interpretation of the measured values in a health risk context. Biomonitoring Equivalents (BEs) are defined as the concentration or range of concentrations of a chemical or its metabolite in a biological medium (blood, urine, or other medium) that is consistent with an existing health-based exposure guideline. BE values are derived by integrating available data on pharmacokinetics with existing chemical risk assessments. This study reviews available health-based exposure guidance values for bisphenol A (BPA) from Health Canada, the United States Environmental Protection Agency (USEPA) and the European Food Safety Authority (EFSA). BE values were derived based on data on BPA urinary excretion in humans. The BE value corresponding to the oral provisional tolerable daily intake (pTDI) of 25 microg/kg-d from Health Canada is 1mg/L (1.3mg/g creatinine); value corresponding to the US EPA reference dose (RfD) and EFSA tolerable daily intake (TDI) estimates (both of which are equal to 50 microg/kg-d) is 2mg/L (2.6 mg/g creatinine). These values are estimates of the 24-h average urinary BPA concentrations that are consistent with steady-state exposure at the respective exposure guidance values. These BE values may be used as screening tools for evaluation of central tendency measures of population biomonitoring data for BPA in a risk assessment context and can assist in prioritization of the potential need for additional risk assessment efforts for BPA relative to other chemicals. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  9. General Dynamic Equivalent Modeling of Microgrid Based on Physical Background

    Directory of Open Access Journals (Sweden)

    Changchun Cai

    2015-11-01

    Full Text Available Microgrid is a new power system concept consisting of small-scale distributed energy resources; storage devices and loads. It is necessary to employ a simplified model of microgrid in the simulation of a distribution network integrating large-scale microgrids. Based on the detailed model of the components, an equivalent model of microgrid is proposed in this paper. The equivalent model comprises two parts: namely, equivalent machine component and equivalent static component. Equivalent machine component describes the dynamics of synchronous generator, asynchronous wind turbine and induction motor, equivalent static component describes the dynamics of photovoltaic, storage and static load. The trajectory sensitivities of the equivalent model parameters with respect to the output variables are analyzed. The key parameters that play important roles in the dynamics of the output variables of the equivalent model are identified and included in further parameter estimation. Particle Swarm Optimization (PSO is improved for the parameter estimation of the equivalent model. Simulations are performed in different microgrid operation conditions to evaluate the effectiveness of the equivalent model of microgrid.

  10. Patient preference for genders of health professionals.

    NARCIS (Netherlands)

    Kerssens, J.J.; Bensing, J.M.; Andela, M.G.

    1997-01-01

    Preferences for physicians' gender is an obvious and well documented example of considerations of patients' attitudes. But research carried out in this field is rather limited to the domain of family medicine. This article describes preferences for 13 different health professions: surgeons,

  11. Motor equivalence and structure of variance: multi-muscle postural synergies in Parkinson's disease.

    Science.gov (United States)

    Falaki, Ali; Huang, Xuemei; Lewis, Mechelle M; Latash, Mark L

    2017-07-01

    We explored posture-stabilizing multi-muscle synergies with two methods of analysis of multi-element, abundant systems: (1) Analysis of inter-cycle variance; and (2) Analysis of motor equivalence, both quantified within the framework of the uncontrolled manifold (UCM) hypothesis. Data collected in two earlier studies of patients with Parkinson's disease (PD) were re-analyzed. One study compared synergies in the space of muscle modes (muscle groups with parallel scaling of activation) during tasks performed by early-stage PD patients and controls. The other study explored the effects of dopaminergic medication on multi-muscle-mode synergies. Inter-cycle variance and absolute magnitude of the center of pressure displacement across consecutive cycles were quantified during voluntary whole-body sway within the UCM and orthogonal to the UCM space. The patients showed smaller indices of variance within the UCM and motor equivalence compared to controls. The indices were also smaller in the off-drug compared to on-drug condition. There were strong across-subject correlations between the inter-cycle variance within/orthogonal to the UCM and motor equivalent/non-motor equivalent displacements. This study has shown that, at least for cyclical tasks, analysis of variance and analysis of motor equivalence lead to metrics of stability that correlate with each other and show similar effects of disease and medication. These results show, for the first time, intimate links between indices of variance and motor equivalence. They suggest that analysis of motor equivalence, which requires only a handful of trials, could be used broadly in the field of motor disorders to analyze problems with action stability.

  12. Dose sculpting with generalized equivalent uniform dose

    International Nuclear Information System (INIS)

    Wu Qiuwen; Djajaputra, David; Liu, Helen H.; Dong Lei; Mohan, Radhe; Wu, Yan

    2005-01-01

    With intensity-modulated radiotherapy (IMRT), a variety of user-defined dose distribution can be produced using inverse planning. The generalized equivalent uniform dose (gEUD) has been used in IMRT optimization as an alternative objective function to the conventional dose-volume-based criteria. The purpose of this study was to investigate the effectiveness of gEUD optimization to fine tune the dose distributions of IMRT plans. We analyzed the effect of gEUD-based optimization parameters on plan quality. The objective was to determine whether dose distribution to selected structures could be improved using gEUD optimization without adversely altering the doses delivered to other structures, as in sculpting. We hypothesized that by carefully defining gEUD parameters (EUD 0 and n) based on the current dose distributions, the optimization system could be instructed to search for alternative solutions in the neighborhood, and we could maintain the dose distributions for structures already satisfactory and improve dose for structures that need enhancement. We started with an already acceptable IMRT plan optimized with any objective function. The dose distribution was analyzed first. For structures that dose should not be changed, a higher value of n was used and EUD 0 was set slightly higher/lower than the EUD value at the current dose distribution for critical structures/targets. For structures that needed improvement in dose, a higher to medium value of n was used, and EUD 0 was set to the EUD value or slightly lower/higher for the critical structure/target at the current dose distribution. We evaluated this method in one clinical case each of head and neck, lung and prostate cancer. Dose volume histograms, isodose distributions, and relevant tolerance doses for critical structures were used for the assessment. We found that by adjusting gEUD optimization parameters, the dose distribution could be improved with only a few iterations. A larger value of n could lead to

  13. Test of the Equivalence Principle in an Einstein Elevator

    Science.gov (United States)

    Shapiro, Irwin I.; Glashow, S.; Lorenzini, E. C.; Cosmo, M. L.; Cheimets, P. N.; Finkelstein, N.; Schneps, M.

    2004-01-01

    The scientific goal of the experiment is to test the equality of gravitational and inertial mass (i.e., to test the Principle of Equivalence) by measuring the independence of the rate of fall of bodies from their compositions. The measurement is accomplished by measuring the relative displacement (or equivalently acceleration) of two falling bodies of different materials which are the proof masses of a differential accelerometer spinning about an horizontal axis to modulate a possible violation signal. A non-zero differential acceleration appearing at the signal frequency will indicate a violation of the Equivalence Principle. The goal of the experiment is to measure the Eotvos ratio og/g (differential acceleration/common acceleration) with a targeted accuracy that is about two orders of magnitude better than the state of the art (presently at several parts in 10(exp 13). The analyses carried out during this first grant year have focused on: (1) evaluation of possible shapes for the proof masses to meet the requirements on the higher-order mass moment disturbances generated by the falling capsule; (2) dynamics of the instrument package and differential acceleration measurement in the presence of errors and imperfections; (3) computation of the inertia characteristic of the instrument package that enable a separation of the signal from the dynamics-related noise; (4) a revised thermal analysis of the instrument package in light of the new conceptual design of the cryostat; (5) the development of a dynamic and control model of the capsule attached to the gondola and balloon to define the requirements for the leveling mechanism (6) a conceptual design of the leveling mechanism that keeps the capsule aligned before release from the balloon; and (7) a new conceptual design of the customized cryostat and a preliminary valuation of its cost. The project also involves an international cooperation with the Institute of Space Physics (IFSI) in Rome, Italy. The group at IFSI

  14. Dosimetric characteristics of water equivalent for two solid water phantoms

    International Nuclear Information System (INIS)

    Wang Jianhua; Wang Xun; Ren Jiangping

    2011-01-01

    Objective: To investigate the water equivalent of two solid water phantoms. Methods: The X-ray and electron beam depth-ion curves were measured in water and two solid water phantoms, RW3 and Virtual Water. The water-equivalency correction factors for the two solid water phantoms were compared. We measured and calculated the range sealing factors and the fluence correction factors for the two solid water phantoms in the case of electron beams. Results: The average difference between the measured ionization in solid water phantoms and water was 0.42% and 0.16% on 6 MV X-ray (t=-6.15, P=0.001 and t=-1.65, P=0.419) and 0.21% and 0.31% on 10 MV X-ray (t=1.728, P=0.135 and t=-2.296, P=0.061), with 17.4% and 14.5% on 6 MeV electron beams (t=-1.37, P=0.208 and t=-1.47, P=0.179) and 7.0% and 6.0% on 15 MeV electron beams (t=-0.58, P=0.581 and t=-0.90, P=0.395). The water-equivalency correction factors for the two solid water phantoms varied slightly largely, F=58.54, P=0.000 on 6 MV X-ray, F=0.211, P=0.662 on 10 MV X-ray, F=0.97, P=0.353 on 6 MeV electron beams, F=0.14, P=0.717 on 15 MeV electron beams. However, they were almost equal to 1 near the reference depths. The two solid water phantoms showed a similar tread of C pl increasing (F=26.40, P=0.014) and h pl decreasing (F=7.45, P=0.072) with increasing energy. Conclusion: The solid water phantom should undergo a quality control test before being clinical use. (authors)

  15. The radiobiology of boron neutron capture therapy: Are ''photon-equivalent'' doses really photon-equivalent?

    International Nuclear Information System (INIS)

    Coderre, J.A.; Diaz, A.Z.; Ma, R.

    2001-01-01

    Boron neutron capture therapy (BNCT) produces a mixture of radiation dose components. The high-linear energy transfer (LET) particles are more damaging in tissue than equal doses of low-LET radiation. Each of the high-LET components can multiplied by an experimentally determined factor to adjust for the increased biological effectiveness and the resulting sum expressed in photon-equivalent units (Gy-Eq). BNCT doses in photon-equivalent units are based on a number of assumptions. It may be possible to test the validity of these assumptions and the accuracy of the calculated BNCT doses by 1) comparing the effects of BNCT in other animal or biological models where the effects of photon radiation are known, or 2) if there are endpoints reached in the BNCT dose escalation clinical trials that can be related to the known response to photons of the tissue in question. The calculated Gy-Eq BNCT doses delivered to dogs and to humans with BPA and the epithermal neutron beam of the Brookhaven Medical Research Reactor were compared to expected responses to photon irradiation. The data indicate that Gy-Eq doses in brain may be underestimated. Doses to skin are consistent with the expected response to photons. Gy-Eq doses to tumor are significantly overestimated. A model system of cells in culture irradiated at various depths in a lucite phantom using the epithermal beam is under development. Preliminary data indicate that this approach can be used to detect differences in the relative biological effectiveness of the beam. The rat 9L gliosarcoma cell survival data was converted to photon-equivalent doses using the same factors assumed in the clinical studies. The results superimposed on the survival curve derived from irradiation with Cs-137 photons indicating the potential utility of this model system. (author)

  16. Dynamic equivalence relation on the fuzzy measure algebras

    Directory of Open Access Journals (Sweden)

    Roya Ghasemkhani

    2017-04-01

    Full Text Available The main goal of the present paper is to extend classical results from the measure theory and dynamical systems to the fuzzy subset setting. In this paper, the notion of  dynamic equivalence relation is introduced and then it is proved that this relation is an equivalence relation. Also, a new metric on the collection of all equivalence classes is introduced and it is proved that this metric is complete.

  17. Dose equivalent distributions in the AAEC total body nitrogen facility

    International Nuclear Information System (INIS)

    Allen, B.J.; Bailey, G.M.; McGregor, B.J.

    1985-01-01

    The incident neutron dose equivalent in the AAEC total body nitrogen facility is measured by a calibrated remmeter. Dose equivalent rates and distributions are calculated by Monte Carlo techniques which take account of the secondary neutron flux from the collimator. Experiment and calculation are found to be in satisfactory agreement. The effective dose equivalent per exposure is determined by weighting organ doses, and the potential detriment per exposure is calculated from ICRP risk factors

  18. Equivalence principle violations and couplings of a light dilaton

    International Nuclear Information System (INIS)

    Damour, Thibault; Donoghue, John F.

    2010-01-01

    We consider possible violations of the equivalence principle through the exchange of a light 'dilaton-like' scalar field. Using recent work on the quark-mass dependence of nuclear binding, we find that the dilaton-quark-mass coupling induces significant equivalence-principle-violating effects varying like the inverse cubic root of the atomic number - A -1/3 . We provide a general parametrization of the scalar couplings, but argue that two parameters are likely to dominate the equivalence-principle phenomenology. We indicate the implications of this framework for comparing the sensitivities of current and planned experimental tests of the equivalence principle.

  19. Floyd's principle, correctness theories and program equivalence

    NARCIS (Netherlands)

    Bergstra, J.A.; Tiuryn, J.; Tucker, J.V.

    1982-01-01

    A programming system is a language made from a fixed class of data abstractions and a selection of familiar deterministic control and assignment constructs. It is shown that the sets of all ‘before-after’ first-order assertions which are true of programs in any such language can uniquely determine

  20. Equivalent Dipole Vector Analysis for Detecting Pulmonary Hypertension

    Science.gov (United States)

    Harlander, Matevz; Salobir, Barbara; Toplisek, Janez; Schlegel, Todd T.; Starc, Vito

    2010-01-01

    Various 12-lead ECG criteria have been established to detect right ventricular hypertrophy as a marker of pulmonary hypertension (PH). While some criteria offer good specificity they lack sensitivity because of a low prevalence of positive findings in the PH population. We hypothesized that three-dimensional equivalent dipole (ED) model could serve as a better detection tool of PH. We enrolled: 1) 17 patients (12 female, 5 male, mean age 57 years, range 19-79 years) with echocardiographically detected PH (systolic pulmonary arterial pressure greater than 35 mmHg) and no significant left ventricular disease; and 2) 19 healthy controls (7 female, 12 male, mean age 44, range 31-53 years) with no known heart disease. In each subject we recorded a 5-minute high-resolution 12-lead conventional ECG and constructed principal signals using singular value decomposition. Assuming a standard thorax dimension of an adult person with homogenous and isotropic distribution of thorax conductance, we determined moving equivalent dipoles (ED), characterized by the 3D location in the thorax, dipolar strength and the spatial orientation, in time intervals of 5 ms. We used the sum of all ED vectors in the second half of the QRS complex to derive the amplitude of the right-sided ED vector (RV), if the orientation of ED was to the right side of the thorax, and in the first half the QRS to derive the amplitude of the left-sided vector (LV), if the orientation was leftward. Finally, the parameter RV/LV ratio was determined over an average of 256 complexes. The groups differed in age and gender to some extent. There was a non-significant trend toward higher RV in patients with PH (438 units 284) than in controls (280 plus or minus 140) (p = 0.066) but the overlap was such that RV alone was not a good predictor of PH. On the other hand, the RV/LV ratio was a better predictor of PH, with 11/17 (64.7%) of PH patients but only in 1/19 (5.3%) control subjects having RV/LV ratio greater than or

  1. Equivalent Sensor Radiance Generation and Remote Sensing from Model Parameters. Part 1; Equivalent Sensor Radiance Formulation

    Science.gov (United States)

    Wind, Galina; DaSilva, Arlindo M.; Norris, Peter M.; Platnick, Steven E.

    2013-01-01

    In this paper we describe a general procedure for calculating equivalent sensor radiances from variables output from a global atmospheric forecast model. In order to take proper account of the discrepancies between model resolution and sensor footprint the algorithm takes explicit account of the model subgrid variability, in particular its description of the probably density function of total water (vapor and cloud condensate.) The equivalent sensor radiances are then substituted into an operational remote sensing algorithm processing chain to produce a variety of remote sensing products that would normally be produced from actual sensor output. This output can then be used for a wide variety of purposes such as model parameter verification, remote sensing algorithm validation, testing of new retrieval methods and future sensor studies. We show a specific implementation using the GEOS-5 model, the MODIS instrument and the MODIS Adaptive Processing System (MODAPS) Data Collection 5.1 operational remote sensing cloud algorithm processing chain (including the cloud mask, cloud top properties and cloud optical and microphysical properties products.) We focus on clouds and cloud/aerosol interactions, because they are very important to model development and improvement.

  2. Feedback-Equivalence of Nonlinear Systems with Applications to Power System Equations.

    Science.gov (United States)

    Marino, Riccardo

    The key concept of the dissertation is feedback equivalence among systems affine in control. Feedback equivalence to linear systems in Brunovsky canonical form and the construction of the corresponding feedback transformation are used to: (i) design a nonlinear regulator for a detailed nonlinear model of a synchronous generator connected to an infinite bus; (ii) establish which power system network structures enjoy the feedback linearizability property and design a stabilizing control law for these networks with a constraint on the control space which comes from the use of d.c. lines. It is also shown that the feedback linearizability property allows the use of state feedback to contruct a linear controllable system with a positive definite linear Hamiltonian structure for the uncontrolled part if the state space is even; a stabilizing control law is derived for such systems. Feedback linearizability property is characterized by the involutivity of certain nested distributions for strongly accessible analytic systems; if the system is defined on a manifold M diffeomorphic to the Euclidean space, it is established that the set where the property holds is a submanifold open and dense in M. If an analytic output map is defined, a set of nested involutive distributions can be always defined and that allows the introduction of an observability property which is the dual concept, in some sense, to feedback linearizability: the goal is to investigate when a nonlinear system affine in control with an analytic output map is feedback equivalent to a linear controllable and observable system. Finally a nested involutive structure of distributions is shown to guarantee the existence of a state feedback that takes a nonlinear system affine in control to a single input one, both feedback equivalent to linear controllable systems, preserving one controlled vector field.

  3. Equivalent Circulation Density Analysis of Geothermal Well by Coupling Temperature

    Directory of Open Access Journals (Sweden)

    Xiuhua Zheng

    2017-02-01

    Full Text Available The accurate control of the wellbore pressure not only prevents lost circulation/blowout and fracturing formation by managing the density of the drilling fluid, but also improves productivity by mitigating reservoir damage. Calculating the geothermal pressure of a geothermal well by constant parameters would easily bring big errors, as the changes of physical, rheological and thermal properties of drilling fluids with temperature are neglected. This paper researched the wellbore pressure coupling by calculating the temperature distribution with the existing model, fitting the rule of density of the drilling fluid with the temperature and establishing mathematical models to simulate the wellbore pressures, which are expressed as the variation of Equivalent Circulating Density (ECD under different conditions. With this method, the temperature and ECDs in the wellbore of the first medium-deep geothermal well, ZK212 Yangyi Geothermal Field in Tibet, were determined, and the sensitivity analysis was simulated by assumed parameters, i.e., the circulating time, flow rate, geothermal gradient, diameters of the wellbore, rheological models and regimes. The results indicated that the geothermal gradient and flow rate were the most influential parameters on the temperature and ECD distribution, and additives added in the drilling fluid should be added carefully as they change the properties of the drilling fluid and induce the redistribution of temperature. To ensure the safe drilling and velocity of pipes tripping into the hole, the depth and diameter of the wellbore are considered to control the surge pressure.

  4. The equivalent internal orientation and position noise for contour integration.

    Science.gov (United States)

    Baldwin, Alex S; Fu, Minnie; Farivar, Reza; Hess, Robert F

    2017-10-12

    Contour integration is the joining-up of local responses to parts of a contour into a continuous percept. In typical studies observers detect contours formed of discrete wavelets, presented against a background of random wavelets. This measures performance for detecting contours in the limiting external noise that background provides. Our novel task measures contour integration without requiring any background noise. This allowed us to perform noise-masking experiments using orientation and position noise. From these we measure the equivalent internal noise for contour integration. We found an orientation noise of 6° and position noise of 3 arcmin. Orientation noise was 2.6x higher in contour integration compared to an orientation discrimination control task. Comparing against a position discrimination task found position noise in contours to be 2.4x lower. This suggests contour integration involves intermediate processing that enhances the quality of element position representation at the expense of element orientation. Efficiency relative to the ideal observer was lower for the contour tasks (36% in orientation noise, 21% in position noise) compared to the controls (54% and 57%).

  5. A 'Toolbox' Equivalent Process for Safety Analysis Software

    International Nuclear Information System (INIS)

    O'Kula, K.R.; Eng, Tony

    2004-01-01

    Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 2002-1 (Quality Assurance for Safety-Related Software) identified a number of quality assurance issues on the use of software in Department of Energy (DOE) facilities for analyzing hazards, and designing and operating controls that prevent or mitigate potential accidents. The development and maintenance of a collection, or 'toolbox', of multiple-site use, standard solution, Software Quality Assurance (SQA)-compliant safety software is one of the major improvements identified in the associated DOE Implementation Plan (IP). The DOE safety analysis toolbox will contain a set of appropriately quality-assured, configuration-controlled, safety analysis codes, recognized for DOE-broad, safety basis applications. Currently, six widely applied safety analysis computer codes have been designated for toolbox consideration. While the toolbox concept considerably reduces SQA burdens among DOE users of these codes, many users of unique, single-purpose, or single-site software may still have sufficient technical justification to continue use of their computer code of choice, but are thwarted by the multiple-site condition on toolbox candidate software. The process discussed here provides a roadmap for an equivalency argument, i.e., establishing satisfactory SQA credentials for single-site software that can be deemed ''toolbox-equivalent''. The process is based on the model established to meet IP Commitment 4.2.1.2: Establish SQA criteria for the safety analysis ''toolbox'' codes. Implementing criteria that establish the set of prescriptive SQA requirements are based on implementation plan/procedures from the Savannah River Site, also incorporating aspects of those from the Waste Isolation Pilot Plant (SNL component) and the Yucca Mountain Project. The major requirements are met with evidence of a software quality assurance plan, software requirements and design documentation, user's instructions, test report, a

  6. Development of solid water-equivalent radioactive certified reference materials

    International Nuclear Information System (INIS)

    Finke, E.; Greupner, H.; Groche, K.; Rittwag, R.; Geske, G.

    1991-01-01

    This paper presents a brief description of the development of solid water-equivalent beta volume radioactive certified reference materials. These certified reference materials were prepared for the beta fission nuclides 90 Sr/ 90 Y, 137 Cs, 147 Pm and 204 Tl. Comparative measurements of liquid and solid water-equivalent beta volume radioactive certified reference materials are discussed. (author)

  7. Equivalence of quantum states under local unitary transformations

    International Nuclear Information System (INIS)

    Fei Shaoming; Jing Naihuan

    2005-01-01

    In terms of the analysis of fixed point subgroup and tensor decomposability of certain matrices, we study the equivalence of quantum bipartite mixed states under local unitary transformations. For non-degenerate case an operational criterion for the equivalence of two such mixed bipartite states under local unitary transformations is presented

  8. 40 CFR 133.105 - Treatment equivalent to secondary treatment.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Treatment equivalent to secondary treatment. 133.105 Section 133.105 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS SECONDARY TREATMENT REGULATION § 133.105 Treatment equivalent to secondary treatment...

  9. Microcystin-LR equivalent concentrations in fish tissue during a ...

    African Journals Online (AJOL)

    The effects of a decomposing cyanobacteria bloom on water quality and the accumulation of microcystin-LR equivalent toxin in fish at Loskop Dam were studied in May 2012. Enzyme-linked immunosorbent assay [ELISA] was used to confirm the presence of microcystin-LR equivalent in the water and to determine the ...

  10. Decompositional equivalence: A fundamental symmetry underlying quantum theory

    OpenAIRE

    Fields, Chris

    2014-01-01

    Decompositional equivalence is the principle that there is no preferred decomposition of the universe into subsystems. It is shown here, by using simple thought experiments, that quantum theory follows from decompositional equivalence together with Landauer's principle. This demonstration raises within physics a question previously left to psychology: how do human - or any - observers agree about what constitutes a "system of interest"?

  11. Preparation of A-150 tissue-equivalent plastic films

    International Nuclear Information System (INIS)

    Saion, E.B.; Shaari, A.H.; Watt, D.E.

    1992-01-01

    A-150 tissue-equivalent (TE) plastic is widely used as a wall material for tissue-equivalent proportional counters (TEPCS) used in experimental microdosimetry. The objective of this note is to give a technical account of how A-150 TE plastic film can be fabricated in the laboratory from commercially available A-150 TE plastic. (author)

  12. Equivalence of several Chern-Simons matter models

    International Nuclear Information System (INIS)

    Chen, W.; Itoi, C.

    1994-01-01

    Chern-Simons (CS) coupling characterizes not only statistics, but also spin and scaling dimension of matter fields. We demonstrate spin transmutation in relativistic CS matter theory, and moreover show equivalence of several models. We study the CS vector model in some detail, which provides a consistent check to the assertion of the equivalence

  13. 29 CFR 4.170 - Furnishing fringe benefits or equivalents.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Furnishing fringe benefits or equivalents. 4.170 Section 4... Standards Compliance with Compensation Standards § 4.170 Furnishing fringe benefits or equivalents. (a) General. Fringe benefits required under the Act shall be furnished, separate from and in addition to the...

  14. Theory of Covariance Equivalent ARMAV Models of Civil Engineering Structures

    DEFF Research Database (Denmark)

    Andersen, P.; Brincker, Rune; Kirkegaard, Poul Henning

    1996-01-01

    In this paper the theoretical background for using covariance equivalent ARMAV models in modal analysis is discussed. It is shown how to obtain a covariance equivalent ARMA model for a univariate linear second order continous-time system excited by Gaussian white noise. This result is generalized...

  15. Theory of Covariance Equivalent ARMAV Models of Civil Engineering Structures

    DEFF Research Database (Denmark)

    Andersen, P.; Brincker, Rune; Kirkegaard, Poul Henning

    In this paper the theoretical background for using covariance equivalent ARMAV models in modal analysis is discussed. It is shown how to obtain a covariance equivalent ARMA model for a univariate linear second order continuous-time system excited by Gaussian white noise. This result is generalize...

  16. Graphene-based THz modulator analyzed by equivalent circuit model

    DEFF Research Database (Denmark)

    Xiao, Binggang; Chen, Jing; Xie, Zhiyi

    2016-01-01

    A terahertz (THz) modulator based on graphene is proposed and analysed by use of equivalent transmission line of a homogeneous mediumand the local anisotropic model of the graphene conductivity. The result calculated by the equivalent circuit is consistent with that obtained byFresnel transfer...

  17. The lexicographical handling of grammatical equivalence: the case ...

    African Journals Online (AJOL)

    Lexicographers compiling translating dictionaries are not exclusively concerned with semantic equivalence when selecting translating equivalents for lemmata, but often include also grammatical information in illustrative examples when the lexical item to be translated does not have an exact grammatical counterpart in the ...

  18. 30 CFR 90.206 - Approved sampling devices; equivalent concentrations.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Approved sampling devices; equivalent... LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.206 Approved sampling devices; equivalent...

  19. Teaching Brain-Behavior Relations Economically with Stimulus Equivalence Technology

    Science.gov (United States)

    Fienup, Daniel M.; Covey, Daniel P.; Critchfield, Thomas S.

    2010-01-01

    Instructional interventions based on stimulus equivalence provide learners with the opportunity to acquire skills that are not directly taught, thereby improving the efficiency of instructional efforts. The present report describes a study in which equivalence-based instruction was used to teach college students facts regarding brain anatomy and…

  20. Foundations of gravitation theory: the principle of equivalence

    International Nuclear Information System (INIS)

    Haugan, M.P.

    1978-01-01

    A new framework is presented within which to discuss the principle of equivalence and its experimental tests. The framework incorporates a special structure imposed on the equivalence principle by the principle of energy conservation. This structure includes relations among the conceptual components of the equivalence principle as well as quantitative relations among the outcomes of its experimental tests. One of the most striking new results obtained through use of this framework is a connection between the breakdown of local Lorentz invariance and the breakdown of the principle that all bodies fall with the same acceleration in a gravitational field. An extensive discussion of experimental tests of the equivalence principle and their significance is also presented. Within the above framework, theory-independent analyses of a broad range of equivalence principle tests are possible. Gravitational redshift experiments. Doppler-shift experiments, the Turner-Hill and Hughes-Drever experiments, and a number of solar-system tests of gravitation theories are analyzed. Application of the techniques of theoretical nuclear physics to the quantitative interpretation of equivalence principle tests using laboratory materials of different composition yields a number of important results. It is found that current Eotvos experiments significantly demonstrate the compatibility of the weak interactions with the equivalence principle. It is also shown that the Hughes-Drever experiment is the most precise test of local Lorentz invariance yet performed. The work leads to a strong, tightly knit empirical basis for the principle of equivalence, the central pillar of the foundations of gravitation theory

  1. Clinical Effectiveness of Statin Therapy After Ischemic Stroke: Primary Results From the Statin Therapeutic Area of the Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) Study.

    Science.gov (United States)

    O'Brien, Emily C; Greiner, Melissa A; Xian, Ying; Fonarow, Gregg C; Olson, DaiWai M; Schwamm, Lee H; Bhatt, Deepak L; Smith, Eric E; Maisch, Lesley; Hannah, Deidre; Lindholm, Brianna; Peterson, Eric D; Pencina, Michael J; Hernandez, Adrian F

    2015-10-13

    In patients with ischemic stroke, data on the real-world effectiveness of statin therapy for clinical and patient-centered outcomes are needed to better inform shared decision making. Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) is a Patient-Centered Outcomes Research Institute-funded research program designed with stroke survivors to evaluate the effectiveness of poststroke therapies. We linked data on patients ≥65 years of age enrolled in the Get With The Guidelines-Stroke Registry to Medicare claims. Two-year to postdischarge outcomes of those discharged on a statin versus not on a statin were adjusted through inverse probability weighting. Our coprimary outcomes were major adverse cardiovascular events and home time (days alive and out of a hospital or skilled nursing facility). Secondary outcomes included all-cause mortality, all-cause readmission, cardiovascular readmission, and hemorrhagic stroke. From 2007 to 2011, 77 468 patients who were not taking statins at the time of admission were hospitalized with ischemic stroke; of these, 71% were discharged on statin therapy. After adjustment, statin therapy at discharge was associated with a lower hazard of major adverse cardiovascular events (hazard ratio, 0.91; 95% confidence interval, 0.87-0.94), 28 more home-time days after discharge (PStatin therapy at discharge was not associated with increased risk of hemorrhagic stroke (hazard ratio, 0.94; 95% confidence interval, 0.72-1.23). Among statin-treated patients, 31% received a high-intensity dose; after risk adjustment, these patients had outcomes similar to those of recipients of moderate-intensity statin. In older ischemic stroke patients who were not taking statins at the time of admission, discharge statin therapy was associated with lower risk of major adverse cardiovascular events and nearly 1 month more home time during the 2-year period after hospitalization. © 2015 American Heart Association

  2. Investigation of Equivalent Unsprung Mass and Nonlinear Features of Electromagnetic Actuated Active Suspension

    Directory of Open Access Journals (Sweden)

    Jun Yin

    2015-01-01

    Full Text Available Electromagnetic actuated active suspension benefits active control and energy harvesting from vibration at the same time. However, the rotary type electromagnetic actuated active suspension introduces a significant extra mass on the unsprung mass due to the inertia of the rotating components of the actuator. The magnitude of the introduced unsprung mass is studied based on a gearbox type actuator and a ball screw type actuator. The geometry of the suspension and the actuator also influence the equivalent unsprung mass significantly. The suspension performance simulation or control logic derived should take this equivalent unsprung mass into account. Besides, an extra force should be compensated due to the nonlinear features of the suspension structure and it is studied. The active force of the actuator should compensate this extra force. The discovery of this paper provides a fundamental for evaluating the rotary type electromagnetic actuated active suspension performance and control strategy derived as well as controlling the electromagnetic actuated active suspension more precisely.

  3. Evaluation of a tissue equivalent ionization chamber in X-ray beams

    Energy Technology Data Exchange (ETDEWEB)

    Perini, Ana Paula; Neves, Lucio Pereira; Santos, William de Souza; Caldas, Linda V.E., E-mail: aperini@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Frimaio, Audrew [Seal Technology Ind. Com. Ltda, Sao Paulo, SP (Brazil); Costa, Paulo R. [Universidade de Sao Paulo (USP/IF), Sao Paulo, SP (Brazil). Inst. de Fisica

    2014-07-01

    Tissue equivalent materials present a variety of uses, including routine quality assurance and quality control programs in both diagnostic and therapeutic physics. They are frequently used in research facilities to measure doses delivered to patients undergoing various clinical procedures. This work presents the development and evaluation of a tissue equivalent ionization chamber, with a sensitive volume of 2.3 cm{sup 3}, for routine use in X-rays beams. This ionization chamber was developed at the Calibration Laboratory/IPEN. The new tissue equivalent material was developed at the Physics Institute of the University of Sao Paulo. In order to evaluate the dosimetric performance of the new ionization chamber, several tests described by international standards were undertaken, and all results were within the recommended limits. (author)

  4. Evaluation of a tissue equivalent ionization chamber in X-ray beams

    International Nuclear Information System (INIS)

    Perini, Ana Paula; Neves, Lucio Pereira; Santos, William de Souza; Caldas, Linda V.E.; Frimaio, Audrew; Costa, Paulo R.

    2014-01-01

    Tissue equivalent materials present a variety of uses, including routine quality assurance and quality control programs in both diagnostic and therapeutic physics. They are frequently used in research facilities to measure doses delivered to patients undergoing various clinical procedures. This work presents the development and evaluation of a tissue equivalent ionization chamber, with a sensitive volume of 2.3 cm 3 , for routine use in X-rays beams. This ionization chamber was developed at the Calibration Laboratory/IPEN. The new tissue equivalent material was developed at the Physics Institute of the University of Sao Paulo. In order to evaluate the dosimetric performance of the new ionization chamber, several tests described by international standards were undertaken, and all results were within the recommended limits. (author)

  5. Calculation simulation of equivalent irradiation swelling for dispersion nuclear fuel

    International Nuclear Information System (INIS)

    Cai Wei; Zhao Yunmei; Gong Xin; Ding Shurong; Huo Yongzhong

    2015-01-01

    The dispersion nuclear fuel was regarded as a kind of special particle composites. Assuming that the fuel particles are periodically distributed in the dispersion nuclear fuel meat, the finite element model to calculate its equivalent irradiation swelling was developed with the method of computational micro-mechanics. Considering irradiation swelling in the fuel particles and the irradiation hardening effect in the metal matrix, the stress update algorithms were established respectively for the fuel particles and metal matrix. The corresponding user subroutines were programmed, and the finite element simulation of equivalent irradiation swelling for the fuel meat was performed in Abaqus. The effects of the particle size and volume fraction on the equivalent irradiation swelling were investigated, and the fitting formula of equivalent irradiation swelling was obtained. The results indicate that the main factors to influence equivalent irradiation swelling of the fuel meat are the irradiation swelling and volume fraction of fuel particles. (authors)

  6. Derivation of Accident-Specific Material-at-Risk Equivalency Factors

    Energy Technology Data Exchange (ETDEWEB)

    Jason P. Andrus; Dr. Chad L. Pope

    2012-05-01

    A novel method for calculating material at risk (MAR) dose equivalency developed at the Idaho National Laboratory (INL) now allows for increased utilization of dose equivalency for facility MAR control. This method involves near-real time accounting for the use of accident and material specific release and transport. It utilizes all information from the committed effective dose equation and the five factor source term equation to derive dose equivalency factors which can be used to establish an overall facility or process MAR limit. The equivalency factors allow different nuclide spectrums to be compared for their respective dose consequences by relating them to a specific quantity of an identified reference nuclide. The ability to compare spectrums to a reference limit ensures that MAR limits are in fact bounding instead of attempting to establish a representative or bounding spectrum which may lead to unintended or unanalyzed configurations. This methodology is then coupled with a near real time material tracking system which allows for accurate and timely material composition information and corresponding MAR equivalency values. The development of this approach was driven by the complex nature of processing operations in some INL facilities. This type of approach is ideally suited for facilities and processes where the composition of the MAR and possible release mechanisms change frequently but in well defined fashions and in a batch-type nature.

  7. On identifying name equivalences in digital libraries. Name equivalence, Surname matching, Author identification, Databases

    Directory of Open Access Journals (Sweden)

    Dror G. Feitelson

    2004-01-01

    Full Text Available The services provided by digital libraries can be much improved by correctly identifying variants of the same name. For example, this will allow for better retrieval of all the works by a certain author. We focus on variants caused by abbreviations of first names, and show that significant achievements are possible by simple lexical analysis and comparison of names. This is done in two steps: first a pairwise matching of names is performed, and then these are used to find cliques of equivalent names. However, these steps can each be performed in a variety of ways. We therefore conduct an experimental analysis using two real datasets to find which approaches actually work well in practice. Interestingly, this depends on the size of the repository, as larger repositories may have many more similar names.

  8. The performance of low pressure tissue-equivalent chambers and a new method for parameterising the dose equivalent

    International Nuclear Information System (INIS)

    Eisen, Y.

    1986-01-01

    The performance of Rossi-type spherical tissue-equivalent chambers with equivalent diameters between 0.5 μm and 2 μm was tested experimentally using monoenergetic and polyenergetic neutron sources in the energy region of 10 keV to 14.5 MeV. In agreement with theoretical predictions both chambers failed to provide LET information at low neutron energies. A dose equivalent algorithm was derived that utilises the event distribution but does not attempt to correlate event size with LET. The algorithm was predicted theoretically and confirmed by experiment. The algorithm that was developed determines the neutron dose equivalent, from the data of the 0.5 μm chamber, to better than +-20% over the energy range of 30 keV to 14.5 MeV. The same algorithm also determines the dose equivalent from the data of the 2 μm chamber to better than +-20% over the energy range of 60 keV to 14.5 MeV. The efficiency of the chambers is 33 counts per μSv, or equivalently about 10 counts s -1 per mSv.h -1 . This efficiency enables the measurement of dose equivalent rates above 1 mSv.h -1 for an integration period of 3 s. Integrated dose equivalents can be measured as low as 1 μSv. (author)

  9. The cost of collective dose equivalent

    International Nuclear Information System (INIS)

    Clark, M.J.; Fleishman, A.B.

    1979-01-01

    The successful application of the ALARA principle is dependent on a monetary evaluation of collective dose, so that the costs of control may be directly compared with the costs of detriment. The paper initially reviews the traditional, quantitative methods of valuing human life from which a monetary value of the man-sievert can be derived by subsequent application of risk factors. The political, ethical and economic implications of employing such techniques in radiological protection are noted. An alternative approach to the problem is then outlined, based on estimating the marginal value of a change in risk. At low levels of individual risk this includes only the tangible, economic consequences of detriment from output losses and medical costs. However, as risk levels rise, social costs related to the anxiety associated with radiation-induced health effects are also incorporated and the valuation increases disproportionally. While such valuations are in principle measurable, in the absence of empirical data a risk/detriment cost relationship is proposed, leading to a variable monetary value of the man-sievert which is a function of the per caput dose of a given population sub-group. Application of this methodology will help to ensure that radiological protection resources are spent in areas where they are most required. (author)

  10. Mathematical simulation of biologically equivalent doses for LDR-HDR

    International Nuclear Information System (INIS)

    Slosarek, K.; Zajusz, A.

    1996-01-01

    Based on the LQ model examples of biologically equivalent doses LDR, HDR and external beams were calculated. The biologically equivalent doses for LDR were calculated by appending to the LQ model the corrector for the time of repair of radiation sublethal damages. For radiation continuously delivered at a low dose rate the influence of sublethal damage repair time changes on biologically equivalent doses were analysed. For fractionated treatment with high dose rate the biologically equivalent doses were calculated by adding to the LQ model the formula of accelerated repopulation. For total biologically equivalent dose calculation for combine LDR-HDR-Tele irradiation examples are presented with the use of different parameters of the time of repair of sublethal damages and accelerated repopulation. The calculations performed show, that the same biologically equivalent doses can be obtained for different parameters of cell kinetics changes during radiation treatment. It also shows, that during biologically equivalent dose calculations for different radiotherapy schedules, ignorance of cell kinetics parameters can lead to relevant errors

  11. Epigone migraine vertigo (EMV): a late migraine equivalent.

    Science.gov (United States)

    Pagnini, P; Vannucchi, P; Giannoni, B; Pecci, R

    2014-02-01

    Migrainous headache is determined by pathogenetic mechanisms that are also able to affect the peripheral and/or central vestibular system, so that vestibular symptoms may substitute and/or present with headache. We are convinced that there can be many different manifestations of vestibular disorders in migrainous patients, representing true different clinical entities due to their different characteristics and temporal relashionship with headache. Based on such considerations, we proposed a classification of vertigo and other vestibular disorders related to migraine, and believe that a particular variant of migraine-related vertigo should be introduced, namely "epigone migraine vertigo" (EMV): this could be a kind of late migraine equivalent, i.e. a kind of vertigo, migrainous in origin, starting late in the lifetime that substitutes, as an equivalent, pre-existing migraine headache. To clarify this particular clinical picture, we report three illustrative clinical cases among 28 patients collected during an observation period of 13 years (November 1991 - November 2004). For all patients, we collected complete personal clinical history. All patients underwent standard neurotological examination, looking for spontaneous-positional, gaze-evoked and caloric induced nystagmus, using an infrared video camera. We also performed a head shaking test (HST) and an head thrust test (HTT). Ocular motility was tested looking at saccades and smooth pursuit. To exclude other significant neurological pathologies, a brain magnetic resonance imaging (MRI) with gadolinium was performed. During the three months after the first visit, patients were invited to keep a diary noting frequency, intensity and duration of vertigo attacks. After that period, we suggested that they use prophylactic treatment with flunarizine (5 mg per day) and/or acetylsalicylic acid (100 mg per day), or propranolol (40 mg twice a day). All patients were again recommended to note in their diary the frequency

  12. Modelling of dynamic equivalents in electric power grids

    International Nuclear Information System (INIS)

    Craciun, Diana Iuliana

    2010-01-01

    In a first part, this research thesis proposes a description of the context and new constraints of electric grids: architecture, decentralized production with the impact of distributed energy resource systems, dynamic simulation, and interest of equivalent models. Then, the author discusses the modelling of the different components of electric grids: synchronous and asynchronous machines, distributed energy resource with power electronic interface, loading models. She addresses the techniques of reduction of electric grid models: conventional reduction methods, dynamic equivalence methods using non linear approaches or evolutionary algorithm-based methods of assessment of parameters. This last approach is then developed and implemented, and a new method of computation of dynamic equivalents is described

  13. Asymptotically double lacunry equivalent sequences defined by Orlicz functions

    Directory of Open Access Journals (Sweden)

    Ayhan Esi

    2014-04-01

    Full Text Available This paper presents the following definition which is natural combition of the definition for asymptotically equivalent and Orlicz function. The two nonnegative double sequences x=(x_{k,l} and y=(y_{k,l} are said to be M-asymptotically double equivalent to multiple L provided that for every ε>0, P-lim_{k,l}M(((|((x_{k,l}/(y_{k,l}-L|/ρ=0, for some ρ>0, (denoted by x∽y and simply M-asymptotically double equivalent if L=1. Also we give some new concepts related to this definition and some inclusion theorems.

  14. Calculation of committed dose equivalent from intake of tritiated water

    International Nuclear Information System (INIS)

    Law, D.V.

    1978-08-01

    A new computerized method of calculating the committed dose equivalent from the intake of tritiated water at Harwell is described in this report. The computer program has been designed to deal with a variety of intake patterns and urine sampling schemes, as well as to produce committed dose equivalents corresponding to any periods for which individual monitoring for external radiation is undertaken. Details of retrospective doses are added semi-automatically to the Radiation Dose Records and committed dose equivalents are retained on a separate file. (author)

  15. The Application of Equivalence Theory to Advertising Translation

    Institute of Scientific and Technical Information of China (English)

    张颖

    2017-01-01

    Through analyzing equivalence theory, the author tries to find a solution to the problems arising in the process of ad?vertising translation. These problems include cultural diversity, language diversity and special requirement of advertisement. The author declares that Nida''s functional equivalence is one of the most appropriate theories to deal with these problems. In this pa?per, the author introduces the principles of advertising translation and culture divergences in advertising translation, and then gives some advertising translation practices to explain and analyze how to create good advertising translation by using functional equivalence. At last, the author introduces some strategies in advertising translation.

  16. Spaces of homotopy self-equivalences a survey

    CERN Document Server

    Rutter, John W

    1997-01-01

    This survey covers groups of homotopy self-equivalence classes of topological spaces, and the homotopy type of spaces of homotopy self-equivalences. For manifolds, the full group of equivalences and the mapping class group are compared, as are the corresponding spaces. Included are methods of calculation, numerous calculations, finite generation results, Whitehead torsion and other areas. Some 330 references are given. The book assumes familiarity with cell complexes, homology and homotopy. Graduate students and established researchers can use it for learning, for reference, and to determine the current state of knowledge.

  17. Apparent violation of the principle of equivalence and Killing horizons

    International Nuclear Information System (INIS)

    Zimmerman, R.L.; Farhoosh, H.; Oregon Univ., Eugene

    1980-01-01

    By means of the principle of equivalence it is deduced that the qualitative behavior of the Schwarzschild horizon about a uniformly accelerating particle. This result is confirmed for an exact solution of a uniformly accelerating object in the limit of small accelerations. For large accelerations the Schwarzschild horizon appears to violate the qualitative behavior established via the principle of equivalence. When similar arguments are extended to an observable such as the red shift between two observers, there is no departure from the results expected from the principle of equivalence. The resolution of the paradox is brought about by a compensating effect due to the Rindler horizon. (author)

  18. Risk Stratification and Shared Decision Making for Colorectal Cancer Screening: A Randomized Controlled Trial.

    Science.gov (United States)

    Schroy, Paul C; Duhovic, Emir; Chen, Clara A; Heeren, Timothy C; Lopez, William; Apodaca, Danielle L; Wong, John B

    2016-05-01

    Eliciting patient preferences within the context of shared decision making has been advocated for colorectal cancer (CRC) screening, yet providers often fail to comply with patient preferences that differ from their own. To determine whether risk stratification for advanced colorectal neoplasia (ACN) influences provider willingness to comply with patient preferences when selecting a desired CRC screening option. Randomized controlled trial. Asymptomatic, average-risk patients due for CRC screening in an urban safety net health care setting. Patients were randomized 1:1 to a decision aid alone (n= 168) or decision aid plus risk assessment (n= 173) arm between September 2012 and September 2014. The primary outcome was concordance between patient preference and test ordered; secondary outcomes included patient satisfaction with the decision-making process, screening intentions, test completion rates, and provider satisfaction. Although providers perceived risk stratification to be useful in selecting an appropriate screening test for their average-risk patients, no significant differences in concordance were observed between the decision aid alone and decision aid plus risk assessment groups (88.1% v. 85.0%,P= 0.40) or high- and low-risk groups (84.5% v. 87.1%,P= 0.51). Concordance was highest for colonoscopy and relatively low for tests other than colonoscopy, regardless of study arm or risk group. Failure to comply with patient preferences was negatively associated with satisfaction with the decision-making process, screening intentions, and test completion rates. Single-institution setting; lack of provider education about the utility of risk stratification into their decision making. Providers perceived risk stratification to be useful in their decision making but often failed to comply with patient preferences for tests other than colonoscopy, even among those deemed to be at low risk of ACN. © The Author(s) 2016.

  19. Lipschitz equivalence of self-similar sets with touching structures

    International Nuclear Information System (INIS)

    Ruan, Huo-Jun; Wang, Yang; Xi, Li-Feng

    2014-01-01

    Lipschitz equivalence of self-similar sets is an important area in the study of fractal geometry. It is known that two dust-like self-similar sets with the same contraction ratios are always Lipschitz equivalent. However, when self-similar sets have touching structures the problem of Lipschitz equivalence becomes much more challenging and intriguing at the same time. So far, all the known results only cover self-similar sets in R with no more than three branches. In this study we establish results for the Lipschitz equivalence of self-similar sets with touching structures in R with arbitrarily many branches. Key to our study is the introduction of a geometric condition for self-similar sets called substitutable. (paper)

  20. Approved Drug Products with Therapuetic Equivalence Evaluations (Orange Book)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The publication Approved Drug Products with Therapeutic Equivalence Evaluations (the List, commonly known as the Orange Book) identifies drug products approved on...

  1. ESA GlobSnow Snow Water Equivalent (SWE)

    Data.gov (United States)

    National Aeronautics and Space Administration — The European Space Agency (ESA) Global Snow Monitoring for Climate Research (GlobSnow) snow water equivalent (SWE) v2.0 data record contains snow information derived...

  2. Bisimulation Meet PCTL Equivalences for Probabilistic Automata (Journal Version)

    DEFF Research Database (Denmark)

    Song, Lei; Zhang, Lijun; Godskesen, Jens Christian

    2013-01-01

    Probabilistic automata (PA) have been successfully applied in the formal verification of concurrent and stochastic systems. Efficient model checking algorithms have been studied, where the most often used logics for expressing properties are based on PCTL and its extension PCTL*. Various behavioral...... equivalences are proposed for PAs, as a powerful tool for abstraction and compositional minimization for PAs. Unfortunately, the behavioral equivalences are well-known to be strictly stronger than the logical equivalences induced by PCTL or PCTL*. This paper introduces novel notions of strong bisimulation...... relations, which characterizes PCTL and PCTL* exactly. We also extend weak bisimulations characterizing PCTL and PCTL* without next operator, respectively. Thus, our paper bridges the gap between logical and behavioral equivalences in this setting....

  3. Noncommutative Yang-Mills from equivalence of star products

    International Nuclear Information System (INIS)

    Jurco, B.; Schupp, P.

    2000-01-01

    It is shown that the transformation between ordinary and noncommutative Yang-Mills theory as formulated by Seiberg and Witten is due to the equivalence of certain star products on the D-brane world-volume. (orig.)

  4. Noncommutative Yang-Mills from equivalence of star products

    Energy Technology Data Exchange (ETDEWEB)

    Jurco, B. [Max-Planck-Institut fuer Mathematik, Bonn (Germany); Schupp, P. [Sektion Physik, Universitaet Muenchen, Theresienstrasse 37, 80333 Muenchen (Germany)

    2000-05-01

    It is shown that the transformation between ordinary and noncommutative Yang-Mills theory as formulated by Seiberg and Witten is due to the equivalence of certain star products on the D-brane world-volume. (orig.)

  5. Existence and equivalence of twisted products on a symplectic manifold

    International Nuclear Information System (INIS)

    Lichnerowicz, A.

    1979-01-01

    The twisted products play an important role in Quantum Mechanics. A distinction is introduced between Vey *sub(γ) products and strong Vey *sub(γ) products and it is proved that each *sub(γ) product is equivalent to a Vey *sub(γ) product. If b 3 (W) = 0, the symplectic manifold (W,F) admits strong Vey *sub(Gn) products. If b 2 (W) = 0, all *sub(γ) products are equivalent as well as the Vey Lie algebras. In the general case the formal Lie algebras are characterized which are generated by a *sub(γ) product and it proved that the existance of a *sub(γ)-product is equivalent to the existance of a formal Lie algebra infinitesimally equivalent to a Vey Lie algebra at the first order. (Auth.)

  6. On conjugate points and the Leitmann equivalent problem approach

    NARCIS (Netherlands)

    Wagener, F.O.O.

    2009-01-01

    This article extends the Leitmann equivalence method to a class of problems featuring conjugate points. The class is characterised by the requirement that the set of indifference points of a given problem forms a finite stratification.

  7. Evaluation of pharmaceutical and chemical equivalence of selected ...

    African Journals Online (AJOL)

    Personal

    Evaluation of Pharmaceutical and Chemical Equivalence of Selected Brands of Diclofenac Sodium .... strength- friability. /disintegration time ratio. (CSFR/DT). Drug content. % w/w ... Table 3: Parameters obtained from Kitazawa analysis. Brand.

  8. Do positrons and antiprotons respect the weak equivalence principle?

    International Nuclear Information System (INIS)

    Hughes, R.J.

    1990-01-01

    We resolve the difficulties which Morrison identified with energy conservation and the gravitational red-shift when particles of antimatter, such as the positron and antiproton, do not respect the weak equivalence principle. 13 refs

  9. Characteristics of natural background external radiation and effective dose equivalent

    International Nuclear Information System (INIS)

    Fujimoto, Kenzo

    1989-01-01

    The two sources of natural radiation - cosmic rays and primordial radionuclides - are described. The factors affecting radiation doses received from natural radiation and the calculation of effective dose equivalent due to natural radiation are discussed. 10 figs., 3 tabs

  10. Estimating water equivalent snow depth from related meteorological variables

    International Nuclear Information System (INIS)

    Steyaert, L.T.; LeDuc, S.K.; Strommen, N.D.; Nicodemus, M.L.; Guttman, N.B.

    1980-05-01

    Engineering design must take into consideration natural loads and stresses caused by meteorological elements, such as, wind, snow, precipitation and temperature. The purpose of this study was to determine a relationship of water equivalent snow depth measurements to meteorological variables. Several predictor models were evaluated for use in estimating water equivalent values. These models include linear regression, principal component regression, and non-linear regression models. Linear, non-linear and Scandanavian models are used to generate annual water equivalent estimates for approximately 1100 cooperative data stations where predictor variables are available, but which have no water equivalent measurements. These estimates are used to develop probability estimates of snow load for each station. Map analyses for 3 probability levels are presented

  11. The principle of equivalence and the Trojan asteroids

    International Nuclear Information System (INIS)

    Orellana, R.; Vucetich, H.

    1986-05-01

    An analysis of the Trojan asteroids motion has been carried out in order to set limits to possible violations to the principle of equivalence. Preliminary results, in agreement with general relativity, are reported. (author)

  12. Einstein's equivalence principle instead of the inertia forces

    International Nuclear Information System (INIS)

    Herreros Mateos, F.

    1997-01-01

    In this article I intend to show that Einstein's equivalence principle substitutes advantageously the inertia forces in the study and resolution of problems in which non-inertial systems appear. (Author) 13 refs

  13. Establishment of an equivalence acceptance criterion for accelerated stability studies.

    Science.gov (United States)

    Burdick, Richard K; Sidor, Leslie

    2013-01-01

    In this article, the use of statistical equivalence testing for providing evidence of process comparability in an accelerated stability study is advocated over the use of a test of differences. The objective of such a study is to demonstrate comparability by showing that the stability profiles under nonrecommended storage conditions of two processes are equivalent. Because it is difficult at accelerated conditions to find a direct link to product specifications, and hence product safety and efficacy, an equivalence acceptance criterion is proposed that is based on the statistical concept of effect size. As with all statistical tests of equivalence, it is important to collect input from appropriate subject-matter experts when defining the acceptance criterion.

  14. Analysis of equivalent antenna based on FDTD method

    Directory of Open Access Journals (Sweden)

    Yun-xing Yang

    2014-09-01

    Full Text Available An equivalent microstrip antenna used in radio proximity fuse is presented. The design of this antenna is based on multilayer multi-permittivity dielectric substrate which is analyzed by finite difference time domain (FDTD method. Equivalent iterative formula is modified in the condition of cylindrical coordinate system. The mixed substrate which contains two kinds of media (one of them is airtakes the place of original single substrate. The results of equivalent antenna simulation show that the resonant frequency of equivalent antenna is similar to that of the original antenna. The validity of analysis can be validated by means of antenna resonant frequency formula. Two antennas have same radiation pattern and similar gain. This method can be used to reduce the weight of antenna, which is significant to the design of missile-borne antenna.

  15. - Synonymy in the Translation Equivalent Paradigms of a Standard ...

    African Journals Online (AJOL)

    directional dictionaries". ... Examples from Groot Woordeboek / Major Dictionary, ... Examples of such divergence which may require labelling (or even more ..... Selection and Presentation of Ready Equivalents in a Translation Dictionary.

  16. On the equivalence of different definitions of R-operation

    International Nuclear Information System (INIS)

    Wegrzyn, P.

    1989-01-01

    Three well-known definitions of R-operation in the BPHZ formalism are presented. The equivalence between the Zimmermann's forest formula and the factorized version of R-operation is proved. 11 refs. (author)

  17. Development of solid water-equivalent radioactive certified reference materials

    Energy Technology Data Exchange (ETDEWEB)

    Finke, E.; Greupner, H.; Groche, K.; Rittwag, R. (Office for Standardization, Metrology and Quality Control (ASMW), Berlin (Germany, F.R.)); Geske, G. (Jena Univ. (Germany, F.R.))

    1991-01-01

    This paper presents a brief description of the development of solid water-equivalent beta volume radioactive certified reference materials. These certified reference materials were prepared for the beta fission nuclides {sup 90}Sr/{sup 90}Y, {sup 137}Cs, {sup 147}Pm and {sup 204}Tl. Comparative measurements of liquid and solid water-equivalent beta volume radioactive certified reference materials are discussed. (author).

  18. Annual average equivalent dose of workers form health area

    International Nuclear Information System (INIS)

    Daltro, T.F.L.; Campos, L.L.

    1992-01-01

    The data of personnel monitoring during 1985 and 1991 of personnel that work in health area were studied, obtaining a general overview of the value change of annual average equivalent dose. Two different aspects were presented: the analysis of annual average equivalent dose in the different sectors of a hospital and the comparison of these doses in the same sectors in different hospitals. (C.G.C.)

  19. Equivalence between quantum simultaneous games and quantum sequential games

    OpenAIRE

    Kobayashi, Naoki

    2007-01-01

    A framework for discussing relationships between different types of games is proposed. Within the framework, quantum simultaneous games, finite quantum simultaneous games, quantum sequential games, and finite quantum sequential games are defined. In addition, a notion of equivalence between two games is defined. Finally, the following three theorems are shown: (1) For any quantum simultaneous game G, there exists a quantum sequential game equivalent to G. (2) For any finite quantum simultaneo...

  20. An equivalence between momentum and charge in string theory

    International Nuclear Information System (INIS)

    Horne, J.H.; Horowitz, G.T.; Steif, A.R.

    1992-01-01

    It is shown that for a translationally invariant solution to string theory, spacetime duality interchanges the momentum in the symmetry direction and the axion charge per unit length. As one application, we show explicitly that charged black strings are equivalent to boosted (uncharged) black strings. The extremal black strings (which correspond to the field outside of a fundamental macroscopic string) are equivalent to plane-fronted waves describing strings moving at the speed of light

  1. Modified methods for growing 3-D skin equivalents: an update.

    Science.gov (United States)

    Lamb, Rebecca; Ambler, Carrie A

    2014-01-01

    Artificial epidermis can be reconstituted in vitro by seeding primary epidermal cells (keratinocytes) onto a supportive substrate and then growing the developing skin equivalent at the air-liquid interface. In vitro skin models are widely used to study skin biology and for industrial drug and cosmetic testing. Here, we describe updated methods for growing 3-dimensional skin equivalents using de-vitalized, de-epidermalized dermis (DED) substrates including methods for DED substrate preparation, cell seeding, growth conditions, and fixation procedures.

  2. Feedback equivalence of convolutional codes over finite rings

    Directory of Open Access Journals (Sweden)

    DeCastro-García Noemí

    2017-12-01

    Full Text Available The approach to convolutional codes from the linear systems point of view provides us with effective tools in order to construct convolutional codes with adequate properties that let us use them in many applications. In this work, we have generalized feedback equivalence between families of convolutional codes and linear systems over certain rings, and we show that every locally Brunovsky linear system may be considered as a representation of a code under feedback convolutional equivalence.

  3. An Algebraic Approach to Knowledge Bases Informational Equivalence

    OpenAIRE

    Plotkin, B.; Plotkin, T.

    2003-01-01

    In this paper we study the notion of knowledge from the positions of universal algebra and algebraic logic. We consider first order knowledge which is based on first order logic. We define categories of knowledge and knowledge bases. These notions are defined for the fixed subject of knowledge. The key notion of informational equivalence of two knowledge bases is introduced. We use the idea of equivalence of categories in this definition. We prove that for finite models there is a clear way t...

  4. Exact equivalent straight waveguide model for bent and twisted waveguides

    DEFF Research Database (Denmark)

    Shyroki, Dzmitry

    2008-01-01

    Exact equivalent straight waveguide representation is given for a waveguide of arbitrary curvature and torsion. No assumptions regarding refractive index contrast, isotropy of materials, or particular morphology in the waveguide cross section are made. This enables rigorous full-vector modeling...... of in-plane curved or helically wound waveguides with use of available simulators for straight waveguides without the restrictions of the known approximate equivalent-index formulas....

  5. Multi-channel phase-equivalent transformation and supersymmetry

    OpenAIRE

    Shirokov, A. M.; Sidorenko, V. N.

    2000-01-01

    Phase-equivalent transformation of local interaction is generalized to the multi-channel case. Generally, the transformation does not change the number of the bound states in the system and their energies. However, with a special choice of the parameters, the transformation removes one of the bound states and is equivalent to the multi-channel supersymmetry transformation recently suggested by Sparenberg and Baye. Using the transformation, it is also possible to add a bound state to the discr...

  6. Equivalence groups of (2+1) dimensional diffusion equation

    OpenAIRE

    Özer, Saadet

    2017-01-01

    If a given set of differential equations contain somearbitrary functions, parameters, we have in fact a family of sets of equationsof the same structure. Almost all field equations of classical physichs havethis property, representing different materials with various paramaters.  Equivalence groups are defined as the groupof transformations which leave a given family of differential equationsinvariant. Therefore, equivalence group of family of differential equations isan important area within...

  7. Gap sequence, Lipschitz equivalence and box dimension of fractal sets

    International Nuclear Information System (INIS)

    Rao Hui; Yang Yamin; Ruan Huojun

    2008-01-01

    We introduce a notion of gap sequences for compact sets E subset of R d , which is a generalization of the gap sequences of compact sets on the real line. We show that if the gap sequences of two fractal sets are not equivalent, then these two sets cannot be Lipschitz equivalent, where the latter fact is usually very hard to verify. Finally, we show that for some typical fractal sets, the gap sequences characterize the upper box dimension

  8. Extended Equivalence Principle: Implications for Gravity, Geometry and Thermodynamics

    OpenAIRE

    Sivaram, C.; Arun, Kenath

    2012-01-01

    The equivalence principle was formulated by Einstein in an attempt to extend the concept of inertial frames to accelerated frames, thereby bringing in gravity. In recent decades, it has been realised that gravity is linked not only with geometry of space-time but also with thermodynamics especially in connection with black hole horizons, vacuum fluctuations, dark energy, etc. In this work we look at how the equivalence principle manifests itself in these different situations where we have str...

  9. The Equivalence of Grayson and Friedlander-Suslin Spectral Sequences

    OpenAIRE

    Podkopaev, Oleg

    2013-01-01

    This thesis establishes the equivalence of Grayson and Friedlander-Suslin spectral sequences, that was previously only known for the respective E_2-terms. We develop the necessary techniques regarding K_0-presheaves of spectra, building on the work of M. Walker and construct certain filtrations on the K-theory presheaf of spectra that we use as intermediate steps in obtaining the equivalence of the filtrations.

  10. Course design via Equivalency Theory supports equivalent student grades and satisfaction in online and face-to-face psychology classes

    Directory of Open Access Journals (Sweden)

    David eGarratt-Reed

    2016-05-01

    Full Text Available There has been a recent rapid growth in the number of psychology courses offered online through institutions of higher education. The American Psychological Association (APA has highlighted the importance of ensuring the effectiveness of online psychology courses. Despite this, there have been inconsistent findings regarding student grades, satisfaction, and retention in online psychology units. Equivalency Theory posits that online and classroom-based learners will attain equivalent learning outcomes when equivalent learning experiences are provided. We present a case study of an online introductory psychology unit designed to provide equivalent learning experiences to the pre-existing face-to-face version of the unit. Academic performance, student feedback, and retention data from 866 Australian undergraduate psychology students were examined to assess whether the online unit produced comparable outcomes to the ‘traditional’ unit delivered face-to-face. Student grades did not significantly differ between modes of delivery, except for a group-work based assessment where online students performed more poorly. Student satisfaction was generally high in both modes of the unit, with group-work the key source of dissatisfaction in the online unit. The results provide partial support for Equivalency Theory. The group-work based assessment did not provide an equivalent learning experience for students in the online unit highlighting the need for further research to determine effective methods of engaging students in online group activities. Consistent with previous research, retention rates were significantly lower in the online unit, indicating the need to develop effective strategies to increase online retention rates. While this study demonstrates successes in presenting online students with an equivalent learning experience, we recommend that future research investigates means of successfully facilitating collaborative group-work assessment

  11. An equivalent fluid/equivalent medium approach for the numerical simulation of coastal landslides propagation: theory and case studies

    OpenAIRE

    P. Mazzanti; F. Bozzano

    2009-01-01

    Coastal and subaqueous landslides can be very dangerous phenomena since they are characterised by the additional risk of induced tsunamis, unlike their completely-subaerial counterparts. Numerical modelling of landslides propagation is a key step in forecasting the consequences of landslides. In this paper, a novel approach named Equivalent Fluid/Equivalent Medium (EFEM) has been developed. It adapts common numerical models and software that were originally designed for subaerial landslides i...

  12. ASCERTAINMENT OF THE EQUIVALENT CIRCUIT PARAMETERS OF THE ASYNCHRONOUS MACHINE

    Directory of Open Access Journals (Sweden)

    V. S. Safaryan

    2015-01-01

    Full Text Available The article considers experimental and analytical determination of the asynchronous machine equivalent-circuit parameters with application of the reference data. Transient processes investigation of the asynchronous machines necessitates the equivalent circuit parameters (resistance impedance, inductances and coefficient of the stator-rotor contours mutual inductance that help form the transitory-process mathematical simulation model. The reference books do not provide those parameters; they instead give the rated ones (active power, voltage, slide, coefficient of performance and capacity coefficient as well as the ratio of starting and nominal currents and torques. The noted studies on the asynchronous machine equivalent-circuits parametrization fail to solve the problems ad finem or solve them with admissions. The paper presents experimental and analytical determinations of the asynchronous machine equivalent-circuit parameters: the experimental one based on the results of two measurements and the analytical one where the problem boils down to solving a system of nonlineal algebraic equations. The authors investigate the equivalent asynchronous machine input-resistance properties and adduce the dependence curvatures of the input-resistances on the slide. They present a symbolic model for analytical parameterization of the asynchronous machine equivalent-circuit that represents a system of nonlineal equations and requires one of the rotor-parameters arbitrary assignment. The article demonstrates that for the asynchronous machine equivalent-circuit experimental parameterization the measures are to be conducted of the stator-circuit voltage, current and active power with two different slides and arbitrary assignment of one of the rotor parameters. The paper substantiates the fact that additional measurement does not discard the rotor-parameter choice arbitrariness. The authors establish that in motoring mode there is a critical slide by which the

  13. Equivalence Checking between Pre-synthesis and Post-synthesis Programs by Using VIS

    International Nuclear Information System (INIS)

    Lee, Jonghoon; Yoo, Junbeom; Choi, Jonggyun; Lee, Jangsoo

    2013-01-01

    PLC (Programmable Logic Controller)-based Software development, the design programs are translated into implementation programs, and behavioral equivalence between the design and implementation is demonstrated by formal method based technique. In FPGA-based software development, the design programs are also synthesized into implementation programs. However, in this process, testing and simulation based comparison techniques are mainly used. This paper proposes a formal method based technique to demonstrate behavioral equivalence between pre-synthesis and post-synthesis programs with VIS (Verification Interacting with Synthesis) verification system. We translated into BLIF-MV which is front-end of VIS, from Verlag and EDIF net list which synthesized from the same Verlag by an automatic synthesis tool. This paper proposes a formal method based technique to confirm correctness of synthesis by using equivalence checking of VIS verification system. In order to confirm the effectiveness of the proposed technique, we performed a case study with a part of prototype version of the RPS BP, and demonstrated a behavioral equivalence between Verlag HDL and EDIF post-synthesis net list

  14. Equivalence Checking between Pre-synthesis and Post-synthesis Programs by Using VIS

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jonghoon; Yoo, Junbeom [Konkuk Univ., Seoul (Korea, Republic of); Choi, Jonggyun; Lee, Jangsoo [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2013-05-15

    PLC (Programmable Logic Controller)-based Software development, the design programs are translated into implementation programs, and behavioral equivalence between the design and implementation is demonstrated by formal method based technique. In FPGA-based software development, the design programs are also synthesized into implementation programs. However, in this process, testing and simulation based comparison techniques are mainly used. This paper proposes a formal method based technique to demonstrate behavioral equivalence between pre-synthesis and post-synthesis programs with VIS (Verification Interacting with Synthesis) verification system. We translated into BLIF-MV which is front-end of VIS, from Verlag and EDIF net list which synthesized from the same Verlag by an automatic synthesis tool. This paper proposes a formal method based technique to confirm correctness of synthesis by using equivalence checking of VIS verification system. In order to confirm the effectiveness of the proposed technique, we performed a case study with a part of prototype version of the RPS BP, and demonstrated a behavioral equivalence between Verlag HDL and EDIF post-synthesis net list.

  15. Resonant Rectifier ICs for Piezoelectric Energy Harvesting Using Low-Voltage Drop Diode Equivalents.

    Science.gov (United States)

    Din, Amad Ud; Chandrathna, Seneke Chamith; Lee, Jong-Wook

    2017-04-19

    Herein, we present the design technique of a resonant rectifier for piezoelectric (PE) energy harvesting. We propose two diode equivalents to reduce the voltage drop in the rectifier operation, a minuscule-drop-diode equivalent (MDDE) and a low-drop-diode equivalent (LDDE). The diode equivalents are embedded in resonant rectifier integrated circuits (ICs), which use symmetric bias-flip to reduce the power used for charging and discharging the internal capacitance of a PE transducer. The self-startup function is supported by synchronously generating control pulses for the bias-flip from the PE transducer. Two resonant rectifier ICs, using both MDDE and LDDE, are fabricated in a 0.18 μm CMOS process and their performances are characterized under external and self-power conditions. Under the external-power condition, the rectifier using LDDE delivers an output power P OUT of 564 μW and a rectifier output voltage V RECT of 3.36 V with a power transfer efficiency of 68.1%. Under self-power conditions, the rectifier using MDDE delivers a P OUT of 288 μW and a V RECT of 2.4 V with a corresponding efficiency of 78.4%. Using the proposed bias-flip technique, the power extraction capability of the proposed rectifier is 5.9 and 3.0 times higher than that of a conventional full-bridge rectifier.

  16. Resonant Rectifier ICs for Piezoelectric Energy Harvesting Using Low-Voltage Drop Diode Equivalents

    Science.gov (United States)

    Din, Amad Ud; Chandrathna, Seneke Chamith; Lee, Jong-Wook

    2017-01-01

    Herein, we present the design technique of a resonant rectifier for piezoelectric (PE) energy harvesting. We propose two diode equivalents to reduce the voltage drop in the rectifier operation, a minuscule-drop-diode equivalent (MDDE) and a low-drop-diode equivalent (LDDE). The diode equivalents are embedded in resonant rectifier integrated circuits (ICs), which use symmetric bias-flip to reduce the power used for charging and discharging the internal capacitance of a PE transducer. The self-startup function is supported by synchronously generating control pulses for the bias-flip from the PE transducer. Two resonant rectifier ICs, using both MDDE and LDDE, are fabricated in a 0.18 μm CMOS process and their performances are characterized under external and self-power conditions. Under the external-power condition, the rectifier using LDDE delivers an output power POUT of 564 μW and a rectifier output voltage VRECT of 3.36 V with a power transfer efficiency of 68.1%. Under self-power conditions, the rectifier using MDDE delivers a POUT of 288 μW and a VRECT of 2.4 V with a corresponding efficiency of 78.4%. Using the proposed bias-flip technique, the power extraction capability of the proposed rectifier is 5.9 and 3.0 times higher than that of a conventional full-bridge rectifier. PMID:28422085

  17. Equivalent modeling of PMSG-based wind power plants considering LVRT capabilities: electromechanical transients in power systems.

    Science.gov (United States)

    Ding, Ming; Zhu, Qianlong

    2016-01-01

    Hardware protection and control action are two kinds of low voltage ride-through technical proposals widely used in a permanent magnet synchronous generator (PMSG). This paper proposes an innovative clustering concept for the equivalent modeling of a PMSG-based wind power plant (WPP), in which the impacts of both the chopper protection and the coordinated control of active and reactive powers are taken into account. First, the post-fault DC link voltage is selected as a concentrated expression of unit parameters, incoming wind and electrical distance to a fault point to reflect the transient characteristics of PMSGs. Next, we provide an effective method for calculating the post-fault DC link voltage based on the pre-fault wind energy and the terminal voltage dip. Third, PMSGs are divided into groups by analyzing the calculated DC link voltages without any clustering algorithm. Finally, PMSGs of the same group are equivalent as one rescaled PMSG to realize the transient equivalent modeling of the PMSG-based WPP. Using the DIgSILENT PowerFactory simulation platform, the efficiency and accuracy of the proposed equivalent model are tested against the traditional equivalent WPP and the detailed WPP. The simulation results show the proposed equivalent model can be used to analyze the offline electromechanical transients in power systems.

  18. Attainment of radiation equivalency in nuclear power plant radioactive product management

    International Nuclear Information System (INIS)

    Adamov, E.O.; Ganev, I.Kh.; Orlov, V.V.

    1992-01-01

    Basic provisions for radiation equivalent radioactive waste disposal are formulated and conditions for its realization are considered. They include simultaneous removal of uranium and long-living products of its decay from the ore, separation of actinides from the fuel in the course of chemical reprocessing for burning in reactors, and possibly strontium and cesium with the purpose of their useful utilization and long-term controlled waste storage in the near-surface facilities

  19. Vitamin A equivalency of beta-carotene in healthy adults: limitation of the extrinsic dual-isotope dilution technique to measure matrix effect.

    NARCIS (Netherlands)

    Loo-Bouwman, C.A. Van; West, C.E.; Breemen, R.B. van; Zhu, D.; Siebelink, E.; Versloot, P.; Hulshof, P.J.; Lieshout, M. van; Russel, F.G.M.; Schaafsma, G.; Naber, A.H.J.

    2009-01-01

    Data on the vitamin A equivalency of beta-carotene in food are inconsistent. We quantified the vitamin A equivalency (microg) of beta-carotene in two diets using the dual-isotope dilution technique and the oral-faecal balance technique. A diet-controlled, cross-over intervention study was conducted

  20. Vitamin A equivalency of ß-carotene in healthy adults: limitation of the extrinsic dual-isotope dilution technique to measure matrix effect

    NARCIS (Netherlands)

    Bouwman, C.A.; West, C.E.; Breemen, van R.B.; Zhu, D.; Siebelink, E.; Versloot, P.; Hulshof, P.J.M.; Lieshout, van M.; Russel, F.G.M.; Schaafsma, G.; Naber, T.H.J.

    2009-01-01

    Data on the vitamin A equivalency of ß-carotene in food are inconsistent. We quantified the vitamin A equivalency (¿g) of ß-carotene in two diets using the dual-isotope dilution technique and the oral¿faecal balance technique. A diet-controlled, cross-over intervention study was conducted in