Sample records for controlled patient-preference equivalence

  1. Breaking bad news: patients' preferences and health locus of control. (United States)

    Martins, Raquel Gomes; Carvalho, Irene Palmares


    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. Understanding breast cancer patients' preference for two types of exercise training during chemotherapy in an unblinded randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Vallance Jeffrey K


    Full Text Available Abstract Background Patient preference for group assignment may affect outcomes in unblinded trials but few studies have attempted to understand such preferences. The purpose of the present study was to examine factors associated with breast cancer patients' preference for two types of exercise training during chemotherapy. Methods Breast cancer patients (N = 242 completed a battery of tests including a questionnaire that assessed patient preference and the theory of planned behavior (TPB prior to being randomized to usual care, resistance exercise training (RET, or aerobic exercise training (AET. Results 99 (40.9% participants preferred RET, 88 (36.4% preferred AET, and 55 (22.7% reported no preference. Past exercisers (p = 0.023, smokers (p = 0.004, and aerobically fitter participants (p = 0.005 were more likely to prefer RET. As hypothesized, participants that preferred AET had more favorable TPB beliefs about AET whereas participants that preferred RET had more favorable TPB beliefs about RET. In multivariate modeling, patient preference for RET versus AET was explained (R2 = .46; p 2 = .48; p Conclusion Breast cancer patients' preference for RET versus AET during chemotherapy was predicted largely by a difference in motivation for each type of exercise which, in turn, was based on differences in their beliefs about the anticipated benefits, enjoyment, and difficulty of performing each type of exercise during chemotherapy. These findings may help explain patient preference effects in unblinded behavioral trials. Trial Registration Identifier NCT00115713.

  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. (United States)

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


    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, on 22nd May 2013).

  4. What if your patient prefers an alternative pain control method? Self-hypnosis in the control of pain. (United States)

    Nickelson, C; Brende, J O; Gonzalez, J


    Despite the availability of specialized treatments for chronic pain, including biofeedback training, relaxation training, and hypnotic treatment, most physicians rely on the traditional approaches of surgery or pharmacotherapy. The patient in this case study had severe and chronic pain but found little relief from pain medications that also caused side effects. She then took the initiative to learn and practice self-hypnosis with good results. Her physician in the resident's internal medicine clinic supported her endeavor and encouraged her to continue self-hypnosis. This patient's success shows that self-hypnosis can be a safe and beneficial approach to control or diminish the pain from chronic pain syndrome and can become a useful part of a physician's therapeutic armamentarium.

  5. Effect of communication skills training program for oncologists based on patient preferences for communication when receiving bad news: a randomized controlled trial. (United States)

    Fujimori, Maiko; Shirai, Yuki; Asai, Mariko; Kubota, Kaoru; Katsumata, Noriyuki; Uchitomi, Yosuke


    The aim of this study was to identify the effects of a communication skills training (CST) program for oncologists, developed based on patient preferences regarding oncologists' communication. Thirty oncologists were randomly assigned to either an intervention group (IG; 2-day CST workshop) or control group (CG). Participants were assessed on their communication performance during simulated consultation and their confidence in communicating with patients at baseline and follow-up. A total of 1,192 patients (response rate, 84.6%) who had consultations with the participating oncologists at baseline and/or follow-up were assessed regarding their distress using the Hospital Anxiety and Depression Scale, satisfaction with the consultation, and trust in their oncologist after the consultation. At the follow-up survey, the performance scores of the IG had improved significantly, in terms of their emotional support (P = .011), setting up a supportive environment (P = .002), and ability to deliver information (P = .001), compared with those of the CG. Oncologists in the IG were rated higher at follow-up than those in the CG in terms of their confidence in themselves (P = .001). Patients who met with oncologists after they had undergone the CST were significantly less depressed than those who met with oncologists in the CG (P = .027). However, the CST program did not affect patient satisfaction with oncologists' style of communication. A CST program based on patient preferences is effective for both oncologists and patients with cancer. Oncologists should consider CST as an approach to enhancing their communication skills. © 2014 by American Society of Clinical Oncology.

  6. On equivalence classes in iterative learning control

    NARCIS (Netherlands)

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


    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

  7. Unpacking cancer patients' preferences for information about their care. (United States)

    Ellis, Erin M; Varner, Ashley


    Patient-centered decision making requires cancer patients be actively involved and feel sufficiently informed about their care, but patients' preferences for information are often unrecognized or unmet by their oncologist, particularly for more distressing topics. This study examined cancer patients' preferences for information about three care-related topics: (1) diagnostic information, (2) treatment costs, and (3) prognosis. We tested whether factors known to influence information preferences (psychological distress, control preferences, and financial distress) were differently associated with information preferences for each topic. Cancer patients (N = 176) receiving ongoing treatment completed a questionnaire that assessed their out-of-pocket treatment costs, psychological distress, preferences for control over their medical decisions, and the amount of information they desired and received from their oncologists about the three topics. Patients' preferences were less often met for treatment cost information than for the other topics, p information than they received. One-third of patients also wanted more prognostic information than they received. Patients' preferences for diagnostic information did not differ as a function of financial burden, distress, or control preferences, ps > 0.05. Preferences for cost information were greater among patients who preferred more control over their medical decisions, p = 0.016. Patients' preferences for prognostic information were greater among those desiring more control and with lower distress, ps information preferences. Appreciating the variability in information preferences across topics and patients may aid efforts to meet patients' information needs and improve outcomes.

  8. Rethinking of ureteral stent removal using an extraction string; what patients feel and what is patients' preference? : a randomized controlled study. (United States)

    Kim, Dae Ji; Son, Jeong Hwan; Jang, Seok Heun; Lee, Jae Won; Cho, Dae Sung; Lim, Chae Hong


    Ureteral stent removal using an extraction string is advantageous because it can obviate an invasive cystoscopy, but there is a paucity of data on how patients feel about it, and how bothersome or beneficial it is. We performed this study to evaluate patients' preference for stent removal using an extraction string and which parameters could affect it. In total, 114 consecutive patients undergoing ureteral stent insertion after ureteroscopic stone removal (URS) for unilateral recurrent ureter stones were enrolled. Patients were randomized to a string group or a no string group. Stent removal was performed on the first visit within 7 days postoperatively. All patients were asked to complete the ureteral stent symptom questionnaire, to rate the degree of pain during stent removal using a visual analog scale (VAS) and to answer to questions regarding their preference. No significant differences were found in domain total scores including urinary symptoms (p = 0.17), pain (p = 0.62), general health (p = 0.37), work performance (p = 0.41). However, regarding separate questions for 'dysuria' and 'difficulties with heavy physical activity', there were significant intergroup differences (p = 0.03 and p = 0.04, respectively). Particular, a significantly higher proportion of patients in the string group checked 'stoppage of sexual intercourse due to stent-related problems' than in the no string group (p = 0.03). VAS score on stent removal was significantly higher in the no string group than the string group (p = 0.005). Among the patients who remember the experience of an indwelling ureteral stent in the past, 85% (17/20) of the no string group answered 'No' to the question of 'difference between the methods used in this time and in the past'. On the contrary, 84.2% (16/19) answered 'Yes' to the same question in the string group. And, all 16 patients of the string group who noted differences between the methods preferred ureteral stent removal

  9. Patients' preferences for patient-centered communication

    DEFF Research Database (Denmark)

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


    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....

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

    Energy Technology Data Exchange (ETDEWEB)

    Norinder, O.; Nyman, K.


    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.

  11. Would Your Patient Prefer to Be Considered Your Friend? Patient Preferences in Physician Relationships (United States)

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


    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…

  12. 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.


    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

  13. 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


    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

  14. 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.


    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

  15. 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

  16. 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.


    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

  17. Incorporating patients' preferences into medical decision making. (United States)

    Fraenkel, Liana


    Current models of care emphasize the importance of including patients' values in the decision-making process. This is particularly important for decisions for which there are few data supporting a clear strategy or treatment choice. Constructing preferences for complex decisions requires that patients be able to consider multiple trade-offs between specific risks and benefits. Several marketing research techniques have been recently applied to heath care settings to facilitate this process. Most can be programmed to generate patients' preferences or priorities, which can then be used to improve patient-physician communication. In this article, we will describe some of the currently available approaches that have been successfully used in the health care setting. We provide case examples to illustrate the potential value of adopting each of these approaches in clinical practice.

  18. Patients' preferences for information in bariatric surgery. (United States)

    Coblijn, Usha K; Lagarde, Sjoerd M; de Raaff, Christel A L; van Wagensveld, Bart A; Smets, Ellen M A


    The decision to undergo bariatric surgery is multifactorial and made both by patient and doctor. Information is of the utmost importance for this decision. To investigate the bariatric surgery patient's preferences regarding information provision in bariatric surgery. A teaching hospital, bariatric center of excellence in Amsterdam, the Netherlands. All patients who underwent a primary laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy between September 2013 and September 2014 were approached by mail to participate. A questionnaire was used to elicit patient preferences for the content and format of information. Sociodemographic characteristics, clinicopathologic factors, and psychologic factors were explored as predictors for specific preferences. Of the 356 eligible patients, 112 (31.5%) participated. The mean age was 49.2 (±10.7) years, and 91 (81.3%) patients were female. Patients deemed the opportunity to ask questions (96.4%) the most important feature of the consult, followed by a realistic view on expectations-for example, results of the procedure (95.5%) and information concerning the consequences of surgery for daily life (89.1%). Information about the risk of complications on the order of 10% was desired by 93% of patients; 48% desired information about lower risks (.1%). Only 25 patients (22.3%) desired detailed information concerning their weight loss after surgery. Bariatric patients wished for information about the consequences of surgery on daily life, whereas the importance of information concerning complications decreased when their incidence lessened. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  19. 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


    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.

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

    Directory of Open Access Journals (Sweden)

    Eneko Unamuno


    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.

  1. Patients' preference to hear cancer diagnosis.

    Directory of Open Access Journals (Sweden)

    Mohammad Arbabi


    Full Text Available Bad news disclosure is one of the complex communication tasks of the physicians. Bad news is defined as:" any news that adversely and seriously affects an individual's view of his or her future". Recent studies indicate that the patients' and physicians' attitudes toward disclosure of bad news have been changed since few years ago. The evidence of breaking bad news is also different across different cultures. In the present study, we aimed to evaluate the patients' prospect about breaking bad news and to provide a clinical guidance for Iranian patients and those patients in countries with a similar cultural background.A cross sectional descriptive study was conducted on a sample of 200 cancer patients at a cancer institute in Tehran. The patients' demographic characteristics and their attitudes toward the manner of disclosing the diagnosis were registered in a research based questionnaire.In this study, 165 patients (82.5% claimed to be aware of the diagnosis; however, only 121 patients (73% were aware of the actual diagnosis of their disease. Most patients tended to know the diagnosis (n = 186, 93% and accepted patient as the first person to be informed (n = 151, 75.5% by their physician (n = 174, 87%. The preference of being alone or with a family member when exposed to bad news was almost the same. Most patients (n = 169, 84.5% believed that physicians should consult the patients to make treatment decisions. Treatment options (n = 140, 70% and life expectancy (n = 121, 60.5% were the most desirable topics to be discussed. Most patients (n = 144, 72% agreed upon allowing them to express their emotional feelings.According to the patients' preferences about being fully informed about the diagnosis, it is suggested that the disclosure of cancer diagnosis be done by a physician and in the presence of a family member. It is also recommended that physicians consult the patients about treatment options.

  2. Including patient preferences and applying guideline recommendations: a conflict?

    NARCIS (Netherlands)

    Brabers, A.; Esch, T.E.M. van; Groenewegen, P.P.; Hek, K.; Mullenders, P.; Dijk, L. van; Jong, J.D. de


    Background: One perceived barrier to adherence to guidelines is the existence of patient preferences which may conflict with them. We examined whether patient preferences influence the prescription of antibiotics in general practice, and how this affects adherence to guidelines. We hypothesised that

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

    International Nuclear Information System (INIS)

    Weissglas, P.


    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

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

    DEFF Research Database (Denmark)

    Weckesser, Johannes Tilman Gabriel; Van Cutsem, Thierry


    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...

  5. Stabilizing Parametric Region of Multiloop PID Controllers for Multivariable Systems Based on Equivalent Transfer Function

    Directory of Open Access Journals (Sweden)

    Xiaoli Luan


    Full Text Available The aim of this paper is to determine the stabilizing PID parametric region for multivariable systems. Firstly, a general equivalent transfer function parameterization method is proposed to construct the multiloop equivalent process for multivariable systems. Then, based on the equivalent single loops, a model-based method is presented to derive the stabilizing PID parametric region by using the generalized Hermite-Biehler theorem. By sweeping over the entire ranges of feasible proportional gains and determining the stabilizing regions in the space of integral and derivative gains, the complete set of stabilizing PID controllers can be determined. The robustness of the design procedure against the approximation in getting the SISO plants is analyzed. Finally, simulation of a practical model is carried out to illustrate the effectiveness of the proposed technique.

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

    International Nuclear Information System (INIS)


    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

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

    International Nuclear Information System (INIS)

    Finesso, Roberto; Spessa, Ezio; Venditti, Mattia


    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

  8. Patient preference for cancer therapy: an overview of measurement approaches

    NARCIS (Netherlands)

    Stiggelbout, A. M.; de Haes, J. C.


    PURPOSE: In the era of evidence-based medicine and shared decision making, the formal assessment of patient preference for treatments or treatment outcomes has attracted much attention. In this article, the two most common approaches to the evaluation of preference, ie, utility assessment and

  9. Patients' preferences in palliative care: A systematic mixed studies review. (United States)

    Sandsdalen, Tuva; Hov, Reidun; Høye, Sevald; Rystedt, Ingrid; Wilde-Larsson, Bodil


    It is necessary to develop palliative care to meet existing and future needs of patients and their families. It is important to include knowledge of patient preferences when developing high-quality palliative care services. Previous reviews have focused on patient preferences with regard to specific components of palliative care. There is a need to review research on patient's combined preferences for all elements that constitute palliative care. The aim of this study is to identify preferences for palliative care among patients in the palliative phase of their illness, by synthesizing existing research. Studies were retrieved by searching databases - the Cochrane Library, Medline, CINAHL, PsycINFO, Scopus and Sociological Abstracts - from 1946 to 2014, and by hand searching references in the studies included. A systematic mixed studies review was conducted. Two reviewers independently selected studies for inclusion and extracted data according to the eligibility criteria. Data were synthesized using integrative thematic analysis. The 13 qualitative and 10 quantitative studies identified included participants with different illnesses in various settings. Four themes emerged representing patient preferences for care. The theme 'Living a meaningful life' illustrated what patients strived for. The opportunity to focus on living required the presence of 'Responsive healthcare personnel', a 'Responsive care environment' and 'Responsiveness in the organization of palliative care'. The four themes may be useful for guiding clinical practice and measurements of quality, with the overall goal of meeting future needs and improving quality in palliative care services to suit patients' preferences. © The Author(s) 2015.

  10. Patients preference for doctors' gender in North Western, Nigeria ...

    African Journals Online (AJOL)

    Background: Cultural and religious beliefs affect the way people perceive illness and therapeutic interventions. These also affect the ability of patients and doctors to communicate freely, Objectives: To determine patients' preference for doctors' gender among patients attending the antenatal and gynaceology clinics in ...

  11. Eliciting patients' preferences for epilepsy diagnostics: a discrete choice experiment. (United States)

    Wijnen, B F M; de Kinderen, R J A; Colon, A J; Dirksen, C D; Essers, B A B; Hiligsmann, M; Leijten, F S S; Ossenblok, P P W; Evers, S M A A


    Diagnosing epilepsy is a lengthy and burdensome process for patients and their family. Although the need for a more patient-centered approach in clinical practice is widely acknowledged, empirical evidence regarding patient preferences for diagnostic modalities in epilepsy is missing. The objectives of this study were 1) to identify to what extent important attributes of diagnostic procedures in epilepsy affect preferences for a procedure, 2) to determine the relative importance of these attributes, and 3) to calculate overall utility scores for routine electroencephalography (EEG) and magnetoencephalography (MEG) recordings. A discrete choice experiment was performed to determine patients' preferences, which involved presentation of pairwise choice tasks regarding hypothetical scenarios. Scenarios varied along six attributes: "way of measuring brain activity", "duration", "freedom of movement", "travel time", "type of additional examination", and "chance of additional examination". Choice tasks were constructed using a statistically efficient design, and the questionnaire contained 15 unique unlabeled choice tasks. Mixed multinomial logistic regression was used to estimate patients' preferences. A total of 289 questionnaires were included in the analysis. McFadden's pseudo R(2) showed a model fit of 0.28, and all attributes were statistically significant. Heterogeneity in preferences was present for all attributes. "Freedom of movement" and "Chance of additional examination" were perceived as the most important attributes. Overall utility scores did not substantially differ between routine EEG and MEG. This study suggests that the identified attributes are important in determining patients' preference for epilepsy diagnostics. It can be concluded that MEG is not necessarily more patient-friendly than a routine EEG in primary diagnostics and, regarding additional diagnostics, patients have a strong preference for long-term 24-h EEG over EEG after sleep deprivation

  12. Patient Preferences for Managing Insomnia: A Discrete Choice Experiment. (United States)

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


    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 < 0.05); had an ongoing, as opposed to a predefined, duration of treatment course (p < 0.05); required some, as opposed to no, additional time commitment (p < 0.05); and had lower monthly out-of-pocket treatment costs (p < 0.001). However, treatment onset of action had no influence on preference. Age, help-seeking status, concession card status and fatigue severity significantly influenced treatment preference. Participants' prioritization of investing time in treatment and valuing the maintainability of therapeutic gains suggests a stronger inclination towards non-pharmacological treatment, defying current assumptions that patients prefer 'quick-fixes' for managing insomnia.

  13. Establishing specificity in psychotherapy: a meta-analysis of structural equivalence of placebo controls. (United States)

    Baskin, Thomas W; Tierney, Sandy Callen; Minami, Takuya; Wampold, Bruce E


    Placebo treatments in psychotherapy cannot adequately control for all common factors, which thereby attenuates their effects vis-a-vis active treatments. In this study, the authors used meta-analytic procedures to test one possible factor contributing to the attenuation of effects: structural inequalities between placebo and active treatments. Structural aspects of the placebo included number and duration of sessions, training of therapist, format of therapy, and restriction of topics. Results indicate that comparisons between active treatments and structurally inequivalent placebos produced larger effects than comparisons between active treatments and structurally equivalent placebos: moreover, the latter comparison produced negligible effects, indicating that active treatments were not demonstrably superior to well-designed placebos. (c) 2003 APA

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

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


    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.

  15. Factors associated with patient preferences for communication of bad news. (United States)

    Fujimori, Maiko; Akechi, Tatsuo; Uchitomi, Yosuke


    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.

  16. Hemodialysis patients' preferences for the management of secondary hyperparathyroidism. (United States)

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


    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

  17. Understanding patients' preferences for surgical management of urethral stricture disease. (United States)

    Hampson, Lindsay A; Lin, Tracy K; Wilson, Leslie; Allen, Isabel E; Gaither, Thomas W; Breyer, Benjamin N


    To understand how prioritization of treatment attributes and treatment choice varies by patient characteristics, we sought to specifically determine how demographic variables affect patient treatment preference. Male patients with urethral stricture disease participated in a choice-based conjoint (CBC) analysis exercise evaluating six treatment attributes associated with internal urethrotomy and urethroplasty. Demographic and past symptom data were collected. Stratified analysis of demographic variables, including age, education, income, was conducted using a mixed effect logistic regression model to evaluate the coefficient size and confidence intervals between the treatments attribute preferences of each strata. 169 patients completed the CBC exercise and were included in our analysis. Overall success of the procedure is the most important treatment attribute to patients and this persists across strata. Older patients (≥65) express preferences for better success rates and fewer future procedures, whereas younger patients prefer a less invasive approach and are more willing to accept additional procedures if needed. Patients with lower levels of education preferred open reconstruction and had a stronger preference against multiple future procedures, whereas those with higher levels of education preferred endoscopic treatment and had a less strong preference against multiple future procedures. Low-income individuals express statistically significant stronger negative preferences against high copay costs compared to high-income individuals. These results can help to inform physicians' counseling about surgical management of urethral stricture disease to better align patient preferences with treatment selection and encourage shared decision making.

  18. Gyrokinetic equivalence

    International Nuclear Information System (INIS)

    Parra, Felix I; Catto, Peter J


    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.

  19. Implementation of shared decision making in physical therapy: observed level of involvement and patient preference. (United States)

    Dierckx, Katreine; Deveugele, Myriam; Roosen, Philip; Devisch, Ignaas


    Shared decision making (SDM) reduces the asymmetrical power between the therapist and the patient. Patient involvement improves patient satisfaction, adherence, and health outcomes and is a prerequisite for good clinical practice. The opportunities for using SDM in physical therapy have been previously considered. The objective of this study was to examine the status of SDM in physical therapy, patients' preferred levels of involvement, and the agreement between therapist perception and patient preferred level of involvement. This was an observational study of real consultations in physical therapy. In total, 237 consultations, undertaken by 13 physical therapists, were audiorecorded, and 210 records were analyzed using the Observing Patient Involvement (OPTION) instrument. Before the consultation, the patient and therapist completed the Control Preference Scale (CPS). Multilevel analysis was used to study the association between individual variables and the level of SDM. Agreement on preferences was calculated using kappa coefficients. The mean OPTION score was 5.2 (SD=6.8), out of a total score of 100. Female therapists achieved a higher OPTION score (b=-0.86, P=0.01). In total, 36.7% of the patients wanted to share decisions, and 36.2% preferred to give their opinion before delegating the decisions. In the majority of cases, therapists believed that they had to decide. The kappa coefficient for agreement was poor at .062 (95% confidence interval=-.018 to .144). Only 13 out of 125 therapists who were personally contacted agreed to participate. Shared decision making was not applied; although patients preferred to share decisions or at least provide their opinion about the treatment, physical therapists did not often recognize this factor. The participating physical therapists were more likely to make decisions in the best interest of their patients; that is, these therapists tended to apply a paternalistic approach rather than involving the patient.

  20. Investigating patients' preferences for cardiac rehabilitation in Denmark

    DEFF Research Database (Denmark)

    Kjaer, Trine; Gyrd-Hansen, Dorte; Willaing, Ingrid


    OBJECTIVES: The objective of this study was to analyze preferences for activities comprised in comprehensive cardiac rehabilitation programs among former cardiac patients from three different hospitals in Copenhagen County, Denmark. METHODS: A discrete choice experiment was applied to elicit...... cardiac patients. We had a response rate of 69 percent. RESULTS: We found that preferences differed with respect to gender and age and that the offer of participation in cardiac rehabilitation activities was not highly valued by older patients, in particular among older men. CONCLUSIONS: The discrete...... choice experiment proved a valuable instrument for the measurement of preferences for cardiac rehabilitation. The study provides important information on patients' preferences for cardiac rehabilitation for healthcare professionals and decision makers....

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

    Directory of Open Access Journals (Sweden)

    Monali Bhosle


    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

  2. Planned vaginal birth or elective repeat caesarean: patient preference restricted cohort with nested randomised trial.

    Directory of Open Access Journals (Sweden)

    Caroline A Crowther

    Full Text Available BACKGROUND: Uncertainty exists about benefits and harms of a planned vaginal birth after caesarean (VBAC compared with elective repeat caesarean (ERC. We conducted a prospective restricted cohort study consisting of a patient preference cohort study, and a small nested randomised trial to compare benefits and risks of a planned ERC with planned VBAC. METHODS AND FINDINGS: 2,345 women with one prior caesarean, eligible for VBAC at term, were recruited from 14 Australian maternity hospitals. Women were assigned by patient preference (n = 2,323 or randomisation (n = 22 to planned VBAC (1,225 patient preference, 12 randomised or planned ERC (1,098 patient preference, ten randomised. The primary outcome was risk of fetal death or death of liveborn infant before discharge or serious infant outcome. Data were analysed for the 2,345 women (100% and infants enrolled. The risk of fetal death or liveborn infant death prior to discharge or serious infant outcome was significantly lower for infants born in the planned ERC group compared with infants in the planned VBAC group (0.9% versus 2.4%; relative risk [RR] 0.39; 95% CI 0.19-0.80; number needed to treat to benefit 66; 95% CI 40-200. Fewer women in the planned ERC group compared with women in the planned VBAC had a major haemorrhage (blood loss ≥ 1,500 ml and/or blood transfusion, (0.8% [9/1,108] versus 2.3% [29/1,237]; RR 0.37; 95% CI 0.17-0.80. CONCLUSIONS: Among women with one prior caesarean, planned ERC compared with planned VBAC was associated with a lower risk of fetal and infant death or serious infant outcome. The risk of major maternal haemorrhage was reduced with no increase in maternal or perinatal complications to time of hospital discharge. Women, clinicians, and policy makers can use this information to develop health advice and make decisions about care for women who have had a previous caesarean. TRIAL REGISTRATION: Current Controlled Trials ISRCTN53974531

  3. Planned vaginal birth or elective repeat caesarean: patient preference restricted cohort with nested randomised trial. (United States)

    Crowther, Caroline A; Dodd, Jodie M; Hiller, Janet E; Haslam, Ross R; Robinson, Jeffrey S


    Uncertainty exists about benefits and harms of a planned vaginal birth after caesarean (VBAC) compared with elective repeat caesarean (ERC). We conducted a prospective restricted cohort study consisting of a patient preference cohort study, and a small nested randomised trial to compare benefits and risks of a planned ERC with planned VBAC. 2,345 women with one prior caesarean, eligible for VBAC at term, were recruited from 14 Australian maternity hospitals. Women were assigned by patient preference (n = 2,323) or randomisation (n = 22) to planned VBAC (1,225 patient preference, 12 randomised) or planned ERC (1,098 patient preference, ten randomised). The primary outcome was risk of fetal death or death of liveborn infant before discharge or serious infant outcome. Data were analysed for the 2,345 women (100%) and infants enrolled. The risk of fetal death or liveborn infant death prior to discharge or serious infant outcome was significantly lower for infants born in the planned ERC group compared with infants in the planned VBAC group (0.9% versus 2.4%; relative risk [RR] 0.39; 95% CI 0.19-0.80; number needed to treat to benefit 66; 95% CI 40-200). Fewer women in the planned ERC group compared with women in the planned VBAC had a major haemorrhage (blood loss ≥ 1,500 ml and/or blood transfusion), (0.8% [9/1,108] versus 2.3% [29/1,237]; RR 0.37; 95% CI 0.17-0.80). Among women with one prior caesarean, planned ERC compared with planned VBAC was associated with a lower risk of fetal and infant death or serious infant outcome. The risk of major maternal haemorrhage was reduced with no increase in maternal or perinatal complications to time of hospital discharge. Women, clinicians, and policy makers can use this information to develop health advice and make decisions about care for women who have had a previous caesarean. Current Controlled Trials ISRCTN53974531

  4. 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


    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......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...

  5. Patient preferences for first-line oral treatment for mild-to-moderate ulcerative colitis: a discrete-choice experiment. (United States)

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


    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

  6. 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


    , and the performance of the secondary controller degrades due to the uncertain communication delay and data drop-out in the LBC lines. Recently, a washout filter-based power sharing method was presented without communication lines and additional control loops. In this paper, the equivalence between secondary control......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...... and washout filter-based power sharing strategy for islanded microgrid is demonstrated, and the generalized washout filter control scheme has been obtained. Additionally, the physical meaning of control parameters of secondary controllers is also presented. Besides, a complete small-signal model...

  7. Dose equivalents of antidepressants: Evidence-based recommendations from randomized controlled trials. (United States)

    Hayasaka, Yu; Purgato, Marianna; Magni, Laura R; Ogawa, Yusuke; Takeshima, Nozomi; Cipriani, Andrea; Barbui, Corrado; Leucht, Stefan; Furukawa, Toshi A


    Dose equivalence of antidepressants is critically important for clinical practice and for research. There are several methods to define and calculate dose equivalence but for antidepressants, only daily defined dose and consensus methods have been applied to date. The purpose of the present study is to examine dose equivalence of antidepressants by a less arbitrary and more systematic method. We used data from all randomized, double-blind, flexible-dose trials comparing fluoxetine or paroxetine as standard drugs with any other active antidepressants as monotherapy in the acute phase treatment of unipolar depression. We calculated the ratio of the mean doses for each study and weighted it by the total sample size to find the weighted mean ratio for each drug, which was then used to define the drug׳s dosage equivalent to fluoxetine 40mg/d. We included 83 studies (14 131 participants). In the primary analysis, fluoxetine 40mg/day was equivalent to paroxetine dosage of 34.0mg/day, agomelatine 53.2mg/day, amitriptyline, 122.3mg/day, bupropion 348.5mg/day, clomipramine 116.1mg/day, desipramine 196.3mg/day, dothiepin 154.8mg/day, doxepin 140.1mg/day, escitalopram 18.0mg/day, fluvoxamine 143.3mg/day, imipramine 137.2mg/day, lofepramine 250.2mg/day, maprotiline 118.0mg/day, mianserin, 101.1mg/day, mirtazapine 50.9mg/day, moclobemide 575.2mg/day, nefazodone 535.2mg/day, nortriptyline 100.9mg/day, reboxetine 11.5mg/day, sertraline 98.5mg/day, trazodone 401.4mg/day, and venlafaxine 149.4mg/day. Sensitivity analyses corroborated the results except for doxepin. The number of studies for some drugs was small. The current method assumes dose response relationship of antidepressants. Our findings can be useful for clinicians when they switch antidepressants and for researchers when they compare various antidepressants in their research. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  8. 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.; Berg, Selina Kikkenborg; Christensen, Jan


    OBJECTIVE: To assess patient preference for exercise setting and examine if choice of setting influences the long-term health benefit of exercise-based cardiac rehabilitation. METHODS: Patients participating in a randomised controlled trial following either heart valve surgery, or radiofrequency...... 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....

  9. ANFIS-based estimation of PV module equivalent parameters: application to a stand-alone PV system with MPPT controller


    KULAKSIZ, Ahmet Afşin


    The performance and system cost of photovoltaic (PV) systems can be improved by employing high-efficiency power conditioners with maximum power point tracking (MPPT) methods. Fast implementation and accurate operation of MPPT controllers can be realized by modeling the characteristics of PV modules, obtaining equivalent parameters. In this study, adaptive neuro-fuzzy inference systems (ANFISs) have been used to obtain 3 of the parameters in a single-diode model of PV cells, namely serie...

  10. 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


    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

  11. Patient Preferences for Device-Aided Treatments Indicated for Advanced Parkinson Disease. (United States)

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


    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.

  12. Patients' preferences in anticoagulant therapy: discrete choice experiment. (United States)

    Najafzadeh, Mehdi; Gagne, Joshua J; Choudhry, Niteesh K; Polinski, Jennifer M; Avorn, Jerry; Schneeweiss, Sebastian S


    With proliferating treatment options for anticoagulant therapy, physicians and patients must choose among them based on their benefits and risks. Using a Discrete Choice Experiment, we elicited patients' relative preferences for specific benefits and risks of anticoagulant therapy. We selected a sample of US patients with cardiovascular disease from an online panel and elicited their preferences for benefits and risks of anticoagulant therapy: nonfatal stroke, nonfatal myocardial infarction, cardiovascular death, minor bleeding, major bleeding, bleeding death, and need for monitoring. These attributes were used to design scenarios describing hypothetical treatments that were labeled as new drug, old drug, or no drug. Latent class analysis was used to identify groups of patients with similar preferences. A total of 341 patients completed all Discrete Choice Experiment questions. On average, patients valued a 1% increased risk of a fatal bleeding event the same as a 2% increase in nonfatal myocardial infarction, a 3% increase in nonfatal stroke, a 3% increase in cardiovascular death, a 6% increase in major bleeding, and a 16% increase in minor bleeding. The odds of choosing no drug or old drug versus new drug were 0.72 (95% confidence interval, 0.61-0.84) and 0.86 (95% confidence interval, 0.81-0.93), respectively. Previous stroke or myocardial infarction was associated with membership in the class with larger negative preferences for these outcomes. Patients' preferences for various outcomes of anticoagulant therapy vary and depend on their previous experiences with myocardial infarction or stroke. Incorporating these preferences into benefit risk calculation and treatment decisions can enhance patient-centered care. © 2014 American Heart Association, Inc.

  13. A Discrete Choice Study of Patient Preferences for Dialysis Modalities. (United States)

    Walker, Rachael C; Morton, Rachael L; Palmer, Suetonia C; Marshall, Mark R; Tong, Allison; Howard, Kirsten


    Improved knowledge about factors that influence patient choices when considering dialysis modality could facilitate health care interventions to increase rates of home dialysis. We aimed to quantify the attributes of dialysis care and the tradeoffs that patients consider when making decisions about dialysis modalities. We conducted a prospective, discrete choice experiment survey with random parameter logit analysis to quantify preferences and tradeoffs for attributes of dialysis treatment in 143 adult patients with CKD expected to require RRT within 12 months (predialysis). The attributes included schedule flexibility, patient out of pocket costs, subsidized transport services, level of nursing support, life expectancy, dialysis training time, wellbeing on dialysis, and dialysis schedule (frequency and duration). We reported outcomes using β -coefficients with corresponding odds ratios and 95% confidence intervals for choosing home-based dialysis (peritoneal dialysis or hemodialysis) compared with facility hemodialysis. Home-based therapies were significantly preferred with the following attributes: longer survival (odds ratio per year, 1.63; 95% confidence interval, 1.25 to 2.12), increased treatment flexibility (odds ratio, 9.22; 95% confidence interval, 2.71 to 31.3), improved wellbeing (odds ratio, 210; 95% confidence interval, 15 to 2489), and more nursing support (odds ratio, 87.3; 95% confidence interval, 3.8 to 2014). Respondents were willing to accept additional out of pocket costs of approximately New Zealand $400 (United States $271) per month (95% confidence interval, New Zealand $333 to $465) to receive increased nursing support. Patients were willing to accept out of pocket costs of New Zealand $223 (United States $151) per month (95% confidence interval, New Zealand $195 to $251) for more treatment flexibility. Patients preferred home dialysis over facility-based care when increased nursing support was available and when longer survival, wellbeing

  14. Patient preference regarding assessment of clinical follow-up after percutaneous coronary intervention: the PAPAYA study

    NARCIS (Netherlands)

    Kok, Marlies M.; von Birgelen, Clemens; Lam, Ming Kai; Löwik, Marije M.; van Houwelingen, K. Gert; Stoel, Martin G.; Louwerenburg, J. (Hans) W.; de Man, Frits H.A.F.; Hartmann, Marc; Doggen, Catharina Jacoba Maria; van Til, Janine Astrid; IJzerman, Maarten Joost


    Aims: To keep patients in long-term clinical follow-up programmes after percutaneous coronary intervention (PCI), knowledge of the patient-preferred mode for follow-up assessment is crucial. We systematically assessed patient preference, and explored potential relationships with age and

  15. Patient Preference for Dosing Frequency Based on Prior Biologic Experience. (United States)

    Zhang, Mingliang; Carter, Chureen; Olson, William H; Johnson, Michael P; Brennem, Susan K; Lee, Seina; Farahi, Kamyar


    There is limited research exploring patient preferences regarding dosing frequency of biologic treatment of psoriasis. Patients with moderate-to-severe plaque psoriasis identified in a healthcare claims database completed a survey regarding experience with psoriasis treatments and preferred dosing frequency. Survey questions regarding preferences were posed in two ways: (1) by likelihood of choosing once per week or 2 weeks, or 12 weeks; and (2) by choosing one option among once every 1-2 or 3-4 weeks or 1-2 or 2-3 months. Data were analyzed by prior biologic history (biologic-experienced vs biologic-naïve, and with one or two specific biologics). Overall, 426 patients completed the survey: 163 biologic-naïve patients and 263 biologic-experienced patients (159 had some experience with etanercept, 105 with adalimumab, and 49 with ustekinumab). Among patients who indicated experience with one or two biologics, data were available for 219 (30 with three biologics and 14 did not specify which biologic experience). The majority of biologic-naïve (68.8%) and overall biologic-experienced (69.4%) patients indicated that they were very likely to choose the least frequent dosing option of once every 12 weeks (Table 1). In contrast, fewer biologic-naïve (9.1% and 16.7%) and biologic-experienced (22.5% and 25.3%) patients indicated that they were very likely to choose the 1-week and 2-week dosing interval options, respectively. In each cohort grouped by experience with specific biologics, among those with no experience with ustekinumab, the most chosen option was 1-2 weeks. The most frequently chosen option was every 2-3 months, among patients with any experience with ustekinumab, regardless of their experience with other biologics. The least frequent dosing interval was preferred among biologic naïve patients and patients who had any experience with ustekinumab. Dosing interval may influence the shared decision-making process for psoriasis treatment with biologics. J

  16. Management of chronic knee pain: A survey of patient preferences and treatment received

    Directory of Open Access Journals (Sweden)

    Hurley Michael V


    Full Text Available Abstract Background A range of interventions exist for the management of knee pain, but patient preferences for treatment are not clear. In this study the management received by people with chronic knee pain, their management preferences and reasons for these preferences were recorded. Methods At baseline assessment of a clinical trial of rehabilitation for chronic knee pain, 415 participants were asked about their i previous management, ii preferred treatment, if any, iii whether they would undergo knee surgery and iv reasons for their preferences. Results Previous management – Medication was the most common treatment, followed by physiotherapy, 39 participants had received no treatment. Preferences – 166 patients expressed no treatment preference. Of those who expressed a preference the most popular option was physiotherapy, whilst not having surgery was the third most frequent response. The most common reason for preferring physiotherapy and not wanting surgery was prior experience. Willingness to accept surgery – 390 participants were not waiting for knee replacement surgery, and overall 81% would not accept surgery if offered, usually because pain was not perceived to be severe enough to warrant surgery. Conclusion Most chronic knee pain is managed with medication despite concerns about safety, efficacy and cost, management guidelines recommendations and people's management preferences. Previous experience and perceptions of need were major determinants of people's preferences, but many people were unaware of management options. Appreciating patient preferences and provision of more information about management options are important in facilitating informed patient/clinician discussion and agreement. Trial Registration Current Controlled Trials, ISRCTN 94658828

  17. 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


    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.

  18. 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.


    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

  19. CT colonography and colonoscopy: Assessment of patient preference in a 5-week follow-up study

    NARCIS (Netherlands)

    van Gelder, Rogier E.; Birnie, Erwin; Florie, Jasper; Schutter, Michiel P.; Bartelsman, Joep F.; Snel, Pleun; Laméris, Johan S.; Bonsel, Gouke J.; Stoker, Jaap


    PURPOSE: To prospectively evaluate short- and midterm patient preference of computed tomographic (CT) colonography relative to colonoscopy in patients at increased risk for colorectal cancer and to elucidate determinants of preference. MATERIALS AND METHODS: Consecutive patients at increased risk

  20. 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.


    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

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

    National Research Council Canada - National Science Library

    Catalona, William


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

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

    National Research Council Canada - National Science Library

    Catalona, WIlliam


    .... 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...

  3. Methods to perform systematic reviews of patient preferences: a literature survey


    Yu, Tsung; Enkh-Amgalan, Nomin; Zorigt, Ganchimeg


    Background Systematic reviews are a commonly used research design in the medical field to synthesize study findings. At present—although several systematic reviews of patient preference studies are published—there is no clear guidance available for researchers to conduct this type of systematic review. The aim of our study was to learn the most current practice of conducting these systematic reviews by conducting a survey of the literature regarding reviews of quantitative patient preference ...

  4. Patients prefer results from the ordering provider and access to their radiology reports


    Cabarrus, M; Naeger, DM; Rybkin, A; Qayyum, A


    © 2015 American College of Radiology. Purpose: Imaging results are generally communicated to patients by referring providers. Directly communicating results has been suggested as a way for radiologists to add value, though few studies have investigated patients' preferences in this regard. The aim of this study was to determine patients' preferences for receiving their imaging results. Methods: In this institutional review board-approved study, adult outpatients undergoing CT or MRI at an aca...

  5. Postsurgical pain outcome of vertical and transverse abdominal incision: Design of a randomized controlled equivalence trial [ISRCTN60734227

    Directory of Open Access Journals (Sweden)

    Motsch Johann


    Full Text Available Abstract Background There are two ways to open the abdominal cavity in elective general surgery: vertically or transversely. Various clinical studies and a meta-analysis have postulated that the transverse approach is superior to other approaches as regards complications. However, in a recent survey it was shown that 90 % of all abdominal incisions in visceral surgery are still vertical incisions. This discrepancy between existing recommendations of clinical trials and clinical practice could be explained by the lack of acceptance of these results due to a number of deficits in the study design and analysis, subsequent low internal validity, and therefore limited external generalisability. The objective of this study is to address the issue from the patient's perspective. Methods This is an intraoperatively randomized controlled observer and patient-blinded two-group parallel equivalence trial. The study setting is the Department of General-, Visceral-, Trauma Surgery and Outpatient Clinic of the University of Heidelberg, Medical School. A total of 172 patients of both genders, aged over 18 years who are scheduled for an elective abdominal operation and are eligible for either a transverse or vertical incision. To show equivalence of the two approaches or the superiority of one of them from the perspective of the patient, a primary endpoint is defined: the pain experienced by the patient (VAS 0–100 on day two after surgery and the amount of analgesic required (piritramide [mg/h]. A confidence interval approach will be used for analysis. A global α-Level of 0.05 and a power of 0.8 is guaranteed, resulting in a size of 86 patients for each group. Secondary endpoints are: time interval to open and close the abdomen, early-onset complications (frequency of burst abdomen, postoperative pulmonary complications, and wound infection and late complications (frequency of incisional hernias. Different outcome variables will be ranked by patients and

  6. An Investigation of Patient Preferences for Music Played Before Electroconvulsive Therapy. (United States)

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


    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.

  7. A Framework for Incorporating Patient Preferences Regarding Benefits and Risks into Regulatory Assessment of Medical Technologies. (United States)

    Ho, Martin; Saha, Anindita; McCleary, K Kimberly; Levitan, Bennett; Christopher, Stephanie; Zandlo, Kristen; Braithwaite, R Scott; Hauber, A Brett

    In response to 2012 guidance in which the US Food and Drug Administration's (FDA) Center for Devices and Radiological Health (CDRH) stated the importance of patient-centric measures in regulatory benefit-risk assessments, the Medical Device Innovation Consortium (MDIC) initiated a project. The project was used to develop a framework to help the Food and Drug Administration (FDA) and industry sponsors understand how patient preferences regarding benefit and risk might be integrated into the review of innovative medical devices. A public-private partnership of experts from medical device industry, government, academia and non-profits collaborated on development of the MDIC patient centered benefit-risk framework. The MDIC Framework examines what patient preference information is and the potential use and value of patient preference information in the regulatory process and across the product development life cycle. The MDIC Framework also includes a catalog of patient preference assessment methods and an agenda for future research to advance the field. This article discusses key concepts in patient preference assessment of particular importance for regulators and researchers that are addressed in the MDIC Framework for patient centered benefit-risk assessment as well as the unique public-private collaboration that led its development. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  8. 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


    . 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

  9. Patient preference for bra or binder after breast surgery. (United States)

    Laura, Sharon; Clark, David; Harvey, Fiona


    No data are currently available to assess the relative merits of breast binder or bra following breast surgery. A randomized controlled study was undertaken to compare a breast binder with a bra postoperatively for patients undergoing lumpectomies, partial mastectomies and total mastectomies. Fifty-eight patients were included in the study. Six different parameters were compared and the bra was found better on all criteria; a small group of patients who initially used a binder and then, for a second procedure, used a bra, found the bra more comfortable. Postoperative discomfort can be decreased by using a well-fitting bra rather than a breast binder.

  10. Tubers from potato lines expressing a tomato Kunitz protease inhibitor are substantially equivalent to parental and transgenic controls. (United States)

    Khalf, Moustafa; Goulet, Charles; Vorster, Juan; Brunelle, France; Anguenot, Raphaël; Fliss, Ismaïl; Michaud, Dominique


    Recombinant protease inhibitors represent useful tools for the development of insect-resistant transgenic crops, but questions have been raised in recent years about the impact of these proteins on endogenous proteases and chemical composition of derived food products. In this study, we performed a detailed compositional analysis of tubers from potato lines expressing the broad-spectrum inhibitor of Ser and Asp proteases, tomato cathepsin D inhibitor (SlCDI), to detect possible unintended effects on tuber composition. A compositional analysis of key nutrients and toxic chemicals was carried out with tubers of SlCDI-expressing and control (comparator) lines, followed by a two-dimensional gel electrophoresis (2-DE) proteomic profiling of total and allergenic proteins to detect eventual effects at the proteome level. No significant differences were observed among control and SlCDI-expressing lines for most chemicals assayed, in line with the very low abundance of SlCDI in tubers. Likewise, proteins detected after 2-DE showed no quantitative variation among the lines, except for a few proteins in some control and test lines, independent of slcdi transgene expression. Components of the patatin storage protein complex and Kunitz protease inhibitors immunodetected after 2-DE showed unaltered deposition patterns in SlCDI-expressing lines, clearly suggesting a null impact of slcdi on the intrinsic allergenic potential of potato tubers. These data suggest, overall, a null impact of slcdi expression on tuber composition and substantial equivalence between comparator and SlCDI-expressing tubers despite reported effects on leaf protein catabolism. They also illustrate the usefulness of proteomics as a tool to assess the authenticity of foods derived from novel-generation transgenic plants.

  11. Immediate versus delayed insertion of an etonogestrel releasing implant at medical abortion-a randomized controlled equivalence trial. (United States)

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


    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

  12. Equivalence of quality control strains of microorganisms used in the compendial microbiological tests: are national culture collection strains identical? (United States)

    Cundell, Anthony M; Chatellier, Sonia; Schumann, Peter; Lilischkis, Richard


    The pharmacopoeias list a number of microorganisms to be used in the compendial microbiological tests for confirming the growth-promoting, indicative, and inhibitory properties of the media and demonstrating the suitability of the test for a specific test article. Major national culture collections are specified as the sources for these test strains based on their history of deposition and maintenance and use in the compendial tests. Using these microorganisms, it has long been assumed that these strains are interchangeable and that sourcing the strains from different culture collections has no impact on the result of the media quality control and method qualification tests. In order to evaluate whether this assumption is correct and to add more certainty to the procedures, we investigated whether there are detectable differences among isolates of the same strain sourced from different culture collections. Using various phenotypic and genotypic identification and strain typing methods, nine major pharmacopoeial species were analyzed. As expected, most of the species showed very uniform patterns across the isolates, indicating that the strains were indeed identical. Surprisingly, the strains of Salmonella enterica subsp. enterica serotype abony showed distinct differences at both the genotypic and the phenotypic level, suggesting that the strains sourced from the different culture collections were not identical strains, or that they have undergone detectable genetic shift from the time they were derived from the original depositor. Irrespective of the level of genotypic or phenotypic homology identified here, there are no practical consequences on their performance in compendial assays. It is concluded that the compendial strains investigated in this study are indeed equivalent and will perform identically in compendial tests, making it safe to base pharmaceutical quality control procedures on the strains sourced from any of the recognized national culture

  13. 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.


    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

  14. Patients Prefer Boarding in Inpatient Hallways: Correlation with the National Emergency Department Overcrowding Score (United States)

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


    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. PMID:22235374

  15. 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.


    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

  16. Why consider patients' preferences? A discourse analysis of clinical practice guideline developers. (United States)

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


    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.

  17. Patients' Preferences for Surgical Management of Esophageal Cancer: A Discrete Choice Experiment. (United States)

    de Bekker-Grob, Esther W; Niers, Eva J; van Lanschot, J Jan B; Steyerberg, Ewout W; Wijnhoven, Bas P L


    Obtaining insight into patients' preferences is important to optimize cancer care. We investigated patients' preferences for surgical management of esophageal cancer. We conducted a discrete choice experiment among adult patients who had undergone esophagectomy for adenocarcinoma or squamous cell cancer of the esophagus. Patients' preferences were quantified with regression analysis using scenarios based on five aspects: risk of in-hospital mortality, risk of persistent symptoms, chance of 5-year survival, risk of surgical and non-surgical complications, and hospital volume of esophageal cancer surgery. The response rate was 68 % (104/142). All aspects proved to influence patients' preferences (p < 0.05). Persisting gastrointestinal symptoms and 5-year survival were the most important attributes, but preferences varied between patients. On average, patients were willing to trade-off 9.5 % (CI 2.4-16.6 %) 5-year survival chance to obtain a surgical treatment with 30 % lower risk of gastrointestinal symptoms, or 8.1 % (CI 4.0-12.2 %) 5-year survival chance for being treated in a high instead of a low-volume hospital. Patients are willing to trade-off some 5-year survival chance to achieve an improvement in early outcomes. Given the preference heterogeneity among participants, the present study underlines the importance of a patient-tailored approach when discussing prognosis and treatment.

  18. Accounting for Patient Preferences Regarding Life-Sustaining Treatment in Evaluations of Medical Effectiveness and Quality. (United States)

    Walkey, Allan J; Barnato, Amber E; Wiener, Renda Soylemez; Nallamothu, Brahmajee K


    The importance of understanding patient preferences for life-sustaining treatment is well described for individual clinical decisions; however, its role in evaluations of healthcare outcomes and quality has received little attention. Decisions to limit life-sustaining therapies are strongly associated with high risks for death in ways that are unaccounted for by routine measures of illness severity. However, this essential information is generally unavailable to researchers, with the potential for spurious inferences. This may lead to "confounding by unmeasured patient preferences" (a type of confounding by indication) and has implications for assessments of treatment effectiveness and healthcare quality, especially in acute and critical care settings in which risk for death and adverse events are high. Through a collection of case studies, we explore the effect of unmeasured patient resuscitation preferences on issues critical for researchers and research consumers to understand. We then propose strategies to more consistently elicit, record, and harmonize documentation of patient preferences that can be used to attenuate confounding by unmeasured patient preferences and provide novel opportunities to improve the patient centeredness of medical care for serious illness.

  19. Patients prefer boarding in inpatient hallways: correlation with the national emergency department overcrowding score. (United States)

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


    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.

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

    Directory of Open Access Journals (Sweden)

    John R. Richards


    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.

  1. The value of quantitative patient preferences in regulatory benefit-risk assessment

    NARCIS (Netherlands)

    Oude Egbrink, Mart; IJzerman, Maarten Joost


    Quantitative patient preferences are a method to involve patients in regulatory benefit-risk assessment. Assuming preferences can be elicited, there might be multiple advantages to their use. Legal, methodological and procedural issues do however imply that preferences are currently at most part of

  2. Patients Prefer Results From the Ordering Provider and Access to Their Radiology Reports. (United States)

    Cabarrus, Miguel; Naeger, David M; Rybkin, Alexander; Qayyum, Aliya


    Imaging results are generally communicated to patients by referring providers. Directly communicating results has been suggested as a way for radiologists to add value, though few studies have investigated patients' preferences in this regard. The aim of this study was to determine patients' preferences for receiving their imaging results. In this institutional review board-approved study, adult outpatients undergoing CT or MRI at an academic medical center and an affiliated county hospital over a 4-week period (n = 2,483) were surveyed. The survey assessed patients' preferred delivery method for radiology results and their understanding of radiologists' education and role. A total of 617 surveys (25% response rate) were completed, 475 (77%) and 142 (23%) by academic medical center and county hospital patients, respectively. Among all respondents, the majority of patients (387 of 617 [63%]) preferred models of results delivery centered on the referring physician as opposed to the radiologist. Regardless of who verbally relayed the results, 64% of all respondents (398 of 617) wanted the option to receive a copy of the report, and 522 of 614 (85%) wanted to see their images. Among patients wanting copies of their reports, academic medical center patients expressed equal interest in mail, e-mail, and online portal options (33%, 31%, and 36%, respectively), and county hospital patients preferred mail (55%, 28%, and 17%, respectively) (P < .001). Patients prefer receiving their imaging results through their referring providers. Many patients would also like to view their images and receive copies of their reports, potential avenues through which radiologists could add value. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  3. Is acarbose equivalent to tolbutamide as first treatment for newly diagnosed type 2 diabetes in general practice? A randomised controlled trial.

    NARCIS (Netherlands)

    Laar, F.A. van de; Lucassen, P.L.B.J.; Kemp, J.; Lisdonk, E.H. van de; Weel, C. van; Rutten, G.


    We performed a double blind randomised controlled trial in general practice to assess equivalence between tolbutamide and acarbose with respect to the effect on mean HbA(1c) in newly diagnosed patients with type 2 diabetes. Secondary objectives were to compare the effects of both treatments on

  4. Physician's gender, communication style, patient preferences and patient satisfaction in gynecology and obstetrics: a systematic review. (United States)

    Janssen, Sabine M; Lagro-Janssen, Antoine L M


    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. Studies were identified by searching the online databases PubMed, PsycINFO, Embase and the Cochrane Library. The search strategies 'gender'; 'obstetrics' and 'gynecology' were combined with 'communication'; 'physician-patient relations'; 'patient preference' and 'patient satisfaction'. After screening title and abstract, evaluating full text and quality assessment, 9 articles were included in this review. Most patients preferred a female rather than a male gynecologist-obstetrician. This was partly explained by a more patient-centered communication style used by female gynecologists-obstetricians. Also experience and clinical competence were important factors in choosing a gynecologist-obstetrician. It was not clear whether patient's age or ethnicity influenced patients gender preference. Patient satisfaction increased when gynecologists-obstetricians used a patient-centered communication style. Preference for a female gynecologist-obstetrician might be explained by a more patient-centered communication style used by female gynecologists-obstetricians. Using a patient-centered communication style increases patient satisfaction. To increase patient satisfaction, gynecologists-obstetricians should learn to integrate patient-centered communication style into the consultation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Patients' preferred and perceived roles in making decisions about adjuvant chemotherapy for non-small-cell lung cancer. (United States)

    Moth, Erin; McLachlan, Sue-Anne; Veillard, Anne-Sophie; Muljadi, Nick; Hudson, Malcolm; Stockler, Martin R; Blinman, Prunella


    People with cancer have varying preferences for involvement in decision-making between active, collaborative and passive roles. We sought the preferred and perceived involvement in decision-making among patients considering adjuvant chemotherapy (ACT) after resection of early non-small cell lung cancer (NSCLC). Patients considering ACT for NSCLC were asked to complete a self-administered questionnaire at baseline and 6 months. Preferred and perceived decision-making roles were assessed by the Control Preferences Scale (CPS). We examined differences between preferred and perceived roles, differences in preferred roles over time, determinants of preferences, and differences in treatment preferences between patients preferring active and less active roles. 98 patients completed the baseline questionnaire; 75 completed the 6 month questionnaire. Most patients were male (55%) with a median age of 64 years (range, 43-79 years). Preferred role in decision-making at baseline (n=98) was active in 27%, collaborative in 47%, and passive in 27%. Perceived decision-making roles matched the preferred role in 79% of patients. Individuals' role preferences often varied between baseline and 6 months, but there was no consistent direction to the change (25% changed preference to more active involvement, 22% to less active). Preferring a more active role was associated with university education (OR 2.9, p=0.02), deciding not to have ACT (OR 5.0, pdecision-making role judged larger survival benefits necessary to make ACT worthwhile than those preferring a passive role. Most patients with resected NSCLC preferred and perceived a collaborative role in decision-making about ACT. Clinicians should elicit and consider patients' preferences for involvement in decision-making when discussing ACT for NSCLC. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. 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


    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....... The proposed technique is based on the evaluation of the closed-loop transient responses of both axes of the synchronous reference frame when a proportional-integral current controller is implemented. The method gives a set of resistance and inductance values that should be employed for a rigorous design...... 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...

  7. Patient preferences for treatment of low back pain-a discrete choice experiment. (United States)

    Kløjgaard, Mirja Elisabeth; Manniche, Claus; Pedersen, Line Bjørnskov; Bech, Mickael; Søgaard, Rikke


    Back pain imposes a substantial economic and social burden, and treatment decisions are distorted by conflicting evidence. Thus, it is important to include patient preferences in decision making and policy making. To contribute to the understanding of patient preferences in relation to the choice of treatment for low back pain. A discrete choice experiment was conducted with consecutive patients referred to a regional spine center. The respondents (n = 348) were invited to respond to a choice of two hypothetical treatment options and an opt-out option. The treatment attributes included the treatment modality, the risk of relapse, the reduction in pain, and the expected increase in the ability to perform activities of daily living. In addition, the wait time to achieve the treatment effect was used as a payment vehicle. Mixed logit models were created to perform analysis. Subgroup analysis, dividing respondents into sociodemographic and disease-related categories, further explored the willingness to wait. Respondents assigned positive utilities to positive treatment outcomes and disutility to higher risks and longer waits for effects of treatment and to surgical interventions. The model captured significant heterogeneity within the sample for the outcomes of pain reduction and the ability to pursue activities of daily living and for the treatment modality. The subgroup analysis revealed differences in the willingness to wait, especially with regard to treatment modality, the level of pain experienced at the time of data collection, and the respondents' preferences for surgery. The majority of the respondents prefer nonsurgical interventions, but patients are willing to wait for more ideal outcomes and preferred interventions. The results show that health care professionals have a very important task in communicating clearly about the expected results of treatment and the basis of their treatment decisions, as patients' preferences are highly individual. Copyright

  8. Treatment of dysfunctional uterine bleeding: patient preferences for endometrial ablation, a levonorgestrel-releasing intrauterine device, or hysterectomy

    NARCIS (Netherlands)

    Bourdrez, Petra; Bongers, Marlies Y.; Mol, Ben W. J.


    OBJECTIVE: To investigate patient preferences for endometrial ablation and a levonorgestrel-releasing intrauterine device (IUD) as alternatives to hysterectomy in the treatment of dysfunctional uterine bleeding. DESIGN: Comparative study based on structured interviews. SETTING: A large teaching

  9. 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.


    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

  10. "Finding the Right FIT": Rural Patient Preferences for Fecal Immunochemical Test (FIT) Characteristics. (United States)

    Pham, Robyn; Cross, Suzanne; Fernandez, Bianca; Corson, Kathryn; Dillon, Kristen; Yackley, Coco; Davis, Melinda M


    Colorectal cancer (CRC) is the third leading cause of cancer death in the United States, yet 1 in 3 Americans have never been screened for CRC. Annual screening using fecal immunochemical tests (FITs) is often a preferred modality in populations experiencing CRC screening disparities. Although multiple studies evaluate the clinical effectiveness of FITs, few studies assess patient preferences toward kit characteristics. We conducted this community-led study to assess patient preferences for FIT characteristics and to use study findings in concert with clinical effectiveness data to inform regional FIT selection. We collaborated with local health system leaders to identify FITs and recruit age eligible (50 to 75 years), English or Spanish speaking community members. Participants completed up to 6 FITs and associated questionnaires and were invited to participate in a follow-up focus group. We used a sequential explanatory mixed-methods design to assess participant preferences and rank FIT kits. First, we used quantitative data from user testing to measure acceptability, ease of completion, and specimen adequacy through a descriptive analysis of 1) fixed response questionnaire items on participant attitudes toward and experiences with FIT kits, and 2) a clinical assessment of adherence to directions regarding collection, packaging, and return of specimens. Second, we analyzed qualitative data from focus groups to refine FIT rankings and gain deeper insight into the pros and cons associated with each tested kit. Seventy-six FITs were completed by 18 participants (Range, 3 to 6 kits per participant). Over half (56%, n = 10) of the participants were Hispanic and 50% were female (n = 9). Thirteen participants attended 1 of 3 focus groups. Participants preferred FITs that were single sample, used a probe and vial for sample collection, and had simple, large-font instructions with colorful pictures. Participants reported challenges using paper to catch samples, had

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

    DEFF Research Database (Denmark)

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


    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...... combination of gemcitabine plus cisplatin (GC) has demonstrated comparable survival and an improved toxicity profile (Von der Maase et al. 2000). At present, the importance to patients of the toxicity of chemotherapy has not been widely studied. An earlier study in bladder cancer indicated that toxicity...... was an important determinant of treatment preference (Davey et al. 2000). A study of preferences for advanced bladder cancer therapy in the UK was proposed....

  12. 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)


    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.)

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

    Directory of Open Access Journals (Sweden)

    O'Connor Annette M


    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.

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

  15. Survey of patients' preference for the location of rehabilitation ward rounds. (United States)

    New, Peter W


    To survey inpatients in a rehabilitation hospital regarding their preference for ward rounds to be conducted at the bedside or in a consulting room. Before-after trial. Patients were seen on ward round at the bedside during one week and then in a consulting room the following week. Patients were asked about their preferred setting and their reasons for their preference. Rehabilitation inpatients (n=45) in Melbourne, Australia with predominantly acute neurological and orthopaedic impairments. Age, gender and impairment category of respondents were noted. Ward round preference was analysed assuming a binomial distribution. A statistically significant number (p=0.04) of patients preferred to be seen in the consulting room (n=29, 64%). There were 13 (29%) who preferred the bedside and 3 (7%) indicated no preference. There was no influence of gender (p=0.1) or impairment category (p=0.3) on preference, but younger patients preferred the consulting room (p=0.03). Most rehabilitation patients in hospital would rather attend a ward round held in a consulting room than at the bedside. The consulting room has many advantages over the traditional bedside location for ward rounds in a rehabilitation hospital.

  16. "In the physio we trust": A qualitative study on patients' preferences for physiotherapy. (United States)

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


    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.

  17. Patient Preferences for Injectable Treatments for Multiple Sclerosis in the United States: A Discrete-Choice Experiment. (United States)

    Poulos, Christine; Kinter, Elizabeth; Yang, Jui-Chen; Bridges, John F P; Posner, Joshua; Reder, Anthony T


    Patients' perceptions and experiences of medication efficacy, medication adverse events, dosing frequency, and dosing complexity have been found to influence adherence to injectable disease-modifying treatments (DMTs) in patients with multiple sclerosis (MS). The aim of this study was to quantify patient preferences for features of injectable DMTs for MS. Adult patients in the United States (US) with a self-reported diagnosis of MS completed an online discrete-choice experiment survey to assess preference for a number of features of a hypothetical injectable DMT. Patients chose hypothetical treatments in paired comparisons, where each treatment was described by features or attributes, including the number of years until disability progression, the number of relapses in the next 4 years, injection time, the frequency of injections, the occurrence of flu-like symptoms (FLS), and severity of injection-site reactions. Random-parameters logit regression parameters were used to calculate preference weights of attribute levels and the relative importance of changes in treatment features. Of the 205 patients who completed the survey, 192 provided sufficient data for analysis. The results indicated a broad range of tradeoffs that patients would be willing to make. With regard to this, the relative importance of an improvement in the number of years until disability progression from 1 to 2 (i.e., vertical distance between preference weights for these attribute levels) was 0.9 [95% confidence interval (CI) 0.5-1.2], the relative importance of this change was approximately equivalent to that of an improvement from 12 injections per month to two (mean 0.8, 95% CI 0.4-1.2), or approximately equivalent to a decrease from four to one relapses in the next 4 years (mean 0.8, 95% CI 0.5-1.2), or FLS 3 days after every injection to 3 days after some injections (mean 1.0, 95% CI 0.6-1.4). These results suggest that an improvement in treatment efficacy may be as important as a reduction

  18. Controlling human corneal stromal stem cell contraction to mediate rapid cell and matrix organization of real architecture for 3-dimensional tissue equivalents. (United States)

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


    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

  19. Understanding Patients' Preferences for Referrals to Specialists for an Asymptomatic Condition. (United States)

    Dunlea, Robert; Lenert, Leslie


    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

  20. Politico-economic equivalence

    DEFF Research Database (Denmark)

    Gonzalez Eiras, Martin; Niepelt, Dirk


    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 state are equivalent to another such pair if both pairs give rise to the same allocation in politico-economic equilibrium. The equivalence conditions help to identify factors that render institutional change non-neutral and to construct politico-economic equilibria in new policy regimes. We exemplify...

  1. Editorial: New operational dose equivalent quantities

    International Nuclear Information System (INIS)

    Harvey, J.R.


    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.)

  2. 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


    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

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

    DEFF Research Database (Denmark)

    Nielsen, René Ernst; Nielsen, Jimmi


      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-effe...... 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.  ......-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...

  4. Comments on TNT Equivalence

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, P.W.


    The term ``TNT Equivalence`` is used throughout the explosives and related industries to compare the effects of the output of a given explosive to that of TNT. This is done for technical design reasons in scaling calculation such as for the prediction of blast waves, craters, and structural response, and is also used as a basis for government regulations controlling the shipping, handling and storage of explosive materials, as well as for the siting and design of explosive facilities. TNT equivalence is determined experimentally by several different types of tests, the most common of which include: plate dent, ballistic mortar, trauzl, sand crush, and air blast. All of these tests do not necessarily measure the same output property of the sample explosive. As examples of this, some tests depend simply upon the CJ pressure, some depend upon the PV work in the CJ zone and in the Taylor wave behind the CJ plane, some are functions of the total work which includes that from secondary combustion in the air mixing region of the fireball and are acutely effected by the shape of the pressure-time profile of the wave. Some of the tests incorporate systematic errors which are not readily apparent, and which have a profound effect upon skewing the resultant data. Further, some of the tests produce different TNT Equivalents for the same explosive which are a function of the conditions at which the test is run. This paper describes the various tests used, discusses the results of each test and makes detailed commentary on what the test is actually measuring, how the results may be interpreted, and if and how these results can be predicted by first principals based calculations. Extensive data bases are referred to throughout the paper and used in examples for each point in the commentaries.

  5. Colorectal cancer patients' preferences for type of caregiver during survivorship care. (United States)

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


    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.

  6. What Do Patients Prefer? Understanding Patient Perspectives on Receiving a New Breast Cancer Diagnosis. (United States)

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


    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.

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

    Directory of Open Access Journals (Sweden)

    Tong Allison


    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.

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

    Directory of Open Access Journals (Sweden)

    Yi Zhen Chiang


    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.

  9. Overcoming patient barriers to discussing physician hand hygiene: do patients prefer electronic reminders to other methods? (United States)

    Michaelsen, Kaarin; Sanders, Jason L; Zimmer, Shanta M; Bump, Gregory M


    Despite agreement that handwashing decreases hospital-acquired infections (HAIs), physician hand hygiene remains suboptimal. Interventions to empower patients to discuss handwashing have had variable success. To understand patient perceived barriers to discussing physician hand hygiene and to determine whether patients prefer electronic alerts over printed information as an intervention to discuss physician handwashing. Cross-sectional study of 250 medical/surgical patients at an academic medical center. Ninety-six percent of patients had heard of HAIs. Ninety-six percent of patients thought it was important for physicians to clean their hands before touching anything in a patient's room. The majority of patients (78%) believed patients should remind physicians to clean their hands. Thirty-two percent of patients observed physician hand hygiene noncompliance. In multivariate analysis, predictors of not speaking up regarding physician hand hygiene included never having worked in health care (odds ratio [OR], 2.8 [95% confidence interval (CI), 1.5-5.1]), not observing a physician clean hands before touching the patient (OR, 2.4 [95% CI, 1.3-4.4]), and not thinking patients should have to remind physicians to clean hands (OR, 5.5 [95% CI, 2.4-12.7]). Ninety-three percent of patients favored electronic device reminders over printed information as an intervention to encourage patients to discuss hand hygiene with their doctors. The strongest predictor of not challenging a doctor to clean their hands was not believing it was the patient's role to do so. Patients prefer electronic device reminders to printed information as an aid in overcoming barriers to discussing hand hygiene with physicians.

  10. The best marketing strategy in aesthetic plastic surgery: evaluating patients' preferences by conjoint analysis. (United States)

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


    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.

  11. Women's Acceptability of Misoprostol Treatment for Incomplete Abortion by Midwives and Physicians - Secondary Outcome Analysis from a Randomized Controlled Equivalence Trial at District Level in Uganda.

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    Amanda Cleeve

    Full Text Available This study aimed to assess women´s acceptability of diagnosis and treatment of incomplete abortion with misoprostol by midwives, compared with physicians.This was an analysis of secondary outcomes from a multi-centre randomized controlled equivalence trial at district level in Uganda. Women with first trimester incomplete abortion were randomly allocated to clinical assessment and treatment with misoprostol by a physician or a midwife. The randomisation (1:1 was done in blocks of 12 and stratified for health care facility. Acceptability was measured in expectations and satisfaction at a follow up visit 14-28 days following treatment. Analysis of women's overall acceptability was done using a generalized linear mixed-effects model with an equivalence range of -4% to 4%. The study was not masked. The trial is registered at, NCT 01844024.From April 2013 to June 2014, 1108 women were assessed for eligibility of which 1010 were randomized (506 to midwife and 504 to physician. 953 women were successfully followed up and included in the acceptability analysis. 95% (904 of the participants found the treatment satisfactory and overall acceptability was found to be equivalent between the two study groups. Treatment failure, not feeling calm and safe following treatment, experiencing severe abdominal pain or heavy bleeding following treatment, were significantly associated with non-satisfaction. No serious adverse events were recorded.Treatment of incomplete abortion with misoprostol by midwives and physician was highly, and equally, acceptable to NCT01844024.

  12. Equivalence principles and electromagnetism (United States)

    Ni, W.-T.


    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.

  13. Biodegradable magnesium-based screw clinically equivalent to titanium screw in hallux valgus surgery: short term results of the first prospective, randomized, controlled clinical pilot study (United States)


    Purpose Nondegradable steel-and titanium-based implants are commonly used in orthopedic surgery. Although they provide maximal stability, they are also associated with interference on imaging modalities, may induce stress shielding, and additional explantation procedures may be necessary. Alternatively, degradable polymer implants are mechanically weaker and induce foreign body reactions. Degradable magnesium-based stents are currently being investigated in clinical trials for use in cardiovascular medicine. The magnesium alloy MgYREZr demonstrates good biocompatibility and osteoconductive properties. The aim of this prospective, randomized, clinical pilot trial was to determine if magnesium-based MgYREZr screws are equivalent to standard titanium screws for fixation during chevron osteotomy in patients with a mild hallux valgus. Methods Patients (n=26) were randomly assigned to undergo osteosynthesis using either titanium or degradable magnesium-based implants of the same design. The 6 month follow-up period included clinical, laboratory, and radiographic assessments. Results No significant differences were found in terms of the American Orthopaedic Foot and Ankle Society (AOFAS) score for hallux, visual analog scale for pain assessment, or range of motion (ROM) of the first metatarsophalangeal joint (MTPJ). No foreign body reactions, osteolysis, or systemic inflammatory reactions were detected. The groups were not significantly different in terms of radiographic or laboratory results. Conclusion The radiographic and clinical results of this prospective controlled study demonstrate that degradable magnesium-based screws are equivalent to titanium screws for the treatment of mild hallux valgus deformities. PMID:23819489

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

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    Lavender Tina


    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

  15. Patient preferences for community pharmacy asthma services: a discrete choice experiment. (United States)

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


    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

  16. Patient Preference in Dermatologist Attire in the Medical, Surgical, and Wound Care Settings. (United States)

    Fox, Joshua D; Prado, Giselle; Baquerizo Nole, Katherine L; Macquahe, Flor; Herskovitz, Ingrid; Rosa, Ashley; Akhtar, Shifa; Aldahan, Adam; Shah, Vidhi; Mlacker, Stephanie; Cardenas, Gabriel; Kirsner, Robert S


    Patients' perceptions of their physician can affect subjective and objective outcomes. Physician attire influences patients' perceptions of their physician and consequently may affect patient outcomes. To determine patient preferences for different types of dermatologist attire in dermatology medical, surgical, and wound care clinics. We hypothesized that patients in the dermatology medical setting would prefer professional attire, while patients in the dermatology surgical and wound care setting would prefer surgical scrubs. This study analyzed responses to a cross-sectional, anonymous survey by English-speaking dermatology patients (aged 18 years or older) at general, surgical, and wound care clinics in an academic center in Miami, Florida. Patients who could not read and understand the survey were excluded. Participants received pictures of a physician wearing business attire, professional attire, surgical attire, and casual attire, and responded by indicating which physician they preferred for each of 19 questions. Frequencies of responses were recorded, and χ2 and regression tests were performed. Response frequencies. Surveys were administered to 261 persons, and 255 participated and completed enough of the questions to be included in the outcome analyses (118 men, 121 women, 22 unknown [did not answer sex question]), mean (SD) age, 56.3 (18.6) years; about 49% of those who reported their sex were men; 56% were Hispanic; and 85% were white. Approximately 72% of respondents held a college degree or higher. About 63%, 24%, and 13% of respondents were medical, surgical, and wound care dermatology patients, respectively. Roughly 73%, 19%, 6%, and 2% of cumulative responses were for professional, surgical, business, and casual attire, respectively. Respondents who received a picture of a black male or black female physician were more likely to exclusively prefer professional attire: unadjusted odds ratios (ORs) 3.21 (95% CI, 1.39-7.42) and 2.78 (95% CI, 1

  17. Willingness to pay to assess patient preferences for therapy in a Canadian setting

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    Nicol Ruth E


    Full Text Available Abstract Background Adult outpatient parenteral antibiotic therapy (OPAT programs have been reported in the literature for over 20 years, however there are no published reports quantifying preference for treatment location of patients referred to an OPAT program. The purpose of this study was to elicit treatment location preferences and willingness to pay (WTP from patients referred to an OPAT program. Methods A multidisciplinary, single centre, prospective study at a 1000-bed Canadian adult tertiary care teaching hospital. This study involved a WTP questionnaire that was administered over a 9-month study period. Eligible and consenting patients referred to the OPAT program were asked to state their preference for treatment location and WTP for a hypothetical treatment scenario involving intravenous antibiotic therapy. Multiple linear regression analysis was performed to determine predictors of WTP. Results Of 131 eligible patients, 91 completed the WTP questionnaire. The majority of participants were males, married, in their sixth decade of life and had a secondary school education or greater. The majority of participants were retired or they were employed with annual household incomes less than $60,000. Osteomyelitis was the most common type of infection for which parenteral therapy was required. Of those 87 patients who indicated a preference, 77 (89% patients preferred treatment at home, 10 (11% patients preferred treatment in hospital. Seventy-one (82% of these patients provided interpretable WTP responses. Of these 71 patients, 64 preferred treatment at home with a median WTP of $490 CDN (mean $949, range $20 to $6250 and 7 preferred treatment in the hospital with a median WTP of $500 CDN (mean $1123, range $10 to $3000. Tests for differences in means and medians revealed no differences between WTP values between the treatment locations. The total WTP for the seven patients who preferred hospital treatment was $7,859 versus $60,712 for the

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

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    David J. Kim


    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

  19. Impact of gender on patient preferences for technology-based behavioral interventions. (United States)

    Kim, David J; Choo, Esther K; Ranney, Megan L


    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. 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. 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%; p=0.03), Internet (66.8% versus 59.0%; p=0.03), and social networks (53.3% versus 42.6%; p=0.01). 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 prevention, gender modified the relationship between other demographic

  20. What factors determine patients' preference for tumour necrosis factor inhibitors in ankylosing spondylitis? (United States)

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


    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.

  1. Breaking Bad News: Patient Preferences and the Role of Family Members when Delivering a Cancer Diagnosis. (United States)

    Rao, Abha; Ekstrand, Maria; Heylen, Elsa; Raju, Girish; Shet, Arun


    Western physicians tend to favour complete disclosure of a cancer diagnosis to the patient, while non-Western physicians tend to limit disclosure and include families in the process; the latter approach is prevalent in clinical oncology practice in India. Few studies, however, have examined patient preferences with respect to disclosure or the role of family members in the process. Structured interviews were conducted with patients (N=127) in the medical oncology clinic of a tertiary referral hospital in Bangalore, India. Patients ranged in age from 18-88 (M=52) and were mostly male (59%). Most patients (72%) wanted disclosure of the diagnosis cancer, a preference significantly associated with higher education and English proficiency. A majority wanted their families to be involved in the process. Patients who had wanted and not wanted disclosure differed with respect to their preferences regarding the particulars of disclosure (timing, approach, individuals involved, role of family members). Almost all patients wanted more information concerning their condition, about immediate medical issues such as treatments or side effects, rather than long-term or non-medical issues. While most cancer patients wanted disclosure of their disease, a smaller group wished that their cancer diagnosis had not been disclosed to them. Regardless of this difference in desire for disclosure, both groups sought similar specific information regarding their cancer and largely favoured involvement of close family in decision making. Additional studies evaluating the influence of factors such as disease stage or family relationships could help guide physicians when breaking bad news.

  2. The importance of patient preferences in the measurement of health care satisfaction. (United States)

    Ross, C K; Steward, C A; Sinacore, J M


    The idea that patients will be more satisfied with health care services that are delivered to meet their preferences is central to the concept of health care marketing. Health care providers increasingly use market segmentation and target marketing to optimize the fit between their services and the consumers who receive them. This study evaluates one model for incorporation of patient preferences into the measurement of satisfaction. Using multiple regression analysis, evaluations of three dimensions of health care satisfaction, interpersonal care, technical quality, access to care accounted for 63% of the variance in overall satisfaction. Inclusion of preferences, defined as importance ranks of each dimension, did not improve ability to predict satisfaction. Four preference segments were identified: interpersonal care seekers, access/quality seekers, access seekers and quality seekers. These four subgroups differed significantly on a number of sociodemographic, health status and health service use characteristics but no significant differences were found in satisfaction between preference segments. Patient satisfaction can best be measured as quality evaluations of dimensions without regard to preferences. In considering the merits of market segmentation and target marketing, alternative satisfaction models that link preferences to health care satisfaction or the possibility that preference targeting does not lead to greater satisfaction should be evaluated.

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

  4. Patient preferences and comparative ocular responses to rigid and soft contact lenses. (United States)

    Fonn, D; Gauthier, C A; Pritchard, N


    Patient preferences and ocular responses were compared between rigid and soft contact lenses by randomly fitting 32 neophyte subjects with a rigid lens in 1 eye and a soft lens in the contralateral eye. Twenty-seven of 32 subjects completed the 3-month study and 16 subjects were willing to continue for an additional 3-month extension. Subjects preferred the comfort and handling of the soft lens but preferred the vision provided by the rigid lens and initially its ease of maintenance. There was also a marked preference for the soft lens when all aspects of lens wear were compared. Objectively, the rigid lenses were responsible for more ocular changes than the soft lenses. Palpebral aperture sizes of the rigid gas permeable (RGP) wearing eyes decreased significantly (0.5 mm; p lens wearing eyes. The incidence of corneal staining was significantly greater in the rigid lens wearing eye (50% RGP vs. 22% soft) but limbal injection was greater in the soft lens wearing eye (18% soft vs. 6% RGP). Refractive sphere, cylinder, and corneal astigmatism decreased in the rigid lens wearing eye after 3 months. This daily wear clinical trial has shown a marked subjective preference for wearing soft lenses with fewer short-term ocular effects.

  5. Teriflunomide for the treatment of relapsing–remitting multiple sclerosis: patient preference and adherence

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    Bayas A


    Full Text Available Antonios Bayas,1 Mathias Mäurer2 1Department of Neurology, Klinikum Augsburg, Augsburg, Germany; 2Department of Neurology, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany Abstract: Multiple sclerosis (MS, a chronic demyelinating neuroinflammatory disease of the central nervous system, is the most common neurological disorder leading to disability in young adulthood. In the last 2 decades, numerous treatments for relapsing–remitting MS have been approved with eleven treatment options available worldwide. One of the determinants in treatment selection is disease activity in the individual patient. However, patient preferences play an increasingly major role in treatment decision making. With teriflunomide, a reversible inhibitor of the enzyme dihydroorotate dehydrogenase, a new oral therapeutic option, given once daily, has been approved within the last 2 years by the regulatory agencies. The current review focuses on characteristics of the drug relevant for patients’ preferences in the treatment decision process in the light of the available medications. Perceiving and considering patients’ preferences will have an effect on treatment adherence, which is known to be often low in MS patients. Teriflunomide-related adherence issues will also be discussed regarding mode of application, dosing, and potential side effects. Keywords: disease modifying treatment, oral, first line, pharmacovigilance

  6. Patient preferences for direct hearing aid provision by a private dispenser. A discrete choice experiment. (United States)

    Grutters, Janneke P C; Joore, Manuela A; Kessels, Alfons G H; Davis, Adrian C; Anteunis, Lucien J C


    Our objective was to elicit patient preferences for transferring elements of hearing aid provision from the medical sector [Ear Nose and Throat (ENT) specialists and audiological centers] to private hearing aid dispensers, and to understand the trade-offs between different elements of hearing aid provision. A discrete choice experiment was administered from 150 hearing-impaired persons in the Netherlands. Mean age was 71 (range 18-95) and 57% were male. Participants preferred the initial assessment at the dispenser, higher accuracy in identifying persons in need of medical care, shorter duration of the total hearing aid provision, and a follow-up at the ENT specialist. They required compensation of at least euro 17 per 2 mo extra duration, euro 54 for an initial assessment at the ENT specialist, euro 119 per 10% decrease in accuracy, and euro 227 to forgo the follow-up at the ENT specialist. Preferences were influenced by sex, age, educational level, and experience with hearing aid provision. Hearing-impaired persons are receptive to transferring elements of hearing aid provision from the medical sector to private dispensers. Although safety and efficiency issues should also be considered, from the present study we can conclude that in the organization of hearing aid provision hearing-impaired persons prefer an initial assessment at a private dispenser when the dispenser is at least 95% as accurate as the ENT specialist, and prefer a follow-up visit at the ENT specialist.

  7. Health literacy and computer-assisted instruction: usability and patient preference. (United States)

    Duren-Winfield, Vanessa; Onsomu, Elijah O; Case, Douglas L; Pignone, Michael; Miller, David


    The authors investigated the feasibility of using computer-assisted instruction in patients of varying literacy levels by examining patients' preferences for learning and their ability to use 2 computer-based educational programs. A total of 263 participants 50-74 years of age with varying health literacy levels interacted with 1 of 2 educational computer programs as part of a randomized trial of a colorectal cancer screening decision aid. A baseline and postprogram evaluation survey were completed. More than half (56%) of the participants had limited health literacy. Regardless of literacy level, doctors were the most commonly used source of medical information-used frequently by 85% of limited and adequate literacy patients. In multivariate logistic regression, only those with health insurance (OR = 2.35, p = .06) and computer use experience (OR = 0.39, p = .03) predicted the ability to complete the programs without assistance compared with those without health insurance or prior computer use, respectively. Although patients with limited health literacy had less computer experience, the majority completed the programs without any assistance and stated that they learned more than they would have from a brochure. Future research should investigate ways that computer-assisted instruction can be incorporated in medical care to enhance patient understanding.

  8. The impact of marketing language on patient preference for robot-assisted surgery. (United States)

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


    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.

  9. Factors affecting direction and strength of patient preferences for treatment of molar teeth with nonvital pulps. (United States)

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


    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.

  10. Patients' preferences and economic considerations play an important role in treatment decisions: a discrete choice experiment among rheumatologists. (United States)

    Hifinger, Monika; Hiligsmann, Mickael; Ramiro, Sofia; Severens, Johan L; Fautrel, Bruno; Watson, Verity; Boonen, Annelies


    To evaluate to what extent rheumatologists consider economic aspects and patients' preferences when choosing drug treatments in patients with active RA. In a discrete choice experiment, rheumatologists were asked to choose between two unlabelled drug treatment options for a hypothetical RA patient with moderate disease activity who failed two synthetic DMARDs. Attributes and levels of drug treatments were selected based on existing literature, rheumatologists' opinion and expert consensus. This resulted in five attributes each described by three levels: efficacy (level of improvement and achieved state on DAS28), safety (probability of a serious adverse event), patients' preference (level of agreement), annual medication costs and cost-effectiveness (incremental cost-effectiveness ratio). An efficient experimental design generated 14 treatment choices and a random parameter logit model estimated the relative importance of attributes. Sixty-three rheumatologists from the Netherlands contributed to the analysis; 44% were female and mean (sd) age was 49 (8) years. Drug efficacy had the strongest relative contribution to the drug choice (44%) followed by medication costs (24%), patients' preference (17%) and cost-effectiveness (14%). Patients' preferences were most relevant when patients disliked a proposed treatment. The risk of serious but uncommon or rare side effects only played a minor role in the treatment choice (1%). In addition to drug efficacy, rheumatologists account for economic aspects and for patients' preferences when deciding on drugs. Decisions are more influenced by absolute costs than relative cost-effectiveness and by patients' disliking as opposed to favouring the treatment. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email:

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

    Hogan, Tyler James; Silverman, Michael J


    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

  12. Characterization of revenue equivalence

    NARCIS (Netherlands)

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


    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

  13. Characterization of Revenue Equivalence

    NARCIS (Netherlands)

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


    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

  14. On the operator equivalents

    International Nuclear Information System (INIS)

    Grenet, G.; Kibler, M.


    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

  15. Why do some patients prefer to leave decisions up to the doctor: lack of self-efficacy or a matter of trust? (United States)

    Chawla, Neetu; Arora, Neeraj K


    Decision-making preferences among cancer survivors during their follow-up care remains understudied and limited research examines factors that underlie these preferences. The purpose of this study was to assess cancer patients' decision-making preferences during follow-up care, the role of trust and self-efficacy, and the effect of preferences on health outcomes. Six hundred twenty-three bladder, leukemia, and colorectal cancer survivors were recruited to the Assessment of Patient Experiences of Cancer Care study between April 2003 and November 2004. Respondents were asked about their follow-up care experiences, including decision-making preferences, trust in physicians, self-efficacy, health-related quality of life (HRQOL), and health appraisal. Unadjusted mean scores of trust and self-efficacy measures by decision preference group were examined. Multinomial logistic and linear regressions were conducted to examine predictors of decision-making preferences and the impact of decision-making preferences on HRQOL and health appraisal. While the majority of patients preferred shared decision-making (61.0 %), 16.1 % preferred to control their decisions and 22.1 % preferred physician control over decisions. Compared to the other groups, patients preferring physician control had greater trust in their physician (p trust among all patients. Findings from this study provide unique insights into the decision-making preferences of cancer patients during receipt of follow-up care, which remains an understudied phase of cancer care delivery. Results underscore the need for approaches to decision-making and patient engagement to become more nuanced and to encourage patients to participate in decision-making in ways they are most comfortable. Furthermore, physicians and health care professionals should foster environments that promote trust and clear communication regardless of patient decision-making styles.

  16. 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.

  17. "Is There An App For That?" Orthopaedic Patient Preferences For A Smartphone Application. (United States)

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


    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

  18. 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


    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.

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


    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. 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  20. Standardized patients' preferences for pharmacist interactive communication style: A mixed method approach. (United States)

    Guirguis, Lisa M; Nusair, Mohammad B


    Interactive communication approaches may help to shift pharmacy practice toward more patient-centered care. One example of such an approach is the 3 prime questions (3PQs). Patients' preferences for pharmacists' interactive communication styles were not identified in the literature. The purpose of this paper was to explore standardized patient (SP) preferences, satisfaction, and perceptions of pharmacists' communication style and changes in pharmacist to standardized patient talk-time ratio. Mixed methods, before and after evaluation. SPs were hired from the University of Alberta's Standardized Patient Program, Canada. Twelve SPs and 10 pharmacists. SPs were video recorded interacting with the same pharmacists before and after pharmacist training on the 3PQs. SPs participated in an open-ended interview using stimulated recall on videos of their pharmacist encounters. Explore SP preferences, satisfaction, and perceptions of pharmacists' communication style, in addition to changes in pharmacist to standardized patient talk-time ratio before and after the intervention Generally SPs were satisfied with pharmacists' interactive communication style post training. Qualitative themes varied with SPs' preference for an interactive approach (58%, i.e., Conversation with Equals, Double Check, and Manageable Information) or traditional approach (33%, i.e., Expected Information, Shouldn't the Pharmacist Know, and Feels Uncomfortable) and improvements in item scores varied by type of prescription. Pharmacists' use of the 3PQs increased patient talk time for scenarios with new chronic and acute medication, though pharmacists still dominated the conversation. Just over half of SPs preferred an interactive communication style, although a third of SPs preferred a communication style that focused on information provision. Patients had more time to talk in some interactive encounters. Pharmacists may need to be aware of patient expectations when using the 3PQs. Copyright © 2016

  1. Topics in orbit equivalence

    CERN Document Server

    Kechris, Alexander S


    This volume provides a self-contained introduction to some topics in orbit equivalence theory, a branch of ergodic theory. The first two chapters focus on hyperfiniteness and amenability. Included here are proofs of Dye's theorem that probability measure-preserving, ergodic actions of the integers are orbit equivalent and of the theorem of Connes-Feldman-Weiss identifying amenability and hyperfiniteness for non-singular equivalence relations. The presentation here is often influenced by descriptive set theory, and Borel and generic analogs of various results are discussed. The final chapter is a detailed account of Gaboriau's recent results on the theory of costs for equivalence relations and groups and its applications to proving rigidity theorems for actions of free groups.

  2. Patients' preferences for primary health care - a systematic literature review of discrete choice experiments. (United States)

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


    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

  3. Patients' preferences: a discrete-choice experiment for treatment of non-small-cell lung cancer. (United States)

    Mühlbacher, Axel C; Bethge, Susanne


    Lung cancer is a major cause of cancer-related deaths and thus represents a global health problem. According to World Health Organization (WHO) estimates, approximately 1.37 million people die each year from lung cancer. Different therapeutic approaches as well as several treatment options exist. To date decisions on which therapies to use have largely been made by clinical experts. Comparative preference studies show that underlying weighting of treatment goals by experts is not necessarily congruent with the preferences of affected patients. The aim of this empirical study was to ascertain patient preferences in relation to treatment of non-small-cell lung cancer (NSCLC). After identification of patient-relevant treatment attributes via literature review and qualitative interviews(ten) a discrete-choice experiment including seven patient-relevant attributes was conducted using a fractional factorial NGene-design. Statistical data analysis was performed using latent class models. The qualitative part of this study identified outcome measures related to efficacy, side effects and mode of administration. A total of 211 NSCLC patients (N = 211) participated in the computer-assisted personal interview. A clear preference for an increase in "progression-free survival" (coef.: 1.087) and a reduction of "tumor-associated symptoms"(cough, shortness of breath and pain); coef.: 1.090) was demonstrated, followed by the reduction of side effects: "nausea and vomiting" (coef.: 0.605); "rash" (coef.: 0.432); "diarrhea" (coef.: 0.427); and, "tiredness and fatigue" (coef.: 0.423). The "mode of administration" was less important for participants (coef.: 0.141). Preference measurement showed "progression-free survival" and "tumor-associated symptoms" had a significant influence on the treatment decision. Subgroup analysis revealed that the importance of "progression-free survival" increases with increased therapy experience. Based on the presented results therapies can be

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

    Directory of Open Access Journals (Sweden)

    Posnett J


    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

  5. The development and initial validation of a clinical tool for patients' preferences on patient participation--The 4Ps. (United States)

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


    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.

  6. Equivalent drawbead performance in deep drawing simulations

    NARCIS (Netherlands)

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


    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

  7. Evaluation of the effectiveness of manual chest physiotherapy techniques on quality of life at six months post exacerbation of COPD (MATREX: a randomised controlled equivalence trial

    Directory of Open Access Journals (Sweden)

    Cross Jane L


    Full Text Available Abstract Background Manual chest physiotherapy (MCP techniques involving chest percussion, vibration, and shaking have long been used in the treatment of respiratory conditions. However, methodological limitations in existing research have led to a state of clinical equipoise with respect to this treatment. Thus, for patients hospitalised with an exacerbation of Chronic Obstructive Pulmonary Disease (COPD, clinical preference tends to dictate whether MCP is given to assist with sputum clearance. We standardised the delivery of MCP and assessed its effectiveness on disease-specific quality of life. Methods In this randomised, controlled trial powered for equivalence, 526 patients hospitalised with acute COPD exacerbation were enrolled from four centres in the UK. Patients were allocated to receive MCP plus advice on airway clearance or advice on chest clearance alone. The primary outcome was a COPD specific quality of life measure, the Saint Georges Respiratory Questionnaire (SGRQ at six months post randomisation. Analyses were by intention to treat (ITT. This study was registered, ISRCTN13825248. Results All patients were included in the analyses, of which 372 (71% provided evaluable data for the primary outcome. An effect size of 0·3 standard deviations in SGRQ score was specified as the threshold for superiority. The ITT analyses showed no significant difference in SGRQ for patients who did, or did not receive MCP (95% CI −0·14 to 0·19. Conclusions These data do not lend support to the routine use of MCP in the management of acute exacerbation of COPD. However, this does not mean that MCP is of no therapeutic value to COPD patients in specific circumstances.

  8. Magnetic resonance enterography or video capsule endoscopy – what do Crohn’s disease patients prefer?

    Directory of Open Access Journals (Sweden)

    Lahat A


    , bloating, and abdominal pain were all significantly more prominent in MRE as compared to CE (P<0.0001, P<0.0001, P<0.0001, P=0.009, P=0.0002, P<0.0001, respectively. MRE was perceived as a more difficult procedure (P<0.0001. Furthermore, MRE was associated with a specific adverse event – claustrophobia. Seventy-eight percent of patients (44 patients preferred to repeat CE as compared to 22% (P<0.0001 who preferred MRE.Conclusion: CE was better tolerated by CD patients compared to MRE and was preferred by 78% of patients. The superior tolerability of CE should be considered along with the diagnostic features, and more data sought when choosing between these two modalities for CD patients for long-term follow-up. Keywords: inflammatory bowel disease, Crohn’s imaging, MRE, capsule endoscopy, patients’ preference 

  9. Equivalence in Ventilation and Indoor Air Quality

    Energy Technology Data Exchange (ETDEWEB)

    Sherman, Max; Walker, Iain; Logue, Jennifer


    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.

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

    Nafees, Beenish; Lloyd, Andrew J; Ballinger, Rachel S; Emmanuel, Anton


    Most patients with bowel dysfunction secondary to neurological illness are managed by a range of nonsurgical methods, including dietary changes, laxatives, and suppository use to transanal irrigation (TAI). The aim of the present study was to explore individuals' preferences regarding TAI devices and furthermore investigate willingness to pay (WTP) for attributes in devices in the UK. A discrete choice experiment survey was conducted to evaluate the patients' perceived value of TAI devices. Attributes were selected based upon a literature review and input from clinicians. Interviews were conducted with three clinicians and the survey was developed and finalized with the input from both patients and professionals. The final attributes were "risk of urinary tract infections" (UTIs), "risk of fecal incontinence" (FI), "frequency of use", "time spent on toilet", "ease of use", "level of control/independence", and "cost". Participants were recruited by a patient panel of TAI device users in the UK. Data were analyzed using the conditional logit model whereby the coefficients obtained from the model provided an estimate of the (log) odds ratios (ORs) of preference for attributes. WTP was also estimated for each attribute. A total of 129 participants were included in the final analyses. Sixty two percent of the participants had suffered from three UTIs in the preceding year and 58% of patients reported currently experiencing FI using their current device. All attributes were significant predictors of choice. The most important attributes for participants were the "risk of FI", "frequency of use", and "risk of UTIs". 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.

  11. How Many Equivalent Resistances?

    Indian Academy of Sciences (India)

    It is straightforward to construct the set of equiv- alent resistance for circuits constructed from a bunch of four or five equal resistors. But as the bunch size increases it becomes difficult to find the order of the set of equivalent resistances. Even the computer programs runs out of mem- ory. Here we present an analytical result ...

  12. How Many Equivalent Resistances?

    Indian Academy of Sciences (India) [3]. Antoni Amengual, The intriguing properties of the equivalent resistances of n equal resistors combined in series and in parallel, American Journal of Physics, Vol.68, No.2, pp.175–179, 2000. DOI: 10.1119/1.19396. [4]. Neil J A Sloane (Ed.), The On-Line Encyclopedia ...

  13. Radioactive waste equivalence

    International Nuclear Information System (INIS)

    Orlowski, S.; Schaller, K.H.


    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. The principle of equivalence

    International Nuclear Information System (INIS)

    Unnikrishnan, C.S.


    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

  15. Mass Equivalent Dyads

    NARCIS (Netherlands)

    van der Wijk, V.; Bai, Shaoping; Ceccarelli, Marco


    In this paper it is shown how a general 2-DoF dyad can be designed mass equivalent to a general (1-DoF) link element. This is useful in the synthesis of balanced mechanisms, for instance to increase or reduce the number of DoFs of a balanced mechanism maintaining its balance. Also it can be used as

  16. Correspondences. Equivalence relations

    International Nuclear Information System (INIS)

    Bouligand, G.M.


    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

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


    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

  18. From equivalence to adaptation

    Directory of Open Access Journals (Sweden)

    Paulina Borowczyk


    Full Text Available The aim of this paper is to illustrate in which cases the translators use the adaptation when they are confronted with a term related to sociocultural aspects. We will discuss the notions of equivalence and adaptation and their limits in the translation. Some samples from Arte TV news and from the American film Shrek translated into Polish, German and French will be provided as a support for this article.

  19. Pinned equivalence relations

    Czech Academy of Sciences Publication Activity Database

    Zapletal, Jindřich


    Roč. 18, č. 3 (2011), s. 559-564 ISSN 1073-2780 R&D Projects: GA AV ČR IAA100190902; GA MŠk MEB060909; GA MŠk MEB051006 Institutional research plan: CEZ:AV0Z10190503 Keywords : equivalence relations Subject RIV: BA - General Mathematics Impact factor: 0.743, year: 2011

  20. Patients' preferences for patient-centered communication: a survey from an outpatient department in rural Sierra Leone. (United States)

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


    To investigate patients' preferences for patient-centered communication (PCC) in the encounter with healthcare professionals in an outpatient department in rural Sierra Leone. A survey was conducted using an adapted version of the Patient-Practitioner Orientation Scale (PPOS) as a structured interview guide. The study population was drawn from the population of all adults attending for treatment or treatment for their children. 144 patients were included in the analysis. Factors, such as doctor's friendly approach, the interpersonal relationship and information-sharing were all scored high (patient-centered) on the PPOS. Factors associated with shared-decision making had a lower (doctor-centered) score. A high educational level was associated with a more patient-centered scoring, an association that was most pronounced in the female population. The results provide an insight into the patients' preferences for PCC. Patients expressed a patient-centered attitude toward certain areas of PCC, while other areas were less expressed. More research is needed in order to fully qualify the applicability of PCC in resource-poor settings. Stakeholders and healthcare professionals should aim to strengthen healthcare practice by focusing on PCC in the medical encounter while taking into considerations the patients' awareness and preferences for PCC. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. [Preferences for the attributes of home enteral nutrition (HEN) in Spain. Do caregivers know their patients' preferences? (United States)

    Olveira, Gabriel; Martínez-Olmos, Miguel Ángel; Fernández de Bobadilla, Belén; Ferrer, Mercedes; Virgili, Nuria; Vega, Belén; Blanco, Mercedes; Layola, Miquel; Lizán, Luis; Aceituno, Susana


    Establishing a home enteral nutrition (HEN) that is adapted to the patient's needs and preferences can improve their quality of life and adherence, contributing to a higher treatment efficiency, better prognosis and cost reduction. As in most cases, patients need total or partial help from their caregivers, and there is a need for evaluating how well do caregivers know their patients' priorities. Exploring patients' preferences for HEN characteristics in Spain, and the concordance between patients and caregivers. A cross-sectional observational study based on the discrete choice experiment methodology. A set of eight choice scenarios generated from six attributes with two levels each was presented along with an ad hoc questionnaire on the importance and satisfaction with HEN. The relative importance (RI) of each attribute and the patient-caregiver concordance was estimated in every question. One hundred and forty-eight patients participated, and in 77 cases both the patient and the caregiver took the survey. The most important attributes (RI) for HEN were adaptation to comorbidities (33%), tolerability (33%), nutrients and calories (26%) and package characteristics (8%). Patients showed a high degree of satisfaction with the assistance received. Concordance between patient and caregiver was found in every question, being it moderate to good. According to patients, an ideal HEN product would be adaptable to comorbidities, easy to tolerate, providing the necessary nutrients and calories, with an easy to handle package. Caregivers know well their patients' preferences.

  2. Equivalences of coisotropic submanifolds

    DEFF Research Database (Denmark)

    Schaetz, Florian; Zambon, Marco

    We study the role that Hamiltonian and symplectic diffeomorphisms play in the deformation problem of coisotropic submanifolds. We prove that the action by Hamiltonian diffeomorphisms corresponds to the gauge-action of the $L_\\infty$-algebra of Oh and Park. Moreover we introduce the notion of exte...... of extended gauge-equivalence and show that in the case of Oh and Park's $L_\\infty$-algebra one recovers the action of symplectic isotopies on coisotropic submanifolds. Finally, we consider the transversally integrable case in detail....

  3. Studies on the Neutron Radiation Damage Equivalence

    Directory of Open Access Journals (Sweden)

    ZOU De-hui


    Full Text Available To establish a unified standard of the evaluation of different sources of radiation damage, the neutron radiation damage equivalent standard source was determined both at home and abroad, and a lot of equivalence research work was done for making weapons anti neutron radiation performance examination and acceptance basis. The theoretical research progress was combed according to the relationship between the displacement damage function and the radiation source spectra ,and the experimental research progress was combed from the basic experimental methods, the controlling trend of effect parameters and field parameters. The experiment method to reduce the uncertainty was discussed, and present the research directions of radiation damage equivalence.

  4. Establishing Substantial Equivalence: Proteomics (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.

  5. Stuttering Equivalence for Parity Games


    Cranen, Sjoerd; Keiren, Jeroen J. A.; Willemse, Tim A. C.


    We study the process theoretic notion of stuttering equivalence in the setting of parity games. We demonstrate that stuttering equivalent vertices have the same winner in the parity game. This means that solving a parity game can be accelerated by minimising the game graph with respect to stuttering equivalence. While, at the outset, it might not be clear that this strategy should pay off, our experiments using typical verification problems illustrate that stuttering equivalence speeds up sol...

  6. 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.

  7. Renal transplant patients' preference for the supply and delivery of immunosuppressants in Wales: a discrete choice experiment. (United States)

    Hagemi, Anke; Plumpton, Catrin; Hughes, Dyfrig A


    Prescribing policy recommendations aimed at moving immunosuppressant prescribing for renal transplant patients from primary to secondary care may result in benefits of increased safety and reduced cost. However, there is little evidence of patients' preferences for receiving their immunosuppressant therapy from hospitals compared to community dispensing. The aim of this study was to elicit patient preferences for different service configurations focusing in particular on home delivery versus collection of medication from hospital. A discrete choice experiment was administered to 265 renal transplant patients in North Wales. Respondents were presented 18 pairwise choices, labelled as either home delivery or hospital collection, and described by the attributes: frequency of supply, waiting time (for delivery or collection) and method of ordering (provider contact, patient contact via phone, patient contact electronically). Data were analysed using a random-effects logit model and marginal rates of substitution calculated based on the waiting time attribute. A response rate of 63% was achieved, with 5332 usable observations from 150 respondents. Method of delivery (β coefficient 1.21; 95% confidence interval 1.05 to 1.38), frequency of supply (0.05; 0.03 to 0.08) waiting time (-0.00, -0.00 to -0.00), provider contact (desirable) (0.20; 0.12 to 0.27), patient contact by telephone (desirable) (0.09; 0.01 to 0.17) and patient contact electronically (undesirable) (-0.292; -0.37 to -0.21) were statistically significant (p delivery service. Patients indicate a clear preference for a home delivery service. They prefer providers to make contact when new immunosuppressant supplies are required and show preference against ordering medication electronically. A policy for secondary care prescribing and hospital collection of medicines does not align with this preference.

  8. Clinical marginal fit of zirconia crowns and patients' preferences for impression techniques using intraoral digital scanner versus polyvinyl siloxane material. (United States)

    Sakornwimon, Nawapat; Leevailoj, Chalermpol


    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.

  9. Amoxicillin/clavulanic acid is ineffective at preventing otitis media in children with presumed viral upper respiratory infection: a randomized, double-blind equivalence, placebo-controlled trial. (United States)

    Autret-Leca, Elisabeth; Giraudeau, Bruno; Ployet, Marie Joseph; Jonville-Béra, Annie-Pierre


    To assess the equivalence of amoxicillin/clavulanic acid and placebo in the prevention of acute otitis media in children at high risk of acute otitis media who develop upper respiratory tract infection. This was a multicentre, equivalence, randomized, double-blind trial of two parallel groups comparing 5 days of amoxicillin/clavulanic acid 75 mg kg-1 day-1 (i.e. 25 mg kg-1 every 8 h) and placebo. The main outcome measure was acute otitis media occurring within 8-12 days of initiating treatment. Two hundred and three infants, aged 3 months-3 years with upper respiratory tract infection over 36 h and a history of recurrent acute otitis media were included over 8.5 months. Two children were lost to follow-up. Patient characteristics were similar in both groups. In the intention to treat analysis the frequency of acute otitis media was 16.2% (16/99) in the placebo group and 9.6% (10/104) in the amoxicillin/clavulanic acid group (P = 0.288). The difference between acute otitis media rates was 6.6% (one-sided 95% confidence interval of 14.3%). The occurrence of side-effects was similar in the amoxicillin/clavulanic acid and placebo groups. The difference in effectiveness between antibiotic and placebo was not greater than 14.3%, and we calculated that 94 children would need to be exposed to antibiotics to avoid six cases of acute otitis media. In view of the risk of development of resistance due to frequent exposure to antibiotics, our study supports the need for reduction in the administration of antibiotics in upper respiratory tract infection even in children at high risk of acute otitis media.

  10. Equivalence relations and the reinforcement contingency. (United States)

    Sidman, M


    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.

  11. Depressed patients' preferences for education about medications by pharmacists in Kuwait. (United States)

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


    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.

  12. New recommendations for dose equivalent

    International Nuclear Information System (INIS)

    Bengtsson, G.


    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)

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


    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

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

    Sawyer, Alyssa C P; Lynch, John; Bowering, Kerrie; Jeffs, Debra; Clark, Jenny; Mpundu-Kaambwa, Christine; Sawyer, Michael G


    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). 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 infants. The knowledge gained from this

  15. 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.


    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.

  16. Topological equivalence of nonlinear autonomous dynamical systems

    International Nuclear Information System (INIS)

    Nguyen Huynh Phan; Tran Van Nhung


    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

  17. Paediatric oncology patient preference for oral nutritional supplements in a clinical setting. (United States)

    Cohen, Jennifer; Rosen, Kate; Russell, Ken K; Wakefield, Claire E; Goodenough, Belinda


    Oral nutrition supplements are commonly used to increase the nutrient intake of children who are undergoing treatment for cancer. However, little research has been conducted systematically examining preferences for oral supplements in this population. This study aims to address a gap in the literature by examining taste preferences of oral nutrition supplements routinely recommended for children undergoing treatment for cancer. Twenty-one children undergoing treatment for cancer and 38 healthy control subjects participated in an acute double-blinded feeding trial. A variety of energy drinks, available both commercially and in the hospital, were sampled. Patients rated the taste of the drinks on a 10-cm coloured analogue scale. A commercially-based drink (Moove™) rated the highest in the blinded and branded tests for the treatment (mean rating out of 10, 6.44±2.69 and 7.26±2.33, respectively) and control groups (mean rating, 7.61±1.91 and 7.70±2.32, respectively). Taste ratings were significantly higher for commercially available supplements over the hospital-prepared supplements, (p=0.041), with no main effect for tasting condition (i.e. blinded versus branded, p=0.902). There was a statistically significant trend such that ratings, when the brand that was known decreased for hospital supplements, while ratings for commercially available supplements increased (p=0.014). Fresh milk-based supplements were the preferred type of oral nutrition supplement in a cohort of paediatric oncology patients. The data also suggest that commercially available products are more likely to be accepted than hospital-prepared supplements. This pilot study supports the need for further research in the area of oral nutrition supplements for paediatric oncology patients as a way of determining a reliable way to estimate preferences and therefore maximise compliance. Results from this research could be also used as the basis for designing research to study the effects of flavour

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

    Directory of Open Access Journals (Sweden)

    E. D. Bateman


    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.

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


    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 < 0.001), while an increase of 1% in 'chance of OHSS' or 5% 'risk of cycle cancellation due to low response' was non-preferred (mean coefficients -0.31 and -0.24, respectively, P < 0.01). The majority of respondents was willing to trade-off a lower

  20. What determines patient preferences for treating low risk basal cell carcinoma when comparing surgery vs imiquimod? A discrete choice experiment survey from the SINS trial

    Directory of Open Access Journals (Sweden)

    Tinelli Michela


    Full Text Available Abstract Background The SINS trial (Controlled Clinical Trials ISRCTN48755084; Eudract No. 2004-004506-24 is a randomised controlled trial evaluating long term success of excisional surgery vs. imiquimod 5% cream for low risk nodular and superficial basal cell carcinoma (BCC. The trial included a discrete choice experiment questionnaire to explore patient preferences of a cream versus surgery for the treatment of their skin cancer. Methods The self-completed questionnaire was administered at baseline to 183 participants, measuring patients’ strength of preferences when choosing either alternative ‘surgery’ or ‘imiquimod cream’ instead of a fixed ‘current situation’ option (of surgical excision as standard practice in UK. The treatments were described according to: cost, chance of complete clearance, side effects and appearance. Participants had to choose between various scenarios. Analysis was performed using a mixed logit model, which took into account the impact of previous BCC treatment and sample preference variability. Results The analysis showed that respondents preferred ‘imiquimod cream’ to their ‘current situation’ or ‘surgery’, regardless of previous experience of BCC symptoms and treatment. Respondents were more likely to be worried about their cosmetic outcomes and side effects they might experience over and above their chance of clearance and cost. Those with no experience of surgery (compared with experience valued more the choice of ‘imiquimod cream’ (£1013 vs £781. All treatment characteristics were significant determinants of treatment choice, and there was significant variability in the population preferences for all of them. Conclusions Patients with BCC valued more ‘imiquimod cream’ than alternative ‘surgery’ options, and all treatment characteristics were important for their choice of care. Understanding how people with a BCC value alternative interventions may better inform the

  1. What determines patient preferences for treating low risk basal cell carcinoma when comparing surgery vs imiquimod? A discrete choice experiment survey from the SINS trial. (United States)

    Tinelli, Michela; Ozolins, Mara; Bath-Hextall, Fiona; Williams, Hywel C


    The SINS trial (Controlled Clinical Trials ISRCTN48755084; Eudract No. 2004-004506-24) is a randomised controlled trial evaluating long term success of excisional surgery vs. imiquimod 5% cream for low risk nodular and superficial basal cell carcinoma (BCC). The trial included a discrete choice experiment questionnaire to explore patient preferences of a cream versus surgery for the treatment of their skin cancer. The self-completed questionnaire was administered at baseline to 183 participants, measuring patients' strength of preferences when choosing either alternative 'surgery' or 'imiquimod cream' instead of a fixed 'current situation' option (of surgical excision as standard practice in UK). The treatments were described according to: cost, chance of complete clearance, side effects and appearance. Participants had to choose between various scenarios. Analysis was performed using a mixed logit model, which took into account the impact of previous BCC treatment and sample preference variability. The analysis showed that respondents preferred 'imiquimod cream' to their 'current situation' or 'surgery', regardless of previous experience of BCC symptoms and treatment. Respondents were more likely to be worried about their cosmetic outcomes and side effects they might experience over and above their chance of clearance and cost. Those with no experience of surgery (compared with experience) valued more the choice of 'imiquimod cream' (£1013 vs £781). All treatment characteristics were significant determinants of treatment choice, and there was significant variability in the population preferences for all of them. Patients with BCC valued more 'imiquimod cream' than alternative 'surgery' options, and all treatment characteristics were important for their choice of care. Understanding how people with a BCC value alternative interventions may better inform the development of health care interventions.

  2. What matters in type 2 diabetes mellitus oral treatment? A discrete choice experiment to evaluate patient preferences. (United States)

    Mühlbacher, Axel; Bethge, Susanne


    The aim of this empirical study is to evaluate patient preferences for different characteristics of oral type 2 diabetes mellitus (T2DM) treatment. As T2DM treatment requires strict adherence, patient needs and preferences should be taken into consideration. Based on a qualitative and quantitative analysis, a discrete choice experiment (DCE) was applied to identify patient preferences. Apart from six identical attributes (adjustment of glycated hemoglobin [HbA1c], prevention of hypoglycemia, risk of genital infection, risk of gastrointestinal problems, risk of urinary tract infection, and weight change), one continuous variable of either "additional healthy life years" (AHY) or "additional costs" attribute (AC) was included. The DCE was conducted using a fractional factorial design, and the statistical data analysis used random effect logit models. In total, N = 626 (N = 318 AHY + N = 308 AC) T2DM patients participated in the survey. The estimation revealed a clear dominance for prevention of hypoglycemia (coefficient 0.937) and adjustment of HbA1c (coefficient 0.541). The attributes, "additional healthy life years" (coefficient 0.458) or "additional costs" (coefficient 0.420), were in the middle rank and both of significant impact. The side effects, risk of genital infection (coefficient 0.301), risk of gastrointestinal problems (coefficient 0.296), and risk of urinary tract infection (coefficient 0.241) followed in this respective order. Possible weight change (coefficient 0.047) was of less importance (last rank) to the patients in this evaluation. These survey results demonstrate how much a (hypothetical) T2DM oral treatment characteristic affects the treatment decision. The preference data can be used for risk-benefit assessment, cost-benefit assessment, and the establishment of patient-oriented evidence. Understanding how patients perceive and value different aspects of diabetes oral treatment is vital to the optimal design and evaluation of treatment

  3. Equivalence principle and gravitational redshift. (United States)

    Hohensee, Michael A; Chu, Steven; Peters, Achim; Müller, Holger


    We investigate leading order deviations from general relativity that violate the Einstein equivalence principle in the gravitational standard model extension. We show that redshift experiments based on matter waves and clock comparisons are equivalent to one another. Consideration of torsion balance tests, along with matter-wave, microwave, optical, and Mössbauer clock tests, yields comprehensive limits on spin-independent Einstein equivalence principle-violating standard model extension terms at the 10(-6) level.

  4. Testing statistical hypotheses of equivalence

    CERN Document Server

    Wellek, Stefan


    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

  5. Equivalent drawbead model

    NARCIS (Netherlands)

    Meinders, Vincent T.

    Drawbeads are commonly used in the deep drawing process to control the flow of the material during the deformation operation. In the drawbead a sheet material is forced to flow along a sort of threshold and as a result the material is restrained to flow into the die to fast. The force needed to pull

  6. Occupational dose equivalent limits

    International Nuclear Information System (INIS)

    Goldfinch, E.P.


    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)

  7. Incorporating patient preferences into drug development and regulatory decision making : Results from a quantitative pilot study with cancer patients, carers, and regulators

    NARCIS (Netherlands)

    Postmus, D.; Mavris, M.; Hillege, H. L.; Salmonson, T.; Ryll, B.; Plate, A.; Moulon, I.; Eichler, H-G; Bere, N.; Pignatti, F.

    Currently, patient preference studies are not required to be included in marketing authorization applications to regulatory authorities, and the role and methodology for such studies have not been agreed upon. The European Medicines Agency (EMA) conducted a pilot study to gain experience on how the

  8. 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.


    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

  9. Regional Equivalence Scales for Convenience Foods


    Tedford, John R.; Capps, Oral, Jr.; Havlicek, Joseph, Jr.


    Estimates of regional adult equivalence scales for convenience foods were obtained using the model developed by Buse and Salathe and using data from the 1977-78 Nationwide Food Consumption Survey. Wide dispa rities exist in scale values among regions, controlling for other factors, suggesting that age-sex composition of households have differential impacts on convenience food expenditures.

  10. 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


    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

  11. A patient-preference cohort study of office versus inpatient uterine polyp treatment for abnormal uterine bleeding. (United States)

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


    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.

  12. Patients' preference in migraine

    NARCIS (Netherlands)

    Dekker, François (Frans)


    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

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

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


    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.

  14. Randomized, active-controlled, comparative phase 3 efficacy and safety equivalence trial of Ovaleap® (recombinant human follicle-stimulating hormone) in infertile women using assisted reproduction technology (ART). (United States)

    Strowitzki, Thomas; Kuczynski, Waldemar; Mueller, Arnd; Bias, Peter


    Pharmacokinetic studies with XM17 (Ovaleap®), a recombinant human follicle-stimulating hormone (r-hFSH, follitropin alfa), have demonstrated good safety and tolerability in healthy women whose endogenous FSH levels were down-regulated with a long agonist protocol. In these studies, Ovaleap® pharmacokinetics were dose-proportional and bioequivalent to the reference follitropin alfa product (Gonal-f®). The objective of the present study is to determine whether Ovaleap® is equivalent to Gonal-f® with respect to the number of oocytes retrieved in infertile but ovulatory women undergoing assisted reproductive technology (ART) therapy. This multinational, multicenter, randomized (1:1), active-controlled, assessor-blind, comparative study included infertile normally gonadotrophic women 18 to 37 years old with a body mass index of 18 to 29 kg/m(2) and regular menstrual cycles of 21 to 35 days undergoing ART therapy. During a 5-day fixed-dose phase, women received 150 IU/day of Ovaleap® (n = 153) or Gonal-f® (n = 146), followed by an up to 15-day dose-adaptation phase during which doses could be adjusted every 3 to 5 days, up to a maximum of 450 IU/day. Ovaleap® was to be deemed equivalent to Gonal-f® if the two-sided 0.95 confidence interval (CI) for the difference in the number of oocytes retrieved fell within the equivalence range of ±3 oocytes. Similar numbers of oocytes were retrieved in the 2 treatment groups. The mean ± SD number of oocytes retrieved was 12.2 ± 6.7 in the Ovaleap® group and 12.1 ± 6.7 in the Gonal-f® group (intent-to-treat [ITT] population). Regression analysis estimated a mean difference of 0.03 oocytes between the treatment groups (95 % CI: -0.76-0.82), which was well within the prespecified equivalence range of ±3 oocytes. Ovaleap® and Gonal-f® showed favorable and comparable safety profiles, with no unexpected safety findings. Ovaleap® has shown the same efficacy and safety as Gonal-f® for

  15. Unitary equivalence of quantum walks

    International Nuclear Information System (INIS)

    Goyal, Sandeep K.; Konrad, Thomas; Diósi, Lajos


    Highlights: • We have found unitary equivalent classes in coined quantum walks. • A single parameter family of coin operators is sufficient to realize all simple one-dimensional quantum walks. • Electric quantum walks are unitarily equivalent to time dependent quantum walks. - Abstract: A simple coined quantum walk in one dimension can be characterized by a SU(2) operator with three parameters which represents the coin toss. However, different such coin toss operators lead to equivalent dynamics of the quantum walker. In this manuscript we present the unitary equivalence classes of quantum walks and show that all the nonequivalent quantum walks can be distinguished by a single parameter. Moreover, we argue that the electric quantum walks are equivalent to quantum walks with time dependent coin toss operator

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

  17. Patient preferences and extended-release naltrexone: A new opportunity to treat opioid use disorders in Ukraine. (United States)

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


    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.

  18. Assessing patient preferences for the delivery of different community-based models of care using a discrete choice experiment. (United States)

    Dixon, Simon; Nancarrow, Susan A; Enderby, Pamela M; Moran, Anna M; Parker, Stuart G


    To assess patient preferences for different models of care defined by location of care, frequency of care and principal carer within community-based health-care services for older people. Discrete choice experiment administered within a face-to-face interview. An intermediate care service in a large city within the United Kingdom. The projected sample size was calculated to be 200; however, 77 patients were recruited to the study. The subjects had recently been discharged from hospital and were living at home and were receiving short-term care by a publicly funded intermediate care service. Not applicable. The degree of preference, measured using single utility score, for individual service characteristics presented within a series of potential care packages. Location of care was the dominant service characteristics with care at home being the strongly stated preference when compared with outpatient care (0.003), hospital care (<0.001) and nursing home care (<0.001) relative to home care, although this was less pronounced among less sick patients. Additionally, the respondents indicated a dislike for very frequent care contacts. No particular type of professional carer background was universally preferred but, unsurprisingly, there was evidence that sick patients showed a preference for nurse-led care. Patients have clear preferences for the location for their care and were able to state preferences between different care packages when their ideal service was not available. Service providers can use this information to assess which models of care are most preferred within resource constraints. © 2013 Crown copyright. Health Expectations © 2013 John Wiley & Sons Ltd.

  19. First and Foremost Battle the Virus: Eliciting Patient Preferences in Antiviral Therapy for Hepatitis C Using a Discrete Choice Experiment. (United States)

    Mühlbacher, Axel; Bethge, Susanne

    There has been tremendous progress regarding treatment options for hepatitis C virus (HCV) infection. Several interferon-free regimens are awaiting regulatory approval. These innovations promise substantial reductions in the burden of disease and side effects as well as a decrease in treatment duration. The aim of this quantitaitive study was to elicit patient preferences for attributes of innovative antiviral therapies for hepatitis C. A systematic literature search and 14 semi-structured interviews were performed, resulting in eight patient-relevant characteristics. For the discrete choice experiment, an experimental design (3×3 + 5×6) was generated using Ngene software. The survey was conducted in August 2014 through computer-assisted personal interviews. The data were effects-coded in a random parameter logit estimation. Participants were patients with HCV (N = 561; 58.1% men) in different treatment states. The analysis revealed a predominance of the attribute "reaching sustained virological response." When considering confidence intervals, the results showed three different preference ranks. At first place was "sustained virological response" (level difference [LD] 3.98), second was "anemia" (LD 1.10), followed by "number of interferon injections" (LD 0.92), "rash" (LD 0.82), "nausea and/or diarrhea" (LD 0.79), and "duration of antiviral therapy" (LD 0.78). The last position was occupied by both "tiredness/fatigue" (LD 0.31) and "headache" (LD 0.34). From the patients' point of view, sustained virological response is the most essential criterion for choosing an HCV therapy. It was ranked at the highest, dominating all side effects and modes of administration. Furthermore, this study proved that patients consider both the probability of occurrence and the severity of treatment-induced side effects. Results clearly point to valuation of probabilities that is separate from that of severity. Copyright © 2016 International Society for Pharmacoeconomics and

  20. Bio-equivalent doses of recombinant HCG and recombinant LH during ovarian stimulation result in similar oestradiol output: a randomized controlled study. (United States)

    Alsbjerg, Birgit; Elbaek, Helle Olesen; Laursen, Rita Jakubcionyte; Povlsen, Betina Boel; Haahr, Thor; Yding Andersen, Claus; Humaidan, Peter


    In nature, HCG is secreted by the implanting embryo from peri-implantation and onwards. In contrast, LH is mandatory for steroidogenesis and follicular development during the follicular phase, working in synergy with FSH. Moreover, LH is mandatory for the function of the corpus luteum. Although LH and HCG bind to the same receptor, significant molecular, structural and functional differences exist, inducing differences in bioactivity. This randomized controlled study compared the effect of recombinant FSH stimulation combined with daily either micro-dose recombinant HCG or recombinant LH supplementation in a 1:1 bioactivity ratio from day 1 of stimulation in a long gonadotrophin releasing hormone agonist down regulation protocol. A total of 100 patients from a public clinic completed the study. The primary end-point was the oestradiol level on the day of ovulation trigger and the median oestradiol level in the HCG supplemented group was 8662 pmol/l versus 9203 pmol/l in the recombinant LH supplemented group; therefore, no significant difference was found. Moreover, no differences were observed in the number of oocytes retrieved or in the live birth rate. We conclude that recombinant HCG and recombinant LH are equally effective in boosting oestradiol synthesis during ovarian stimulation when used in a 1:1 bioactivity ratio. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  1. Transfer of a conditional ordering response through conditional equivalence classes


    Wulfert, Edelgard; Hayes, Steven C.


    Eight adult humans were taught conditional discriminations in a matching-to-sample format that led to the formation of two four-member equivalence classes. When subjects were taught to select one comparison stimulus from each class in a set order, they then ordered all other members of the equivalence classes without explicit training. When the ordering response itself was brought under conditional control, conditional sequencing also transferred to all other members of the two equivalence cl...

  2. The Ankle Injury Management (AIM) trial: a pragmatic, multicentre, equivalence randomised controlled trial and economic evaluation comparing close contact casting with open surgical reduction and internal fixation in the treatment of unstable ankle fractures in patients aged over 60 years. (United States)

    Keene, David J; Mistry, Dipesh; Nam, Julian; Tutton, Elizabeth; Handley, Robert; Morgan, Lesley; Roberts, Emma; Gray, Bridget; Briggs, Andrew; Lall, Ranjit; Chesser, Tim Js; Pallister, Ian; Lamb, Sarah E; Willett, Keith


    Close contact casting (CCC) may offer an alternative to open reduction and internal fixation (ORIF) surgery for unstable ankle fractures in older adults. We aimed to (1) determine if CCC for unstable ankle fractures in adults aged over 60 years resulted in equivalent clinical outcome compared with ORIF, (2) estimate cost-effectiveness to the NHS and society and (3) explore participant experiences. A pragmatic, multicentre, equivalence randomised controlled trial incorporating health economic evaluation and qualitative study. Trauma and orthopaedic departments of 24 NHS hospitals. Adults aged over 60 years with unstable ankle fracture. Those with serious limb or concomitant disease or substantial cognitive impairment were excluded. CCC was conducted under anaesthetic in theatre by surgeons who attended training. ORIF was as per local practice. Participants were randomised in 1 : 1 allocation via remote telephone randomisation. Sequence generation was by random block size, with stratification by centre and fracture pattern. Follow-up was conducted at 6 weeks and, by blinded outcome assessors, at 6 months after randomisation. The primary outcome was the Olerud-Molander Ankle Score (OMAS), a patient-reported assessment of ankle function, at 6 months. Secondary outcomes were quality of life (as measured by the European Quality of Life 5-Dimensions, Short Form questionnaire-12 items), pain, ankle range of motion and mobility (as measured by the timed up and go test), patient satisfaction and radiological measures. In accordance with equivalence trial US Food and Drug Administration guidance, primary analysis was per protocol. We recruited 620 participants, 95 from the pilot and 525 from the multicentre phase, between June 2010 and November 2013. The majority of participants, 579 out of 620 (93%), received the allocated treatment; 52 out of 275 (19%) who received CCC later converted to ORIF because of loss of fracture reduction. CCC resulted in equivalent ankle

  3. Incorporating patient preferences into drug development and regulatory decision making: Results from a quantitative pilot study with cancer patients, carers, and regulators. (United States)

    Postmus, D; Mavris, M; Hillege, H L; Salmonson, T; Ryll, B; Plate, A; Moulon, I; Eichler, H-G; Bere, N; Pignatti, F


    Currently, patient preference studies are not required to be included in marketing authorization applications to regulatory authorities, and the role and methodology for such studies have not been agreed upon. The European Medicines Agency (EMA) conducted a pilot study to gain experience on how the collection of individual preferences can inform the regulatory review. Using a short online questionnaire, ordinal statements regarding the desirability of different outcomes in the treatment of advanced cancer were elicited from 139 participants (98 regulators, 29 patient or carers, and 12 healthcare professionals). This was followed by face-to-face meetings to gather feedback and validate the individual responses. In this article we summarize the EMA pilot study and discuss the role of patient preference studies within the regulatory review. Based on the results, we conclude that our preference elicitation instrument was easy to implement and sufficiently precise to learn about the distribution of the participants' individual preferences. © 2015 American Society for Clinical Pharmacology and Therapeutics.

  4. Long-acting reversible contraceptive acceptability and unintended pregnancy among women presenting for short-acting methods: a randomized patient preference trial. (United States)

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


    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

  5. Trust, social support and patient type--associations between patients perceived trust, supportive communication and patients preferences in regard to paternalism, clarification and participation of severely injured patients. (United States)

    Ommen, Oliver; Janssen, Christian; Neugebauer, Edmund; Bouillon, Bertil; Rehm, Klaus; Rangger, Christoph; Erli, Hans Josef; Pfaff, Holger


    Trust is an important aspect of physician-patient-interaction, both in terms of compliance and patient- and physician-reported outcomes. Trust-building communication is especially important in terms of severely injured patients because of severity of their injuries and frequently associated physical and psychological consequences. Patients preferences concerning medical treatment (patient type) is also regarded to be important in terms of trust. The objective of this study was to investigate the relationships between patients perceived trust, supportive communication of physicians and patient type of severely injured patients. Seventy-one severely injured patients, who were predominantly injured in the workplace or in traffic accidents and were treated in one of four hospitals in Northrhine-Westfalia between 2001 and 2005, completed a self-administered questionnaire. "Trust in physicians_short form" (TRIP_sf) describes different aspects, such as general trust, competence of doctors and the feeling to be in good hands. "Informational support" and "emotional support" comprise verbal and non-verbal aspects, such as clear and understandable information or devotion and empathic manner. "Patient type" measures patients preferences in regard to paternalism of physician, clarification of medical facts and participation in treatment. Trust is strongly correlated with informational (.628**) and emotional support (.542**) and is less correlated with patients preferences of "paternalism" (.250*)", "clarification" (.438**) and participation" (.378**). Informational and emotional support are in general not significantly correlated with type of patient, all correlations were adjusted for age, gender, marital and socioeconomic status, length of hospital stay, and severity of injury. Trust is significantly related to patient type but more related to doctor support: the results confirm the importance of supportive communication in terms of emotional and informational support

  6. Internet Use Frequency and Patient-Centered Care: Measuring Patient Preferences for Participation Using the Health Information Wants Questionnaire (United States)

    Wang, Mo; Feldman, Robert; Zhou, Le


    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

  7. An online resource of digital stories about cancer genetics: qualitative study of patient preferences and information needs. (United States)

    Iredale, Rachel; Mundy, Lisa; Hilgart, Jennifer


    The Cancer Genetics Service for Wales (CGSW) was established in 1998 as an all-Wales service for individuals with concerns about their family history of cancer. CGSW offers a range of services such as risk assessment, genetic counseling, and genetic testing. Individuals referred to cancer genetics services often have unmet information and support needs, and they value access to practical and experiential information from other patients and health professionals. As a result of the lifelong nature of genetic conditions, a fundamental challenge is to meet the ongoing needs of these patients by providing easily accessible and reliable information. Our aims were to explore how the long-term information and support needs of CGSW patients could be met and to assess whether an online bank of digital stories about cancer genetics would be acceptable to patients. In 2009, CGSW organized patient panels across Wales. During these events, 169 patients were asked for their feedback about a potential online resource of digital stories from CGSW patients and staff. A total of 75 patients registered to take part in the project and 23 people from across Wales agreed to share their story. All participants took part in a follow-up interview. Patient preferences for an online collection of cancer genetics stories were collected at the patient panels. Key topics to be covered by the stories were identified, and this feedback informed the development of the website to ensure that patients' needs would be met. The 23 patient storytellers were aged between 28 and 75 years, and 19 were female. The digital stories reflect patients' experiences within CGSW and the implications of living with or at risk of cancer. Follow-up interviews with patient storytellers showed that they shared their experiences as a means of helping other patients and to increase understanding of the cancer genetics service. Digital stories were also collected from 12 members of staff working at CGSW. The digital

  8. 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


    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

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

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


    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:, 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

  10. Matching of equivalent field regions

    DEFF Research Database (Denmark)

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


    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...

  11. Equivalent linearization of nonlinear forces (United States)

    Meng, Guang; Xue, Zhongqing


    A method used for equivalent linearization of the two orthogonal squeeze-film forces is extended here to the general case of n degrees of freedom and n components of nonlinear forces, and the expressions for equivalent linear coefficients are derived. Nonlinear forces can be linearized by the methods of Fourier expansion, active and reactive powers, or mean-square error. The n components of nonlinear forces can all be expressed formally as the sum of an average force, a linear spring force, and a linear damping force. This paper also gives a flow chart for calculating the steady-state responses of a nonlinear system with many degrees of freedom, using the method of equivalent linearization. The resulting saving in computation time is demonstrated by a numerical example of a flexible rotor-bearing system with a noncentralized squeeze-film damper.

  12. Attainment of radiation equivalency principle

    International Nuclear Information System (INIS)

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


    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

  13. Comments on field equivalence principles

    DEFF Research Database (Denmark)

    Appel-Hansen, Jørgen


    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...

  14. On the Einstein equivalence principle

    International Nuclear Information System (INIS)

    Gabriel, M.D.


    The Einstein equivalence principle, the cornerstone of our present day understanding of gravity, is used to explore a deeper connection between the deflection of starlight by a spinning object and the Lense-Thirring dragging of inertial frames. It is also noted that experiment has not established that the gravitomagnetic coupling to currents of particle rest-mass energy, to currents of electromagnetic energy, and to currents of all other types of energy are identical as predicted by the Einstein equivalence principle. The detailed analysis of how atomic physics experiments originated by Hughes and by Drever can constrain such possible violations of the Einstein equivalence principle is given. Atomic clocks are also important tools used to test local Lorentz invariance and hence one important aspect of Einstein equivalence principle. The sensitivity of atomic clocks to preferred-frame effects is studied here for the first time, and the behavior of the hydrogen-maser clocks of the Gravity Probe A experiment is analyzed to illustrate use of the techniques involved

  15. Evolution of water equivalent phantoms

    International Nuclear Information System (INIS)

    Yabutani, Toshimine; Ida, Yoshihiro; Sawada, Takeshi


    In radiation therapy, the dose absorbed by the target tissue needs to be extremely accurate. In order to obtain the target absorbed dose, radiation dose measurements are performed using a phantom instead of the patient's body, because the target absorbed dose cannot be directly measured. Although water is the best human muscle equivalent phantom, it is not useful for this purpose. Therefore, water equivalent solid phantoms are usually used for the measurements. We compared the following water equivalent solid phantoms for water: Tough water phantom, 457 Solid water phantom, RW-3, Mix-DP, polystyrene resin, polyethylene resin, and acrylic resin. The measurements obtained were ionization current in the phantoms as determined by ionization chamber, tissue-maximum ratio, transmission measurements in water with and without the phantoms, Hounsfield units of the phantoms for uniformity of inside phantoms as determined by computed tomography, and accuracy of the phantoms. Results showed the phantoms to be almost equivalent to water, except for the acrylic resin phantom. However, the phantoms had various characteristics that affected accuracy, and the phantoms underwent change with time. Measurement error was caused by the characteristics of the phantoms. Therefore, it is important to measure the calibration coefficient of phantoms for water, regardless of what is stated on paper. (author)

  16. [Development and test-theoretical analysis of an instrument for data collection on patients' preferences and experiences concerning participation in nursing care decisions in acute hospitals]. (United States)

    Smoliner, Andrea; Hantikainen, Virpi; Mayer, Hanna; Ponocny-Seliger, Elisabeth; Them, Christa


    Patient orientation and patient participation are important aspects of modern health care and should be taken into consideration in the context of nursing care decision-making. The concept of evidence-based nursing also includes patient preferences in participation on decision-making, an area, however, which has not been adequately investigated so far. The aim of the present study was the development and testing of an instrument in German language for collecting data on patients' preferences and the experience of patients regarding their participation in nursing care decision-making in acute hospitals. The generation of items was based on available literature and in collaboration with specialists, using the theoretical model of Charles, Gafni and Whelan (1999). For testing the instrument, data was collected on 967 adult patients in surgical and medical wards of five hospitals in Vienna from October 2007 to March 2008. Test theoretical analyses included checking internal consistency, construct validity and criterion validity. The reliability of the scale preference and experience were confirmed by Cronbach's alpha (> or = 0.84) and the results of item analysis. The construct validity was supported by representing the decision model in the data. The criterion validity (concordant and discriminant validity) was tested with the two external criterions of subjective satisfaction with the information provided and decision making, and was supported by the results both at the level of total scores and at the level of item scores. In summary, the developed instrument represents an adequately reliable and valid test-theoretic, and also model-theoretic instrument for research in the field of evidence-based nursing. Therefore it is capable of gathering new knowledge on patients' preferences on participation in nursing care decision making.

  17. The Source Equivalence Acceleration Method

    International Nuclear Information System (INIS)

    Everson, Matthew S.; Forget, Benoit


    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

  18. Toward Patient-Centered Telerehabilitation Design: Understanding Chronic Pain Patients' Preferences for Web-Based Exercise Telerehabilitation Using a Discrete Choice Experiment. (United States)

    Cranen, Karlijn; Groothuis-Oudshoorn, Catharina Gm; Vollenbroek-Hutten, Miriam Mr; IJzerman, Maarten J


    Patient-centered design that addresses patients' preferences and needs is considered an important aim for improving health care systems. At present, within the field of pain rehabilitation, patients' preferences regarding telerehabilitation remain scarcely explored and little is known about the optimal combination between human and electronic contact from the patients' perspective. In addition, limited evidence is available about the best way to explore patients' preferences. Therefore, the assessment of patients' preferences regarding telemedicine is an important step toward the design of effective patient-centered care. To identify which telerehabilitation treatment options patients with chronic pain are most likely to accept as alternatives to conventional rehabilitation and assess which treatment attributes are most important to them. A discrete choice experiment with 15 choice tasks, combining 6 telerehabilitation treatment characteristics, was designed. Each choice task consisted of 2 hypothetical treatment scenarios and 1 opt-out scenario. Relative attribute importance was estimated using a bivariate probit regression analysis. One hundred and thirty surveys were received, of which 104 were usable questionnaires; thus, resulting in a total of 1547 observations. Physician communication mode, the use of feedback and monitoring technology (FMT), and exercise location were key drivers of patients' treatment preferences (P<.001). Patients were willing to accept less frequent physician consultation offered mainly through video communication, provided that they were offered FMT and some face-to-face consultation and could exercise outside their home environment at flexible exercise hours. Home-based telerehabilitation scenarios with minimal physician supervision were the least preferred. A reduction in health care premiums would make these telerehabilitation scenarios as attractive as conventional clinic-based rehabilitation. "Intermediate" telerehabilitation

  19. Equivalent statistics and data interpretation. (United States)

    Francis, Gregory


    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.

  20. 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.

  1. Equivalence in bilingual lexicography: criticism and suggestions ...

    African Journals Online (AJOL)

    A reminder of general problems in the formation of terminology, as illustrated by the German Äquivalence (Eng. equivalence) and äquivalent (Eng. equivalent), is followed by a critical discussion of the concept of equivalence in contrastive lexicology. It is shown that especially the concept of partial equivalence is ...

  2. 21 CFR 26.9 - Equivalence determination. (United States)


    ... 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...

  3. Wijsman Orlicz Asymptotically Ideal -Statistical Equivalent Sequences

    Directory of Open Access Journals (Sweden)

    Bipan Hazarika


    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.

  4. Derived equivalences for group rings

    CERN Document Server

    König, Steffen


    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.

  5. Generating carbyne equivalents with photoredox catalysis (United States)

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


    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.

  6. The preliminary results of a comparative effectiveness evaluation of adhesiolysis and caudal epidural injections in managing chronic low back pain secondary to spinal stenosis: a randomized, equivalence controlled trial. (United States)

    Manchikanti, Laxmaiah; Cash, Kimberly A; McManus, Carla D; Pampati, Vidyasagar; Singh, Vijay; Benyamin, Ramsin


    Lumbar surgery and epidural injections for spinal stenosis are the most commonly performed interventions in the United States. However, there is only moderate evidence to the effectiveness of surgery and caudal epidural injections. The next sequential step is adhesiolysis and hypertonic neurolysis with targeted delivery. There have not been any randomized trials evaluating the effectiveness of percutaneous adhesiolysis and targeted delivery of local anesthetic, steroid and hypertonic sodium chloride solution in lumbar spinal stenosis. A randomized, equivalence, controlled trial. An interventional pain management practice, a specialty referral center, a private practice setting in the United States. To evaluate the effectiveness of percutaneous epidural adhesiolysis in patients with chronic low back and lower extremity pain with lumbar central spinal stenosis and compare with fluoroscopically directed caudal epidural injections. Patients were randomly assigned to one of 2 groups with 25 patients in each group. Group I patients received caudal epidural injections with catheterization up to S3 with local anesthetic, 0.9% sodium chloride solution, non-particulate betamethasone and served as the control group. Group II patients received percutaneous adhesiolysis with targeted delivery and injection of lidocaine, 10% hypertonic sodium chloride solution, and non-particulate Betamethasone and formed the intervention group. Randomization was performed by computer-generated random allocation sequence by simple randomization. Multiple outcome measures were utilized including the Numeric Rating Scale (NRS), the Oswestry Disability Index 2.0 (ODI), employment status, and opioid intake with assessment at 3, 6, and 12 months post treatment. Significant pain relief was described as 50% or more, whereas significant improvement in the disability score was defined as a reduction of 40% or more. This evaluation showed significant pain relief (>or= 50%) in 76% of the patients at one

  7. Ensemble Equivalence for Distinguishable Particles

    Directory of Open Access Journals (Sweden)

    Antonio Fernández-Peralta


    Full Text Available Statistics of distinguishable particles has become relevant in systems of colloidal particles and in the context of applications of statistical mechanics to complex networks. In this paper, we present evidence that a commonly used expression for the partition function of a system of distinguishable particles leads to huge fluctuations of the number of particles in the grand canonical ensemble and, consequently, to nonequivalence of statistical ensembles. We will show that the alternative definition of the partition function including, naturally, Boltzmann’s correct counting factor for distinguishable particles solves the problem and restores ensemble equivalence. Finally, we also show that this choice for the partition function does not produce any inconsistency for a system of distinguishable localized particles, where the monoparticular partition function is not extensive.

  8. Expanding the Interaction Equivalency Theorem

    Directory of Open Access Journals (Sweden)

    Brenda Cecilia Padilla Rodriguez


    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.

  9. 46 CFR 175.540 - Equivalents. (United States)


    ... 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...

  10. Equivalent damage of loads on pavements

    CSIR Research Space (South Africa)

    Prozzi, JA


    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...

  11. Some spectral equivalences between Schroedinger operators

    International Nuclear Information System (INIS)

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


    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

  12. Equivalence ratio and constriction effects on RBCC thrust augmentation (United States)

    Koupriyanov, M.; Etele, J.


    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.

  13. Thévenin equivalent based static contingency assessment

    DEFF Research Database (Denmark)


    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....

  14. Randomized cross-over study of patient preference for oral or intravenous vinorelbine in combination with carboplatin in the treatment of advanced NSCLC

    DEFF Research Database (Denmark)

    Jensen, Lisa Helene Toft; Østerlind, Kell Erik; Rytter, C.


    BACKGROUND: Most chemotherapeutics are administrated intravenously (iv), but some are also available in an oral (po) formulation. This study was designed with the primary objective to estimate the patients' preference for po or iv vinorelbine in combination with carboplatin for the palliative...... treatment of non-small cell lung cancer (NSCLC). Secondary aims were to evaluate toxicity, efficacy, and subjective reasons the preference. PATIENTS AND METHODS: Sixty-one patients were randomized in a cross-over trial to two cycles of carboplatin day 1 and vinorelbine day 1 and day 8 iv followed by two...... cycles of carboplatin and vinorelbine po, or the opposite. Patients, who did not show progressive disease after four cycles, had a free choice of iv or po vinorelbine for the next two cycles. RESULTS: Forty-three patients were evaluable for preference and 32 (74%, 95% CI 61-88%) chose po (p

  15. 'Conditional candour' and 'knowing me': an interpretive description study on patient preferences for physician behaviours during end-of-life communication. (United States)

    Abdul-Razzak, Amane; You, John; Sherifali, Diana; Simon, Jessica; Brazil, Kevin


    To understand patients' preferences for physician behaviours during end-of-life communication. We used interpretive description methods to analyse data from semistructured, one-on-one interviews with patients admitted to general medical wards at three Canadian tertiary care hospitals. Study recruitment took place from October 2012 to August 2013. We used a purposive, maximum variation sampling approach to recruit hospitalised patients aged ≥55 years with a high risk of mortality within 6-12 months, and with different combinations of the following demographic variables: race (Caucasian vs non-Caucasian), gender and diagnosis (cancer vs non-cancer). A total of 16 participants were recruited, most of whom (69%) were women and 70% had a non-cancer diagnosis. Two major concepts regarding helpful physician behaviour during end-of-life conversations emerged: (1) 'knowing me', which reflects the importance of acknowledging the influence of family roles and life history on values and priorities expressed during end-of-life communication, and (2) 'conditional candour', which describes a process of information exchange that includes an assessment of patients' readiness, being invited to the conversation, and sensitive delivery of information. Our findings suggest that patients prefer a nuanced approach to truth telling when having end-of-life discussions with their physician. This may have important implications for clinical practice and end-of-life communication training initiatives. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  16. Patient Preferences versus Family Physicians' Perceptions Regarding the Place of End-of-Life Care and Death: A Nationwide Study in Taiwan. (United States)

    Shih, Chih-Yuan; Hu, Wen-Yu; Cheng, Shao-Yi; Yao, Chien-An; Chen, Ching-Yu; Lin, Yen-Chun; Chiu, Tai-Yuan


    Enabling people to die in their preferred place is important for providing high-quality end-of-life care. The study objective was to explore patients' preferences regarding the place of end-of-life care and death and to compare these preferences with the perceptions of their family physicians. This cross-sectional study used stratified random sampling, surveying 400 registered patients and 200 of their family physicians nationwide, with a five-part, structured, self-report questionnaire. Of the selected population, 310 patients (response rate 77.5%) and 169 physicians (response rate 84.5%) responded. Regarding the preferred place for end-of-life care, most of the patients would choose to receive care at home (60.6%) if home care services were available. Additionally, home was the most frequently preferred (66.5%) place of death. The family physicians' survey showed that a higher proportion of physicians selected home as the preferred place for end-of-life care and death (71.6% and 87.2%, respectively). The results of logistic regression analysis showed that patients younger than 50 years of age who believed in Chinese folk religion and who resided in a rural area were more likely to prefer to die at home. The most commonly preferred place for end-of-life care and death is the patient's home. Establishing a community-based palliative care system should be encouraged to allow more individuals to die in their preferred locations. There were discrepancies in the preferred place of end-of-life care and death between the patients' preferences and their family physicians' perceptions. More effective physician-patient communication regarding end-of-life care is needed.

  17. Patient-Centered Research into Outcomes Stroke Patients Prefer and Effectiveness Research: Implementing the patient-driven research paradigm to aid decision making in stroke care. (United States)

    Xian, Ying; O'Brien, Emily C; Fonarow, Gregg C; Olson, DaiWai M; Schwamm, Lee H; Hannah, Deidre; Lindholm, Brianna; Maisch, Lesley; Lytle, Barbara L; Greiner, Melissa A; Wu, Jingjing; Peterson, Eric D; Pencina, Michael J; Hernandez, Adrian F


    Stroke is common and costly, annually depriving the lives and well-being of 800,000 Americans. Despite demonstrated efficacy in clinical trials, questions remain about the safety and clinical effectiveness of various treatment options given patient characteristics, conditions, preferences, and their desired outcomes. The Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) is a Patient-Centered Outcomes Research Institute-sponsored project designed to help patients, physicians, and other stakeholders make informed decisions regarding stroke care and improve outcomes through patient-centered comparative effectiveness research. The primary outcomes identified and prioritized by stroke patients are "home time" (time spent alive and outside a hospital) and major adverse cardiovascular events. With inputs from stroke patients themselves, a series of comparative safety and effectiveness analyses will be performed across 3 prioritized therapeutic areas identified as important by stroke survivors: oral anticoagulants, statin therapy, and antidepressants. We obtained data from Get With the Guidelines-Stroke linked with Medicare claims and follow-up telephone interviews. Our combined retrospective and prospective research strategy allows the evaluation of the safety and effectiveness of various treatment options and patient-centered longitudinal outcomes. To ensure the rapid translation of findings into clinical practice, results will be disseminated to stroke survivors, caregivers, and health care providers through traditional and social media, including an online decision aid tool. PROSPER is a patient-centered outcome research study guided by patients, caregivers, and the broader health care community. By addressing knowledge gaps in treatment uncertainties through comparative effectiveness research, PROSPER has the potential to improve decision making in stroke care and patient outcomes reflecting individual patient

  18. Ultra short pre-seasonal subcutaneous immunotherapy and pre-coseasonal sublingual immunotherapy for pollen allergy: an evaluation of patient's preference in real life. (United States)

    Manzotti, G; Pappacoda, A; Dimatteo, M; Scolari, C; Riario-Sforza, G G; Incorvaia, C


    Specific immunotherapy (SIT) efficacy and safety by subcutaneous (SCIT) and sublingual (SLIT) route is supported by literature data. Pre-coseasonal treatment is currently the more accepted option for pollen immunotherapy in terms of costs and patient's compliance. This retrospective study evaluated the patient's preference concerning subcutaneous or sublingual route in pre-coseasonal treatment. We evaluated 145 patients (79 males, 66 females, age ranging from 14 to 69 years), suffering from moderate-severe rhino-conjunctivitis or mild bronchial asthma and with homogeneous characteristic according to allergic disease severity. We proposed either SLIT, with extracts by different producers, or SCIT with Pollinex 4 (Allergy Therapeutics, Worthing, UK), a product designed for ultra-short administration in 4 injections, highlighting for each kind of SIT the major practical advantages or burdens. Of 145 patients, 72 chose Pollinex 4 SCIT and 73 chose SLIT. SCIT-treated patients received a total of 90 vaccines (18 patients had double course of SCIT). SLIT-treated patients received a total of 87 vaccines (14 patients had double course of SLIT). In the SCIT group, there were 49 males and 23 females; in the SLIT group, there were 30 males and 43 females. Mean age was 36.5 years in SCIT group and 28.5 years in SLIT group. Males preferred SCIT (49 of 72 patients) and females preferred SLIT (43 of 73 patients). No severe reaction was observed either in SCIT or SLIT group. Patients are active subjects in decisional process. Trying to apply in real life the indications coming from guidelines about patient's preference is an important matter. In our patients SCIT with ultra short schedule and SLIT are similarly preferred.

  19. 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


    . 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

  20. Behavioural equivalence for infinite systems - Partially decidable!

    DEFF Research Database (Denmark)

    Sunesen, Kim; Nielsen, Mogens


    For finite-state systems non-interleaving equivalences are computationally at least as hard as interleaving equivalences. In this paper we show that when moving to infinite-state systems, this situation may change dramatically. We compare standard language equivalence for process description...... 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...... to communication free Petri nets. For this simple process language our two notions of non-interleaving equivalences agree. More interestingly, we show that they are decidable, contrasting a result of Hirshfeld that standard interleaving language equivalence is undecidable. Our result is inspired by a recent result...

  1. Assessment of Voltage Stability Using Network Equivalent

    Directory of Open Access Journals (Sweden)

    Abhijit Chakrabarti


    Full Text Available In this paper a fast system voltage stability index (FSVSI has been proposed to assess overall system voltage stability of a multi-bus power system at a particular operating point using the concept of two bus network equivalent. A universal direct voltage stability index has also been explored to assess local (DVSI as well as overall system voltage stability (DSVSI. An index called system transmission quality factor (STQF has been developed to assess the power transmission quality of the overall system in the context of voltage stability. Two FACTS controllers, TCSC and STATCOM have also been incorporated in the present study to observe their effectiveness to ensure voltage stabilty. STATCOM has been found to be superior in order to improve voltage stability of power system as compared to TCSC. The developed concept has been validated using practical India Easten Grid (WBSEB system and it has a high potential of on-line application.

  2. Tobacco products, exemptions from substantial equivalence requirements. Final rule. (United States)


    The Food and Drug Administration (FDA) is issuing this final rule to establish procedures for requesting an exemption from the substantial equivalence requirements of the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act). The final rule describes the process and statutory criteria for requesting an exemption and explains how FDA reviews requests for exemptions. This regulation satisfies the requirement in the Tobacco Control Act that FDA issue regulations implementing the exemption provision.

  3. Effects of strength vs aerobic exercise on pain severity in adults with fibromyalgia: a randomized equivalence trial. (United States)

    Hooten, W Michael; Qu, Wenchun; Townsend, Cynthia O; Judd, Jeffrey W


    Strength training and aerobic exercise have beneficial effects on pain in adults with fibromyalgia. However, the equivalence of strengthening and aerobic exercise has not been reported. The primary aim of this randomized equivalence trial involving patients with fibromyalgia admitted to an interdisciplinary pain treatment program was to test the hypothesis that strengthening (n=36) and aerobic (n=36) exercise have equivalent effects (95% confidence interval within an equivalence margin ± 8) on pain, as measured by the pain severity subscale of the Multidimensional Pain Inventory. Secondary aims included determining the effects of strengthening and aerobic exercise on peak Vo(2) uptake, leg strength, and pressure pain thresholds. In an intent-to-treat analysis, the mean (± standard deviation) pain severity scores for the strength and aerobic groups at study completion were 34.4 ± 11.5 and 37.6 ± 11.9, respectively. The group difference was -3.2 (95% confidence interval, -8.7 to 2.3), which was within the equivalence margin of Δ8. Significant improvements in pain severity (Pstrength (Pstrength group (mean change 0.4 ± 2.6 mL/kg/min). Knowledge of the equivalence and physiological effects of exercise have important clinical implications that could allow practitioners to target exercise recommendations on the basis of comorbid medical conditions or patient preference for a particular type of exercise. This study found that strength and aerobic exercise had equivalent effects on reducing pain severity among patients with fibromyalgia. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  4. Equivalence in Bilingual Lexicography: Criticism and Suggestions*

    Directory of Open Access Journals (Sweden)

    Herbert Ernst Wiegand


    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.


    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.


  5. Equivalences of real submanifolds in complex space.




    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.

  6. Equivalent Simplification Method of Micro-Grid


    Cai Changchun; Cao Xiangqin


    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...

  7. The Complexity of Identifying Large Equivalence Classes

    DEFF Research Database (Denmark)

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


    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...

  8. Calculation methods for determining dose equivalent

    International Nuclear Information System (INIS)

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


    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

  9. Equivalence principle implications of modified gravity models

    International Nuclear Information System (INIS)

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


    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

  10. 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


    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

  11. Patient Preferences for Attributes of Type 2 Diabetes Mellitus Medications in Germany and Spain: An Online Discrete-Choice Experiment Survey. (United States)

    Mansfield, Carol; Sikirica, Mirko V; Pugh, Amy; Poulos, Christine M; Unmuessig, Victoria; Morano, Raul; Martin, Alan A


    Understanding patient preferences for attributes of type 2 diabetes mellitus (T2DM) medications may help explain how the attributes differentially affect patient perceptions and behaviors. In this survey, we quantified the relative preferences among patients in Germany and Spain in separate analyses. A stated-preference, discrete-choice experiment (DCE) survey was designed to elicit preferences for T2DM treatment attributes among patients with self-reported T2DM and who reported being prescribed T2DM medication for > 2 years. Patients recruited from an online national consumer panel completed an online survey. The survey presented choices between eight pairs of hypothetical T2DM treatments defined by seven attributes: chance of reaching target hemoglobin A1c (HbA1c) level; reduced risk of serious heart attack or stroke; frequency of hypoglycemia; risk of gastrointestinal (GI) problems; weight change; mode of administration (oral or injectable); dosing frequency. Data were analyzed using random-parameters logit. Minimum acceptable benefit (MAB) was defined as the minimum increase in the probability of reaching target HbA1c for which respondents would accept less desirable levels of other attributes. In Germany and Spain, 474 and 401 respondents completed the survey, respectively. DCE analysis showed that risk of GI problems was most important to German respondents. MAB analysis found that respondents would require a 56 percentage point increase in the probability of reaching their HbA1c target to offset a change from 0% to 30% risk of GI problems. For Spanish respondents, mode of administration was the most important attribute. These respondents would require a 59 percentage point increase in the probability of reaching their HbA1c target to offset moving from oral to injectable medications. Respondents in Germany and Spain were willing to trade efficacy for improvements in side effects and mode of administration. Given the variety of T2DM medications currently

  12. 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 ...

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

    African Journals Online (AJOL)

    This device incorporates a one-way valve with a fluid reservoir and permits the detection of an air leak, as well as intrapleural pressure differences. Aim. To prove equivalence of the Xpand chest drain compared with standard underwater bottle drainage. Methods. In a non-blinded randomised control trial 67 patients with ...

  14. [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]. (United States)

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


    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.

  15. Patient preferences for attributes of multiple sclerosis disease-modifying therapies: development and results of a ratings-based conjoint analysis. (United States)

    Wilson, Leslie S; Loucks, Aimee; Gipson, Gregory; Zhong, Lixian; Bui, Christine; Miller, Elizabeth; Owen, Mary; Pelletier, Daniel; Goodin, Douglas; Waubant, Emmanuelle; McCulloch, Charles E


    Timely individualized treatment is essential to improving relapsing-remitting multiple sclerosis (RRMS) patient health outcomes, yet little is known about how patients make treatment decisions. We sought to evaluate RRMS patient preferences for risks and benefits of treatment. Fifty patients with RRMS completed conjoint analysis surveys with 16 hypothetical disease-modifying therapy (DMT) medication profiles developed using a fractional factorial design. Medication profiles were assigned preference ratings from 0 (not acceptable) to 10 (most favorable). Medication attributes included a range of benefits, adverse effects, administration routes, and market durations. Analytical models used linear mixed-effects regression. Participants showed the highest preference for medication profiles that would improve their symptoms (β = 0.81-1.03, P disease symptom progression showed DMT preferences of 0.17 point (β = 0.17, P = .002) and 0.12 point (β = 0.12, P symptoms and prevention of progression but not on relapse prevention, the proven drug outcome. Patients were willing to accept some level of serious risk for certain types and amounts of benefits, and they strongly preferred daily oral administration over all other options.

  16. ‘Conditional candour’ and ‘knowing me’: an interpretive description study on patient preferences for physician behaviours during end-of-life communication (United States)

    Abdul-Razzak, Amane; You, John; Sherifali, Diana; Simon, Jessica; Brazil, Kevin


    Objective To understand patients’ preferences for physician behaviours during end-of-life communication. Methods We used interpretive description methods to analyse data from semistructured, one-on-one interviews with patients admitted to general medical wards at three Canadian tertiary care hospitals. Study recruitment took place from October 2012 to August 2013. We used a purposive, maximum variation sampling approach to recruit hospitalised patients aged ≥55 years with a high risk of mortality within 6–12 months, and with different combinations of the following demographic variables: race (Caucasian vs non-Caucasian), gender and diagnosis (cancer vs non-cancer). Results A total of 16 participants were recruited, most of whom (69%) were women and 70% had a non-cancer diagnosis. Two major concepts regarding helpful physician behaviour during end-of-life conversations emerged: (1) ‘knowing me’, which reflects the importance of acknowledging the influence of family roles and life history on values and priorities expressed during end-of-life communication, and (2) ‘conditional candour’, which describes a process of information exchange that includes an assessment of patients’ readiness, being invited to the conversation, and sensitive delivery of information. Conclusions Our findings suggest that patients prefer a nuanced approach to truth telling when having end-of-life discussions with their physician. This may have important implications for clinical practice and end-of-life communication training initiatives. PMID:25296653

  17. A discrete-choice experiment to quantify patient preferences for frequency of glucagon-like peptide-1 receptor agonist injections in the treatment of type 2 diabetes. (United States)

    Hauber, A Brett; Nguyen, Hiep; Posner, Joshua; Kalsekar, Iftekhar; Ruggles, James


    Understanding patients' preferences for attributes of injectable antihyperglycemic regimens may improve patient satisfaction and medication adherence. Our objective was to quantify the preferences of patients with type 2 diabetes mellitus (T2DM) for reducing the frequency of glucagon-like peptide-1 receptor agonist injections from once daily to once weekly. A total of 643 respondents with a self-reported physician diagnosis of type 2 diabetes completed a web-based discrete-choice experiment survey. The sample included four prespecified subgroups: currently using exenatide once weekly (n = 150), liraglutide once daily (n = 153), insulin (but not exenatide once weekly or liraglutide) (n = 156), and no injectable treatment (n = 184). Device attributes included type of injection device, needle size and pain, injection frequency, refrigeration, and injection-site reactions. Random-parameters logit was used to estimate the relative impact of device attributes on treatment choice for each subgroup. In all subgroups, changing injection frequency from daily to weekly (independent of the effect of injection frequency on preferences for other attributes) was the most important predictor of treatment choice. Switching from a longer and thicker needle to a shorter and thinner needle and eliminating injection-site reactions were also statistically significant predictors of device choice (P choices, diagnosis was self-reported, and patients were recruited from an Internet panel and may not be representative of the T2DM patient population.

  18. Flow equivalence and isotopy for subshifts

    DEFF Research Database (Denmark)

    Boyle, Mike; Carlsen, Toke Meier; Eilers, Søren


    We study basic properties of flow equivalence on one-dimensional compact metric spaces with a particular emphasis on isotopy in the group of (self-) flow equivalences on such a space. In particular, we show that such an orbit-preserving map is not always an isotopy, but that this always is the case...

  19. 21 CFR 26.6 - Equivalence assessment. (United States)


    .... (a) The criteria to be used by the parties to assess equivalence are listed in appendix D of this subpart. Information pertaining to the criteria under European Community (EC) competence will be provided... draft programs for assessing the equivalence of the respective regulatory systems in terms of quality...

  20. Equivalency Programmes (EPs) for Promoting Lifelong Learning (United States)

    Haddad, Caroline, Ed.


    Equivalency programmes (EPs) refers to alternative education programmes that are equivalent to the formal education system in terms of curriculum and certification, policy support mechanisms, mode of delivery, staff training, and other support activities such as monitoring, evaluation and assessment. The development of EPs is potentially an…

  1. 7 CFR 1032.54 - Equivalent price. (United States)


    ... 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 ...

  2. 7 CFR 1124.54 - Equivalent price. (United States)


    ... 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 ...

  3. 7 CFR 1000.54 - Equivalent price. (United States)


    ... 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...

  4. 7 CFR 1006.54 - Equivalent price. (United States)


    ... 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 ...

  5. 7 CFR 1030.54 - Equivalent price. (United States)


    ... 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. ...

  6. 7 CFR 1001.54 - Equivalent price. (United States)


    ... 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 ...

  7. 7 CFR 1007.54 - Equivalent price. (United States)


    ... 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 ...

  8. 7 CFR 1126.54 - Equivalent price. (United States)


    ... 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 ...

  9. 7 CFR 1131.54 - Equivalent price. (United States)


    ... 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 ...

  10. 7 CFR 1005.54 - Equivalent price. (United States)


    ... 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 ...

  11. 7 CFR 1033.54 - Equivalent price. (United States)


    ... 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. 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 ...

  13. Mania and Behavioral Equivalents: A Preliminary Study (United States)

    Sturmey, Peter; Laud, Rinita B.; Cooper, Christopher L.; Matson, Johnny L.; Fodstad, Jill C.


    Previous research has failed to address the possibility of behavioral equivalents in people with ID and mania. The relationship between a measure of mania and possible behavioral equivalents was assessed in 693 adults, most with severe or profound ID, living in a large residential setting. The mania subscale of the DASH-II proved to be a…

  14. 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. (United States)

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


    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.

  15. Simultaneity as an Invariant Equivalence Relation (United States)

    Mamone-Capria, Marco


    This paper deals with the concept of simultaneity in classical and relativistic physics as construed in terms of group-invariant equivalence relations. A full examination of Newton, Galilei and Poincaré invariant equivalence relations in ℝ4 is presented, which provides alternative proofs, additions and occasionally corrections of results in the literature, including Malament's theorem and some of its variants. It is argued that the interpretation of simultaneity as an invariant equivalence relation, although interesting for its own sake, does not cut in the debate concerning the conventionality of simultaneity in special relativity.

  16. Pelvic pain and quality of life of women with endometriosis during quadriphasic estradiol valerate/dienogest oral contraceptive: a patient-preference prospective 24-week pilot study. (United States)

    Grandi, Giovanni; Xholli, Anjeza; Napolitano, Antonella; Palma, Federica; Cagnacci, Angelo


    The progestin dienogest (DNG) given alone effectively reduces pelvic pain of women with endometriosis. It is not clear whether the same occurs when DNG is associated with estradiol (E2). Patient preference prospective observational study. Outpatient centre of university hospital. 40 patients with endometriosis and menstrual pain. 24-week treatment with a quadriphasic association of E2 valerate (E2V) and DNG or a nonsteroidal anti-inflammatory drug (NSAID) to be used only in case of pain (ketoprofene 200-mg tablets). Menstrual pain and, when present, intermenstrual pain, and dyspareunia were investigated by means of a 10-cm visual analogue scale (VAS). Quality of life was investigated by the short form 36 (SF-36) of the health-related quality of life questionnaire. Final study group consists of 34 patients, 19 in the E2V/DNG group and 15 in the NSAID group. After 24 weeks, no significant modification of menstrual pain, intermenstrual pain, dyspareunia, or SF-36 score was observed in the NSAID group. Treatment with E2V/DNG reduced the VAS score of menstrual pain by 61% (P < .0001). In the subgroups of women with intermenstrual pain or dyspareunia, E2V/DNG reduced these complaints by 65% (P = .013) and 52% (P = .016), respectively. The reduction in menstrual (P = .0001) and intermenstrual pain (p = 0.03) was significantly greater during E2V/DNG than NSAID. Quality of life improved during E2V/DNG (P = .0002), both in physical (P = .0003) and mental domains (P = .0065). Only a few minor adverse effects were described during E2V/DNG, and none caused withdrawal from treatment. In patients with endometriosis and pelvic pain, the 24-week administration of the quadriphasic association of E2V/DNG decreases pelvic pain and improves quality of life. © The Author(s) 2014.

  17. Rationale and enrollment results for a partially randomized patient preference trial to compare continuation rates of short-acting and long-acting reversible contraception. (United States)

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


    Most published contraceptive continuation rates have scientific limitations and cannot be compared; this is particularly true for dissimilar contraceptives. This study uses a new approach to determine if high continuation rates of long-acting reversible contraception (LARC) and protection from unintended pregnancy are observable in a population not self-selecting to use LARC. We are conducting a partially randomized patient preference trial (PRPPT) to compare continuation rates of short-acting reversible contraception (SARC) and LARC. Only women seeking SARC were invited to participate. Participants chose to be in the preference cohort (self-selected method use) or opted to be randomized to SARC or LARC; only those in the randomized cohort received free product. We compared participant characteristics, reasons for not trying LARC previously and the contraceptive choices that were made. We enrolled 917 eligible women; 57% chose to be in the preference cohort and 43% opted for the randomized trial. The preference and randomized cohorts were similar on most factors. However, the randomized cohort was more likely than the preference cohort to be uninsured (48% versus 36%, respectively) and to cite cost as a reason for not trying LARC previously (50% versus 10%) (pcontraceptive continuation rates and unintended pregnancy in this ongoing trial. The choices participants made were associated with numerous factors; lack of insurance was associated with participation in the randomized trial. This PRPPT will provide new estimates of contraceptive continuation rates, such that any benefits of LARC will be more easily attributable to the technology and not the user. Combined with measuring level of satisfaction with LARC, the results will help project the potential role and benefits of expanding voluntary use of LARC. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. 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.

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

    Hurley, Emily A; Harvey, Steven A; Keita, Mariam; Kennedy, Caitlin E; Roter, Debra; Dao, Sungalo; Doumbia, Seydou; Winch, Peter J


    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. 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). To assess preferences toward contrasting PPC styles within dimensions, we conducted a vignette-based survey with 141 patients across five ART facilities. Significantly more participants chose the vignette demonstrating high psychosocial regard (52.2%) compared to a biomedical style (22.5%) (pstyle (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%) (pstyles 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, clinical outcomes. Emphasis on developing skills in psychosocial regard and on adapting styles of power balance and behavioral guidance to individual patients is likely to yield positive results and should be considered a high priority for ART providers in Mali.

  20. Equivalent resistors of polyhedral resistive structures

    NARCIS (Netherlands)

    van Steenwijk, FJ

    The equivalent resistors of regular polyhedral resistive structures between any two of the vertices are calculated in terms of the characteristic properties of the structures. Some special cases are considered. (C) 1998 American Association of Physics Teachers.

  1. The gauge principle vs. the equivalence principle

    International Nuclear Information System (INIS)

    Gates, S.J. Jr.


    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

  2. The effective theory of Borel equivalence relations

    DEFF Research Database (Denmark)

    Fokina, E.B.; Friedman, S.-D.; Törnquist, Asger Dag


    effectively Borel sets of reals, neither of which contains the range of the other under any effectively Borel function; the proof of this result applies Barwise compactness to a deep theorem of Harrington (see [5,16]) establishing for any recursive ordinal α the existence of Π singletons whose α...... equality on ω is above equality on P (ω), the power set of ω, and any Borel equivalence relation strictly above equality on the reals is above equality modulo finite on P (ω). In this article we examine the effective content of these and related results by studying effectively Borel equivalence relations...... under effectively Borel reducibility. The resulting structure is complex, even for equivalence relations with finitely many equivalence classes. However use of Kleene's O as a parameter is sufficient to restore the picture from the noneffective setting. A key lemma is that of the existence of two...

  3. Equivalence Principle, Higgs Boson and Cosmology

    Directory of Open Access Journals (Sweden)

    Mauro Francaviglia


    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.

  4. Dose equivalent rate calculation tool for FBFC

    International Nuclear Information System (INIS)

    Porte, R.; Lengele, C.; Favier, Th.; Duval, A.


    The authors present the results obtained by a software designed to compute dose equivalent rate for the critical workstations of the FBFC plant in Romans, France, which will have to deal with an uranium more heavily loaded with U 232 . The uranium spectrum and the ageing time can be varied in order to visualize the evolution of the dose equivalent rate in different locations with respect to the ageing time

  5. Dark matter and the equivalence principle (United States)

    Frieman, Joshua A.; Gradwohl, Ben-Ami


    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.

  6. Towards a theory of bias and equivalence


    Vijver, Fons J.R. van de


    "Bias refers to the presence of nuisance factors in cross-cultural research. Three types of bias are distinguished, depending on whether the nuisance factor is located at the level of the construct (construct bias), the measurement instrument as a whole (method bias) or the items (item bias or differential item functioning). Equivalence refers to the measurement level characteristics that apply to cross-cultural score comparisons; three types of equivalence are defined: construct (identity of...

  7. The equivalence principle and spatial curvature

    International Nuclear Information System (INIS)

    Dugdale, D.E.


    An examination is made of the connection between the equivalence principle of general relativity and the non-Euclidean properties of space. The arguments commonly advanced to suggest a necessary connection between these two features of general relativity are reviewed and critically discussed. It is shown that although gravitational time dilation is an immediate consequence of the equivalence principle the corresponding effects on space are not such immediate or logically necessary consequences of this principle. (author)

  8. Approximate unitary equivalence of normaloid type operators


    Zhu, Sen


    In this paper, we explore approximate unitary equivalence of normaloid operators and classify several normaloid type operators including transaloid operators, polynomial-normaloid operators and von Neumann operators up to approximate unitary equivalence. As an application, we explore approximation of transaloid operators with closed numerical ranges. Among other things, it is proved that those transaloid operators with closed numerical ranges are norm dense in the class of transaloid operators.

  9. Barriers and facilitators to a home-based cycling program tailored to older patient preferences in lumbar spinal stenosis: a retrospective mixed-method study. (United States)

    Pauwels, Charlotte; Roren, Alexandra; Gautier, Adrien; Linières, Jonathan; Rannou, François; Poiraudeau, Serge; Nguyen, Christelle


    Lumbar-flexion-based endurance training, namely cycling, could be effective in reducing pain and improving function and health-related quality of life in older people with chronic low back pain. To assess barriers and facilitators to home-based cycling in older patients with lumbar spinal stenosis (LSS). We conducted a retrospective mixed-method study. Patients ≥ 50 years old followed up for LSS from November 2015 to June 2016 in a French tertiary care center were screened. The intervention consisted of a single supervised session followed by home-based sessions of cycling, with dose (number of sessions and duration, distance and power per session) self-determined by patient preference. The primary outcome was assessed by a qualitative approach using semi-structured interviews at baseline and 3 months and was the identification of barriers and facilitators to the intervention. Secondary outcomes were assessed by a quantitative approach and were adherence monitored by a USB stick connected to the bicycle, burden of treatment assessed by the Exercise Therapy Burden Questionnaire (ETBQ) and clinical efficacy assessed by change in lumbar pain, radicular pain, disability, spine-specific activity limitation and maximum walking distance at 3 months. Overall, 15 patients were included and data for 12 were analyzed at 3 months. At baseline, the mean age was 70.9 years (95% CI 64.9-76.8) and 9/15 patients (60.0%) were women. Barriers to cycling were fear of pain and fatigue, a too-large bicycle, burden of hospital follow-up and lack of time and motivation. Facilitators were clinical improvement, surveillance and ease-of-use of the bicycle. Adherence remained stable overtime. The burden of treatment was low (mean ETBQ score: 21.0 [95% confidence interval 11.5-30.5]). At 3 months, 7/12 patients (58.3%) self-reported clinical improvement, with reduced radicular pain and disability (mean absolute differences: -27.5 [-43.3- -11.7], pcycling is a feasible intervention

  10. 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


    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

  11. Equivalence of Szegedy's and coined quantum walks (United States)

    Wong, Thomas G.


    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.

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

    International Nuclear Information System (INIS)

    Palmiotti, G.


    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

  13. Water equivalence of polymer gel dosimeters

    International Nuclear Information System (INIS)

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


    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

  14. Quantum mechanics and the equivalence principle

    International Nuclear Information System (INIS)

    Davies, P C W


    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

  15. Equivalence and Discretisation in Bio-PEPA (United States)

    Galpin, Vashti; Hillston, Jane

    Bio-PEPA is a process algebra for modelling biological systems. An important aspect of Bio-PEPA is the ability it provides to discretise concentrations resulting in a smaller, more manageable state space. The discretisation is based on a step size which determines the size of each discrete level and also the maximum number of levels. This paper considers the relationship between two discretisations of the same Bio-PEPA model that differ only in the step size and hence the maximum number of levels, by using the idea of equivalence from concurrency and process algebra. We present a novel behavioural semantic equivalence, compression bisimulation, that equates two discretisations of the same model and we show that this equivalence is a congruence with respect to the synchronisation operator.

  16. A complex nursing intervention of complementary and alternative medicine (CAM) to increase quality of life in patients with breast and gynecologic cancer undergoing chemotherapy: study protocol for a partially randomized patient preference trial. (United States)

    Klafke, Nadja; Mahler, Cornelia; von Hagens, Cornelia; Rochon, Justine; Schneeweiss, Andreas; Müller, Andreas; Salize, Hans-Joachim; Joos, Stefanie


    Health-related quality of life (HRQoL) is most adversely affected in cancer patients between diagnosis and the end of chemotherapy. The aim of the Complementary Nursing in Gynecologic Oncology (CONGO) study is to assess the effectiveness of a complex nursing care intervention of CAM to increase HRQoL in cancer patients undergoing chemotherapy. CONGO is a prospective partially randomized patient preference (PRPP) trial including adult women diagnosed with breast and gynecologic cancer starting a new chemotherapy regimen. Patients without strong preferences for CAM will be randomized to usual nursing care or complex nursing care; those patients with strong preferences will be allowed their choice. The intervention consists of three interacting and intertwined elements: CAM nursing intervention packet, counseling on CAM using a resource-oriented approach and evidence-based informational material on CAM. Primary outcome data on participants' HRQoL will be collected from baseline until the end of treatment and long-term follow-up using the EORTC-QLQ-C30. Secondary outcomes include nausea, fatigue, pain, anxiety/depression, social support, self-efficacy, patient competence, spiritual wellbeing, and satisfaction with care. Accompanying research on economic outcomes as well as a mixed-methods process evaluation will be conducted. A total of 590 patients (236 patients in the randomized part of the study and 354 patients in the observational part of the study) will be recruited in the two outpatient clinics. The first analysis step will be the intention-to-treat (ITT) analysis of the randomized part of the trial. A linear mixed model will be used to compare the continuous primary endpoint between the intervention and control arm of the randomized group. The observational part of the trial will be analyzed descriptively. External validity will be assessed by comparing randomized with nonrandomized patients. Cancer patients are increasingly using CAM as supportive cancer care

  17. A Logical Characterisation of Static Equivalence

    DEFF Research Database (Denmark)

    Hüttel, Hans; Pedersen, Michael D.


    The work of Abadi and Fournet introduces the notion of a frame to describe the knowledge of the environment of a cryptographic protocol. Frames are lists of terms; two frames are indistinguishable under the notion of static equivalence if they satisfy the same equations on terms. We present a first......-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...

  18. Measurements of the personal dose equivalent

    International Nuclear Information System (INIS)

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


    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

  19. Equivalent circuit analysis of terahertz metamaterial filters

    KAUST Repository

    Zhang, Xueqian


    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.

  20. Fiscal adjustments in Europe and Ricardian equivalence

    Directory of Open Access Journals (Sweden)



    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.

  1. High School Equivalency Testing in Arizona. Forum: Responding to Changes in High School Equivalency Testing (United States)

    Hart, Sheryl


    For decades, the state of Arizona has used the General Educational Development (GED) Test to award the Arizona High School Equivalency (HSE) Diploma, as the GED Test was the only test available, recognized and accepted in the United States as the measure by which adults could demonstrate the educational attainment equivalent to high school…

  2. Beyond Language Equivalence on Visibly Pushdown Automata

    DEFF Research Database (Denmark)

    Srba, Jiri


    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 p...

  3. Equivalence Scales for the Former West Germany

    NARCIS (Netherlands)

    Charlier, E.


    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

  4. [Therapeutic equivalence of the new oral anticoagulants]. (United States)

    Moreno Villar, A; Nacle López, I; Barbero Hernández, M J; Lizan Tudela, L


    In an attempt to minimize the economic impact due to the incorporation of innovative drugs, health authorities have promoted and supported the evaluation and market positioning of drugs, as equivalent therapeutic alternatives. This issue has recently gained importance, possibly due to the current economic crisis. The equivalent therapeutic alternatives are justified by the need to compete on price, and by the authorities recommendation to establish therapeutic equivalence, price and financing of medicinal products at the same time. The establishment of the new oral anticoagulants and the equivalent therapeutic alternatives is a problematic issue if it is based on the absence of direct comparisons between different drugs and the questionable methodology used in the current indirect comparisons. Currently, it is difficult to determine when a new oral anticoagulant is more recommendable than others, but efforts are being made in order to propose alternatives for the decision based on patient characteristics. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  5. 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 ...

  6. Procedures for Determining the Equivalence of Measures. (United States)

    Dunivant, Noel

    Eight different methods are reviewed for determining whether two or more tests are equivalent measures. These methods vary in restrictiveness from the Wilks-Votaw test of compound symmetry (which requires that all means, variances, and covariances are equal), to Joreskog's theory of congeneric tests (which requires only that the tests are measures…

  7. Confluence Modulo Equivalence in Constraint Handling Rules

    DEFF Research Database (Denmark)

    Christiansen, Henning; Kirkeby, Maja Hanne


    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...

  8. Four equivalent lot-sizing models

    NARCIS (Netherlands)

    W. van den Heuvel (Wilco); A.P.M. Wagelmans (Albert)


    textabstractWe study the following lot-sizing models that recently appeared in the literature: a lot-sizing model with a remanufacturing option, a lot-sizing model with production time windows, and a lot-sizing model with cumulative capacities. We show the equivalence of these models with a

  9. Equivalence relations of AF-algebra extensions

    Indian Academy of Sciences (India)

    Home; Journals; Proceedings – Mathematical Sciences; Volume 120; Issue 2. Equivalence Relations of -Algebra Extensions. Changguo Wei. Volume 120 Issue 2 April 2010 ... Author Affiliations. Changguo Wei1. School of Mathematical Sciences, Ocean University of China, Qingdao 266071, People's Republic of China ...

  10. Visual Equivalence and Amodal Completion in Cuttlefish. (United States)

    Lin, I-Rong; Chiao, Chuan-Chin


    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.

  11. 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 ...

  12. On the Leitmann equivalent problem approach

    NARCIS (Netherlands)

    Wagener, F.O.O.


    The purpose of this note is to show how Leitmann’s equivalent problem approach ties in with the classical notions of the Calculus of Variations, and how it can be exploited to give a rapid and elegant approach to Weierstrass’ theory of sufficient conditions. Both fixed and free endpoint conditions

  13. 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 ...

  14. Possibility and necessity measures and integral equivalence

    Czech Academy of Sciences Publication Activity Database

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


    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

  15. Contextual dependencies in a stimulus equivalence paradigm

    NARCIS (Netherlands)

    Dibbets, P.; Maes, J.H.R.; Vossen, J.M.H.


    Two experiments with human subjects assessed contextual dependencies in a stimulus equivalence paradigm. Subjects learned to form two sets of stimuli in a matching-to-sample training procedure. Each set was presented against one of two different background colours, the contextual cues. At test, the

  16. [The equivalence and interchangeability of medical articles]. (United States)

    Antonov, V S


    The information concerning the interchangeability of medical articles is highly valuable because it makes it possible to correlate most precisely medical articles with medical technologies and medical care standards and to optimize budget costs under public purchasing. The proposed procedure of determination of interchangeability is based on criteria of equivalence of prescriptions, functional technical and technological characteristics and effectiveness of functioning of medical articles.

  17. Infinitesimal bi-Lipschitz Equivalence of Functions


    Gaffney, Terence


    We introduce two different notions of infinitesimal bi-Lipschitz equivalence for functions, one related to bi-Lipschitz triviality of families of functions, one related to homeomorphisms which are bi-Lipschitz on the fibers of the functions in the family. We show that the first is not a generic condition, and that the second is.

  18. An Equivalent Circuit for Landau Damping

    DEFF Research Database (Denmark)

    Pécseli, Hans


    An equivalent circuit simulating the effect of Landau damping in a stable plasma‐loaded parallel‐plate capacitor is presented. The circuit contains a double infinity of LC components. The transition from stable to unstable plasmas is simulated by the introduction of active elements into the circuit....

  19. On Behavioral Equivalence of Rational Representations

    NARCIS (Netherlands)

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


    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

  20. Equivalent drawbead model in finite element simulations

    NARCIS (Netherlands)

    Carleer, Bart D.; Carleer, B.D.; Meinders, Vincent T.; Huetink, Han; Lee, J.K.; Kinzel, G.L.; Wagoner, R.


    In 3D simulations of the deep drawing process the drawbead geometries are seldom included. Therefore equivalent drawbeads are used. In order to investigate the drawbead behaviour a 2D plane strain finite element model was used. For verification of this model experiments were performed. The analyses

  1. 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...

  2. 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

  3. Equivalence domination in graphs | Arumugam | Quaestiones ...

    African Journals Online (AJOL)

    Click on the link to view the abstract. Keywords: Equivalence domination, total domination, P3-forming set. Quaestiones Mathematicae 36(2013), 331-340. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · · AJOL African ...

  4. Pharmaceutical Equivalence of Some Commercial Samples of ...

    African Journals Online (AJOL)

    The tablets were subjected to various compendial tests including identification, weight uniformity, uniformity of content, content of active ingredient and uniformity of diameter. Additional tests used as a basis for the assessment of the pharmaceutical equivalence of the products include hardness, disintegration time and ...

  5. Superstring field theory equivalence: Ramond sector

    International Nuclear Information System (INIS)

    Kroyter, Michael


    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. Free Fall and the Equivalence Principle Revisited (United States)

    Pendrill, Ann-Marie


    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.…

  7. 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)


    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.

  8. Equivalent physical models and formulation of equivalent source layer in high-resolution EEG imaging. (United States)

    Yao, Dezhong; He, Bin


    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.

  9. Equivalencies, Identities, Symmetric Differences, and Congruencies in Orthomodular Lattices (United States)

    Megill, Norman D.; Pavičić, Mladen


    It is shown that operations of equivalence cannot serve for building algebras which would induce orthomodular lattices as the operations of implication can. Several properties of equivalence operations have been investigated. Distributivity of equivalence terms and several other 3 variable expressions involving equivalence terms have been proved to hold in any orthomodular lattice. Symmetric differences have been shown to reduce to complements of equivalence terms. Some congruence relations related to equivalence operations and symmetric differences have been considered.

  10. Testing the Equivalence of Regular Languages

    Directory of Open Access Journals (Sweden)

    Marco Almeida


    Full Text Available The minimal deterministic finite automaton is generally used to determine regular languages equality. Antimirov and Mosses proposed a rewrite system for deciding regular expressions equivalence of which Almeida et al. presented an improved variant. Hopcroft and Karp proposed an almost linear algorithm for testing the equivalence of two deterministic finite automata that avoids minimisation. In this paper we improve the best-case running time, present an extension of this algorithm to non-deterministic finite automata, and establish a relationship between this algorithm and the one proposed in Almeida et al. We also present some experimental comparative results. All these algorithms are closely related with the recent coalgebraic approach to automata proposed by Rutten.

  11. Thevenin Equivalent Method for Dynamic Contingency Assessment

    DEFF Research Database (Denmark)

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


    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....

  12. On equivalent resistance of electrical circuits (United States)

    Kagan, Mikhail


    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.

  13. 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.


    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

  14. Derived equivalences induced by good silting complexes


    Breaz, Simion; Modoi, George Ciprian


    Consider a (possibly big) silting object $U$ in a derived category over a (dg-)algebra $A$. Under some fairly general appropriate hypotheses, we show that it induces derived equivalences between the derived category over $A$ and a localization of the derived category of dg-endomorphism algebra $B$ of $U$. If, in addition, $U$ is small then this localization is the whole derived category over $B$.

  15. Visual Equivalence and Amodal Completion in Cuttlefish


    Lin, I-Rong; Chiao, Chuan-Chin


    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...

  16. Equivalency of two-dimensional algebras

    International Nuclear Information System (INIS)

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


    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)

  17. Capacitors with low equivalent series resistance (United States)

    Fleig, Patrick Franz (Inventor); Lakeman, Charles D. E. (Inventor); Fuge, Mark (Inventor)


    An electric double layer capacitor (EDLC) in a coin or button cell configuration having low equivalent series resistance (ESR). The capacitor comprises mesh or other porous metal that is attached via conducting adhesive to one or both the current collectors. The mesh is embedded into the surface of the adjacent electrode, thereby reducing the interfacial resistance between the electrode and the current collector, thus reducing the ESR of the capacitor.

  18. Einstein's equivalence principle in quantum mechanics revisited (United States)

    Nauenberg, Michael


    The gravitational equivalence principle in quantum mechanics is of considerable importance, but it is generally not included in physics textbooks. In this note, we present a precise quantum formulation of this principle and comment on its verification in a neutron diffraction experiment. The solution of the time dependent Schrödinger equation for this problem also gives the wave function for the motion of a charged particle in a homogeneous electric field, which is also usually ignored in textbooks on quantum mechanics.

  19. Quantum mechanics from an equivalence principle

    International Nuclear Information System (INIS)

    Faraggi, A.E.


    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


    Brody, S; Ragsdale, A C


    1. A method of plotting growth curves is presented which is considered more useful than the usual method in bringing out a number of important phenomena such as the equivalence of age in different animals, difference in the shape and duration of corresponding growth cycles in different animals, and also in determinating the age of maxima without resorting to complicated mathematical computations. 2. It is suggested that after the third cycle is past the conceptional age of the maximum of the third cycle may be taken as the age of reference for estimating the equivalent physiological ages in different animals. Before the age of the third cycle, the maxima of the second and first cycles are most conveniently used as points of reference. 3. It is shown that the product of the conceptional age of the maximum of the third cycle by 13, gives a value which is, with the possible exception of man, very near to the normal duration of life of animals under the most favorable conditions of life. In other words, the equivalent physiological ages in different animals bear an approximately constant linear relation to the duration of their growth periods. 4. Attention is called to certain differences in the shape and duration of the corresponding growth cycles in different animals and of the effect of sex on these cycles.

  1. Equivalence of Lagrangian and Hamiltonian BRST quantizations

    International Nuclear Information System (INIS)

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


    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

  2. Energy conservation and the principle of equivalence

    International Nuclear Information System (INIS)

    Haugan, M.P.


    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

  3. Determining sample size when assessing mean equivalence. (United States)

    Asberg, Arne; Solem, Kristine B; Mikkelsen, Gustav


    When we want to assess whether two analytical methods are equivalent, we could test if the difference between the mean results is within the specification limits of 0 ± an acceptance criterion. Testing the null hypothesis of zero difference is less interesting, and so is the sample size estimation based on testing that hypothesis. Power function curves for equivalence testing experiments are not widely available. In this paper we present power function curves to help decide on the number of measurements when testing equivalence between the means of two analytical methods. Computer simulation was used to calculate the probability that the 90% confidence interval for the difference between the means of two analytical methods would exceed the specification limits of 0 ± 1, 0 ± 2 or 0 ± 3 analytical standard deviations (SDa), respectively. The probability of getting a nonequivalence alarm increases with increasing difference between the means when the difference is well within the specification limits. The probability increases with decreasing sample size and with smaller acceptance criteria. We may need at least 40-50 measurements with each analytical method when the specification limits are 0 ± 1 SDa, and 10-15 and 5-10 when the specification limits are 0 ± 2 and 0 ± 3 SDa, respectively. The power function curves provide information of the probability of false alarm, so that we can decide on the sample size under less uncertainty.

  4. Radiation equivalences for genetically active chemicals

    International Nuclear Information System (INIS)

    Moustacchi, E.; Latarjet, R.


    The dose effect of chemical agents, which produces given genetic effect, could be equated to the dose of ionizing radiations, expected to produce the same quantitative effect for the same end-point. The use of a common unit, Rad-equivalent, permits in principle to extrapolate the existing ICRP (International Commission for Radiological Protection) recommendations for radiations on to the recommendations for chemical mutagens. The equivalence between radiation dose and the dose of chemicals is significant only if certain conditions are met. Some of the most important ones will be: a) the reciprocity law, b) the shape of the dose-effect curves, c) the extrapolation of experimental results to man, and d) other factors such as physiological and genetic ones. It is consequently clear that there are limitations to the general character of this notion. Mutagenic chemical pollution is clearly required to be not only qualitatively but also quantitatively regulated. Although today it may appear premature to attempt to use a unifying concept such as rad-equivalent, at some stage in the future, the assessment of the total amounts of risks including radiations will be necessary. A common unit for the comparison and summation of risks will then turn out to be necessary. (Yamashita, S.)

  5. 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.


    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

  6. Approaches to the treatment of zero equivalence in a bilingual ...

    African Journals Online (AJOL)

    The article discusses the treatment of zero equivalence in an English–Slovene diction-ary (ESD). The absence of equivalents in the TL is marked by two symbols: Ø (a complete absence of any equivalent) and # (equivalence at the level of the entire message rather than at word level). Sixty-five lemmata in the ESD contain a ...

  7. 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


    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

  8. Equivalent Circuit Modeling of Hysteresis Motors

    Energy Technology Data Exchange (ETDEWEB)

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


    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.

  9. Applicability constraints of the equivalence theorem

    Energy Technology Data Exchange (ETDEWEB)

    Dobado, A.; Pelaez, J.R. [Departamento de Fisica Teorica, Universidad Complutense, 28040 Madrid (Spain); Urdiales, M.T. [Departamento de Fisica Teorica, Universidad Autonoma, 28049 Madrid (Spain)


    In this work we study the applicability of the equivalence theorem, either for unitary models or within an effective Lagrangian approach. There are two types of limitations: the existence of a validity energy window and the use of the lowest order in the electroweak constants. For the first kind, we consider some methods, based on dispersion theory or the large N limit, that allow us to extend the applicability. For the second, we obtain numerical estimates of the effect of neglecting higher orders in the perturbative expansion. {copyright} {ital 1997} {ital The American Physical Society}

  10. 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.


    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.

  11. Money and bonds: an equivalence theorem


    Narayana R. Kocherlakota


    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...

  12. Physical Sciences Facility Air Emission Control Equivalency Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Brown, David M.; Belew, Shan T.


    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. Integrable topological billiards and equivalent dynamical systems (United States)

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


    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.

  14. Free fall and the equivalence principle revisited (United States)

    Pendrill, Ann-Marie


    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. In addition, Newton’s third law of action and reaction causes the Earth to accelerate towards the falling object, bringing in a mass dependence in the time required for an object to reach ground—in spite of the equivalence between inertial and gravitational mass. These aspects are rarely discussed in textbooks when the motion of everyday objects are discussed. Although these effects are extremely small, it may still be important for teachers to make assumptions and approximations explicit, to be aware of small corrections, and also to be prepared to estimate their size. Even if the corrections are not part of regular teaching, some students may reflect on them, and their questions deserve to be taken seriously.

  15. 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:


    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].

  16. Interchangeability among therapeutic equivalents of lamotrigine: evaluation of quality of life


    Girolineto,Beatriz Maria Pereira; Junior,Veriano Alexandre; Sakamoto,Américo Ceiki; Pereira,Leonardo Régis Leira


    Epilepsy is the most common serious neurological disorder worldwide. Approximately 70% of patients with epilepsy have their seizures controlled by clinical and pharmacological treatment. This research evaluated the possible influence of interchangeability among therapeutic equivalents of LTG on the clinical condition and quality of life of refractory epileptic patients. The study was divided into three periods of 42 days, and an equivalent therapeutic LTG randomly dispensed for each period (t...

  17. Equivalence of nasal and oronasal masks during initial CPAP titration for obstructive sleep apnea syndrome. (United States)

    Teo, Ming; Amis, Terence; Lee, Sharon; Falland, Karina; Lambert, Stephen; Wheatley, John


    Continuous positive airway pressure (CPAP) titration studies are commonly performed using a nasal mask but some patients may prefer a full-face or oronasal mask. There is little evidence regarding the equivalence of different mask interfaces used to initiate treatment. We hypothesized that oronasal breathing when using an oronasal mask increases upper airway collapsibility and that a higher pressure may be required to maintain airway patency. We also assessed patient preferences for the 2 mask interfaces. Prospective, randomized, cross-over design with 2 consecutive CPAP titration nights. Accredited laboratory in a university hospital. Twenty-four treatment-naive subjects with obstructive sleep apnea syndrome and respiratory disturbance index of greater than 15 events per hour. CPAP titration was performed using an auto-titrating machine with randomization to a nasal or oronasal mask, followed by a second titration night using the alternate mask style. There was no significant difference in the mean pressures determined between nasal and oronasal masks, although 43% of subjects had nasal-to-oronasal mask-pressure differences of 2 cm H(2)O or more. Residual respiratory events, arousals, and measured leak were all greater with the oronasal mask. Seventy-nine percent of subjects preferred the nasal mask. Patients with obstructive sleep apnea syndrome can generally switch between nasal and oronasal masks without changing machine pressure, although there are individual differences that may be clinically significant. Measured leak is greater with the oronasal mask. Most patients with obstructive sleep apnea syndrome prefer a nasal mask as the interface for initiation of CPAP. Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN: ACTRN12611000243910. URL:

  18. Multiplicities of states od equivalent fermion shells

    International Nuclear Information System (INIS)

    Savukinas, A.Yu.; Glembotskij, I.I.


    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

  19. Confluence Modulo Equivalence in Constraint Handling Rules

    DEFF Research Database (Denmark)

    Christiansen, Henning; Kirkeby, Maja Hanne


    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...... correctness proofs. A new operational semantics for CHR is introduced that reduces notational overhead significantly and allows to consider confluence for programs with extra-logical and incomplete built-in predicates. Proofs of confluence are demonstrated for programs with redundant data representation, e.......g., sets-as-lists, for dynamic pro- gramming algorithms with pruning as well as a Union-Find program, which are not covered by previous confluence notions for CHR....

  20. Characterization of Destrins with Different Dextrose Equivalents

    Directory of Open Access Journals (Sweden)

    Guanglei Li


    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.

  1. Premetric equivalent of general relativity: Teleparallelism (United States)

    Itin, Yakov; Hehl, Friedrich W.; Obukhov, Yuri N.


    In general relativity (GR), the metric tensor of spacetime is essential since it represents the gravitational potential. In other gauge theories (such as electromagnetism), the so-called premetric approach succeeds in separating the purely topological field equation from the metric-dependent constitutive law. We show here that GR allows for a premetric formulation, too. For this purpose, we apply the teleparallel approach of gravity, which represents GR as a gauge theory based on the translation group. We formulate the metric-free topological field equation and a general linear constitutive law between the basic field variables. The requirement of local Lorentz invariance turns the model into a full equivalent of GR. Our approach opens a way for a natural extension of GR to diverse geometrical structures of spacetime.

  2. 77 FR 55832 - Ambient Air Monitoring Reference and Equivalent Methods: Designation of a New Equivalent Method (United States)


    ... equivalent method determination for the PM 2.5 method was received by the Office of Research and Development... Assurance Handbook for Air Pollution Measurement Systems, Volume I,'' EPA/600/R-94/038a and ``Quality Assurance Handbook for Air Pollution Measurement Systems, Volume II, Ambient Air Quality Monitoring Program...

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


    ...: Internal permeation bench; ESTEL analog inputs/outputs. The application for equivalent method determination... sections of the ``Quality Assurance Handbook for Air Pollution Measurement Systems, Volume I,'' EPA/600/R-94/038a and ``Quality Assurance Handbook for Air Pollution Measurement Systems, Volume II, Ambient...

  4. Birth after caesarean study – planned vaginal birth or planned elective repeat caesarean for women at term with a single previous caesarean birth: protocol for a patient preference study and randomised trial

    Directory of Open Access Journals (Sweden)

    Haslam Ross R


    Full Text Available Abstract Background For women who have a caesarean section in their preceding pregnancy, two care policies for birth are considered standard: planned vaginal birth and planned elective repeat caesarean. Currently available information about the benefits and harms of both forms of care are derived from retrospective and prospective cohort studies. There have been no randomised trials, and recognising the deficiencies in the literature, there have been calls for methodologically rigorous studies to assess maternal and infant health outcomes associated with both care policies. The aims of our study are to assess in women with a previous caesarean birth, who are eligible in the subsequent pregnancy for a vaginal birth, whether a policy of planned vaginal birth after caesarean compared with a policy of planned repeat caesarean affects the risk of serious complications for the woman and her infant. Methods/Design Design: Multicentred patient preference study and a randomised clinical trial. Inclusion Criteria: Women with a single prior caesarean presenting in their next pregnancy with a single, live fetus in cephalic presentation, who have reached 37 weeks gestation, and who do not have a contraindication to a planned VBAC. Trial Entry & Randomisation: Eligible women will be given an information sheet during pregnancy, and will be recruited to the study from 37 weeks gestation after an obstetrician has confirmed eligibility for a planned vaginal birth. Written informed consent will be obtained. Women who consent to the patient preference study will be allocated their preference for either planned VBAC or planned, elective repeat caesarean. Women who consent to the randomised trial will be randomly allocated to either the planned vaginal birth after caesarean or planned elective repeat caesarean group. Treatment Groups: Women in the planned vaginal birth group will await spontaneous onset of labour whilst appropriate. Women in the elective repeat

  5. A bicategorical approach to Morita equivalence for Von Neumann algebras

    NARCIS (Netherlands)

    R.M. Brouwer (Rachel)


    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

  6. Problems of Equivalence in Shona- English Bilingual Dictionaries ...

    African Journals Online (AJOL)

    In compiling bilingual dictionaries, lexicographers are mostly concerned with semantic equivalence. As a result, the practice of bilingual dictionary compilers is usually that of giving one-word equivalents. However, this equivalence is at times difficult to arrive at because of the disparities and incommensurability between ...

  7. Equivalence problem of second order PDE for scale transformations


    NODA, Takahiro


    The purpose of the paper is to consider an equivalence problem of second order partial differential equations for one unknown function of two independent variables under scale transformations. For this equivalence problem, explicit forms of invariant functions are given. In particular, if all of these invariant functions vanish, then PDEs are equivalent to the flat equation.

  8. Problems of Equivalence in Shona- English Bilingual Dictionaries

    African Journals Online (AJOL)


    Abstract: In compiling bilingual dictionaries, lexicographers are mostly concerned with seman- tic equivalence. As a result, the practice of bilingual dictionary compilers is usually that of giving one-word equivalents. However, this equivalence is at times difficult to arrive at because of the disparities and incommensurability ...

  9. Tests of the weak equivalence principle (United States)

    Speake, C. C.; Will, C. M.


    The Einstein equivalence principle is the foundation for general relativity and all metric theories of gravity. Of its three tenets—the equality of acceleration of test bodies, or weak equivalence principle; the validity of Lorentz invariance in local freely falling frames; and the position invariance of local physical laws—the weak equivalence principle has played the most important role historically, and continues to be a focus of intense theoretical and experimental investigation. From the probably apocryphal 16th century demonstrations by Galileo at Pisa's leaning tower to the sensitive torsion-balance measurements of today (both pictured on the cover of this issue), this principle, dubbed WEP, has been crucial to the development of gravitation theory. The universality of the rate of acceleration of all types of matter in a gravitational field can be taken as evidence that gravitation is fundamentally determined by the geometry, or metric, of spacetime. Newton began his magnum opus 'The Principia' with a discussion of WEP and his experiments to verify it, while Einstein took WEP for granted in his construction of general relativity, never once referring to the epochal experiments by Baron Eötvös. The classic 1964 experiment of Roll, Krotkov and Dicke ushered in the modern era of high-precision tests, and the search for a 'fifth force' during the late 1980s (instigated, ironically, by purported anomalies in Eötvös's old data) caused the enterprise to pivot from pure tests of the foundation of GR to searches for new physics beyond the standard model of the non-gravitational interactions. Today, the next generation of experimental tests of WEP are being prepared for launch or are being developed, with the goal of reaching unprecedented levels of sensitivity, in search of signatures of interactions inspired by string theory, extra dimensions and other concepts from the world of high-energy physics. At the same time observations continue using lunar laser

  10. 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.


    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

  11. 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


    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.

  12. Biomonitoring Equivalents for interpretation of urinary fluoride. (United States)

    Aylward, L L; Hays, S M; Vezina, A; Deveau, M; St-Amand, A; Nong, A


    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.

  13. Mathematical Equivalence of Evolution and Design

    Directory of Open Access Journals (Sweden)

    Leonid Perlovsky


    Full Text Available "Every one who is seriously involved in the pursuit of science becomes convinced that a spirit is manifest in the laws of the Universe." This Einsteinian statement remains outside of science. Our current understanding of the mind mechanisms have come close to explaining spirituality from the scientific point of view. In this paper a theory is presented which is a mathematical breakthrough, overcoming decades of limitations in AI, pattern recognition, neural networks, and other attempts to model the brain-mind. Solutions to engineering problems are presented that have overcome previous difficulties in terms of computational complexity. These solutions result in orders of magnitude improvement in detection, prediction, tracking, fusion, and learning situations. The theory is also extended to higher cognitive functions. It models the knowledge instinct operating in the hierarchy of the human brain-mind. At the top are concepts unifying our entire knowledge; we perceive them as concepts of the meaning and purpose of our existence. This theory is formulated mathematically as dynamic and equivalently as teleological. Experimental results supporting the theory are discussed. The theory overcomes various difficulties, including reductionism, which, in the past, interfered with the acceptance of scientific explanations of the spiritual.

  14. A Bayesian equivalency test for two independent binomial proportions. (United States)

    Kawasaki, Yohei; Shimokawa, Asanao; Yamada, Hiroshi; Miyaoka, Etsuo


    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.

  15. Comparison of the effectiveness of a milk-free soy-maize-sorghum-based ready-to-use therapeutic food to standard ready-to-use therapeutic food with 25% milk in nutrition management of severely acutely malnourished Zambian children: an equivalence non-blinded cluster randomised controlled trial. (United States)

    Irena, Abel H; Bahwere, Paluku; Owino, Victor O; Diop, ElHadji I; Bachmann, Max O; Mbwili-Muleya, Clara; Dibari, Filippo; Sadler, Kate; Collins, Steve


    Community-based Management of Acute Malnutrition using ready-to-use therapeutic food (RUTF) has revolutionised the treatment of severe acute malnutrition (SAM). However, 25% milk content in standard peanut-based RUTF (P-RUTF) makes it too expensive. The effectiveness of milk-free RUTF has not been reported hitherto. This non-blinded, parallel group, cluster randomised, controlled, equivalence trial that compares the effectiveness of a milk-free soy-maize-sorghum-based RUTF (SMS-RUTF) with P-RUTF in treatment of children with SAM, closes the gap. A statistician randomly assigned health centres (HC) either to the SMS-RUTF (n = 12; 824 enrolled) or P-RUTF (n = 12; 1103 enrolled) arms. All SAM children admitted at the participating HCs were enrolled. All the outcomes were measured at individual level. Recovery rate was the primary outcome. The recovery rates for SMS-RUTF and P-RUTF were 53.3% and 60.8% for the intention-to-treat (ITT) analysis and 77.9% and 81.8% for per protocol (PP) analyses, respectively. The corresponding adjusted risk difference (ARD) and 95% confidence interval, were -7.6% (-14.9, 0.6%) and -3.5% (-9,6., 2.7%) for ITT (P = 0.034) and PP analyses (P = 0.257), respectively. An unanticipated interaction (interaction P < 0.001 for ITT analyses and 0.0683 for PP analyses) between the study arm and age group was observed. The ARDs were -10.0 (-17.7 to -2.3)% for ITT (P = 0.013) and -4.7 (-10.0 to 0.7) for PP (P = 0.083) analyses for the <24 months age group and 2.1 (-10.3,14.6)% for ITT (P = 0.726) and -0.6 (-16.1, 14.5) for PP (P = 0.939) for the ≥24 months age group. In conclusion, the study did not confirm our hypothesis of equivalence between SMS-RUTF and P-RUTF in SAM management. © 2013 John Wiley & Sons Ltd.

  16. Experimental Evaluation of Equivalent-Fluid Models for Melamine Foam (United States)

    Allen, Albert R.; Schiller, Noah H.


    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.

  17. Biomonitoring Equivalents for bisphenol A (BPA). (United States)

    Krishnan, Kannan; Gagné, Michelle; Nong, Andy; Aylward, Lesa L; Hays, Sean M


    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.

  18. General Dynamic Equivalent Modeling of Microgrid Based on Physical Background

    Directory of Open Access Journals (Sweden)

    Changchun Cai


    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.

  19. 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


    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

  20. Regret about surgical decisions among early-stage breast cancer patients: Effects of the congruence between patients' preferred and actual decision-making roles. (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


    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.

  1. 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.


    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)

  2. Equivalent Viscous Damping Models in Displacement Based Seismic Design

    Directory of Open Access Journals (Sweden)

    Raul Zaharia


    Full Text Available The paper reviews some equivalent viscous damping models used in the displacement based seismic design considering the equivalent linearization. The limits of application of the models are highlighted, based on comparison existing in the literature. The study is part of research developed by author, aimed to determine the equivalent linear parameters in order to predict the maximum displacement response for earthquakes compatible with given response spectra.

  3. 46 CFR Appendix A to Part 154 - Equivalent Stress (United States)


    ... 46 Shipping 5 2010-10-01 2010-10-01 false Equivalent Stress A Appendix A to Part 154 Shipping...—Equivalent Stress I. Equivalent stress (σ c) is calculated by the following formula or another formula... normal stress in “x” direction. σy=total normal stress in “y” direction. τxy=total shear stress in “xy...

  4. Shared Decision-Making in Prostate Cancer Care: Encouraging every patient to be actively involved in decision-making, or ensuring patients' preferred level of involvement? (United States)

    van Stam, Marie-Anne; Pieterse, Arwen H; van der Poel, Henk G; Bosch, J L H Ruud; Tillier, Corinne; Horenblas, Simon; Aaronson, Neil K


    The aims of this study were: (1) to describe preferred and experienced roles in treatment decision-making among patients with localized prostate cancer (PC); (2) to identify how often patients' experienced roles matched their preferred roles; and (3) to determine whether active involvement in decision-making regardless of role preferences, or concordance between preferred and experienced role is the strongest predictor of more favourable patient-reported outcomes. In this prospective, multicenter, observational study we obtained serial questionnaire data from newly-diagnosed localized PC patients (cT1-cT2 or Gleason≤7, PSA≤20) (N=454). Questionnaires were completed prior to treatment, and at three, six, and twelve months post-treatment follow-up. Clinical data were obtained from patients' medical records. Active involvement and role concordance were operationalized using the Control Preferences Scale. Analysis of variance and effect sizes (Cohen's d; 0.2=small, 0.5=medium) were used to compare patients' knowledge of prostate cancer, decisional conflict, decision regret, and overall health-related quality of life (HRQoL). Most patients (87%, n=393) reported having been actively involved in treatment decision-making. However, 17% (n=78) indicated having had either less or more involvement than preferred. Active involvement was significantly associated with more PC knowledge (d=0.30), less decisional conflict (d=0.52), and less decision regret (d=0.34). Role concordance was also, but less strongly, associated with less decisional conflict (d=0.41). Our findings support a policy of encouraging all localized PC patients, regardless of their stated role preferences, to be actively involved in the decision about their treatment. Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. Web- vs. telehealth-based delivery of cognitive behavioral therapy for insomnia: a randomized controlled trial. (United States)

    Holmqvist, M; Vincent, N; Walsh, K


    The purpose of our study was to evaluate and compare two methods of service delivery (web-based and telehealth-based) for chronic insomnia with regard to patient preference, clinical effectiveness, and patient satisfaction. Our study was a randomized controlled trial with manualized telehealth- and web-based delivery conditions (nonblinded). The sample comprised 73 adults with chronic insomnia. Participants received web-based delivery from their homes or telehealth-based delivery from a nearby clinic. Both interventions consisted of identical psychoeducation, sleep hygiene and stimulus control instruction, sleep restriction treatment, relaxation training, cognitive therapy, mindfulness meditation, and medication-tapering assistance. Using a linear mixed model analysis, results showed that both delivery methods produced equivalent changes in insomnia severity, with large effect sizes. Attendance patterns favored telehealth, whereas homework adherence and preference data favored web-based delivery. Web- and telehealth-based delivery are both helpful in treating chronic insomnia in rural-dwelling adults. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Equivalence principle violations and couplings of a light dilaton

    International Nuclear Information System (INIS)

    Damour, Thibault; Donoghue, John F.


    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.

  7. Equivalent Viscous Damping for the Elasto-Plastic Hysteretic Model

    Directory of Open Access Journals (Sweden)

    Raul Zaharia


    Full Text Available The paper proposes some formulae to determine the equivalent linear parameters for spectral earthquake response of SDOF non-linear systems. The proposed formulae for the equivalent viscous damping and equivalent period are valid for the elasto-plastic hysteretic model and for earthquakes compatible with Eurocode 8 response spectra. This study is part of a research aimed to determine the equivalent linear parameters in order to predict the maximum displacement response for earthquake compatible with given response spectra, for different hysteretic models.

  8. Equivalent sensor radiance generation and remote sensing from model parameters - Part 1: Equivalent sensor radiance formulation (United States)

    Wind, G.; da Silva, A. M.; Norris, P. M.; Platnick, S.


    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 probability 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.

  9. Equivalent Dipole Vector Analysis for Detecting Pulmonary Hypertension (United States)

    Harlander, Matevz; Salobir, Barbara; Toplisek, Janez; Schlegel, Todd T.; Starc, Vito


    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

  10. Patient preference with respect to QoL and reduction in opioid-induced constipation (OIC) after treatment with prolonged-release (PR) oxycodone/naloxone compared with previous analgesic therapy [PREFER study]. (United States)

    van Dongen, V C P C; Vanelderen, P J L; Koopmans-Klein, G; van Megen, Y J B; Van Zundert, J; Huygen, F J P M


    The aim of this study was to assess patient preference in terms of quality of life (QoL), analgesia and bowel function for patients with moderate to severe chronic non-malignant pain, when treated with oxycodone PR/naloxone PR compared with the previous WHO-step I and/or WHO-step II analgesic treatment . This was a 3-week open-label phase 3b study conducted in Belgium and the Netherlands, after 3 weeks patients could enter an extension phase. Patient preference with respect to QoL for oxycodone PR/naloxone PR treatment compared with previous WHO-step I and/or WHO-step II analgesics was assessed. A patient was considered a responder with respect to QoL if this assessment was 'better' or 'much better' compared with previous WHO-step I or II analgesics at any time point. Response rate with respect to QoL was 59.2% (95% CI: 51.7-66.8%) for the Full Analysis (FA)-population, for the Per Protocol-population response rate was 71.7% (95% CI: 63.1-80.3%). Explorative analysis showed that response rate with respect to QoL was highest in constipated patients pretreated with WHO-step II analgesics (73.8%). Mean ± SD pain score in the FA-population at start was 74.7 ± 16.6 decreasing to 53.9 ± 24.3 after a median (range) treatment period of 173.5 (31-771) days. For constipated subjects the significant reduction in constipation [improvement of the Bowel Function Index (BFI)], was -24.8 points (95% CI: -17.1 to -32.5). BFI for non-constipated subjects remained well below 28.8. Adverse events with oxycodone PR/naloxone PR treatment were well-known opioid-related adverse events. This study shows that the studied patients previously treated with WHO-step I and/or WHO-step II analgesics prefer treatment with oxycodone PR/naloxone PR with respect to QoL. Moreover, the study shows that treatment with oxycodone PR/naloxone PR significantly reduces OIC in constipated patients and that non-constipated patients do not develop OIC during treatment with oxycodone PR/naloxone PR.

  11. The equivalent internal orientation and position noise for contour integration. (United States)

    Baldwin, Alex S; Fu, Minnie; Farivar, Reza; Hess, Robert F


    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%).

  12. Equivalent Circulation Density Analysis of Geothermal Well by Coupling Temperature

    Directory of Open Access Journals (Sweden)

    Xiuhua Zheng


    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.

  13. V/STOL Equivalent Systems Analysis. (United States)


    something in there that’s bothering me, but I don’t know what. I can certainly get the job done. I wish it was a little bit crisper , so I’ll say that... crisper . In other words, I think it could be just a shade more sensitive to control inputs. I have no problem at all making it do exactly what I want

  14. A 'Toolbox' Equivalent Process for Safety Analysis Software

    International Nuclear Information System (INIS)

    O'Kula, K.R.; Eng, Tony


    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 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

  15. Equivalence of geometric engineering and Hanany-Witten constructions

    International Nuclear Information System (INIS)

    Smith, D.J.


    We show the equivalence of three different realisations of gauge theory in string theory. These are the Hanany-Witten brane constructions, the use of branes as probes and geometric engineering. We illustrate the equivalence via T- and S-dualities with the simplest non-trivial examples in four dimensions: N=2 SYM with gauge groups ΠSU(N i ). (orig.)

  16. 40 CFR 133.105 - Treatment equivalent to secondary treatment. (United States)


    ... 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...

  17. The Public Market Equivalent and Private Equity Performance

    DEFF Research Database (Denmark)

    Sørensen, Morten; Jagannathan, Ravi


    The authors show that the public market equivalent approach is equivalent to assessing the performance of private equity (PE) investments using Rubinstein’s dynamic version of the CAPM. They developed two insights: (1) one need not compute betas of PE investments, and any changes in PE cash flow...

  18. Foundations of gravitation theory: the principle of equivalence

    International Nuclear Information System (INIS)

    Haugan, M.P.


    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

  19. Methodological questions of creating tissue-equivalent phantoms (United States)

    Kolodkin, A. V.; Popov, V. I.; Sychkov, M. A.; Nikl, I.; Erdei, M.; Eyben, O.


    On the basis of analysis and generalization of literature data, the composition of tissue equivalent plastic was justified, parameters of a standard man were determined, plaster and metal forms were created for casting dummies, and an experimental model was produced from tissue equivalent material.

  20. Graphene-based THz modulator analyzed by equivalent circuit model

    DEFF Research Database (Denmark)

    Xiao, Binggang; Chen, Jing; Xie, Zhiyi


    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...

  1. 29 CFR 4.170 - Furnishing fringe benefits or equivalents. (United States)


    ... 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...

  2. Rank equivalent and rank degenerate skew cyclic codes

    DEFF Research Database (Denmark)

    Martinez Peñas, Umberto


    Two skew cyclic codes can be equivalent for the Hamming metric only if they have the same length, and only the zero code is degenerate. The situation is completely different for the rank metric. We study rank equivalences between skew cyclic codes of different lengths and, with the aim of finding...

  3. On the equivalence of brushlet and wavelet bases

    DEFF Research Database (Denmark)

    Borup, Lasse; Nielsen, Morten

    We prove that the Meyer wavelet basis and a class of brushlet systems associated with exponential type partitions of the frequency axis form a family of equivalent (unconditional) bases for the Besov and Triebel-Lizorkin function spaces. This equivalence is then used to obtain new results...

  4. On the equivalence of brushlet and wavelet bases

    DEFF Research Database (Denmark)

    Nielsen, Morten; Borup, Lasse


    We prove that the Meyer wavelet basis and a class of brushlet systems associated with exponential type partitions of the frequency axis form a family of equivalent (unconditional) bases for the Besov and Triebel-Lizorkin function spaces. This equivalence is then used to obtain new results...

  5. 49 CFR 538.8 - Gallon Equivalents for Gaseous Fuels. (United States)


    ... VEHICLES § 538.8 Gallon Equivalents for Gaseous Fuels. The gallon equivalent of gaseous fuels, for purposes... Natural Gas 0.823 Liquefied Natural Gas 0.823 Liquefied Petroleum Gas (Grade HD-5)* 0.726 Hydrogen 0.259...

  6. 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 ...

  7. 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 continous-time system excited by Gaussian white noise. This result is generalized...

  8. Equivalence Between Out-of-Sample Forecast Comparisons and Wald

    DEFF Research Database (Denmark)

    Hansen, Peter Reinhard; Timmermann, Allan

    We establish the equivalence between a commonly used out-of-sample test of equal predictive accuracy and the difference between two Wald statistics. This equivalence greatly simplifies the computational burden of calculating recursive out-of-sample tests and evaluating their critical values. Our...

  9. [Equivalence classes formation applied to learning musical notes]. (United States)

    Escuer Acín, Emilio; García García, Andrés; Bohórquez Zayas, Cristóbal; Gutiérrez Domínguez, Maria Teresa


    Three experiments involving training and application of equivalence classes were carried out. In the first of them, with 6-6 years old children, and applying the equivalence classes logic to musical symbols and sounds learning, the necessary relations to build three equivalence classes (do, mi, sol) of five members each were acquired. In second and third experiments, five and seven equivalence classes (musical notes) of five member each were obtained. Six and a half years old children and one 17 years old Down syndrome diagnosed child took part in them, respectively. Results highlight the theoretical meaning of equivalence classes as explanation of human symbolic behavior, as the educational incomes of improving learning of basic elements in artistic skills.

  10. 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.


    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)

  11. On identifying name equivalences in digital libraries. Name equivalence, Surname matching, Author identification, Databases

    Directory of Open Access Journals (Sweden)

    Dror G. Feitelson


    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.

  12. Investigation of Equivalent Unsprung Mass and Nonlinear Features of Electromagnetic Actuated Active Suspension

    Directory of Open Access Journals (Sweden)

    Jun Yin


    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.

  13. Derivation of Accident-Specific Material-at-Risk Equivalency Factors

    Energy Technology Data Exchange (ETDEWEB)

    Jason P. Andrus; Dr. Chad L. Pope


    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.

  14. Developmentally distinct MYB genes encode functionally equivalent proteins in Arabidopsis. (United States)

    Lee, M M; Schiefelbein, J


    The duplication and divergence of developmental control genes is thought to have driven morphological diversification during the evolution of multicellular organisms. To examine the molecular basis of this process, we analyzed the functional relationship between two paralogous MYB transcription factor genes, WEREWOLF (WER) and GLABROUS1 (GL1), in Arabidopsis. The WER and GL1 genes specify distinct cell types and exhibit non-overlapping expression patterns during Arabidopsis development. Nevertheless, reciprocal complementation experiments with a series of gene fusions showed that WER and GL1 encode functionally equivalent proteins, and their unique roles in plant development are entirely due to differences in their cis-regulatory sequences. Similar experiments with a distantly related MYB gene (MYB2) showed that its product cannot functionally substitute for WER or GL1. Furthermore, an analysis of the WER and GL1 proteins shows that conserved sequences correspond to specific functional domains. These results provide new insights into the evolution of the MYB gene family in Arabidopsis, and, more generally, they demonstrate that novel developmental gene function may arise solely by the modification of cis-regulatory sequences.

  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...... for multivariate systems to an ARMAV model. The covariance equivalent model structure is also considered when the number of channels are different from the number of degrees of freedom to be modelled. Finally, it is reviewed how to estimate an ARMAV model from sampled data....

  16. 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 continous-time system excited by Gaussian white noise. This result is generalized...... for multi-variate systems to an ARMAV model. The covariance equivalent model structure is also considered when the number of channels are different from the number of degrees offreedom to be modelled. Finally, it is reviewed how to estimate an ARMAV model from sampled data....

  17. Modelling of dynamic equivalents in electric power grids

    International Nuclear Information System (INIS)

    Craciun, Diana Iuliana


    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

  18. Spaces of homotopy self-equivalences a survey

    CERN Document Server

    Rutter, John W


    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.

  19. Apparent violation of the principle of equivalence and Killing horizons

    International Nuclear Information System (INIS)

    Zimmerman, R.L.; Farhoosh, H.; Oregon Univ., Eugene


    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)

  20. Calculation of committed dose equivalent from intake of tritiated water

    International Nuclear Information System (INIS)

    Law, D.V.


    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)

  1. Guidelines for the communication of Biomonitoring Equivalents: report from the Biomonitoring Equivalents Expert Workshop. (United States)

    LaKind, Judy S; Aylward, Lesa L; Brunk, Conrad; DiZio, Stephen; Dourson, Michael; Goldstein, Daniel A; Kilpatrick, Michael E; Krewski, Daniel; Bartels, Michael J; Barton, Hugh A; Boogaard, Peter J; Lipscomb, John; Krishnan, Kannan; Nordberg, Monica; Okino, Miles; Tan, Yu-Mei; Viau, Claude; Yager, Janice W; Hays, Sean M


    Biomonitoring Equivalents (BEs) are screening tools for interpreting biomonitoring data. However, the development of BEs brings to the public a relatively novel concept in the field of health risk assessment and presents new challenges for environmental risk communication. This paper provides guidance on methods for conveying information to the general public, the health care community, regulators and other interested parties regarding how chemical-specific BEs are derived, what they mean in terms of health, and the challenges and questions related to interpretation and communication of biomonitoring data. Key communication issues include: (i) developing a definition of the BE that accurately captures the BE concept in lay terms, (ii) how to compare population biomonitoring data to BEs, (iii) interpreting biomonitoring data that exceed BEs for a specific chemical, (iv) how to best describe the confidence in chemical-specific BEs, and (v) key requirements for effective communication with health care professionals. While the risk communication literature specific to biomonitoring is sparse, many of the concepts developed for traditional risk assessments apply, including transparency and discussions of confidence and uncertainty. Communication of BEs will require outreach, education, and development of communication materials specific to several audiences including the lay public and health care providers.

  2. ESA GlobSnow Snow Water Equivalent (SWE) (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...

  3. 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.


    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

  4. Approved Drug Products with Therapuetic Equivalence Evaluations (Orange Book) (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...

  5. On conjugate points and the Leitmann equivalent problem approach

    NARCIS (Netherlands)

    Wagener, F.O.O.


    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.

  6. On conjugate points and the Leitmann equivalent problem approach

    NARCIS (Netherlands)

    Wagener, F.O.O.


    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. Lipschitz equivalence of self-similar sets with touching structures

    International Nuclear Information System (INIS)

    Ruan, Huo-Jun; Wang, Yang; Xi, Li-Feng


    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)

  8. Einstein's equivalence principle instead of the inertia forces

    International Nuclear Information System (INIS)

    Herreros Mateos, F.


    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

  9. The lexicographical handling of grammatical equivalence: the case ...

    African Journals Online (AJOL)

    ... utilise the format of the microstructure as a means to convey grammatical facts of the target language to the learner. Keywords: afrikaans, grammatical equivalence, learners' dictionaries, lexicography, macrostructure, microstructure, morphology, syntax, translating dictionaries, translation theory, trilingual dictionaries, zulu ...

  10. Bisimulation Meet PCTL Equivalences for Probabilistic Automata (Journal Version)

    DEFF Research Database (Denmark)

    Song, Lei; Zhang, Lijun; Godskesen, Jens Christian


    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....

  11. Existence and equivalence of twisted products on a symplectic manifold

    International Nuclear Information System (INIS)

    Lichnerowicz, A.


    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.)

  12. Archive of Census Related Products (ACRP): 1990 ZIP Equivalency Files (United States)

    National Aeronautics and Space Administration — The 1990 Zip Equivalency Files portion of the Archive of Census Related Products (ACRP) contains population and housing data derived from the U.S. Census Bureau's...

  13. Minimum detectable dose equivalant of NTA film for fast neutron

    International Nuclear Information System (INIS)

    Ito, Masashi; Kumazawa, Shigeru; Nishi, Tatsuo; Numakunai, Takao


    A method has been studied of estimating the minimum detectable dose equivalent of fast neutrons for measurement of recoil proton tracks in NTA film. Poisson distribution was applied in estimation of the minimum detectable number of tracks. Factors such as sensitivity of the film for fast neutrons, energy dependency of the film response, and latent image fading of the tracks were taken into consideration in the estimation. The minimum detectable dose equivalent was affected by fluctuation in the number of tracks due to background radiation and degree of the affection depended on the measured area. The minimum detectable dose equivalent decreased with increasing the measuring area of background radiation even if the measuring area of neutron-irradiated film was small. The relation between the minimum detectable dose equivalent and the measuring area of neutron-irradiated film was obtained considering the effect of latent image fading. (author)

  14. 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. (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


    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

  15. Open, Prospective, Multi-Center, Two-Part Study of Patient Preference with Monthly Ibandronate Therapy in Women with Postmenopausal Osteoporosis Switched From Daily or Weekly Alendronate or Risendronate-BONCURE: Results of Turkish Sub-Study

    Directory of Open Access Journals (Sweden)

    Nurten Eskiyurt


    Full Text Available Aim: BONCURE (Bonviva for Current Bisphosphonate Users Regional European Trial, aimed to evaluate patient preference with monthly ibandronate in women with postmenopausal osteoporosis who previously received daily or weekly alendronate or risendronate. Materials and Methods: This prospective, open-label study consisted of two sequential stages, Part A (screening and Part B (treatment. Patients enrolled into Part A completed the Candidate Identification Questionnaire (CIQ. In Part B, after completing the Osteoporosis Patient Satisfaction Questionnaire (OPSATQ, patients received monthly oral ibandronate 150 mg for 6 months. Following treatment, patients completed the OPSAT-Q and Preference Questionnaire. Results: A total of 223 patients (mean age, 63.7±9.51 years were enrolled in Part A from Turkey. Among them, 103 (46.2% answered “YES” to at least one CIQ question. The mean composite OPSAT-Q domain scores increased for convenience (mean change, 15.3±17.7 points, quality of life (10.4±20.4 points, overall satisfaction (11.9±22.7 points, and side effects (3.3±18.8 points. At month 6, 177 subjects (92.7% preferred once-monthly dosing schedule and 99.0% were compliant (≥80% with study treatment. Thirty (15.6% subjects experienced mild to moderate adverse events, mostly gastrointestinal. Conclusion: Postmenopausal women with osteoporosis prefer and are more satisfied and compliant with monthly dosing of ibandronate than daily or weekly bisphosphonate treatment. (Turkish Journal of Osteoporosis 2012;18:1-7

  16. Steganographic Capacity of Images, based on Image Equivalence Classes

    DEFF Research Database (Denmark)

    Hansen, Klaus; Hammer, Christian; Andersen, Jens Damgaard


    The problem of hiding information imperceptibly can be formulated as the problem of determining if a given image is a member of a sufficiently large equivalence class of images which to the Human Visual System appears to be the same image. This makes it possible to replace the given image...... with a modified image similar in appearance but carrying imperceptibly coded information. This paper presents a framework and an experimental algorithm to estimate upper bounds for the size of an equivalence class....

  17. Annual average equivalent dose of workers form health area

    International Nuclear Information System (INIS)

    Daltro, T.F.L.; Campos, L.L.


    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.)

  18. An equivalence between momentum and charge in string theory

    International Nuclear Information System (INIS)

    Horne, J.H.; Horowitz, G.T.; Steif, A.R.


    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

  19. Equivalence principle, gravitational collapse, and the classical particle problem

    International Nuclear Information System (INIS)

    Borzeszkowski, H.-H. von; Yourgrau, W.


    Various modifications of general relativity theory (GRT) are compared from the viewpoint of the equivalence principle. In GRT, gravitational collapse and the classical particle problems are closely connected with Einstein's version of the strong principle of equivalence. It is argued that theories which violate that principle or start its 'telescopic' formulation might avoid collapse. On the other hand, one should evoke Einstein's equations with fourth-order corrections in order to solve the classical particle problem. (author)

  20. Equivalence groups of (2+1) dimensional diffusion equation


    Özer, Saadet


    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...

  1. The Equivalence of Grayson and Friedlander-Suslin Spectral Sequences


    Podkopaev, Oleg


    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.

  2. Gap sequence, Lipschitz equivalence and box dimension of fractal sets

    International Nuclear Information System (INIS)

    Rao Hui; Yang Yamin; Ruan Huojun


    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

  3. A graphical representation of equivalence classes of AMP chain graphs

    Czech Academy of Sciences Publication Activity Database

    Roverato, A.; Studený, Milan


    Roč. 7, č. 6 (2006), s. 1045-1078 ISSN 1532-4435 R&D Projects: GA ČR GA201/04/0393 Institutional research plan: CEZ:AV0Z10750506 Keywords : chain graph * AMP Markov equivalence * strong equivalence * largest deflagged graph Subject RIV: BA - General Mathematics Impact factor: 2.255, year: 2006

  4. Exact equivalent straight waveguide model for bent and twisted waveguides

    DEFF Research Database (Denmark)

    Shyroki, Dzmitry


    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. On the Equivalence of Linear Dimensionality-Reducing Transformations

    DEFF Research Database (Denmark)

    Loog, Marco


    In this JMLR volume, Ye (2008) demonstrates the essential equivalence of two sets of solutions to a generalized Fisher criterion used for linear dimensionality reduction (see Ye, 2005; Loog, 2007). Here, I point out the basic flaw in this new contribution.......In this JMLR volume, Ye (2008) demonstrates the essential equivalence of two sets of solutions to a generalized Fisher criterion used for linear dimensionality reduction (see Ye, 2005; Loog, 2007). Here, I point out the basic flaw in this new contribution....

  6. Feedback equivalence of convolutional codes over finite rings

    Directory of Open Access Journals (Sweden)

    DeCastro-García Noemí


    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.

  7. Noise equivalent circuit of a semiconductor laser diode


    Harder, Christoph; Katz, Joseph; Margalit, S.; Shacham, J.; Yariv, A.


    The noise equivalent circuit of a semiconductor laser diode is derived from the rate equations including Langevin noise sources. This equivalent circuit allows a straightforward calculation of the noise and modulation characteristics of a laser diode combined with electronic components. The intrinsic junction voltage noise spectrum and the light intensity fluctuation of a current driven laser diode are calculated as a function of bias current and frequency.

  8. Equivalent leak definitions for Smart LDAR (leak detection and repair) when using optical imaging technology. (United States)

    Epperson, David; Lev-On, Miriam; Taback, Hal; Siegell, Jeffrey; Ritter, Karin


    Controlling fugitive emissions from leaks in petrochemical industry process equipment now requires periodic monitoring of valves, flanges, pumps etc., typically on a quarterly basis. Previous studies have shown that over 90% of the reducible emissions come from approximately 0.1% of the components, i.e. the large leakers. A new, and more cost-effective approach for controlling these large leakers would entail more frequent monitoring of process equipment, allowing for the detection and repair of the highly leaking components that contribute the most to emissions. This approach has been called "Smart LDAR." New optical imaging instruments, which significantly reduce monitoring costs, are now available to implement such an alternative work practice. This work describes the determination of the leak detection sensitivity (equivalency threshold) that an optical imaging instrument must achieve to ensure that it will provide at least the equivalent emission control of the current leak detection and repair practice. Equivalency thresholds were developed for various monitoring intervals. The U.S. Environment Protection Agency's Monte Carlo simulation approach was used to perform the analysis and to demonstrate that optical imaging, which is capable of identifying all of the largest leakers, can provide better control of fugitive emissions.

  9. Application of transport equivalent cross-sections obtained by the MONSTRE method to SPX1 case

    International Nuclear Information System (INIS)

    Cabrillat, J.C.; Salvatores, M.; Palmiotti, G.; Carta, M.; Peluso, V.


    Application of the MONSTRE method (method to obtain new transport equivalent cross-sections) to SPX1 case is described. E/C values on control rods antireactivities and flux distributions are reported and compared with those evaluated by a ''standard'' reference calculational route, where transport and finite mesh size correction are a posteriori applied. Results obtained by the two methods show a maximum deviation of about 3% on control rod values, in agreement with the ± 4% MONSTRE method uncertainty announced in a companion paper. Moreover, MONSTRE transport equivalent cross-sections reproduce rather well experimental profiles of reaction rates measured in the frame of T1-T2 measurements performed during SPX1 start up. (author). 5 refs, 11 figs, 8 tabs


    Directory of Open Access Journals (Sweden)

    V. S. Safaryan


    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

  11. Accelerometer-assessed Physical Activity in Epidemiology: Are Monitors Equivalent? (United States)

    Rowlands, Alex V; Mirkes, Evgeny M; Yates, Tom; Clemes, Stacey; Davies, Melanie; Khunti, Kamlesh; Edwardson, Charlotte L


    Accelerometers are increasingly being used to assess physical activity in large-scale surveys. Establishing whether key physical activity outcomes can be considered equivalent between three widely used accelerometer brands would be a significant step toward capitalizing on the increasing availability of accelerometry data for epidemiological research. Twenty participants wore a GENEActiv, an Axivity AX3, and an ActiGraph GT9X on their nondominant wrist and were observed for 2 h in a simulated living space. Participants undertook a series of seated and upright light/active behaviors at their own pace. All accelerometer data were processed identically using open-source software (GGIR) to generate physical activity outcomes (including average dynamic acceleration (ACC) and time within intensity cut points). Data were analyzed using pairwise 95% equivalence tests (±10% equivalence zone), intraclass correlation coefficients (ICC) and limits of agreement. The GENEActiv and Axivity could be considered equivalent for ACC (ICC = 0.95, 95% confidence interval (CI), 0.87-0.98), but ACC measured by the ActiGraph was approximately 10% lower (GENEActiv/ActiGraph: ICC = 0.86; 95% CI, 0.56-0.95; Axivity/ActiGraph: ICC = 0.82; 95% CI, 0.50-0.94). For time spent within intensity cut points, all three accelerometers could be considered equivalent to each other for more than 85% of outcomes (ICC ≥0.69, lower 95% CI ≥0.36), with the GENEActiv and Axivity equivalent for 100% of outcomes (ICC ≥0.95, lower 95% CI ≥0.86). GENEActiv and Axivity data processed in GGIR are largely equivalent. If GENEActiv or Axivity is compared with the ActiGraph, time spent within intensity cut points has good agreement. These findings can be used to inform selection of appropriate outcomes if outputs from these accelerometer brands are compared.

  12. Advancing Research on Racial–Ethnic Health Disparities: Improving Measurement Equivalence in Studies with Diverse Samples (United States)

    Landrine, Hope; Corral, Irma


    To conduct meaningful, epidemiologic research on racial–ethnic health disparities, racial–ethnic samples must be rendered equivalent on other social status and contextual variables via statistical controls of those extraneous factors. The racial–ethnic groups must also be equally familiar with and have similar responses to the methods and measures used to collect health data, must have equal opportunity to participate in the research, and must be equally representative of their respective populations. In the absence of such measurement equivalence, studies of racial–ethnic health disparities are confounded by a plethora of unmeasured, uncontrolled correlates of race–ethnicity. Those correlates render the samples, methods, and measures incomparable across racial–ethnic groups, and diminish the ability to attribute health differences discovered to race–ethnicity vs. to its correlates. This paper reviews the non-equivalent yet normative samples, methodologies and measures used in epidemiologic studies of racial–ethnic health disparities, and provides concrete suggestions for improving sample, method, and scalar measurement equivalence. PMID:25566524

  13. Resonant Rectifier ICs for Piezoelectric Energy Harvesting Using Low-Voltage Drop Diode Equivalents. (United States)

    Din, Amad Ud; Chandrathna, Seneke Chamith; Lee, Jong-Wook


    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.

  14. Validity of the Aluminum Equivalent Approximation in Space Radiation Shielding (United States)

    Badavi, Francis F.; Adams, Daniel O.; Wilson, John W.


    The origin of the aluminum equivalent shield approximation in space radiation analysis can be traced back to its roots in the early years of the NASA space programs (Mercury, Gemini and Apollo) wherein the primary radiobiological concern was the intense sources of ionizing radiation causing short term effects which was thought to jeopardize the safety of the crew and hence the mission. Herein, it is shown that the aluminum equivalent shield approximation, although reasonably well suited for that time period and to the application for which it was developed, is of questionable usefulness to the radiobiological concerns of routine space operations of the 21 st century which will include long stays onboard the International Space Station (ISS) and perhaps the moon. This is especially true for a risk based protection system, as appears imminent for deep space exploration where the long-term effects of Galactic Cosmic Ray (GCR) exposure is of primary concern. The present analysis demonstrates that sufficiently large errors in the interior particle environment of a spacecraft result from the use of the aluminum equivalent approximation, and such approximations should be avoided in future astronaut risk estimates. In this study, the aluminum equivalent approximation is evaluated as a means for estimating the particle environment within a spacecraft structure induced by the GCR radiation field. For comparison, the two extremes of the GCR environment, the 1977 solar minimum and the 2001 solar maximum, are considered. These environments are coupled to the Langley Research Center (LaRC) deterministic ionized particle transport code High charge (Z) and Energy TRaNsport (HZETRN), which propagates the GCR spectra for elements with charges (Z) in the range I aluminum equivalent approximation for a good polymeric shield material such as genetic polyethylene (PE). The shield thickness is represented by a 25 g/cm spherical shell. Although one could imagine the progression to greater

  15. Tracer Equivalent Latitude: A Diagnostic Tool for Isentropic Transport Studies. (United States)

    Allen, Douglas R.; Nakamura, Noboru


    Area equivalent latitude based on potential vorticity (PV) is a widely used diagnostic for isentropic transport in the stratosphere and upper troposphere. Here, an alternate method for calculating equivalent latitude is explored, namely, a numerical synthesis of a PV-like tracer from a long-term integration of the advection-diffusion equation on isentropic surfaces. It is found that the tracer equivalent latitude (TrEL) behaves much like the traditional PV equivalent latitude (PVEL) despite the simplified governing physics; this is evidenced by examining the kinematics of the Arctic lower stratospheric vortex. Yet in some cases TrEL performs markedly better as a coordinate for long-lived trace species such as ozone. These instances include analysis of lower stratospheric ozone during the Stratospheric Aerosol and Gas Experiment (SAGE) III Ozone Loss and Validation Experiment (SOLVE) campaign and three-dimensional reconstruction of total column ozone during November-December 1999 from fitted ozone-equivalent latitude relationship. It is argued that the improvement is due to the tracer being free from the diagnostic errors and certain diabatic processes that affect PV. The sensitivity of TrEL to spatial and temporal resolution, advection scheme, and driving winds is also examined.

  16. Higher-order gravity and the classical equivalence principle (United States)

    Accioly, Antonio; Herdy, Wallace


    As is well known, the deflection of any particle by a gravitational field within the context of Einstein’s general relativity — which is a geometrical theory — is, of course, nondispersive. Nevertheless, as we shall show in this paper, the mentioned result will change totally if the bending is analyzed — at the tree level — in the framework of higher-order gravity. Indeed, to first order, the deflection angle corresponding to the scattering of different quantum particles by the gravitational field mentioned above is not only spin dependent, it is also dispersive (energy-dependent). Consequently, it violates the classical equivalence principle (universality of free fall, or equality of inertial and gravitational masses) which is a nonlocal principle. However, contrary to popular belief, it is in agreement with the weak equivalence principle which is nothing but a statement about purely local effects. It is worthy of note that the weak equivalence principle encompasses the classical equivalence principle locally. We also show that the claim that there exists an incompatibility between quantum mechanics and the weak equivalence principle, is incorrect.

  17. A Cp-theory problem book functional equivalencies

    CERN Document Server

    Tkachuk, Vladimir V


    This fourth volume in Vladimir Tkachuk's series on Cp-theory gives reasonably complete coverage of the theory of functional equivalencies through 500 carefully selected problems and exercises. By systematically introducing each of the major topics of Cp-theory, the book is intended to bring a dedicated reader from basic topological principles to the frontiers of modern research. The book presents complete and up-to-date information on the preservation of topological properties by homeomorphisms of function spaces.  An exhaustive theory of t-equivalent, u-equivalent and l-equivalent spaces is developed from scratch.   The reader will also find introductions to the theory of uniform spaces, the theory of locally convex spaces, as well as  the theory of inverse systems and dimension theory. Moreover, the inclusion of Kolmogorov's solution of Hilbert's Problem 13 is included as it is needed for the presentation of the theory of l-equivalent spaces. This volume contains the most important classical re...

  18. Equivalence relations for the 9972-9975 SARP

    International Nuclear Information System (INIS)

    Niemer, K.A.; Frost, R.L.


    Equivalence relations required to determine mass limits for mixtures of nuclides for the Safety Analysis Report for Packaging (SARP) of the Savannah River Site 9972, 9973, 9974, and 9975 shipping casks were calculated. The systems analyzed included aqueous spheres, homogeneous metal spheres, and metal ball-and-shell configurations, all surrounded by an effectively infinite stainless steel or water reflector. Comparison of the equivalence calculations with the rule-of-fractions showed conservative agreement for aqueous solutions, both conservative and non-conservative agreement for the metal homogeneous sphere systems, and non-conservative agreement for the majority of metal ball-and-shell systems. Equivalence factors for the aqueous solutions and homogeneous metal spheres were calculated. The equivalence factors for the non-conservative metal homogeneous sphere systems were adjusted so that they were conservative. No equivalence factors were calculated for the ball-and-shell systems since the -SARP assumes that only homogeneous or uniformly distributed material will be shipped in the 9972-9975 shipping casks, and an unnecessarily conservative critical mass may result if the ball-and-shell configurations are included

  19. Committed dose equivalent in the practice of radiological protection

    International Nuclear Information System (INIS)

    Nenot, J.C.; Piechowski, J.


    In the case of internal exposure, the dose is not received at the moment of exposure, as happens with external exposure, since the incorporated radionuclide irradiates the various organs and tissues during the time it is present in the body. By definition, the committed dose equivalent corresponds to the received dose integrated over 50 years from the date of intake. In order to calculate it, one has to know the intake activity and the value of the committed dose equivalent per unit of intake activity. The uncertainties of the first parameter are such that the committed dose equivalent can only be regarded as an order of magnitude and not as a very accurate quantity. The use of it is justified, however, for, like the dose equivalent for external exposure, it expresses the risk of stochastic effects for the individual concerned since these effects, should they appear, would do so only after a latent period which is generally longer than the dose integration time. Moreover, the use of the committed dose equivalent offers certain advantages for dosimetric management, especially when it is simplified. A practical problem which may arise is that the annual dose limit is apparently exceeded by virtue of the fact that one is taking account, in the first year, of doses which will actually be received only in the following years. These problems are rare enough in practice to be dealt with individually in each case. (author)

  20. Inertia and Double Bending of Light from Equivalence (United States)

    Shuler, Robert L., Jr.


    Careful examination of light paths in an accelerated reference frame, with use of Special Relativity, can account fully for the observed bending of light in a gravitational field, not just half of it as reported in 1911. This analysis also leads to a Machian formulation of inertia similar to the one proposed by Einstein in 1912 and later derived from gravitational field equations in Minkowsky Space by Sciama in 1953. There is a clear inference from equivalence that there is some type of inertial mass increase in a gravitational field. It is the purpose of the current paper to suggest that equivalence provides a more complete picture of gravitational effects than previously thought, correctly predicting full light bending, and that since the theory of inertia is derivable from equivalence, any theory based on equivalence must take account of it. Einstein himself clearly was not satisfied with the status of inertia in GRT, as our quotes have shown. Many have tried to account for inertia and met with less than success, for example Davidson s integration of Sciama s inertia into GRT but only for a steady state cosmology [10], and the Machian gravity theory of Brans and Dicke [11]. Yet Mach s idea hasn t gone away, and now it seems that it cannot go away without also disposing of equivalence.

  1. Verification of an effective dose equivalent model for neutrons

    International Nuclear Information System (INIS)

    Tanner, J.E.; Piper, R.K.; Leonowich, J.A.; Faust, L.G.


    Since the effective dose equivalent, based on the weighted sum of organ dose equivalents, is not a directly measurable quantity, it must be estimated with the assistance of computer modelling techniques and a knowledge of the incident radiation field. Although extreme accuracy is not necessary for radiation protection purposes, a few well chosen measurements are required to confirm the theoretical models. Neutron doses and dose equivalents were measured in a RANDO phantom at specific locations using thermoluminescence dosemeters, etched track dosemeters, and a 1.27 cm (1/2 in) tissue-equivalent proportional counter. The phantom was exposed to a bare and a D 2 O-moderated 252 Cf neutron source at the Pacific Northwest Laboratory's Low Scatter Facility. The Monte Carlo code MCNP with the MIRD-V mathematical phantom was used to model the human body and to calculate the organ doses and dose equivalents. The experimental methods are described and the results of the measurements are compared with the calculations. (author)

  2. Verification of an effective dose equivalent model for neutrons

    International Nuclear Information System (INIS)

    Tanner, J.E.; Piper, R.K.; Leonowich, J.A.; Faust, L.G.


    Since the effective dose equivalent, based on the weighted sum of organ dose equivalents, is not a directly measurable quantity, it must be estimated with the assistance of computer modeling techniques and a knowledge of the radiation field. Although extreme accuracy is not necessary for radiation protection purposes, a few well-chosen measurements are required to confirm the theoretical models. Neutron measurements were performed in a RANDO phantom using thermoluminescent dosemeters, track etch dosemeters, and a 1/2-in. (1.27-cm) tissue equivalent proportional counter in order to estimate neutron doses and dose equivalents within the phantom at specific locations. The phantom was exposed to bare and D 2 O-moderated 252 Cf neutrons at the Pacific Northwest Laboratory's Low Scatter Facility. The Monte Carlo code MCNP with the MIRD-V mathematical phantom was used to model the human body and calculate organ doses and dose equivalents. The experimental methods are described and the results of the measurements are compared to the calculations. 8 refs., 3 figs., 3 tabs

  3. Equivalent-Continuum Modeling With Application to Carbon Nanotubes (United States)

    Odegard, Gregory M.; Gates, Thomas S.; Nicholson, Lee M.; Wise, Kristopher E.


    A method has been proposed for developing structure-property relationships of nano-structured materials. This method serves as a link between computational chemistry and solid mechanics by substituting discrete molecular structures with equivalent-continuum models. It has been shown that this substitution may be accomplished by equating the vibrational potential energy of a nano-structured material with the strain energy of representative truss and continuum models. As important examples with direct application to the development and characterization of single-walled carbon nanotubes and the design of nanotube-based devices, the modeling technique has been applied to determine the effective-continuum geometry and bending rigidity of a graphene sheet. A representative volume element of the chemical structure of graphene has been substituted with equivalent-truss and equivalent continuum models. As a result, an effective thickness of the continuum model has been determined. This effective thickness has been shown to be significantly larger than the interatomic spacing of graphite. The effective thickness has been shown to be significantly larger than the inter-planar spacing of graphite. The effective bending rigidity of the equivalent-continuum model of a graphene sheet was determined by equating the vibrational potential energy of the molecular model of a graphene sheet subjected to cylindrical bending with the strain energy of an equivalent continuum plate subjected to cylindrical bending.

  4. Pulse Equivalent Area Based Orientation of a Class of Under-Actuated System under Constraints

    Directory of Open Access Journals (Sweden)



    Full Text Available A PEA (Pulse Equivalent Area approach for orientation control of an under actuated pointing device is proposed. The presented work is a sequel to the earlier work done by the authors for the orientation control of the drill machine. The desired orientation is realized through control pulses during specific roll instants. These pulses are generated through single pair of electromagnets mounted on the housing of the pointing device. Due to practical limitation of the system, there is an additional constraint on the actuating signal. The amplitude of the actuating signal is fixed and the Pulse width or duration of the pulse can vary. A discrete equivalent model of pointing device is also developed. A novel approach based on PEA is developed since the exact solution of discrete equivalent model under constraints was not possible. The simulations are included to compare proposed technique with the existing technique developed for similar systems. The performance is also shown under both nominal and parameter variations through Monte Carlo simulations

  5. Testing the principle of equivalence by solar neutrinos

    International Nuclear Information System (INIS)

    Minakata, H.; Nunokawa, H.


    We discuss the possibility of testing the principle of equivalence with solar neutrinos. If there exists a violation of the equivalence principle, quarks and leptons with different flavors may not universally couple with gravity. The method we discuss employs the quantum mechanical phenomenon of neutrino oscillation to probe into the nonuniversality of the gravitational couplings of neutrinos. We develop an appropriate formalism to deal with neutrino propagation under the weak gravitational fields of the Sun in the presence of the flavor mixing. We point out that solar neutrino observation by the next generation water Cherenkov detectors can place stringent bounds on the violation of the equivalence principle to 1 part in 10 15 --10 16 if the nonadiabatic Mikheyev-Smirnov-Wolfenstein mechanism is the solution to the solar neutrino problem

  6. Reduction of Linear Functional Systems using Fuhrmann's Equivalence

    Directory of Open Access Journals (Sweden)

    Mohamed S. Boudellioua


    Full Text Available Functional systems arise in the treatment of systems of partial differential equations, delay-differential equations, multidimensional equations, etc. The problem of reducing a linear functional system to a system containing fewer equations and unknowns was first studied by Serre. Finding an equivalent presentation of a linear functional system containing fewer equations and fewer unknowns can generally simplify both the study of the structural properties of the linear functional system and of different numerical analysis issues, and it can sometimes help in solving the linear functional system. In this paper, Fuhrmann's equivalence is used to present a constructive result on the reduction of under-determined linear functional systems to a single equation involving a single unknown. This equivalence transformation has been studied by a number of authors and has been shown to play an important role in the theory of linear functional systems.

  7. Principle of natural and artificial radioactive series equivalency

    International Nuclear Information System (INIS)

    Vasilyeva, A.N.; Starkov, O.V.


    In the present paper one approach used under development of radioactive waste management conception is under consideration. This approach is based on the principle of natural and artificial radioactive series radiotoxic equivalency. The radioactivity of natural and artificial radioactive series has been calculated for 10 9 - years period. The toxicity evaluation for natural and artificial series has also been made. The correlation between natural radioactive series and their predecessors - actinides produced in thermal and fast reactors - has been considered. It has been shown that systematized reactor series data had great scientific significance and the principle of differential calculation of radiotoxicity was necessary to realize long-lived radioactive waste and uranium and thorium ore radiotoxicity equivalency conception. The calculations show that the execution of equivalency principle is possible for uranium series (4n+2, 4n+1). It is a problem for thorium. series. This principle is impracticable for neptunium series. (author)

  8. Basic neuron model electrical equivalent circuit: an undergraduate laboratory exercise. (United States)

    Dabrowski, Katie M; Castaño, Diego J; Tartar, Jaime L


    We developed a hands-on laboratory exercise for undergraduate students in which they can build and manipulate a neuron equivalent circuit. This exercise uses electrical circuit components that resemble neuron components and are easy to construct. We describe the methods for creating the equivalent circuit and how to observe different neuron properties through altering the structure of the equivalent circuit. We explain how this hands-on laboratory activity allows for the better understanding of this fundamental neuroscience concept. At the conclusion of this laboratory exercise, undergraduate students will be able to apply the principles of Ohm's law, cable theory with regards to neurons, and understand the functions of resistance and capacitance in a neuron.

  9. Conditions needed to give meaning to rad-equivalence principle

    International Nuclear Information System (INIS)

    Latarjet, R.


    To legislate on mutagenic chemical pollution the problem to be faced is similar to that tackled about 30 years ago regarding pollution by ionizing radiations. It would be useful to benefit from the work of these 30 years by establishing equivalences, if possible, between chemical mutagens and radiations. Inevitable mutagenic pollutions are considered here, especially those associated with fuel based energy production. As with radiations the legislation must derive from a compromise between the harmful and beneficial effects of the polluting system. When deciding on tolerance doses it is necessary to safeguard the biosphere without inflicting excessive restrictions on industry and on the economy. The present article discusses the conditions needed to give meaning to the notion of rad-equivalence. Some examples of already established equivalences are given, together with the first practical consequences which emerge [fr

  10. On proving confluence modulo equivalence for Constraint Handling Rules

    DEFF Research Database (Denmark)

    Christiansen, Henning; Kirkeby, Maja Hanne


    confluence for a terminating program means that all alternative derivations for a query lead to the exact same final state, confluence modulo equivalence only requires the final states to be equivalent with respect to an equivalence relation tailored for the given program. Secondly, we allow non......-logical built-in predicates such as var/1 and incomplete ones such as is/2, that are ignored in previous work on confluence. To this end, a new operational semantics for CHR is developed which includes such predicates. In addition, this semantics differs from earlier approaches by its simplicity without loss...... of generality, and it may also be recommended for future studies of CHR. For the purely logical subset of CHR, proofs can be expressed in first-order logic, that we show is not sufficient in the present case. We have introduced a formal meta-language that allows reasoning about abstract states and derivations...

  11. Inter digital transducer modelling through Mason equivalent circuit model

    DEFF Research Database (Denmark)

    Mishra, Dipti; Singh, Abhishek; Hussain, Dil muhammed Akbar


    The frequency reliance of inter-digital transducer is analyzed with the help of MASON's Equivalent circuit which is based on Smith's Equivalent circuit which is further based on Foster's Network. An inter-digital transducer has been demonstrated as a RLC network. The circuit is simulated...... by Simulation program with Integrated Circuit Emphasis (HSPICE), a well-liked electronic path simulator. The acoustic wave devices are not suitable to simulation through circuit simulator. In this paper, an electrical model of Mason's Equivalent electrical circuit for an inter-digital transducer (IDT......) is projected which is well-suited with a broadly cast-off universal resolution circuit simulator SPICE built-in out with the proficiency to simulate the negative capacitances and inductances. The investigation is done to prove the straightforwardness of establishing the frequency and time domain physical...

  12. Offsetting Ongoing Methane Emissions --- An Alternative to Emission Equivalence Metrics (United States)

    Clisby, N.; Enting, I. G.; Lauder, A.; Carter, J.; Cowie, A.; Henry, B.; Raupach, M. R.


    The Global Warming Potential (GWP) has been widely adopted as a metric for comparing the climate impact of different greenhouse gases. As has been frequently noted, there are many problems with using GWPs to define emission equivalence in spite of the use of GWPs for this purpose in contexts such as the Kyoto Protocol. We propose that for methane, rather than define emission equivalence, the appropriate comparison is between ongoing emissions of 0.9 to 1.0 kg of CH4 per year and one-off emissions of 1 tonne of carbon. This approach represents an approximate solution to the inverse problem of defining a forcing equivalent index (FEI) that gives exact equivalence of radiative forcing over a range of timescales. In our approach, if ongoing methane emissions are offset by a one-off carbon removal that is built up with 40-year e-folding time, then the result is close to radiatively neutral over periods from years to centuries. In contrast, the GWP provides radiative equivalence (in integrated terms) only at a single time, with large discrepancies at other times. Our approach also follows from consideration of greenhouse gas stabilisation, since stabilising atmospheric CO2 requires an approximate cap on total emissions, while stabilising methane requires stabilisation of ongoing emissions. Our quantitative treatment recognises that, on time scales of centuries, removal of 1 tonne of carbon only lowers the atmospheric carbon content by 0.3 to 0.35 tonnes. We discuss the implications for rangeland grazing systems. In the absence of effective mitigation techniques for methane from rangeland systems, this approach may provide an attractive offset mechanism in spite of requiring that woody vegetation be established and maintained over about 15% of the landscape, or an equivalent amount of carbon storage in soil.

  13. The equivalence myth of quantum mechanics-part II (United States)

    Muller, F. A.

    The author endeavours to show two things: first, that Schrödingers (and Eckarts) demonstration in March (September) 1926 of the equivalence of matrix mechanics, as created by Heisenberg, Born, Jordan and Dirac in 1925, and wave mechanics, as created by Schrödinger in 1926, is not foolproof; and second, that it could not have been foolproof, because at the time matrix mechanics and wave mechanics were neither mathematically nor empirically equivalent. That they were is the Equivalence Myth. In order to make the theories equivalent and to prove this, one has to leave the historical scene of 1926 and wait until 1932, when von Neumann finished his magisterial edifice. During the period 1926-1932 the original families of mathematical structures of matrix mechanics and of wave mechanics were stretched, parts were chopped off and novel structures were added. To Procrustean places we go, where we can demonstrate the mathematical, empirical and ontological equivalence of 'the final versions of' matrix mechanics and wave mechanics. The present paper claims to be a comprehensive analysis of one of the pivotal papers in the history of quantum mechanics: Schrödingers equivalence paper. Since the analysis is performed from the perspective of Suppes structural view ('semantic view') of physical theories, the present paper can be regarded not only as a morsel of the internal history of quantum mechanics, but also as a morsel of applied philosophy of science. The paper is self-contained and presupposes only basic knowledge of quantum mechanics. For reasons of length, the paper is published in two parts; Part I appeared in the previous issue of this journal. Section 1 contains, besides an introduction, also the papers five claims and a preview of the arguments supporting these claims; so Part I, Section 1 may serve as a summary of the paper for those readers who are not interested in the detailed arguments.

  14. What Do Contrast Threshold Equivalent Noise Studies Actually Measure? Noise vs. Nonlinearity in Different Masking Paradigms.

    Directory of Open Access Journals (Sweden)

    Alex S Baldwin

    Full Text Available The internal noise present in a linear system can be quantified by the equivalent noise method. By measuring the effect that applying external noise to the system's input has on its output one can estimate the variance of this internal noise. By applying this simple "linear amplifier" model to the human visual system, one can entirely explain an observer's detection performance by a combination of the internal noise variance and their efficiency relative to an ideal observer. Studies using this method rely on two crucial factors: firstly that the external noise in their stimuli behaves like the visual system's internal noise in the dimension of interest, and secondly that the assumptions underlying their model are correct (e.g. linearity. Here we explore the effects of these two factors while applying the equivalent noise method to investigate the contrast sensitivity function (CSF. We compare the results at 0.5 and 6 c/deg from the equivalent noise method against those we would expect based on pedestal masking data collected from the same observers. We find that the loss of sensitivity with increasing spatial frequency results from changes in the saturation constant of the gain control nonlinearity, and that this only masquerades as a change in internal noise under the equivalent noise method. Part of the effect we find can be attributed to the optical transfer function of the eye. The remainder can be explained by either changes in effective input gain, divisive suppression, or a combination of the two. Given these effects the efficiency of our observers approaches the ideal level. We show the importance of considering these factors in equivalent noise studies.

  15. Quantifying the Combined Effect of Radiation Therapy and Hyperthermia in Terms of Equivalent Dose Distributions

    International Nuclear Information System (INIS)

    Kok, H. Petra; Crezee, Johannes; Franken, Nicolaas A.P.; Stalpers, Lukas J.A.; Barendsen, Gerrit W.; Bel, Arjan


    Purpose: To develop a method to quantify the therapeutic effect of radiosensitization by hyperthermia; to this end, a numerical method was proposed to convert radiation therapy dose distributions with hyperthermia to equivalent dose distributions without hyperthermia. Methods and Materials: Clinical intensity modulated radiation therapy plans were created for 15 prostate cancer cases. To simulate a clinically relevant heterogeneous temperature distribution, hyperthermia treatment planning was performed for heating with the AMC-8 system. The temperature-dependent parameters α (Gy −1 ) and β (Gy −2 ) of the linear–quadratic model for prostate cancer were estimated from the literature. No thermal enhancement was assumed for normal tissue. The intensity modulated radiation therapy plans and temperature distributions were exported to our in-house-developed radiation therapy treatment planning system, APlan, and equivalent dose distributions without hyperthermia were calculated voxel by voxel using the linear–quadratic model. Results: The planned average tumor temperatures T90, T50, and T10 in the planning target volume were 40.5°C, 41.6°C, and 42.4°C, respectively. The planned minimum, mean, and maximum radiation therapy doses were 62.9 Gy, 76.0 Gy, and 81.0 Gy, respectively. Adding hyperthermia yielded an equivalent dose distribution with an extended 95% isodose level. The equivalent minimum, mean, and maximum doses reflecting the radiosensitization by hyperthermia were 70.3 Gy, 86.3 Gy, and 93.6 Gy, respectively, for a linear increase of α with temperature. This can be considered similar to a dose escalation with a substantial increase in tumor control probability for high-risk prostate carcinoma. Conclusion: A model to quantify the effect of combined radiation therapy and hyperthermia in terms of equivalent dose distributions was presented. This model is particularly instructive to estimate the potential effects of interaction from different treatment

  16. New equivalent lumped electrical circuit for piezoelectric transformers. (United States)

    Gonnard, Paul; Schmitt, P M; Brissaud, Michel


    A new equivalent circuit is proposed for a contour-vibration-mode piezoelectric transformer (PT). It is shown that the usual lumped equivalent circuit derived from the conventional Mason approach is not accurate. The proposed circuit, built on experimental measurements, makes an explicit difference between the elastic energies stored respectively on the primary and secondary parts. The experimental and theoretical resonance frequencies with the secondary in open or short circuit are in good agreement as well as the output "voltage-current" characteristic and the optimum efficiency working point. This circuit can be extended to various PT configurations and appears to be a useful tool for modeling electronic devices that integrate piezoelectric transformers.

  17. The equivalence theorem and the production of gravitinos after inflation

    CERN Document Server

    Maroto, A L; Maroto, Antonio L.; Pelaez, Jose R.


    We study the application of the high-energy equivalence between helicity $\\pm 1/2$ gravitinos and goldstinos in order to calculate the production of helicity derive this equivalence for equations of motion, paying attention to several subtleties that appear in this context and are not present in the standard derivations of the theorem, mainly because of the presence of external sources. We also propose the Landau gauge as an alternative to the usual gauge choices given in the standard proofs at the Lagrangian level.

  18. Semantical Characterizations and Complexity of Equivalences in Answer Set Programming


    Eiter, Thomas; Fink, Michael; Woltran, Stefan


    In recent research on non-monotonic logic programming, repeatedly strong equivalence of logic programs P and Q has been considered, which holds if the programs P union R and Q union R have the same answer sets for any other program R. This property strengthens equivalence of P and Q with respect to answer sets (which is the particular case for R is the empty set), and has its applications in program optimization, verification, and modular logic programming. In this paper, we consider more lib...

  19. A Community Standard: Equivalency of Healthcare in Australian Immigration Detention. (United States)

    Essex, Ryan


    The Australian government has long maintained that the standard of healthcare provided in its immigration detention centres is broadly comparable with health services available within the Australian community. Drawing on the literature from prison healthcare, this article examines (1) whether the principle of equivalency is being applied in Australian immigration detention and (2) whether this standard of care is achievable given Australia's current policies. This article argues that the principle of equivalency is not being applied and that this standard of health and healthcare will remain unachievable in Australian immigration detention without significant reform. Alternate approaches to addressing the well documented issues related to health and healthcare in Australian immigration detention are discussed.

  20. Mean and quasideterministic equivalence for linear stochastic dynamics. (United States)

    Hanson, F B; Ryan, D


    In linear, stochastic dynamics it is shown that the quasideterministic population size is equivalent to the mean population size. The quasideterministic dynamics are defined by the conditional infinitesimal mean of the process. The stochastic component of the dynamics includes both Gaussian and Poisson white noise, with amplitude coefficients proportional to the population size. Generalizations are given for nonautonomous coefficients and for distributed Poisson jump amplitudes. A counter example--an exactly integrable nonlinear jump model--shows that the equivalence result does not hold for nonlinear stochastic dynamics.

  1. Categorical Equivalence Between Orthomodular Dynamic Algebras and Complete Orthomodular Lattices (United States)

    Kishida, Kohei; Rafiee Rad, Soroush; Sack, Joshua; Zhong, Shengyang


    This paper provides a categorical equivalence between two types of quantum structures. One is a complete orthomodular lattice, which is used for reasoning about testable properties of a quantum system. The other is an orthomodular dynamic algebra, which is a quantale used for reasoning about quantum actions. The result extends to more restrictive lattices than orthomodular lattices, and includes Hilbert lattices of closed subspaces of a Hilbert space. These other lattice structures have connections to a wide range of different quantum structures; hence our equivalence establishes a categorical connection between quantales and a great variety of quantum structures.

  2. Equivalent equations of motion for gravity and entropy

    International Nuclear Information System (INIS)

    Czech, Bartłomiej; Lamprou, Lampros; McCandlish, Samuel; Mosk, Benjamin; Sully, James


    We demonstrate an equivalence between the wave equation obeyed by the entanglement entropy of CFT subregions and the linearized bulk Einstein equation in Anti-de Sitter space. In doing so, we make use of the formalism of kinematic space and fields on this space, introduced in We show that the gravitational dynamics are equivalent to a gauge invariant wave-equation on kinematic space and that this equation arises in natural correspondence to the conformal Casimir equation in the CFT.

  3. Equivalences of the multi-indexed orthogonal polynomials

    International Nuclear Information System (INIS)

    Odake, Satoru


    Multi-indexed orthogonal polynomials describe eigenfunctions of exactly solvable shape-invariant quantum mechanical systems in one dimension obtained by the method of virtual states deletion. Multi-indexed orthogonal polynomials are labeled by a set of degrees of polynomial parts of virtual state wavefunctions. For multi-indexed orthogonal polynomials of Laguerre, Jacobi, Wilson, and Askey-Wilson types, two different index sets may give equivalent multi-indexed orthogonal polynomials. We clarify these equivalences. Multi-indexed orthogonal polynomials with both type I and II indices are proportional to those of type I indices only (or type II indices only) with shifted parameters

  4. Alexander-equivalent Zariski pairs of irreducible sextics

    DEFF Research Database (Denmark)

    Eyral, Christophe; Oka, Mutsuo


    The existence of Alexander-equivalent Zariski pairs dealing with irreducible curves of degree 6 was proved by Degtyarev. However, no explicit example of such a pair is available (only the existence is known) in the literature. In this paper, we construct the first concrete example.......The existence of Alexander-equivalent Zariski pairs dealing with irreducible curves of degree 6 was proved by Degtyarev. However, no explicit example of such a pair is available (only the existence is known) in the literature. In this paper, we construct the first concrete example....

  5. Interactive short-term effects of equivalent temperature and air pollution on human mortality in Berlin and Lisbon

    International Nuclear Information System (INIS)

    Burkart, Katrin; Canário, Paulo; Breitner, Susanne; Schneider, Alexandra; Scherber, Katharina; Andrade, Henrique; Alcoforado, Maria João; Endlicher, Wilfried


    There is substantial evidence that both temperature and air pollution are predictors of mortality. Thus far, few studies have focused on the potential interactive effects between the thermal environment and different measures of air pollution. Such interactions, however, are biologically plausible, as (extreme) temperature or increased air pollution might make individuals more susceptible to the effects of each respective predictor. This study investigated the interactive effects between equivalent temperature and air pollution (ozone and particulate matter) in Berlin (Germany) and Lisbon (Portugal) using different types of Poisson regression models. The findings suggest that interactive effects exist between air pollutants and equivalent temperature. Bivariate response surface models and generalised additive models (GAMs) including interaction terms showed an increased risk of mortality during periods of elevated equivalent temperatures and air pollution. Cold effects were mostly unaffected by air pollution. The study underscores the importance of air pollution control in mitigating heat effects. -- Highlights: • Interactive effects between air pollution and equivalent temperature result in augmented excess mortality. • High levels of ozone and particulate matter increase adverse heat effects on human mortality. • Cold effects are mostly unaffected by air pollution. • Findings underscore the importance of air pollution control in mitigating heat-related mortality. -- Interactive effects between air pollution and elevated (equivalent) temperatures underscore the importance of air pollution control in mitigating the adverse effects of heat

  6. Chickadees fail standardized operant tests for octave equivalence. (United States)

    Hoeschele, Marisa; Weisman, Ronald G; Guillette, Lauren M; Hahn, Allison H; Sturdy, Christopher B


    Octave equivalence occurs when an observer judges notes separated by a doubling in frequency perceptually similar. The octave appears to form the basis of pitch change in all human cultures and thus may be of biological origin. Previously, we developed a nonverbal operant conditioning test of octave generalization and transfer in humans. The results of this testing showed that humans with and without musical training perceive the octave relationship between pitches. Our goal in the current study was to determine whether black-capped chickadees, a North American songbird, perceive octave equivalence. We chose these chickadees because of their reliance on pitch in assessing conspecific vocalizations, our strong background knowledge on their pitch height perception (log-linear perception of frequency), and the phylogenetic disparity between them and humans. Compared to humans, songbirds are highly skilled at using pitch height perception to classify pitches into ranges, independent of the octave. Our results suggest that chickadees used that skill, rather than octave equivalence, to transfer the note-range discrimination from one octave to the next. In contrast, there is evidence that at least some mammals, including humans, do perceive octave equivalence.

  7. 43 CFR 426.11 - Class 1 equivalency. (United States)


    ... greatest immediate need. (b) Who may request a Class 1 equivalency determination? Only districts may..., successful irrigation farming; and (iii) Is estimated to have the highest relative productive potential... and variable costs of production, including costs of irrigation service, are accounted for. (2) Net...

  8. Probing Students' Ideas of the Principle of Equivalence (United States)

    Bandyopadhyay, Atanu; Kumar, Arvind


    The principle of equivalence was the first vital clue to Einstein in his extension of special relativity to general relativity, the modern theory of gravitation. In this paper we investigate in some detail students' understanding of this principle in a variety of contexts, when they are undergoing an introductory course on general relativity. The…

  9. On the Equivalence of Linear Dimensionality-Reducing Transformations

    DEFF Research Database (Denmark)

    Loog, Marco


    In this JMLR volume, Ye (2008) demonstrates the essential equivalence of two sets of solutions to a generalized Fisher criterion used for linear dimensionality reduction (see Ye, 2005; Loog, 2007). Here, I point out the basic flaw in this new contribution....

  10. Measurement model equivalence in web- and paper-based surveys ...

    African Journals Online (AJOL)

    The aim of this research is to investigate whether web-based and paper-based organisational climate surveys can be regarded as equivalent techniques of data collection. Due to the complex geographical placement of various units of the participating organisation and limited internet access, both paper-based and

  11. On scales of equivalent conditions characterizing weighted Stieltjes inequality

    Czech Academy of Sciences Publication Activity Database

    Gogatishvili, Amiran; Persson, L. E.; Stepanov, V.D.; Wall, P.


    Roč. 86, č. 3 (2012), s. 738-739 ISSN 1064-5624 R&D Projects: GA ČR GA201/08/0383 Institutional support: RVO:67985840 Keywords : integral inequalities * Stieltjes transform * scales of equivalents conditions Subject RIV: BA - General Mathematics Impact factor: 0.376, year: 2012

  12. Robust increases of land equivalent ratio with temporal niche differentiation

    NARCIS (Netherlands)

    Yu, Yang; Makowski, David; Stomph, Tjeerd Jan; Werf, van der Wopke


    Intercropping has been shown to be land use efficient, but there is a large variation in the land equivalent ratio (LER) among studies. We used quantile regression to estimate the effect of temporal niche differentiation and its interaction with other key characteristics of intercropping, i.e.,

  13. Limit groups, positive-genus towers and measure equivalence


    Bridson, Martin R; Tweedale, Michael; Wilton, Henry


    By definition, an $\\omega$-residually free tower is positive-genus if all surfaces used in its construction are of positive genus. We prove that every limit group is virtually a subgroup of a positive-genus $\\omega$-residually free tower. By combining this with results of Gaboriau, we prove that elementarily free groups are measure equivalent to free groups.

  14. 5 CFR 531.407 - Equivalent increase determinations. (United States)


    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Equivalent increase determinations. 531.407 Section 531.407 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS... terminated under § 531.414; (2) A promotion (permanent or temporary) to a higher grade, including the...

  15. Skin Dose Equivalent Measurement from Neutron-Deficient Isotopes

    International Nuclear Information System (INIS)

    Hsu, Hsiao-Hua; Costigan, Steve A.; Romero, Leonard L.; Whicker, Jeffrey J.


    Neutron-deficient-isotopes decay via positron emission and/or electron capture often followed by x-ray, gamma-ray, and 0.511 MeV photons from positron annihilation. For cases of significant area and/or personnel contamination with these isotopes, determination of skin dose equivalent (SDE) is required by 10CFR835. For assessment of SDE, we evaluated the MICROSPEC-2(TM) system manufactured by Bubble Technology Industries of Canada which uses three different probes for dose measurement. We used two probes: (1) the X-probe which measures lower energy (4 - 120 keV) photon energy distributions and determines deep dose equivalent, SDE and dose equivalent to eyes, and (2) the B-probe which measures electron (positron) energy distributions, and determines skin dose equivalent. Also, the measured photon and beta spectra can be used to identify radioactive isotopes in the contaminated area. Measurements with several neutron-deficient sources showed that this system provided reasonably accurate SDE rate measurements when compared with calculated benchmark SDE rates with an average percent difference of 40%. Variations were expected because of differences between the assumed geometries used by MlCROSPEC-2 and the calculations when compared to the measurement conditions

  16. Evaluation of the physicochemical equivalence of three brands of ...

    African Journals Online (AJOL)

    Background: The relatively little resistance to quinine globally has led to an increase in its use in P. falciparum malaria especially in multi-drug resistant strains. Objective: To evaluate the physicochemical and equivalency of three brands of quinine sulphate tablets available in South Western region of Nigeria. Methods: The ...

  17. Equivalent viscous damping procedure for multi-material systems

    International Nuclear Information System (INIS)

    Ahmed, H.; Ma, D.


    The inclusion of accurate viscous damping effects in the seismic analysis of nuclear power plants is discussed. A procedure to evaluate and use equivalent viscous damping coefficients in conjunction with the substructure method of finite element analysis is outlined in detail

  18. Synonymy in the translation equivalent paradigms of a standard ...

    African Journals Online (AJOL)

    The norm in current canonical translation dictionaries with Afrikaans and English as the treated language pair is an undiscriminated grouping of partially synonymous translation equivalents. These are separated by commas as sole markers of synonymy. Lexicographers should reject this practice and embrace the view that ...

  19. Equivalence properties for the Radon-Nikodym property types and ...

    African Journals Online (AJOL)

    We show that the types I- and II-Λ-Radon-Nikodym Property of Banach spaces on the one hand, and the I- and II-Λ-Complete Continuity Property on the other, are equivalent properties whenever Λ is an ordering subset of a discrete abelian group. Mathematics Subject Classification (2000): Primary 46E40, 46G10; ...

  20. Mass Equivalent Pantographs for Synthesis of Balanced Focal Mechanisms

    NARCIS (Netherlands)

    van der Wijk, V.; Lenarcic, Jadran; Merlet, Jean-Pierre


    Force balance is an important property in the design of high-speed high precision machinery to reduce base vibrations and also for the design of inherently safe large movable structures. This paper presents the synthesis of inherently balanced overconstrained focal mechanisms with mass equivalent