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  1. Current Research Studies

    Science.gov (United States)

    ... Success Home > Explore Research > Current Research Studies Current Research Studies Email Print + Share The Crohn’s & Colitis Foundation ... conducted online. Learn more about IBD Partners. Clinical Research Alliance The Clinical Research Alliance is a network ...

  2. The RooPfs study to assess whether improved housing provides additional protection against clinical malaria over current best practice in The Gambia

    DEFF Research Database (Denmark)

    Pinder, Margeret; Conteh, Lesong; Jeffries, David

    2016-01-01

    ) and prompt treatment in The Gambia, determine the incremental cost-effectiveness of the interventions, and analyze the housing market in The Gambia. Methods/design A two-armed, household, cluster-randomized, controlled study will be conducted to assess whether improved housing and LLINs combine to provide...

  3. To assess whether indoor residual spraying can provide additional protection against clinical malaria over current best practice of long-lasting insecticidal mosquito nets in The Gambia: study protocol for a two-armed cluster-randomised trial

    Directory of Open Access Journals (Sweden)

    Parker David

    2011-06-01

    Full Text Available Abstract Background Recently, there has been mounting interest in scaling-up vector control against malaria in Africa. It needs to be determined if indoor residual spraying (IRS with DDT will provide significant marginal protection against malaria over current best practice of long-lasting insecticidal nets (LLINs and prompt treatment in a controlled trial, given that DDT is currently the most persistent insecticide for IRS. Methods A 2 armed cluster-randomised controlled trial will be conducted to assess whether DDT IRS and LLINs combined provide better protection against clinical malaria in children than LLINs alone in rural Gambia. Each cluster will be a village, or a group of small adjacent villages; all clusters will receive LLINs and half will receive IRS in addition. Study children, aged 6 months to 13 years, will be enrolled from all clusters and followed for clinical malaria using passive case detection to estimate malaria incidence for 2 malaria transmission seasons in 2010 and 2011. This will be the primary endpoint. Exposure to malaria parasites will be assessed using light and exit traps followed by detection of Anopheles gambiae species and sporozoite infection. Study children will be surveyed at the end of each transmission season to estimate the prevalence of Plasmodium falciparum infection and the prevalence of anaemia. Discussion Practical issues concerning intervention implementation, as well as the potential benefits and risks of the study, are discussed. Trial Registration ISRCTN01738840 - Spraying And Nets Towards malaria Elimination (SANTE

  4. Experimental study of neoclassical currents

    International Nuclear Information System (INIS)

    Zarnstorff, M.C.; Prager, S.C.

    1985-05-01

    A detailed experimental study is presented of the bootstrap and Pfirsch-Schlueter currents that are predicted by neoclassical transport theory. In a toroidal octupole, on magnetic surfaces within the separatrix, the observed parallel plasma currents are in excellent quantitative agreement with neoclassical theory with regard to the spatial structure (along a magnetic surface), collisionality dependence and toroidal magnetic field dependence. On magnetic surfaces outside the separatrix, the ion portion of the parallel current is in agreement with neoclassical theory but the electron parallel current is observed to obtain a unidirectional component which deviates from and exceeds the theoretical prediction

  5. a qualitative study of providers' perspectives

    African Journals Online (AJOL)

    Background: Glaucoma management is challenging to patients as well as to the eye care providers.The study is aimed at describing the challenges faced by providers using qualitative methods. Methods: In-depth interviews were conducted with selected Ophthalmologists and resident doctors in ophthalmology at centres ...

  6. Detecting aberrant opioid behavior in the emergency department: a prospective study using the screener and Opioid Assessment for Patients with Pain-Revised (SOAPP®-R), Current Opioid Misuse Measure (COMM)™, and provider gestalt.

    Science.gov (United States)

    Varney, Shawn M; Perez, Crystal A; Araña, Allyson A; Carey, Katherine R; Ganem, Victoria J; Zarzabal, Lee A; Ramos, Rosemarie G; Bebarta, Vikhyat S

    2018-03-03

    Emergency department (ED) providers have limited time to evaluate patients at risk for opioid misuse. A validated tool to assess the risk for aberrant opioid behavior may mitigate adverse sequelae associated with prescription opioid misuse. We sought to determine if SOAPP-R, COMM, and provider gestalt were able to identify patients at risk for prescription opioid misuse as determined by pharmacy records at 12 months. We conducted a prospective observational study of adult patients in a high volume US ED. Patients completed the SOAPP-R and COMM, and treating EM providers evaluated patients' opioid misuse risk. We performed variable-centered, person-centered, and hierarchical cluster analyses to determine whether provider gestalt, SOAPP-R, or COMM, or a combination, predicted higher misuse risk. The primary outcome was the number of opioid prescriptions at 12 months according to pharmacy records. For 169 patients (mean age 43 years, 51% female, 73% white), correlation analysis showed a strong relationship between SOAPP-R and COMM with predicting the number of opioid prescriptions dispensed at 12 months. Provider scores estimating opioid misuse were not related to SOAPP-R and only weakly associated with COMM. In our adjusted regression models, provider gestalt and SOAPP-R uniquely predicted opioid prescriptions at 6 and 12 months. Using designated cutoff scores, only SOAPP-R detected a difference in the number of opioid prescriptions. Cluster analysis revealed that provider gestalt, SOAPP-R, and COMM scores jointly predicted opioid prescriptions. Provider gestalt and self-report instruments uniquely predicted the number of opioid prescriptions in ED patients. A combination of gestalt and self-assessment scores can be used to identify at-risk patients who otherwise miss the cutoff scores for SOAPP-R and COMM.

  7. High-current railgap studies

    Energy Technology Data Exchange (ETDEWEB)

    Druce, R.; Gordon, L.; Hofer, W.; Wilson, M.

    1983-06-03

    Characteristics of a 40-kV, 750-kA, multichannel rail gap are presented. The gap is a three electrode, field-distortion-triggered design, with a total switch inductance of less than 10 nH. At maximum ratings, the gap typically switches 10 C per shot, at 700 kA, with a jitter of less than 2 ns. Image-converter streak photographs were used to study channel evolution and current division. Transient gas-pressure measurements were made to investigate the arc generated shocks and to detect single channel failure. Channel current sharing and simultaneity are described and their effects on the switch inductance and lifetime are discussed. Lifetime tests of the rail gap were performed. Degradation in the channel current-sharing and erosion measurements are discussed.

  8. High-current railgap studies

    Science.gov (United States)

    Druce, R.; Gordon, L.; Hofer, W.; Wilson, M.

    1983-06-01

    Characteristics of a 40-kV, 750-kA, multichannel rail gap are presented. The gap is a three electrode, field distortion triggered design, with a total switch inductance of less than 10 nH. At maximum ratings, the gap typically switches 10 C per shot, at 700 kA, with a jitter of less than 2 ns. Channel evolution and current division were studied on image converter streak photographs. Transient gas pressure measurements were made to investigate the arc generated shocks and to detect single channel failure. Channel current sharing and simultaneity are described and their effects on the switch inductance in the channel current sharing and erosion measurements are discussed.

  9. Shared Decision-Making in Oncology - A Qualitative Analysis of Healthcare Providers' Views on Current Practice.

    Science.gov (United States)

    Frerichs, Wiebke; Hahlweg, Pola; Müller, Evamaria; Adis, Christine; Scholl, Isabelle

    2016-01-01

    Despite an increased awareness of shared decision-making (SDM) and its prominent position on the health policy agenda, its implementation in routine care remains a challenge in Germany. In order to overcome this challenge, it is important to understand healthcare providers' views regarding SDM and to take their perspectives and opinions into account in the development of an implementation program. The present study aimed at exploring a) the attitudes of different healthcare providers regarding SDM in oncology and b) their experiences with treatment decisions in daily practice. A qualitative study was conducted using focus groups and individual interviews with different healthcare providers at the University Cancer Center Hamburg, Germany. Focus groups and interviews were audio-recorded, transcribed and analyzed using conventional content analysis and descriptive statistics. N = 4 focus groups with a total of N = 25 participants and N = 17 individual interviews were conducted. Attitudes regarding SDM varied greatly between the different participants, especially concerning the definition of SDM, the attitude towards the degree of patient involvement in decision-making and assumptions about when SDM should take place. Experiences on how treatment decisions are currently made varied. Negative experiences included time and structural constraints, and a lack of (multidisciplinary) communication. Positive experiences comprised informed patients, involvement of relatives and a good physician-patient relationship. The results show that German healthcare providers in oncology have a range of attitudes that currently function as barriers towards the implementation of SDM. Also, their experiences on how decision-making is currently done reveal difficulties in actively involving patients in decision-making processes. It will be crucial to take these attitudes and experiences seriously and to subsequently disentangle existing misconceptions in future implementation programs.

  10. Improving health outcomes for young people with long term conditions: The role of digital communication in current and future patient-clinician communication for NHS providers of specialist clinical services for young people - LYNC study protocol.

    Science.gov (United States)

    Griffiths, Frances E; Atherton, Helen; Barker, Jack R; Cave, Jonathan Ak; Dennick, Kathryn; Dowdall, Peter; Fraser, Joe; Huxley, Caroline; Kim, Sung-Wook; Madan, Jason J; Matharu, Harjit; Musumadi, Luhanga; Palmer, Tom M; Paul, Moli; Sankaranarayanan, Sailesh; Slowther, Anne-Marie; Sujan, Mark A; Sutcliffe, Paul A; Sturt, Jackie

    2015-01-01

    Young people living with long term conditions are vulnerable to health service disengagement. This endangers their long term health. Studies report requests for digital forms of communication - email, text, social media - with their health care team. Digital clinical communication is troublesome for the UK NHS. In this article we aim to present the research protocol for evaluating the impacts and outcomes of digital clinical communications for young people living with long term conditions and provide critical analysis of their use, monitoring and evaluation by NHS providers (LYNC study: Long term conditions, Young people, Networked Communications). The research involves: (a) patient and public involvement activities with 16-24 year olds with and without long term health conditions; (b) six literature reviews; (c) case studies - the main empirical part of the study - and (d) synthesis and a consensus meeting. Case studies use a mixed methods design. Interviews and non-participant observation of practitioners and patients communicating in up to 20 specialist clinical settings will be combined with data, aggregated at the case level (non-identifiable patient data) on a range of clinical outcomes meaningful within the case and across cases. We will describe the use of digital clinical communication from the perspective of patients, clinical staff, support staff and managers, interviewing up to 15 young people and 15 staff per case study. Outcome data includes emergency admissions, A&E attendance and DNA (did not attend) rates. Case studies will be analysed to understand impacts of digital clinical communication on patient health outcomes, health care costs and consumption, ethics and patient safety.

  11. Perceived Need Versus Current Spending: Gaps in Providing Foundational Public Health Services in Communities.

    Science.gov (United States)

    Bekemeier, Betty; Marlowe, Justin; Squires, Linda Sharee; Tebaldi, Jennifer; Park, Seungeun

    Our objective was to estimate the gap between the costs for local health jurisdictions (LHJs) to provide foundational public health services (FPHS) and actual spending on FPHS and to examine factors associated with that gap. We employed resource-based cost estimation methods for this observational study and conducted multivariate analyses with measures derived from secondary administrative data. We used primary data collected from LHJ leaders that depicted 2014 spending and perceived need. We also included secondary administrative data depicting annual 2000-2013 expenditures organized into categories containing key elements of FPHS areas. We included primary data from a representative sample of 10 LHJs in Washington State and secondary data for all 35 LHJs in Washington. Participants were public health practice leaders from each sample LHJ. Our main outcome of interest was the gap identified between current spending and the perceived spending needed to provide FPHS in a jurisdiction. Actual FPHS spending was approximately 65% of spending needed to provide overall FPHS for our sample LHJs, but the size of the gap varied substantially by program. Some gaps also varied widely by LHJ, with spending gaps widest among rural and high poverty communities. Percent poverty and the metropolitan nature of a jurisdiction were factors significantly related to FPHS spending in our multivariate analyses. Actual spending lags far behind local officials' estimates of spending needed to provide FPHS and is likely influenced by local conditions. Major apparent gaps between spending and need, particularly in areas such as costly Business Competencies, underscore the need for cross-cutting capabilities to support public health system responsiveness and for attention to be paid to local conditions.

  12. Current food chain information provides insufficient information for modern meat inspection of pigs.

    Science.gov (United States)

    Felin, Elina; Jukola, Elias; Raulo, Saara; Heinonen, Jaakko; Fredriksson-Ahomaa, Maria

    2016-05-01

    Meat inspection now incorporates a more risk-based approach for protecting human health against meat-borne biological hazards. Official post-mortem meat inspection of pigs has shifted to visual meat inspection. The official veterinarian decides on additional post-mortem inspection procedures, such as incisions and palpations. The decision is based on declarations in the food chain information (FCI), ante-mortem inspection and post-mortem inspection. However, a smooth slaughter and inspection process is essential. Therefore, one should be able to assess prior to slaughter which pigs are suitable for visual meat inspection only, and which need more profound inspection procedures. This study evaluates the usability of the FCI provided by pig producers and considered the possibility for risk ranking of incoming slaughter batches according to the previous meat inspection data and the current FCI. Eighty-five slaughter batches comprising 8954 fattening pigs were randomly selected at a slaughterhouse that receives animals from across Finland. The mortality rate, the FCI and the meat inspection results for each batch were obtained. The current FCI alone provided insufficient and inaccurate information for risk ranking purposes for meat inspection. The partial condemnation rate for a batch was best predicted by the partial condemnation rate calculated for all the pigs sent for slaughter from the same holding in the previous year (p<0.001) and by prior information on cough declared in the current FCI (p=0.02) statement. Training and information to producers are needed to make the FCI reporting procedures more accurate. Historical meat inspection data on pigs slaughtered from the same holdings and well-chosen symptoms/signs for reporting, should be included in the FCI to facilitate the allocation of pigs for visual inspection. The introduced simple scoring system can be easily used for additional information for directing batches to appropriate meat inspection procedures. To

  13. A Self-Oscillating Control Scheme for a Boost Converter Providing a Controlled Output Current

    DEFF Research Database (Denmark)

    Knott, Arnold; Pfaffinger, Gerhard R.; Andersen, Michael A. E.

    2011-01-01

    Most switched mode power supplies provide a regulated voltage at their output. However, there are applications requiring a controlled current. Among others are battery chargers, test equipment for converters driven by solar cells, and LED drivers. This paper describes a dc–dc power converter real...

  14. Providing current radiation safety according to new version of 'Ukrytie' object regulation

    International Nuclear Information System (INIS)

    Borovoj, A.A.; Vysotskij, E.D.; Krinitsyn, A.P.; Bogatov, S.A.

    1999-01-01

    Main provisions are given of the 'Ukryttia' object's Regulation related to provision of radiation safety during the object's operation. The safety is provided due to the realization by the object's personnel of functions of global monitoring of current radiation conditions, as well as of the measures of operative or preventive suppression of radiation abnormalities sources

  15. Rainforest pharmacopeia in Madagascar provides high value for current local and prospective global uses.

    Directory of Open Access Journals (Sweden)

    Christopher D Golden

    Full Text Available Botanical diversity provides value to humans through carbon sequestration, air and water purification, and the provisioning of wild foods and ethnomedicines. Here we calculate the value of botanical ethnomedicines in a rainforest region of Madagascar, the Makira Protected Area, using a substitution method that combines replacement costs and choice modeling. The Makira watershed may comprise approximately 0.8% of global botanical diversity and possesses enormous value both in its ability to provision botanical ethnomedicines to local people and as a source of potentially novel pharmaceutical drugs for society as a whole. Approximately 241 locally-recognized species are used as ethnomedicines, including 113 agricultural or weed species. We equated each ethnomedicinal treatment to the monetary value of a comparable pharmaceutical treatment adjusted by personal preferences in perceived efficacy (rather than from known or assumed medicinal equivalency. The benefit value of these botanical ethnomedicines per individual is $5.40-7.90 per year when using the value of highly subsidized Malagasy pharmaceuticals and $100.60-287.40 when using the value of American pharmaceuticals. Using local pharmaceuticals as substitutes, the value per household is $30.24-44.30 per year, equivalent to 43-63% of median annual household income, demonstrating their local importance. Using the value of American pharmaceuticals, the amount is equivalent to 22-63% of the median annual health care expenditures for American adults under 45 in 2006. The potential for developing novel biomedicines from the Makira watershed's unique flora ranges in untapped benefit value from $0.3-5.7 billion for American pharmaceutical companies, non-inclusive of the importance of providing novel medicines and improved healthcare to society. This study provides evidence of the tremendous current local and prospective global value of botanical ethnomedicines and furthers arguments for the

  16. Current Knowledge and Practice of Pediatric Providers in Umbilical Cord Blood Banking.

    Science.gov (United States)

    Armstrong, Amy E; Fonstad, Rachel; Spellman, Stephen; Tullius, Zoe; Chaudhury, Sonali

    2018-02-01

    More than 35 000 umbilical cord blood (UCB) transplants have been performed worldwide, prompting the development of private and public banks to collect and store UCB cells. We hypothesized that pediatricians, who are uniquely poised to discuss UCB banking (UCBB) during prenatal or sibling visits, rarely do so. Through distribution of a 26-question electronic survey to general and subspecialty pediatric providers, we assessed baseline knowledge and conversations about UCBB. A total of 473 providers completed the survey; only 22% of physicians ever discussed UCBB with expectant parents. The majority responded that autologous UCB transplants were indicated in malignant (73%) and nonmalignant (61%) conditions; however, these are rare indications. Providers practicing >10 years were more likely to address UCBB ( P ≤ .001), whereas younger and female general pediatric providers were significantly less likely ( P < .001). Overall, pediatric providers rarely speak to families about UCBB, and we believe that they can be better informed to its current clinical utility.

  17. Measuring physical inactivity: do current measures provide an accurate view of "sedentary" video game time?

    Science.gov (United States)

    Fullerton, Simon; Taylor, Anne W; Dal Grande, Eleonora; Berry, Narelle

    2014-01-01

    Measures of screen time are often used to assess sedentary behaviour. Participation in activity-based video games (exergames) can contribute to estimates of screen time, as current practices of measuring it do not consider the growing evidence that playing exergames can provide light to moderate levels of physical activity. This study aimed to determine what proportion of time spent playing video games was actually spent playing exergames. Data were collected via a cross-sectional telephone survey in South Australia. Participants aged 18 years and above (n = 2026) were asked about their video game habits, as well as demographic and socioeconomic factors. In cases where children were in the household, the video game habits of a randomly selected child were also questioned. Overall, 31.3% of adults and 79.9% of children spend at least some time playing video games. Of these, 24.1% of adults and 42.1% of children play exergames, with these types of games accounting for a third of all time that adults spend playing video games and nearly 20% of children's video game time. A substantial proportion of time that would usually be classified as "sedentary" may actually be spent participating in light to moderate physical activity.

  18. Surface conductivity of Mercury provides current closure and may affect magnetospheric symmetry

    Directory of Open Access Journals (Sweden)

    P. Janhunen

    2004-04-01

    Full Text Available We study what effect a possible surface conductivity of Mercury has on the closure of magnetospheric currents by making six runs with a quasi-neutral hybrid simulation. The runs are otherwise identical but use different synthetic conductivity models: run 1 has a fully conducting planet, run 2 has a poorly conducting planet ( m and runs 3-6 have one of the hemispheres either in the dawn-dusk or day-night directions, conducting well, the other one being conducting poorly. Although the surface conductivity is not known from observations, educated guesses easily give such conductivity values that magnetospheric currents may close partly within the planet, and as the conductivity depends heavily on the mineral composition of the surface, the possibility of significant horizontal variations cannot be easily excluded. The simulation results show that strong horizontal variations may produce modest magnetospheric asymmetries. Beyond the hybrid simulation, we also briefly discuss the possibility that in the nightside there may be a lack of surface electrons to carry downward current, which may act as a further source of surface-related magnetospheric asymmetry. Key words. Magnetospheric physics (planetary magnetospheres; current systems; solar wind-magnetosphere interactions.6

  19. Surface conductivity of Mercury provides current closure and may affect magnetospheric symmetry

    Directory of Open Access Journals (Sweden)

    P. Janhunen

    2004-04-01

    Full Text Available We study what effect a possible surface conductivity of Mercury has on the closure of magnetospheric currents by making six runs with a quasi-neutral hybrid simulation. The runs are otherwise identical but use different synthetic conductivity models: run 1 has a fully conducting planet, run 2 has a poorly conducting planet ( $sigma{=}10^{-8} Omega^{-1}$ m$^{-1}$ and runs 3-6 have one of the hemispheres either in the dawn-dusk or day-night directions, conducting well, the other one being conducting poorly. Although the surface conductivity is not known from observations, educated guesses easily give such conductivity values that magnetospheric currents may close partly within the planet, and as the conductivity depends heavily on the mineral composition of the surface, the possibility of significant horizontal variations cannot be easily excluded. The simulation results show that strong horizontal variations may produce modest magnetospheric asymmetries. Beyond the hybrid simulation, we also briefly discuss the possibility that in the nightside there may be a lack of surface electrons to carry downward current, which may act as a further source of surface-related magnetospheric asymmetry.

    Key words. Magnetospheric physics (planetary magnetospheres; current systems; solar wind-magnetosphere interactions.6

  20. Study of longshore current equations for currents in Visakhapatnam beach

    Digital Repository Service at National Institute of Oceanography (India)

    Chandramohan, P.; Rao, T.V.N.

    Longshore currents were measured along the Visakhapatnam Beach, Andhra Pradesh, India at weekly intervals from March 1978 to March 1979. Visual observations on breaker characteristics were also made during this period. Using modified Longuet...

  1. Current knowledge attitudes, and practices of healthcare providers about leprosy in Assam, India

    Directory of Open Access Journals (Sweden)

    Sumit Kar

    2010-01-01

    Full Text Available Background: Leprosy is a chronic infectious disease that is associated with serious morbidity and is a disease of public health concern because of the case load and the social stigma attached to the disease. Aim: To understand the knowledge of, and attitudes towards, leprosy amongst healthcare providers in Assam, India. Settings and Design: This cross-sectional study was conducted during March to June 2007 in different health institutions of the Kamrup district of Assam. Results: Among the program managers interviewed, only half were organizing training sessions, and 37.5% were involved in supervision of the program activities at the periphery level. Among the program managers who were involved with leprosy elimination, only half were organizing training session and 37.5% were involved in supervision of the program activities at the periphery level. Medical officers consistently demonstrated higher knowledge about leprosy, followed by health supervisors and multipurpose workers (MPWs, including nursing staff. Regarding training status with regard to leprosy, 90% of medical officers, 80% of health supervisors and around 87% of MPWs (83% of male MPWs and 89% of female MPWs had attended training programs on leprosy. Regarding WHO MDT, 80% of health supervisors, 84.8% of male MPWs and 86.2% of female MPWs had an idea of MDT and treatment duration of various categories of patients. Conclusions: These observations suggest that there appear to be adequate knowledge and positive behavior among healthcare providers with regard to leprosy in this part of India. However, there is still a need to organize training programs at regular intervals to train new recruits, as well as reinforce and update the knowledge of those already trained.

  2. Diagnostic imaging, a 'parallel' discipline. Can current technology provide a reliable digital diagnostic radiology department

    International Nuclear Information System (INIS)

    Moore, C.J.; Eddleston, B.

    1985-01-01

    Only recently has any detailed criticism been voiced about the practicalities of the introduction of generalised, digital, imaging complexes in diagnostic radiology. Although attendant technological problems are highlighted the authors argue that the fundamental causes of current difficulties are not in the generation but in the processing, filing and subsequent retrieval for display of digital image records. In the real world, looking at images is a parallel process of some complexity and so it is perhaps untimely to expect versatile handling of vast image data bases by existing computer hardware and software which, by their current nature, perform tasks serially. (author)

  3. Current attitudes and practices of obesity counselling by health care providers.

    Science.gov (United States)

    Petrin, Christine; Kahan, Scott; Turner, Monique; Gallagher, Christine; Dietz, William H

    Relatively few patients receive obesity counselling consistent with the USPSTF guidelines, and many health care professionals (HCPs) are biased in their attitudes towards obesity management. A national sample of family physicians, internists, OB/GYN physicians, and nurse practitioners (NPs) completed a web-based survey of beliefs, practice, and knowledge regarding obesity management. A majority of HCPs believe that it is both the patient's and the provider's responsibility to ensure that the patient is counselled about obesity. Obesity (77%), obesity-related diseases (79%), or obesity-related risk factors (71%) prompt HCPs to offer obesity counselling; 59% of HCPs wait for the patient to broach the subject of their weight. Increased blood pressure (89%) and heart disease risks (90%) are the most common themes in counselling. Across all HCPs except NPs "exercise" is discussed more frequently than "physical activity" (85% vs 81%), "diet" more frequently than "eating habits" (77% vs 75%), and "obesity" more frequently than "unhealthy weight" (60% vs 45%). NPs are more likely to discuss physical activity, eating habits, and unhealthy weight instead. To improve counselling for obesity, HCPs reported needing more time (70%), training in obesity management (53%), improved reimbursement (53%), and better tools to help patients recognise obesity risks (50%). Obesity-related diseases, risk factors, or obesity alone predict obesity counselling amongst HCPs. Better training in weight management and tools to help patients recognise risks appear to be key elements in helping patients compare the risks of what they may consider invasive therapy against the risks of continued obesity. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  4. Revisiting Peruvian anchovy ( Engraulis ringens) trophodynamics provides a new vision of the Humboldt Current system

    Science.gov (United States)

    Espinoza, Pepe; Bertrand, Arnaud

    2008-10-01

    The Peruvian anchovy or anchoveta ( Engraulis ringens) forages on plankton and is a main prey for marine mammals, seabirds, fish, and fishers, and is therefore a key element of the food web in the Humboldt Current system (HCS). Here, we present results from the analysis of 21,203 anchoveta stomach contents sampled during 23 acoustic surveys over the period 1996-2003. Prey items were identified to the genus level, and the relative dietary importance of different prey was assessed by determination of their carbon content. Variability in stomach fullness was examined relative to the diel cycle, the distance from the coast, sea surface temperature, and latitude, using generalized additive models (GAMs). Whereas phytoplankton largely dominated anchoveta diets in terms of numerical abundance and comprised >99% of ingested prey items, the carbon content of prey items indicated that zooplankton was by far the most important dietary component, with euphausiids contributing 67.5% of dietary carbon followed by copepods (26.3%). Stomach fullness data showed that anchoveta feed mainly during daytime between 07h00 and 18h00, although night-time feeding also made a substantial contribution to total food consumption. Stomach fullness also varied with latitude, distance from the coast, and temperature, but with substantial variability indicating a high degree of plasticity in anchoveta feeding behaviour. The results suggest an ecological role for anchoveta that challenges current understanding of its position in the foodweb, the functioning of the HCS, and trophic models of the HCS.

  5. Modelling catchment areas for secondary care providers: a case study.

    Science.gov (United States)

    Jones, Simon; Wardlaw, Jessica; Crouch, Susan; Carolan, Michelle

    2011-09-01

    Hospitals need to understand patient flows in an increasingly competitive health economy. New initiatives like Patient Choice and the Darzi Review further increase this demand. Essential to understanding patient flows are demographic and geographic profiles of health care service providers, known as 'catchment areas' and 'catchment populations'. This information helps Primary Care Trusts (PCTs) to review how their populations are accessing services, measure inequalities and commission services; likewise it assists Secondary Care Providers (SCPs) to measure and assess potential gains in market share, redesign services, evaluate admission thresholds and plan financial budgets. Unlike PCTs, SCPs do not operate within fixed geographic boundaries. Traditionally, SCPs have used administrative boundaries or arbitrary drive times to model catchment areas. Neither approach satisfactorily represents current patient flows. Furthermore, these techniques are time-consuming and can be challenging for healthcare managers to exploit. This paper presents three different approaches to define catchment areas, each more detailed than the previous method. The first approach 'First Past the Post' defines catchment areas by allocating a dominant SCP to each Census Output Area (OA). The SCP with the highest proportion of activity within each OA is considered the dominant SCP. The second approach 'Proportional Flow' allocates activity proportionally to each OA. This approach allows for cross-boundary flows to be captured in a catchment area. The third and final approach uses a gravity model to define a catchment area, which incorporates drive or travel time into the analysis. Comparing approaches helps healthcare providers to understand whether using more traditional and simplistic approaches to define catchment areas and populations achieves the same or similar results as complex mathematical modelling. This paper has demonstrated, using a case study of Manchester, that when estimating

  6. Current and future funding sources for specialty mental health and substance abuse treatment providers.

    Science.gov (United States)

    Levit, Katharine R; Stranges, Elizabeth; Coffey, Rosanna M; Kassed, Cheryl; Mark, Tami L; Buck, Jeffrey A; Vandivort-Warren, Rita

    2013-06-01

    Goals were to describe funding for specialty behavioral health providers in 1986 and 2005 and examine how the recession, parity law, and Affordable Care Act (ACA) may affect future funding. Numerous public data sets and actuarial methods were used to estimate spending for services from specialty behavioral health providers (general hospital specialty units; specialty hospitals; psychiatrists; other behavioral health professionals; and specialty mental health and substance abuse treatment centers). Between 1986 and 2005, hospitals-which had received the largest share of behavioral health spending-declined in importance, and spending shares trended away from specialty hospitals that were largely funded by state and local governments. Hospitals' share of funding from private insurance decreased from 25% in 1986 to 12% in 2005, and the Medicaid share increased from 11% to 23%. Office-based specialty providers continued to be largely dependent on private insurance and out-of-pocket payments, with psychiatrists receiving increased Medicaid funding. Specialty centers received increased funding shares from Medicaid (from 11% to 29%), and shares from other state and local government sources fell (from 64% to 46%). With ACA's full implementation, spending on behavioral health will likely increase under private insurance and Medicaid. Parity in private plans will also push a larger share of payments for office-based professionals from out-of-pocket payments to private insurance. As ACA provides insurance for formerly uninsured individuals, funding by state behavioral health authorities of center-based treatment will likely refocus on recovery and support services. Federal Medicaid rules will increase in importance as more people needing behavioral health treatment become covered.

  7. Testing Solutions of the Protection Systems Provided with Delay Maximum Current Relays

    Directory of Open Access Journals (Sweden)

    Horia BALAN

    2017-12-01

    Full Text Available Relay protection is one of the main forms of automation control of electro energy systems, having as primary aims fault detection and disconnection of the faulty element in order to avoid the extent of damages and the as fast as possible recovery to the normal operation regime for the rest of the system. Faults that occur in the electro energy system can be classified considering on one hand their causes and on the other their types, but in the vast majority of cases the causes of the faults are combined. Further, considering their nature, faults are classified in faults due to the insulation’s damage, in faults due to the destruction of the integrity of the circuits and faults determined by interruptions. With respect to their nature, faults are short circuits, earthing faults and phases interruptions. At the same time, considering their type, faults are divided in transversal and longitudinal ones. The paper presents a testing solution of the delayed maximal current relays using a T3000 ISA Test measuring equipment.

  8. S'COOL Provides Research Opportunities and Current Data for Today's Technological Classroom

    Science.gov (United States)

    Green, Carolyn J.; Chambers, Lin H.; Racel, Anne M.

    1999-01-01

    NASA's Students' Cloud Observations On-Line (S'COOL) project, a hands-on educational project, was an innovative idea conceived by the scientists in the Radiation Sciences Branch at NASA Langley Research Center, Hampton, Virginia, in 1996. It came about after a local teacher expressed the idea that she wanted her students to be involved in real-life science. S'COOL supports NASA's Clouds and the Earth's Radiant Energy System (CERES) instrument, which was launched on the Tropical Rainforest Measuring Mission (TRMM) in November, 1997, as part of NASA's Earth Science Enterprise. With the S'COOL project students observe clouds and related weather conditions, compute data and note vital information while obtaining ground truth observations for the CERES instrument. The observations can then be used to help validate the CERES measurements, particularly detection of clear sky from space. In addition to meeting math, science and geography standards, students are engaged in using the computer to obtain, report and analyze current data, thus bringing modern technology into the realm of classroom, a paradigm that demands our attention.

  9. A multi-channel stimulator and electrode array providing a rotating current whirlpool for electrical stimulation of wounds.

    Science.gov (United States)

    Petrofsky, J; Suh, H J; Fish, A; Hernandez, V; Abdo, A; Collins, K; Mendoza, E; Yang, T-N

    2008-01-01

    When electrical stimulation is used on wounds, the electrical current has difficulty penetrating areas where there is necrotic tissue. Further, for an irregularly shaped wound, current distribution is poor in some areas of the wound since conventional two-electrode delivery systems provide the greatest current in a line directly between the electrodes. A new stimulator and electrode system is described which uses three electrodes spaced around a wound to disperse current more evenly. The stimulator senses tissue impedance and then redirects current by altering its Thevenin's output impedance for each electrode; each of the three electrodes becomes the active one in sequence while the remaining are the sink electrodes. Eight subjects were examined to test the stimulator. Electrical stimulation was applied to the skin above the quadriceps muscle at currents of 15 mA in six subjects without wounds and in two subjects with wounds. The relationship between electrode position and current dispersion on the skin was examined with a two-electrode vs. a three-electrode system to set stimulation parameters for the computer. The results showed that the three-electrode system could (1) detect areas of the skin with high impedance; (2) compensate by altering the Thevenin's output impedance at each of the three electrodes to shift current to high impedance areas; (3) provide uniform current across the skin as assessed by skin current and blood flow measurements with a laser Doppler flow imager.

  10. Current status of system development to provide databases of nuclides migration

    International Nuclear Information System (INIS)

    Sasamoto, Hiroshi; Yoshida, Yasushi; Isogai, Takeshi; Suyama, Tadahiro; Shibata, Masahiro; Yui, Mikazu; Jintoku, Takashi

    2005-01-01

    JNC has developed databases of nuclides migration for safety assessment of high-level radioactive waste (HLW) repository, and they have been used in the second progress report to present the technical reliability of HLW geological disposal system in Japan. The technical level and applicability of databases have been highly evaluated even overseas. To provide the databases broadly over the world and to promote the use of the databases, we have performed the followings: 1) development of tools to convert the database format from geochemical code PHREEQE to PHREEQC, GWB and EQ3/6 and 2) set up a web site (http://migrationdb.jnc.go.jp) which enables the public to access to the databases. As a result, the number of database users has significantly increased. Additionally, a number of useful comments from the users can be applied to modification and/or update of databases. (author)

  11. Current Practices for Providing School Field Trip Meals: Perspectives of School Nutrition Managers and Teachers

    Science.gov (United States)

    Sneed, Jeannie; Vaterlaus Patten, Emily

    2015-01-01

    Purpose/Objectives: The Healthy, Hunger Free Kids Act of 2010 extended the requirements for a school food safety program to wherever food is stored, prepared, or served, including meals for field trips. The purpose of this study was to determine what foods are used for field trip meals, how those foods are transported and stored, and what standard…

  12. The ENIQ pilot study: current status

    Energy Technology Data Exchange (ETDEWEB)

    Lemaitre, P; Eriksen, B; Crutzen, S [European Commission, DG Joint Research Centre, Petten (Netherlands); Hansch, M [Preussische Elektrizitaets-AG (Preussenelektra), Hannover (Germany); Whittle, J [AEA Technology, Warrington (United Kingdom)

    1998-11-01

    A pilot study is currently being carried out by ENIQ (European Network for Inspection Qualification) in order to explore the issues involved in inspection qualification applied along the general principles of the European methodology. The components selected for the pilot study are austenitic pipe to pipe and pipe to elbows welds typical of those in BWR recirculation loops. A range of defect parameters has been defined. A suitable inspection procedure designed to find the designated defects will be applied to geometrically representative test pieces. The procedure/equipment will be qualified through open trials and technical justification. The personnel qualification will be done in a blind way. Once all features of the inspection system will have been qualified an in-service inspection will be simulated in order to test the feasibility of the qualification approach followed. In this paper the current status of this pilot study is discussed. (orig.)

  13. A review of competencies developed for disaster healthcare providers: limitations of current processes and applicability.

    Science.gov (United States)

    Daily, Elaine; Padjen, Patricia; Birnbaum, Marvin

    2010-01-01

    In order to prepare the healthcare system and healthcare personnel to meet the health needs of populations affected by disasters, educational programs have been developed by numerous academic institutions, hospitals, professional organizations, governments, and non-government organizations. Lacking standards for best practices as a foundation, many organizations and institutions have developed "core competencies" that they consider essential knowledge and skills for disaster healthcare personnel. The Nursing Section of the World Association for Disaster and Emergency Medicine (WADEM) considered the possibility of endorsing an existing set of competencies that could be used to prepare nurses universally to participate in disaster health activities. This study was undertaken for the purpose of reviewing published disaster health competencies to determine commonalities and universal applicability for disaster preparedness. In 2007, a review of the electronic literature databases was conducted using the major keywords: disaster response competencies; disaster preparedness competencies; emergency response competencies; disaster planning competencies; emergency planning competencies; public health emergency preparedness competencies; disaster nursing competencies; and disaster nursing education competencies. A manual search of references and selected literature from public and private sources also was conducted. Inclusion criteria included: English language; competencies listed or specifically referred to; competencies relevant to disaster, mass-casualty incident (MCI), or public health emergency; and competencies relevant to healthcare. Eighty-six articles were identified; 20 articles failed to meet the initial inclusion criteria; 27 articles did not meet the additional criteria, leaving 39 articles for analysis. Twenty-eight articles described competencies targeted to a specific profession/discipline, while 10 articles described competencies targeted to a defined role

  14. Multiscale Study of Currents Affected by Topography

    Science.gov (United States)

    2015-09-30

    1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Multiscale Study of Currents Affected by Topography ...the effects of topography on the ocean general and regional circulation with a focus on the wide range of scales of interactions. The small-scale...details of the topography and the waves, eddies, drag, and turbulence it generates (at spatial scales ranging from meters to mesoscale) interact in the

  15. The state of multiple sclerosis: current insight into the patient/health care provider relationship, treatment challenges, and satisfaction

    Directory of Open Access Journals (Sweden)

    Tintoré M

    2016-12-01

    . Top challenges identified by patients in managing their DMT were cost, side effects/tolerability of treatment, and uncertainty if treatment was working. Half of the patients reported skipping doses, but only 68% told their health care provider that they did so. Conclusion: Several important differences in perception were identified between patients and neurologists concerning treatment selection, satisfaction, expectations, goals, and comfort discussing symptoms, as well as treatment challenges and skipped doses. The study results emphasize that patient/neurologist communication and patient input into the treatment decision-making process likely influence patient satisfaction with treatment. Keywords: health care provider survey, multiple sclerosis, patient-health care provider relationship, patient survey, treatment expectations, treatment satisfaction

  16. The state of multiple sclerosis: current insight into the patient/health care provider relationship, treatment challenges, and satisfaction

    Science.gov (United States)

    Tintoré, Mar; Alexander, Maggie; Costello, Kathleen; Duddy, Martin; Jones, David E; Law, Nancy; O’Neill, Gilmore; Uccelli, Antonio; Weissert, Robert; Wray, Sibyl

    2017-01-01

    Background Managing multiple sclerosis (MS) treatment presents challenges for both patients and health care professionals. Effective communication between patients with MS and their neurologist is important for improving clinical outcomes and quality of life. Methods A closed-ended online market research survey was used to assess the current state of MS care from the perspective of both patients with MS (≥18 years of age) and neurologists who treat MS from Europe and the US and to gain insight into perceptions of treatment expectations/goals, treatment decisions, treatment challenges, communication, and satisfaction with care, based on current clinical practice. Results A total of 900 neurologists and 982 patients completed the survey, of whom 46% self-identified as having remitting-relapsing MS, 29% secondary progressive MS, and 11% primary progressive MS. Overall, patients felt satisfied with their disease-modifying therapy (DMT); satisfaction related to comfort in speaking with their neurologist and participation in their DMT decision-making process. Patients who self-identified as having relapsing-remitting MS were more likely to be very satisfied with their treatment. Top challenges identified by patients in managing their DMT were cost, side effects/tolerability of treatment, and uncertainty if treatment was working. Half of the patients reported skipping doses, but only 68% told their health care provider that they did so. Conclusion Several important differences in perception were identified between patients and neurologists concerning treatment selection, satisfaction, expectations, goals, and comfort discussing symptoms, as well as treatment challenges and skipped doses. The study results emphasize that patient/neurologist communication and patient input into the treatment decision-making process likely influence patient satisfaction with treatment. PMID:28053511

  17. The state of multiple sclerosis: current insight into the patient/health care provider relationship, treatment challenges, and satisfaction.

    Science.gov (United States)

    Tintoré, Mar; Alexander, Maggie; Costello, Kathleen; Duddy, Martin; Jones, David E; Law, Nancy; O'Neill, Gilmore; Uccelli, Antonio; Weissert, Robert; Wray, Sibyl

    2017-01-01

    Managing multiple sclerosis (MS) treatment presents challenges for both patients and health care professionals. Effective communication between patients with MS and their neurologist is important for improving clinical outcomes and quality of life. A closed-ended online market research survey was used to assess the current state of MS care from the perspective of both patients with MS (≥18 years of age) and neurologists who treat MS from Europe and the US and to gain insight into perceptions of treatment expectations/goals, treatment decisions, treatment challenges, communication, and satisfaction with care, based on current clinical practice. A total of 900 neurologists and 982 patients completed the survey, of whom 46% self-identified as having remitting-relapsing MS, 29% secondary progressive MS, and 11% primary progressive MS. Overall, patients felt satisfied with their disease-modifying therapy (DMT); satisfaction related to comfort in speaking with their neurologist and participation in their DMT decision-making process. Patients who self-identified as having relapsing-remitting MS were more likely to be very satisfied with their treatment. Top challenges identified by patients in managing their DMT were cost, side effects/tolerability of treatment, and uncertainty if treatment was working. Half of the patients reported skipping doses, but only 68% told their health care provider that they did so. Several important differences in perception were identified between patients and neurologists concerning treatment selection, satisfaction, expectations, goals, and comfort discussing symptoms, as well as treatment challenges and skipped doses. The study results emphasize that patient/neurologist communication and patient input into the treatment decision-making process likely influence patient satisfaction with treatment.

  18. Effective factors in providing holistic care: a qualitative study.

    Science.gov (United States)

    Zamanzadeh, Vahid; Jasemi, Madineh; Valizadeh, Leila; Keogh, Brian; Taleghani, Fariba

    2015-01-01

    Holistic care is a comprehensive model of caring. Previous studies have shown that most nurses do not apply this method. Examining the effective factors in nurses' provision of holistic care can help with enhancing it. Studying these factors from the point of view of nurses will generate real and meaningful concepts and can help to extend this method of caring. A qualitative study was used to identify effective factors in holistic care provision. Data gathered by interviewing 14 nurses from university hospitals in Iran were analyzed with a conventional qualitative content analysis method and by using MAXQDA (professional software for qualitative and mixed methods data analysis) software. Analysis of data revealed three main themes as effective factors in providing holistic care: The structure of educational system, professional environment, and personality traits. Establishing appropriate educational, management systems, and promoting religiousness and encouragement will induce nurses to provide holistic care and ultimately improve the quality of their caring.

  19. Measuring Physical Inactivity: Do Current Measures Provide an Accurate View of “Sedentary” Video Game Time?

    Directory of Open Access Journals (Sweden)

    Simon Fullerton

    2014-01-01

    Full Text Available Background. Measures of screen time are often used to assess sedentary behaviour. Participation in activity-based video games (exergames can contribute to estimates of screen time, as current practices of measuring it do not consider the growing evidence that playing exergames can provide light to moderate levels of physical activity. This study aimed to determine what proportion of time spent playing video games was actually spent playing exergames. Methods. Data were collected via a cross-sectional telephone survey in South Australia. Participants aged 18 years and above (n=2026 were asked about their video game habits, as well as demographic and socioeconomic factors. In cases where children were in the household, the video game habits of a randomly selected child were also questioned. Results. Overall, 31.3% of adults and 79.9% of children spend at least some time playing video games. Of these, 24.1% of adults and 42.1% of children play exergames, with these types of games accounting for a third of all time that adults spend playing video games and nearly 20% of children’s video game time. Conclusions. A substantial proportion of time that would usually be classified as “sedentary” may actually be spent participating in light to moderate physical activity.

  20. Lake Titicaca: History and current studies

    International Nuclear Information System (INIS)

    Paredes Riveros, M.A.; Gonfiantini, R.

    1999-01-01

    This article summarizes results of Titicaca lake water balance studies including the findings of the IAEA Technical Cooperation Project RLA/08/022. Direct precipitation over the lake accounts for about 55% of the water inflow and rivers and streams provide about 45% of the water inflow. Diffuse groundwater leakage into the lake from coastal aquifers is believed to represent a negligible term of water balance. Evaporation from the lake is strong and accounts for more than 95% of the water losses. The isotopic and chemical composition data obtained within the frameworks of the IAEA Technical Cooperation Project RLA/08/022 are discussed

  1. Lake Titicaca: History and current studies

    Energy Technology Data Exchange (ETDEWEB)

    Paredes Riveros, M A [PELT, Puno (Peru); Gonfiantini, R [Istituto di Geocronologia e Geochimica Isotopica del CNR, Pisa (Italy)

    1999-12-01

    This article summarizes results of Titicaca lake water balance studies including the findings of the IAEA Technical Cooperation Project RLA/08/022. Direct precipitation over the lake accounts for about 55% of the water inflow and rivers and streams provide about 45% of the water inflow. Diffuse groundwater leakage into the lake from coastal aquifers is believed to represent a negligible term of water balance. Evaporation from the lake is strong and accounts for more than 95% of the water losses. The isotopic and chemical composition data obtained within the frameworks of the IAEA Technical Cooperation Project RLA/08/022 are discussed.

  2. Music-Evoked Emotions—Current Studies

    Science.gov (United States)

    Schaefer, Hans-Eckhardt

    2017-01-01

    The present study is focused on a review of the current state of investigating music-evoked emotions experimentally, theoretically and with respect to their therapeutic potentials. After a concise historical overview and a schematic of the hearing mechanisms, experimental studies on music listeners and on music performers are discussed, starting with the presentation of characteristic musical stimuli and the basic features of tomographic imaging of emotional activation in the brain, such as functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), which offer high spatial resolution in the millimeter range. The progress in correlating activation imaging in the brain to the psychological understanding of music-evoked emotion is demonstrated and some prospects for future research are outlined. Research in psychoneuroendocrinology and molecular markers is reviewed in the context of music-evoked emotions and the results indicate that the research in this area should be intensified. An assessment of studies involving measuring techniques with high temporal resolution down to the 10 ms range, as, e.g., electroencephalography (EEG), event-related brain potentials (ERP), magnetoencephalography (MEG), skin conductance response (SCR), finger temperature, and goose bump development (piloerection) can yield information on the dynamics and kinetics of emotion. Genetic investigations reviewed suggest the heredity transmission of a predilection for music. Theoretical approaches to musical emotion are directed to a unified model for experimental neurological evidence and aesthetic judgment. Finally, the reports on musical therapy are briefly outlined. The study concludes with an outlook on emerging technologies and future research fields. PMID:29225563

  3. Effective factors in providing holistic care: A qualitative study

    Directory of Open Access Journals (Sweden)

    Vahid Zamanzadeh

    2015-01-01

    Full Text Available Background: Holistic care is a comprehensive model of caring. Previous studies have shown that most nurses do not apply this method. Examining the effective factors in nurses′ provision of holistic care can help with enhancing it. Studying these factors from the point of view of nurses will generate real and meaningful concepts and can help to extend this method of caring. Materials and Methods: A qualitative study was used to identify effective factors in holistic care provision. Data gathered by interviewing 14 nurses from university hospitals in Iran were analyzed with a conventional qualitative content analysis method and by using MAXQDA (professional software for qualitative and mixed methods data analysis software. Results: Analysis of data revealed three main themes as effective factors in providing holistic care: The structure of educational system, professional environment, and personality traits. Conclusion: Establishing appropriate educational, management systems, and promoting religiousness and encouragement will induce nurses to provide holistic care and ultimately improve the quality of their caring.

  4. Business Intelligence. A Presentation of the Current Lead Solutions and a Comparative Analysis of the Main Providers

    Directory of Open Access Journals (Sweden)

    Bogdan-Andrei IONESCU

    2014-09-01

    Full Text Available The aim of this paper is to synthesize the concepts behind Business Intelligence, by studying the solutions available on the market provided by the main players. We will present the software solutions already provided by them emphasizing the main advantages and benefits of each of them, but also as a comparative analysis, designed to reveal the area in which each provider is more remarkable than the others.

  5. The Current Canon in British Romantics Studies.

    Science.gov (United States)

    Linkin, Harriet Kramer

    1991-01-01

    Describes and reports on a survey of 164 U.S. universities to ascertain what is taught as the current canon of British Romantic literature. Asserts that the canon may now include Mary Shelley with the former standard six major male Romantic poets, indicating a significant emergence of a feminist perspective on British Romanticism in the classroom.…

  6. Experimental studies of coaxial plasma gun current

    International Nuclear Information System (INIS)

    Price, D.W.

    1988-01-01

    In this investigation of a coaxial plasma gun, plasma sheath currents and related behavior are examined. Plasma behavior in the gun affects gun characteristics. Plasma gun applications are determined by the plasma behavior. The AFWL PUFF capacitor bank (72 μF, 29 nH, 120 kV) drives the plasma gun using a deuterium fill gas. The gas breakdown site is isolated from the dielectric/vacuum interface in the AFWL system. Two gas values deliver gas in the system. The first delivers gas from the gun breech and the second optional valve delivers gas to the gun muzzle. Currents and voltages are measured by Rogowski coils, B probes and capacitive voltage probes. A O-D slug model is used to predict the current, inductance, gun voltage and plasma sheath velocity. The slug model assumes the sheath transits the gun with all mass in the sheath. In the snowplow mode, the plasma sheath is thin with a sharp current rise and drop. Our system operated in a transition mode between the snowplow and deflagration modes with early snowplow behavior and late deflagration behavior. Neutrons are produced in a plasma pinch at the gun muzzle, indicating snowplow behavior. The slug theory models overall gun behavior to experimental accuracy. Experimental results are compared to four theories for plasma sheath velocities: the Alfven collisionally limited model, the Rosenbluth model, the Fishbine saturated model and a single particle drift model. Experimental velocities vary from 10 5 to 10 6 m/s. Only the single particle drift and the slug model calculations are of the right magnitude (8 x 10 5 m/s). The Fishbine and the Rosenbluth models predict slower velocities (2 x 10 5 m/s). The Alfven model is not applicable to this system

  7. Providing health information to the general public: a survey of current practices in academic health sciences libraries.

    Science.gov (United States)

    Hollander, S M

    2000-01-01

    A questionnaire was mailed to 148 publicly and privately supported academic health sciences libraries affiliated with Association of American Medical Colleges (AAMC-accredited medical schools in the United States and Canada to determine level of access and services provided to the general public. For purposes of this study, "general public" was defined as nonaffiliated students or health care professionals, attorneys and other nonhealth-related professionals, patients from affiliated or other hospitals or clinics, and general consumers. One hundred five (71%) libraries responded. Results showed 98% of publicly supported libraries and 88% of privately supported libraries provided access to some or all of the general public. Publicly supported libraries saw greater numbers of public patrons, often provided more services, and were more likely to circulate materials from their collections than were privately supported libraries. A significant number of academic health sciences libraries housed a collection of consumer-oriented materials and many provided some level of document delivery service, usually for a fee. Most allowed the public to use some or all library computers. Results of this study indicated that academic health sciences libraries played a significant role in serving the information-seeking public and suggested a need to develop written policies or guidelines covering the services that will be provided to minimize the impact of this service on primary clientele.

  8. Providing health information to the general public: a survey of current practices in academic health sciences libraries*

    Science.gov (United States)

    Hollander, Sue M.

    2000-01-01

    A questionnaire was mailed to 148 publicly and privately supported academic health sciences libraries affiliated with Association of American Medical Colleges (AAMC)–accredited medical schools in the United States and Canada to determine level of access and services provided to the general public. For purposes of this study, “general public” was defined as nonaffiliated students or health care professionals, attorneys and other nonhealth-related professionals, patients from affiliated or other hospitals or clinics, and general consumers. One hundred five (71%) libraries responded. Results showed 98% of publicly supported libraries and 88% of privately supported libraries provided access to some or all of the general public. Publicly supported libraries saw greater numbers of public patrons, often provided more services, and were more likely to circulate materials from their collections than were privately supported libraries. A significant number of academic health sciences libraries housed a collection of consumer-oriented materials and many provided some level of document delivery service, usually for a fee. Most allowed the public to use some or all library computers. Results of this study indicated that academic health sciences libraries played a significant role in serving the information-seeking public and suggested a need to develop written policies or guidelines covering the services that will be provided to minimize the impact of this service on primary clientele. PMID:10658965

  9. Integrating alternative providers into managed care: a case study.

    Science.gov (United States)

    Broida, M

    1997-09-01

    Alternative medical techniques have become extremely popular, particularly in the western United States. Washington State recently enacted a law requiring certain health plans to include alternative providers on their physician panels. The author describes the efforts of one MCO to comply.

  10. Study, design and manufacture eddy current probes for industry applications

    International Nuclear Information System (INIS)

    Nguyen Phuc; Nguyen Van Thuy; Vuong Binh Duong; Do Minh Duc; Trinh Dinh Truong; Tran Trong Duc; Do Tung Khanh; Dang Quang Trung

    2016-01-01

    This study is based on the studying, designing and manufacturing of eddy current probes for industry applications. The main tasks of this study include: i) Describes the overview and classification of eddy current probes (which can be classified into three categories based on the mode of operation: absolute eddy current probe, differential eddy current probe and reflect eddy current probe); ii) Describes the three methods of probe designing and manufacturing (including experimental, analytical and numerical designs); iii) Describes the designing and manufacturing of eddy current probes for industry applications, which based on experimental and analytical methods. Based on this study, we have successfully manufactured some current probes (including absolute eddy current probe, differential eddy current probe and reflect eddy current probe) for surface and tube inspections. (author)

  11. Current status of studies on nodular corrosion

    International Nuclear Information System (INIS)

    Yasuda, Takayoshi; Kawasaki, Satoru; Echigoya, Hironori; Kinoshita, Yutaka; Kubota, Hiroyuki; Konishi, Takao; Yamanaka, Tuneyasu.

    1993-01-01

    The studies on nodular corrosion formed on the outer surface of BWR fuel cladding tubes were reviewed. Main factors affecting the corrosion behavior were material and environmental conditions and combined effect. The effects of such material conditions as fabrication process, alloy elements, texture and surface treatment and environmental factors as neutron irradiation, thermo-hydrodynamic, water chemistry, purity of the coolant and contact with foreign metals on the corrosion phenomena were surveyed. Out-of-reactor corrosion test methods and models for the corrosion mechanism were also reviewed. Suppression of the accumulated annealing temperature during tube reduction process improved the nodular corrosion resistance of Zircaloys. Improved resistance for the nodular corrosion was reported for the unirradiated Zircaloys with some additives. Detailed irradiation test under the BWR conditions is needed to confirm the trend. Concerning the environmental factors, boiling on the cladding surface due to heat flux reduces the nodular corrosion susceptibility, while oxidizing radical generated from dissolved oxygen accelerates the corrosion. Concerning corrosion mechanisms, importance of such phenomena as the depleted zone of alloying elements in zirconium matrix, reduction of H + to H 2 in oxide layer, electrochemical property of precipitates, crystallographic anisotropy of oxidation rates were revealed. (author) 59 refs

  12. Do two current canine parvovirus type 2 and 2b vaccines provide protection against the new type 2c variant?

    Science.gov (United States)

    Larson, Laurie J; Schultz, R D

    2008-01-01

    Three groups (n=9 or 10) of 12-week-old canine parvovirus type 2 (CPV-2) antibody-negative puppies were vaccinated: one group with a product containing modified-live CPV-2b (Galaxy DA2PPv; Schering-Plough Animal Health), one group with a product containing modified-live CPV-2 (Continuum DAP, Intervet), and one group (controls) with sterile saline. All puppies receiving CPV-2 and CPV-2b vaccines developed antibody as determined by the hemagglutination inhibition assay. All groups of puppies were challenged with a combination of virulent CPV-2b and CPV-2c 5 weeks after vaccination. All puppies in the CPV-2 and CPV-2b vaccinated groups were protected from disease, whereas all control group puppies developed disease and 50% died or were euthanized. This study demonstrated that the CPV-2 and CPV-2b vaccine components of the Continuum DAP and Galaxy DA2PPv products, respectively, provided protection against the CPV-2b virus and also provided complete protection against the new CPV-2c variant.

  13. Current Conceptual Challenges in the Study of Rhythm Processing Deficits

    Directory of Open Access Journals (Sweden)

    Pauline eTranchant

    2015-06-01

    Full Text Available Interest in the study of rhythm processing deficits (RPD is currently growing in the cognitive neuroscience community, as this type of investigation constitutes a powerful tool for the understanding of normal rhythm processing. Because this field is in its infancy, it still lacks a common conceptual vocabulary to facilitate effective communication between different researchers and research groups. In this commentary, we provide a brief review of recent reports of RPD through the lens of one important empirical issue: the method by which beat perception is measured, and the consequences of method selection for the researcher’s ability to specify which mechanisms are impaired in RPD. This critical reading advocates for the importance of matching measurement tools to the putative neurocognitive mechanisms under study, and reveals the need for effective and specific assessments of the different aspects of rhythm perception and synchronization.

  14. What to provide and how to provide it? : - a study on small companies' demand for audit and alternative services

    OpenAIRE

    Franzén, Liza

    2010-01-01

    The 1st of July 2010 is the statutory audit going to be abolished in Sweden. After the abolition 96 % of the limited companies do not have to conduct an audit.  This research will therefore study the small companies’ demand for audit and alternative services, and how the services shall be provided to best align with the clients’ demands. This study will be conducted with a positivistic perception of knowledge, since the aim is to explain what factors that affect the companies’ demand. With st...

  15. Comparative study on current trading system and online trading: the ...

    African Journals Online (AJOL)

    Comparative study on current trading system and online trading: the case of ... of online trading and factors affecting its feasibility of implementation in ECX. ... The study found that there is significant capacity problem with major skills gap with ...

  16. Influence of Provider Communication on Women's Delivery Expectations and Birth Experience Appraisal: A Qualitative Study.

    Science.gov (United States)

    Ledford, Christy J W; Canzona, Mollie Rose; Womack, Jasmyne J; Hodge, Joshua A

    2016-07-01

    Although current research suggests that patient-provider prenatal communication and expectation-setting affects women's outcomes, more needs to be understood about the kinds of communication experiences that shape women's expectations, the nature of expectations that women hold, and how those expectations influence their appraisal of labor and delivery. The goal of this study is to draw connections between provider communication, birth experience expectations, and birth experience appraisals. Recently delivered mothers (n=36) were recruited at a mid-Atlantic community hospital. Using a grounded theory approach, interviews were systematically analyzed to uncover how participants perceived provider communication during their prenatal care, how participants described their expectations of the birth experience, and how expectations affected appraisals of the experience. Mothers recognize providers' use of patient-centered communication in messages of empowerment, emotional support, explanation, decision making, and elicitation. Findings posit that it is the inflexibility or flexibility of expectations that may determine mothers' appraisals of the birth experience. Mothers continue to rely on providers as partners in health care. Through patient-centered communication, providers can help mothers develop flexible expectations of the birth experience, which in turn can result in positive appraisals of delivery.

  17. Health care providers' attitudes towards termination of pregnancy: A qualitative study in South Africa

    Directory of Open Access Journals (Sweden)

    Orner Phyllis

    2009-08-01

    Full Text Available Abstract Background Despite changes to the abortion legislation in South Africa in 1996, barriers to women accessing abortion services still exist including provider opposition to abortions and a shortage of trained and willing abortion care providers. The dearth of abortion providers undermines the availability of safe, legal abortion, and has serious implications for women's access to abortion services and health service planning. In South Africa, little is known about the personal and professional attitudes of individuals who are currently working in abortion service provision. Exploring the factors which determine health care providers' involvement or disengagement in abortion services may facilitate improvement in the planning and provision of future services. Methods Qualitative research methods were used to collect data. Thirty four in-depth interviews and one focus group discussion were conducted during 2006 and 2007 with health care providers who were involved in a range of abortion provision in the Western Cape Province, South Africa. Data were analysed using a thematic analysis approach. Results Complex patterns of service delivery were prevalent throughout many of the health care facilities, and fragmented levels of service provision operated in order to accommodate health care providers' willingness to be involved in different aspects of abortion provision. Related to this was the need expressed by many providers for dedicated, stand-alone abortion clinics thereby creating a more supportive environment for both clients and providers. Almost all providers were concerned about the numerous difficulties women faced in seeking an abortion and their general quality of care. An overriding concern was poor pre and post abortion counselling including contraceptive counselling and provision. Conclusion This is the first known qualitative study undertaken in South Africa exploring providers' attitudes towards abortion and adds to the body of

  18. My Daddy Takes Care of Me! Fathers as Care Providers. Current Population Reports. Household Economic Studies.

    Science.gov (United States)

    Casper, Lynne M.

    1997-01-01

    This report examines statistical data on fathers caring for their children during mothers' working hours and which types of fathers are the most likely to take care of their children. Data are taken from the Survey of Income and Program Participation, a longitudinal survey conducted at four-month intervals by the Census Bureau. Care by fathers is…

  19. Contraception Initiation in the Emergency Department: A Pilot Study on Providers' Knowledge, Attitudes, and Practices.

    Science.gov (United States)

    Liles, Iyanna; Haddad, Lisa B; Lathrop, Eva; Hankin, Abigail

    2016-05-01

    Almost half of all pregnancies in the United States are unintended; these pregnancies are associated with adverse outcomes. Many reproductive-age females seek care in the emergency department (ED), are at risk of pregnancy, and are amenable to contraceptive services in this setting. Through a pilot study, we sought to assess ED providers' current practices; attitudes; and knowledge of emergency contraception (EC) and nonemergency contraception (non-EC), as well as barriers with respect to contraception initiation. ED physicians and associate providers in Georgia were e-mailed a link to an anonymous Internet questionnaire using state professional databases and contacts. The questionnaire included Likert scales with multiple-choice questions to assess study objectives. Descriptive statistics were generated as well as univariate analyses using χ(2) and Fisher exact tests. A total of 1232 providers were e-mailed, with 119 questionnaires completed. Participants were predominantly physicians (80%), men (59%), and individuals younger than 45 years (59%). Common practices were referrals (96%), EC prescriptions (77%), and non-EC prescriptions (40%). Common barriers were perceived as low likelihood for follow-up (63%), risk of complications (58%), and adverse effects (51%). More than 70% of participants correctly identified the highly effective contraceptive methods, 3% identified the correct maximum EC initiation time, and 42% correctly recognized pregnancy as a higher risk than hormonal contraception use for pulmonary embolism. Most ED providers in this pilot study referred patients for contraception; however, there was no universal contraceptive counseling and management. Many ED providers in this study had an incorrect understanding of the efficacy, risks, and eligibility associated with contraceptive methods. This lack of understanding may affect patient access and be a barrier to patient care.

  20. Crane RF accelerator for high current radiation damage studies

    International Nuclear Information System (INIS)

    Whitham, K.; Anamkath, H.; Evans, K.; Lyons, S.; Palmer, D.; Miller, R.; Treas, P.; Zante, T.

    1992-01-01

    An electron accelerator was designed and built for the Naval Weapons Support Center for transient radiation effects on electronics experiments and testing. The Crane L Band RF Electron Linac was designed to provide high currents over a wide range of pulse widths and energies. The energy extends to 60 MeV and pulse widths vary from a few ns to 10 μsec. Beam currents range from 20 amps in the short pulse case to 1.5 amps in the long pulse case. This paper describes the linac, its architecture, the e-gun and pulser, waveguides, klystrons and modulator, vacuum system, beam transport, and control systems. fig., tab

  1. Study of runaway current generation following disruptions in KSTAR

    International Nuclear Information System (INIS)

    Chen, Z Y; Kim, W C; Yu, Y W; England, A C; Yoo, J W; Hahn, S H; Yoon, S W; Lee, K D; Oh, Y K; Kwak, J G; Kwon, M

    2013-01-01

    The high fraction of runaway current conversion following disruptions has an important effect on the first wall for next-generation tokamaks. Because of the potentially severe consequences of a large full current runaway beam on the first wall in an unmitigated disruption, runaway suppression is given a high priority. The behavior of runaway currents both in spontaneous disruptions and in D 2 massive gas injection (MGI) shutdown experiments is investigated in the KSTAR tokamak. The experiments in KSTAR show that the toroidal magnetic field threshold, B T >2 T, for runaway generation is not absolute. A high fraction of runaway current conversion following spontaneous disruptions is observed at a much lower toroidal magnetic field of B T = 1.3 T. A dedicated fast valve for high-pressure gas injection with 39.7 bar is developed for the study of disruptions. A study of runaway current parameters shows that the conversion efficiency of pre-disruptive plasma currents into runaway current can reach over 80% both in spontaneous disruptions and in D 2 MGI shutdown experiments in KSTAR. (paper)

  2. A study of inclusive charged current neutrino interactions in deuterium

    International Nuclear Information System (INIS)

    Visser, C.P.

    1986-01-01

    In this thesis the results of an analysis of inclusive neutrino and antineutrino interaction on deuterium nuclei are presented. The use of deuterium as a target provides a mean to study proton and neutron scattering separately. The presently accepted theory of electro-weak interactions is reviewed. Applications of the quark-parton model in the context of deep-inelastic neutrino interactions on nucleons are summarized. The concept of scaling and its consequences are treated, together with some sources of violation of scaling. The properties of the CERN wide-band neutrino beam and an overview of the elements of this beam are given. The method to determine the energy distribution and the composition of the neutrino and antineutrino beam is described. The technique employed to separate neutrino interactions on protons and neutrons is discussed. Results of the measurement of the total nucleon charged-current cross-sections and differential cross-sections are presented. The relative contributions of quarks and antiquarks to the neutrino cross-sections are deduced from y-distributions and compared to those obtained from the total cross-section measurements. Finally, the analysis of the structure functions is given. (Auth.)

  3. Exploring family physicians' reasons to continue or discontinue providing intrapartum care: Qualitative descriptive study.

    Science.gov (United States)

    Dove, Marion; Dogba, Maman Joyce; Rodríguez, Charo

    2017-08-01

    To examine the reasons why family physicians continue or discontinue providing intrapartum care in their clinical practice. Qualitative descriptive study. Two hospitals located in a multicultural area of Montreal, Que, in November 2011 to June 2012. Sixteen family physicians who were current or former providers of obstetric care. Data were collected using semistructured qualitative interviews. Thematic analysis was used to analyze the interview transcripts. Three overarching themes that help create understanding of why family doctors continue to provide obstetric care were identified: their attraction, often initiated by role models early in their careers, to practising complete continuity of care and accompanying patients in a special moment in their lives; the personal, family, and organizational pressures experienced while pursuing a family medicine career that includes obstetrics; and their ongoing reflection about continuing to practise obstetrics. The practice of obstetrics was very attractive to family physician participants whether they provided intrapartum care or decided to stop. More professional support and incentives might help keep family doctors practising obstetrics. Copyright© the College of Family Physicians of Canada.

  4. A Study on Librarian Service Providers' Awareness and Perceptions of Library Services for the Disabled

    Directory of Open Access Journals (Sweden)

    Younghee Noh

    2011-12-01

    Full Text Available The purpose of this study is to improve library promotional marketing for the disabled by identifying requirements of public library disability services. This study aimed to investigate librarian service providers' awareness of library programs for the disabled in order to prepare a systematic plan for promoting such library services. Research methods used are a literature analysis and survey. First, the ratio of respondents with experience promoting activities and services for the disabled was less than 50%. Second, regarding methods for promoting library disability services, the respondents used library homepages, press releases, library user guides, library newsletters, and library pamphlets in that order. Third, when asked what kind of PR media the library disability service providers had experience with and how often they use it, library boards and banners were the most common response. Fourth, suggested improvements to the current design and content of PR materials included: clearer word choice (or greater understandability, more detailed descriptions, simpler layouts, and more interesting or eye-catching content in that order. Fifth, the library disability services which are in the most need of public relations were guide information for library disability services, Library and Information Service (DOI services and search services, using alternative materials and the library collection, and aiding the information search. Overall, when evaluating the promotion of disability services in Korea, the library's public relations for disabled services needs to improve because currently neither librarians nor the disabled community they are targeting has frequent or quality experience with it. Thus, the policy department for the library disability services must develop a variety of promotional strategies adjusted for each type of the disability and distribute PR materials to service providers individually, making sure to utilize effective PR

  5. Current status of studies on temperature fluctuation phenomena in LMFRs

    International Nuclear Information System (INIS)

    Ohshima, H.; Muramatsu, T.; Kobayashi, J.; Yamaguchi, A.

    1994-01-01

    This paper describes the current status of studies being performed in PNC on temperature fluctuation phenomena occurring in fast reactors. The studies concentrate on four problems: thermal stratification, thermal striping, core-plenum interaction and free surface sloshing. Both experimental and analytical approaches to reveal these phenomena and to establish design and safety evaluation methods are presented together with future works. (author)

  6. Numerical study of gravity currents in a channel

    International Nuclear Information System (INIS)

    Wang, D.

    1985-01-01

    A three-dimensional, primitive-equation model was used to study gravity currents produced by instantaneous releases of a buoyant fluid in a rectangular channel. Without rotation, the gravity current passes through two distinct phases: an initial adjustment phase in which the front speed is constant, and an eventual self-similar phase in which the front speed decreases with time. With rotation, the gravity current is confined to the right-hand wall, forming a coastal jet. The initial front-speed is constant; however, the front speed decreases rapidly due to strong mixing at the horizontal edge of the gravity current. Also, with rotation, part of the buoyant fluid is trapped near the source region, forming an anticyclonic vortex

  7. Study of the Weak Charged Hadronic Current in b Decays

    CERN Document Server

    Acciarri, M; Aguilar-Benítez, M; Ahlen, S P; Alpat, B; Alcaraz, J; Alemanni, G; Allaby, James V; Aloisio, A; Alverson, G; Alviggi, M G; Ambrosi, G; Anderhub, H; Andreev, V P; Angelescu, T; Anselmo, F; Antreasyan, D; Arefev, A; Azemoon, T; Aziz, T; Bagnaia, P; Baksay, L; Ball, R C; Banerjee, S; Banicz, K; Barillère, R; Barone, L; Bartalini, P; Baschirotto, A; Basile, M; Battiston, R; Bay, A; Becattini, F; Becker, U; Behner, F; Berdugo, J; Berges, P; Bertucci, B; Betev, B L; Bhattacharya, S; Biasini, M; Biland, A; Bilei, G M; Blaising, J J; Blyth, S C; Bobbink, Gerjan J; Böck, R K; Böhm, A; Borgia, B; Boucham, A; Bourilkov, D; Bourquin, Maurice; Boutigny, D; Branson, J G; Brigljevic, V; Brock, I C; Buffini, A; Buijs, A; Burger, J D; Burger, W J; Busenitz, J K; Buytenhuijs, A O; Cai, X D; Campanelli, M; Capell, M; Cara Romeo, G; Caria, M; Carlino, G; Cartacci, A M; Casaus, J; Castellini, G; Cavallari, F; Cavallo, N; Cecchi, C; Cerrada-Canales, M; Cesaroni, F; Chamizo-Llatas, M; Chan, A; Chang, Y H; Chaturvedi, U K; Chemarin, M; Chen, A; Chen, G; Chen, G M; Chen, H F; Chen, H S; Chen, M; Chiefari, G; Chien, C Y; Choi, M T; Cifarelli, Luisa; Cindolo, F; Civinini, C; Clare, I; Clare, R; Cohn, H O; Coignet, G; Colijn, A P; Colino, N; Commichau, V; Costantini, S; Cotorobai, F; de la Cruz, B; Csilling, Akos; Dai, T S; D'Alessandro, R; De Asmundis, R; De Boeck, H; Degré, A; Deiters, K; Denes, P; De Notaristefani, F; DiBitonto, Daryl; Diemoz, M; Van Dierendonck, D N; Di Lodovico, F; Dionisi, C; Dittmar, Michael; Dominguez, A; Doria, A; Dorne, I; Dova, M T; Drago, E; Duchesneau, D; Duinker, P; Durán, I; Dutta, S; Easo, S; Efremenko, Yu V; El-Mamouni, H; Engler, A; Eppling, F J; Erné, F C; Ernenwein, J P; Extermann, Pierre; Fabre, M; Faccini, R; Falciano, S; Favara, A; Fay, J; Fedin, O; Felcini, Marta; Fenyi, B; Ferguson, T; Fernández, D; Ferroni, F; Fesefeldt, H S; Fiandrini, E; Field, J H; Filthaut, Frank; Fisher, P H; Forconi, G; Fredj, L; Freudenreich, Klaus; Furetta, C; Galaktionov, Yu; Ganguli, S N; García-Abia, P; Gau, S S; Gentile, S; Gerald, J; Gheordanescu, N; Giagu, S; Goldfarb, S; Goldstein, J; Gong, Z F; Gougas, Andreas; Gratta, Giorgio; Grünewald, M W; Gupta, V K; Gurtu, A; Gutay, L J; Hartmann, B; Hasan, A; Hatzifotiadou, D; Hebbeker, T; Hervé, A; Van Hoek, W C; Hofer, H; Hoorani, H; Hou, S R; Hu, G; Innocente, Vincenzo; Janssen, H; Jenkes, K; Jin, B N; Jones, L W; de Jong, P; Josa-Mutuberria, I; Kasser, A; Khan, R A; Kamrad, D; Kamyshkov, Yu A; Kapustinsky, J S; Karyotakis, Yu; Kaur, M; Kienzle-Focacci, M N; Kim, D; Kim, J K; Kim, S C; Kim, Y G; Kinnison, W W; Kirkby, A; Kirkby, D; Kirkby, Jasper; Kiss, D; Kittel, E W; Klimentov, A; König, A C; Korolko, I; Koutsenko, V F; Krämer, R W; Krenz, W; Kuijten, H; Kunin, A; Ladrón de Guevara, P; Landi, G; Lapoint, C; Lassila-Perini, K M; Laurikainen, P; Lebeau, M; Lebedev, A; Lebrun, P; Lecomte, P; Lecoq, P; Le Coultre, P; Lee Jae Sik; Lee, K Y; Leggett, C; Le Goff, J M; Leiste, R; Leonardi, E; Levchenko, P M; Li Chuan; Lieb, E H; Lin, W T; Linde, Frank L; Lista, L; Liu, Z A; Lohmann, W; Longo, E; Lu, W; Lü, Y S; Lübelsmeyer, K; Luci, C; Luckey, D; Luminari, L; Lustermann, W; Ma Wen Gan; Maity, M; Majumder, G; Malgeri, L; Malinin, A; Maña, C; Mangla, S; Marchesini, P A; Marin, A; Martin, J P; Marzano, F; Massaro, G G G; McNally, D; Mele, S; Merola, L; Meschini, M; Metzger, W J; Von der Mey, M; Mi, Y; Mihul, A; Van Mil, A J W; Mirabelli, G; Mnich, J; Molnár, P; Monteleoni, B; Moore, R; Morganti, S; Moulik, T; Mount, R; Müller, S; Muheim, F; Nagy, E; Nahn, S; Napolitano, M; Nessi-Tedaldi, F; Newman, H; Nippe, A; Nisati, A; Nowak, H; Opitz, H; Organtini, G; Ostonen, R; Pandoulas, D; Paoletti, S; Paolucci, P; Park, H K; Pascale, G; Passaleva, G; Patricelli, S; Paul, T; Pauluzzi, M; Paus, C; Pauss, Felicitas; Peach, D; Pei, Y J; Pensotti, S; Perret-Gallix, D; Petrak, S; Pevsner, A; Piccolo, D; Pieri, M; Pinto, J C; Piroué, P A; Pistolesi, E; Plyaskin, V; Pohl, M; Pozhidaev, V; Postema, H; Produit, N; Prokofev, D; Prokofiev, D O; Rahal-Callot, G; Rancoita, P G; Rattaggi, M; Raven, G; Razis, P A; Read, K; Ren, D; Rescigno, M; Reucroft, S; Van Rhee, T; Riemann, S; Riemers, B C; Riles, K; Rind, O; Ro, S; Robohm, A; Rodin, J; Rodríguez-Calonge, F J; Roe, B P; Romero, L; Rosier-Lees, S; Rosselet, P; Van Rossum, W; Roth, S; Rubio, Juan Antonio; Rykaczewski, H; Salicio, J; Sánchez, E; Santocchia, A; Sarakinos, M E; Sarkar, S; Sassowsky, M; Sauvage, G; Schäfer, C; Shchegelskii, V; Schmidt-Kärst, S; Schmitz, D; Schmitz, P; Schneegans, M; Scholz, N; Schopper, Herwig Franz; Schotanus, D J; Schwenke, J; Schwering, G; Sciacca, C; Sciarrino, D; Sens, Johannes C; Servoli, L; Shevchenko, S; Shivarov, N; Shoutko, V; Shukla, J; Shumilov, E; Shvorob, A V; Siedenburg, T; Son, D; Sopczak, André; Soulimov, V; Smith, B; Spillantini, P; Steuer, M; Stickland, D P; Stone, H; Stoyanov, B; Strässner, A; Strauch, K; Sudhakar, K; Sultanov, G G; Sun, L Z; Susinno, G F; Suter, H; Swain, J D; Tang, X W; Tauscher, Ludwig; Taylor, L; Ting, Samuel C C; Ting, S M; Tonutti, M; Tonwar, S C; Tóth, J; Tully, C; Tuchscherer, H; Tung, K L; Uchida, Y; Ulbricht, J; Uwer, U; Valente, E; Van de Walle, R T; Vesztergombi, G; Vetlitskii, I; Viertel, Gert M; Vivargent, M; Völkert, R; Vogel, H; Vogt, H; Vorobev, I; Vorobyov, A A; Vorvolakos, A; Wadhwa, M; Wallraff, W; Wang, J C; Wang, X L; Wang, Z M; Weber, A; Wittgenstein, F; Wu, S X; Wynhoff, S; Xu, J; Xu, Z Z; Yang, B Z; Yang, C G; Yao, X Y; Ye, J B; Yeh, S C; You, J M; Zalite, A; Zalite, Yu; Zemp, P; Zeng, Y; Zhang, Z; Zhang, Z P; Zhou, B; Zhou, Y; Zhu, G Y; Zhu, R Y; Zichichi, Antonino; Ziegler, F

    1997-01-01

    Charged and neutral particle multiplicities of jets associated with identified semileptonic and hadronic b decays are studied. The observed differences between these jets are used to determine the inclusive properties of the weak charged hadronic current. The average charged particle multiplicity of the weak charged hadronic current in b decays is measured for the first time to be 2.69$\\pm$0.07(stat.)$\\pm$0.14(syst.). This result is in good agreement with the JETSET hadronization model of the weak charged hadronic current if 40$\\pm$17\\% of the produced mesons are light--flavored tensor (L=1) mesons. This level of tensor meson production is consistent with the measurement of the $\\pi^0$ multiplicity in the weak charged hadronic current in b decays. \\end{abstract}

  8. Critical current studies of a HTS rectangular coil

    Energy Technology Data Exchange (ETDEWEB)

    Zhong, Z. [Department of Engineering, University of Cambridge (United Kingdom); Chudy, M., E-mail: Michal.chudy@stuba.sk [Graduate School of Technology Management, University of Pretoria (South Africa); Institute of Power and Applied Electrical Engineering, Slovak University of Technology in Bratislava (Slovakia); Ruiz, H.S. [Department of Engineering, University of Leicester, Leicester LE1 7RH (United Kingdom); Zhang, X.; Coombs, T. [Department of Engineering, University of Cambridge (United Kingdom)

    2017-05-15

    Highlights: • Unique square pancake coil was manufactured. • Measurements in relatively high magnetic field were performed. • Different sections of the coil were characterized. • Parts of the coil which are limiting critical current were identified. - Abstract: Nowadays, superconducting high field magnets are used in numerous applications due to their superior properties. High temperature superconductors (HTS) are usually used for production of circular pancake or racetrack coils. However different geometries of HTS coils might be required for some specific applications. In this study, the HTS coil wound on a rectangular frame was fully characterized in homogeneous DC background field. The study contains measurements of critical current angular dependencies. The critical current of the entire coil and two selected strands under different magnitudes and orientations of external magnetic fields are measured. The critical regions of the coil in different angular regimes are determined. This study brings better understanding of the in- field performance of HTS coils wound on frames with right-angles.

  9. Provision of prehospital emergency medical services in Punjab, Pakistan: Case study of a public sector provider.

    Science.gov (United States)

    Sriram, Veena M; Naseer, Rizwan; Hyder, Adnan A

    2017-12-01

    The availability and quality of emergency medical services in low- and middle-income countries, including Pakistan, are extremely limited. New models for prehospital emergency medical services provision have recently emerged across multiple sectors, and research on these models is urgently needed to inform current and future emergency medical services systems in low-resource settings. The objective of this case study was to provide a comprehensive description of the organizational structure and service delivery model of a public sector provider in the Punjab Province of Pakistan, Rescue 1122, with a focus on operations in Lahore. We used case study methodology to systematically describe the organizational model of Rescue 1122. Qualitative data were collected during an in-person site visit to Lahore in June 2013. Three sources were utilized-semi-structured in-depth interviews, document review, and nonparticipant observation. Data were analyzed according to the health system "building blocks" proposed by the World Health Organization. Rescue 1122 is based on a legal framework that provides public financing for EMS, resulting in financial stability for the service. The organization has also reportedly taken positive steps in engaging with communities, and in coordinating across EMS, fire and rescue. We noted benefits and challenges in scaling up the service to all districts in Punjab. Finally, some areas of improvement include supply chain management and expanded data utilization. Our case study highlights key components of the model, areas for strengthening, and opportunities for further research. Rescue 1122 provides an example of a government-financed and operated emergency medical system in a low-resource setting. Copyright © 2017. Published by Elsevier Inc.

  10. Study of Grants, new Mexico, uranium miners: current status

    International Nuclear Information System (INIS)

    Samet, J.M.; Morgan, M.V.; Buechley, R.W.; Key, C.R.; Valdivia, A.A.

    1981-01-01

    The Uranium Epidemiology Study at the University of New Mexico was initiated in 1977 with the objective of assessing health effects of uranium mining in the Grants, New Mexico, area. The planned approach was a cohort study of mortality that would capitalize on the availability of health records at the Grants Clinic. The first year's work confirmed the study's feasibility (Buechley, 1979). Subsequent efforts have focused on the health and exposure data base and comprehensive follow-up. A retrospective cohort study of early miners is in progress; a prospective cohort study of miners who began working under the current federal standard is planned. This report will summarize the current status of the Uranium Epidemiology Study

  11. An Assistive Technology System that Provides Personalized Dressing Support for People Living with Dementia: Capability Study.

    Science.gov (United States)

    Burleson, Winslow; Lozano, Cecil; Ravishankar, Vijay; Lee, Jisoo; Mahoney, Diane

    2018-05-01

    DRESS prototype's reliability, including increasing the size of markers, minimizing garment folding or occlusions, and optimal positioning of participants with respect to the DRESS prototype. This study demonstrates the ability to detect clothing orientation and position and infer current state of dressing using a combination of sensors, intelligent software, and barcode tracking. With improvements identified by this study, the DRESS prototype has the potential to provide a viable option to provide automated dressing support to assist PWDs in maintaining their independence and privacy, while potentially providing their caregivers with the much-needed respite. ©Winslow Burleson, Cecil Lozano, Vijay Ravishankar, Jisoo Lee, Diane Mahoney. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 01.05.2018.

  12. A Systematic Review of Research Studies Examining Telehealth Privacy and Security Practices Used By Healthcare Providers

    Directory of Open Access Journals (Sweden)

    Valerie J.M. Watzlaf

    2017-11-01

    Full Text Available The objective of this systematic review was to systematically review papers in the United States that examine current practices in privacy and security when telehealth technologies are used by healthcare providers. A literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P. PubMed, CINAHL and INSPEC from 2003 – 2016 were searched and returned 25,404 papers (after duplications were removed. Inclusion and exclusion criteria were strictly followed to examine title, abstract, and full text for 21 published papers which reported on privacy and security practices used by healthcare providers using telehealth.  Data on confidentiality, integrity, privacy, informed consent, access control, availability, retention, encryption, and authentication were all searched and retrieved from the papers examined. Papers were selected by two independent reviewers, first per inclusion/exclusion criteria and, where there was disagreement, a third reviewer was consulted. The percentage of agreement and Cohen’s kappa was 99.04% and 0.7331 respectively. The papers reviewed ranged from 2004 to 2016 and included several types of telehealth specialties. Sixty-seven percent were policy type studies, and 14 percent were survey/interview studies. There were no randomized controlled trials. Based upon the results, we conclude that it is necessary to have more studies with specific information about the use of privacy and security practices when using telehealth technologies as well as studies that examine patient and provider preferences on how data is kept private and secure during and after telehealth sessions. Keywords: Computer security, Health personnel, Privacy, Systematic review, Telehealth

  13. Study program for constant current capacitor charging method

    Energy Technology Data Exchange (ETDEWEB)

    Pugh, C.

    1978-10-04

    The objective of the study program was to determine the best method of charging 20,000 to 132,000 microfarads of capacitance to 22 kVdc in 14 to 15 sec. Component costs, sizes, weights, line current graphs, copies of calculations and manufacturer's data are included.

  14. Current research projects on traffic conflicts technique studies.

    NARCIS (Netherlands)

    Hondel, M. van den & and Kraay, J.H.

    1979-01-01

    A review of current research concerning the development, evaluation and use of the traffic conflicts technique is presented. The 32 studies, selected from the IRRD data base, are listed alphabetically by names of countries and under countries by names of research organizations. The IRRD descriptions

  15. Subminiature eddy current transducers for studying boride coatings

    Science.gov (United States)

    Dmitriev, S. F.; Ishkov, A. V.; Malikov, V. N.; Sagalakov, A. M.

    2016-07-01

    Strengthening of parts and units of machines, increased reliability and longer service life is an important task of modern mechanical engineering. The main objects of study in the work were selected steel 65G and 50HGA, wear-resistant boride coatings ternary system Fe-B-Fe n B which were investigated by scanning electron microscopy and eddy-current nondestructive methods.

  16. A population-based study of associations between current posttraumatic stress symptoms and current fatigue.

    Science.gov (United States)

    Lerdal, Anners; Lee, Kathryn A; Rokne, Berit; Knudsen, Øistein; Wahl, Astrid K; Dahl, Alv A

    2010-10-01

    This study explores current experience with posttraumatic stress disorder (PTSD) symptoms and other variables (sociodemographic, mental distress, somatic morbidity, self-rated health, and quality of life [QoL]) in relation to fatigue. A representative sample of the Norwegian population (N = 3,944) was invited to participate in a mailed survey, and 1,857 (47%) returned valid responses on the questionnaire that included the Fatigue Severity Scale and the Posttraumatic Symptom Scale-10. Posttraumatic stress disorder symptoms showed a strong association with fatigue in univariate (β = .41) and multivariate analyses (β = .33). Associations between psychosocial health variables, QoL, and fatigue were confirmed. However, PTSD symptoms showed the strongest association with fatigue in the analyses. Findings need to be replicated in other population samples and in clinical samples with PTSD and fatigue.

  17. Study on current limiting characteristics of SFCL with two trigger current levels

    International Nuclear Information System (INIS)

    Lim, S.H.

    2010-01-01

    In this paper, the superconducting fault current limiter (SFCL) with two trigger current levels was suggested and its effectiveness through the analysis on the current limiting characteristics was described. The proposed SFCL, which consists of the triggering and the limiting components, can limit the fault current by generating the limiting impedance through two steps according to the amplitude of the initial fault current. In case that the fault happens, the lower initial fault current causes the only superconducting element of the triggering component to be quenched. On the other hand, the higher initial fault current makes both the superconducting elements comprising the triggering and the limiting components of the SFCL to be quenched, which contributes to the higher impedance of the SFCL. Therefore, the effective fault current limiting operation of the SFCL can be performed by generating the SFCL's impedance in proportion to the amplitude of the initial fault current. To confirm the current limiting operation of the proposed SFCL, the short-circuit tests of the SFCL according to the fault angle were carried out and its effective fault current limiting operations could be discussed.

  18. Managing the Services Supply Chain in the Department of Defense: An Empirical Study of Current Management Practices

    National Research Council Canada - National Science Library

    Apte, Aruna U; Apte, Uday M; Rendon, Rene G

    2008-01-01

    .... Specifically, we studied the current management practices in such areas as life cycle approach, project management, organization/ management structure, and training provided to services acquisition personnel...

  19. Study of noninductive current generation in a plasma

    International Nuclear Information System (INIS)

    Rax, J.M.

    1987-01-01

    Three aspects of noninductive current generation are treated: (1) The kinetic problem, i.e., coupling between current-carrying energetic electrons on the one hand, and the electromagnetic wave and thermal particles on the other. (2). The electromagnetic problem, i.e., calculation of the wave structure produced by the antennas. (3) The study of nonthermal radiation and electrical responses. Green's functions are used to solve the kinetic problem. The electron distribution function is calculated. For the electromagnetic problem of wave structure at different wave numbers, the Green's function of the Maxwell equations in an inhomogeneous, anisotropic medium which is spatially and temporally scattered was calculated. Perturbation of propagation by diffusion and conversion was studied. The calculation of nonthermal radiation and of transfer of electromagnetic wave energy into magnetic energy is derived from the two preceding problems. A method to produce fusion power quasi-continuously using two inductively and thermally coupled tokamaks is proposed [fr

  20. Study and Evaluation of Current and Future Aircraft Loaders

    Science.gov (United States)

    1986-08-01

    detonation intense Electromagnetic Pulse Eergy (DIP) is gene - rated which could seriously affect the electronic equipment. 2-105 The intense...speciality efforts, such as integrated logistics support (ILS), human factors engineering ( HFE ), and reliability, availability and m aintainability...task analyiis is outlined in detail in Appendix C: Human Fac- tors Enqineering Study and Evaluation of Current and Future Aircraft Loaders. The HFE

  1. Study on pulsed current cathodic protection in a simulated system

    Energy Technology Data Exchange (ETDEWEB)

    Yan, Milin; Li, Helin [Xi' an Jiao Tong Universitiy (China)]|[Tubular Goods Research Center of China National Petroleum Corp. (China); Qiu, Yubing; Guo, Xingpeng [Hua Zhong University of Science and Techonology (China)

    2004-07-01

    The pulsed current cathodic protection (PCCP) is a new cathodic protection (CP) technology and shows more advantages over the conventional DC cathodic protection (DCCP) in oil well casing system. However, little information about PCCP is reported. In this research, a simulated CP system was set up in a pool of 3.5 m x 2.0 m x 3.0 m size, in which the effects of the square wave pulsed current (SWPC) parameters (amplitude: IA, frequency: f, duty cycle: P), auxiliary anode distance (d) and media conductivity ({mu}) on the cathodic potential (E) distribution were studied, and the protection effects of PCCP and DCCP were compared. The results show that with increase of the square wave parameters (IA, f, P), the E distribution becomes more negative and the effects of each current parameter are relate closely to the cathode polarizing state. Only with suitable square wave parameters can the whole cathode be effectively protected. With increase of d and {mu}, the E distribution becomes more uniform. Compared with DCCP system, PCCP system has much more uniform E distribution, costs less average current, and gains much better protection effects. Further, the mechanism of PCCP was analyzed. (authors)

  2. Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study.

    Science.gov (United States)

    Penney, Lauren S; Ritenbaugh, Cheryl; DeBar, Lynn L; Elder, Charles; Deyo, Richard A

    2017-03-24

    Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues. Qualitative data were gathered to evaluate the outcomes of acupuncture and chiropractic (A/C) services for chronic musculoskeletal pain (CMP) using structured interview guides among patients with CMP (n = 90) and primary care providers (PCPs) (n = 25) purposively sampled from a managed care health care system as well as from contracted community A/C providers (n = 14). Focus groups and interviews were conducted patients with CMP with varying histories of A/C use. Plan PCPs and contracted A/C providers took part in individual interviews. All participants were asked about their experiences managing chronic pain and experience with and/or attitudes about A/C treatment. Audio recordings were transcribed and thematically coded. A summarized version of the focus group/interview guides is included in the Additional file 1. We identified four themes around opioid use: (1) attitudes toward use of opioids to manage chronic pain; (2) the limited alternative options for chronic pain management; (3) the potential of A/C care as a tool to help manage pain; and (4) the complex system around chronic pain management. Despite widespread dissatisfaction with opioid medications for pain management, many practical barriers challenged access to other options. Most of the participants' perceived A/C care as helpful for short term pain relief. We identified that problems with timing, expectations, and plan coverage limited A/C care potential for pain relief treatment. These results suggest that education about realistic expectations for chronic pain management and therapy options, as well as making A/C care more easily accessible, might lead to more

  3. Study Provides Insights into Diagnosis, Treatment of Rare Immune Disease: Autoimmmune Lymphoproliferative Syndrome ...

    Science.gov (United States)

    ... in the blood. While DNT cells are a hallmark of ALPS, scientists do not fully understand their ... higher-than-average risk of developing lymphoma, or cancer of the lymph nodes. In the current study, ...

  4. A qualitative study on feedback provided by students in nurse education.

    Science.gov (United States)

    Chan, Zenobia C Y; Stanley, David John; Meadus, Robert J; Chien, Wai Tong

    2017-08-01

    This study aims to help nurse educators/academics understand the perspectives and expectations of students providing their feedback to educators about teaching performance and subject quality. The aim of this study is to reveal students' voices regarding their feedback in nurse education in order to shed light on how the current student feedback practice may be modified. A qualitative study using focus group inquiry. Convenience sampling was adopted and participants recruited from one school of nursing in Hong Kong. A total of 66 nursing students from two pre-registration programs were recruited for seven focus group interviews: one group of Year 1 students (n=21), two groups of Year 3 students (n=27), and four groups of Final Year students (n=18). The interviews were guided by a semi-structured interview guideline and the interview narratives were processed through content analysis. The trustworthiness of this study was guaranteed through peer checking, research meetings, and an audit trail. The participants' privacy was protected throughout the study. Four core themes were discerned based on the narratives of the focus group interviews: (1) "timing of collecting feedback at more than one time point"; (2) "modify the questions being asked in collecting student feedback"; (3) "are electronic means of collecting feedback good enough?; and (4) "what will be next for student feedback?". This study is significant in the following three domains: 1) it contributed to student feedback because it examined the issue from a student's perspective; 2) it explored the timing and channels for collecting feedback from the students' point of view; and 3) it showed the preferred uses of student feedback. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  5. Relationship Between Green Logistics Tendency and Logistics Performance: A Comparative Case Study on Logistics Service Providers

    OpenAIRE

    Ayşenur DOĞRU; Cemile SOLAK FIŞKIN

    2016-01-01

    Increasing concerns related to environmental side effects of the logistics services and competition between the logistics service providers are two pressuring factors on logistics service providers. This study seeks to explore the relation between green logistics tendency and logistic performance from the perspective of logistics service providers. In order to reach this aim, two logistics service providers are investigated by comparative case study method. Findings showed the effects of g...

  6. Clinical providers' experiences with returning results from genomic sequencing: an interview study.

    Science.gov (United States)

    Wynn, Julia; Lewis, Katie; Amendola, Laura M; Bernhardt, Barbara A; Biswas, Sawona; Joshi, Manasi; McMullen, Carmit; Scollon, Sarah

    2018-05-08

    Current medical practice includes the application of genomic sequencing (GS) in clinical and research settings. Despite expanded use of this technology, the process of disclosure of genomic results to patients and research participants has not been thoroughly examined and there are no established best practices. We conducted semi-structured interviews with 21 genetic and non-genetic clinicians returning results of GS as part of the NIH funded Clinical Sequencing Exploratory Research (CSER) Consortium projects. Interviews focused on the logistics of sessions, participant/patient reactions and factors influencing them, how the sessions changed with experience, and resources and training recommended to return genomic results. The length of preparation and disclosure sessions varied depending on the type and number of results and their implications. Internal and external databases, online resources and result review meetings were used to prepare. Respondents reported that participants' reactions were variable and ranged from enthusiasm and relief to confusion and disappointment. Factors influencing reactions were types of results, expectations and health status. A recurrent challenge was managing inflated expectations about GS. Other challenges included returning multiple, unanticipated and/or uncertain results and navigating a rare diagnosis. Methods to address these challenges included traditional genetic counseling techniques and modifying practice over time in order to provide anticipatory guidance and modulate expectations. Respondents made recommendations to improve access to genomic resources and genetic referrals to prepare future providers as the uptake of GS increases in both genetic and non-genetic settings. These findings indicate that returning genomic results is similar to return of results in traditional genetic testing but is magnified by the additional complexity and potential uncertainty of the results. Managing patient expectations, initially

  7. The current situation of human resources for health in the province of Cabinda in Angola: is it a limitation to provide universal access to healthcare?

    Science.gov (United States)

    Macaia, Damas; Lapão, Luís Velez

    2017-12-28

    significant HRH management efforts contributing to this result. Whereas HRH are financed by the State General Budget, the majority of health facilities are still dependent on the Provincial Health Secretariat budget. The study provides a broader view of the current HRH situation in Cabinda Province. Geographical imbalances and other issues with impact in delivering universal access to healthcare are highlighted.

  8. Experimental study of anti-tumor activity of direct current

    International Nuclear Information System (INIS)

    Ito, Hisao; Hashimoto, Shozo

    1989-01-01

    The anti-tumor activity of direct current combined with radiation was studied. The experiments were performed with fibrosarcomas (FSA, NFSA) syngenetic to C3H mice. Direct current (0.6mA, 120min) alone was effective to reduce the tumor sizes, but could not cure the tumors. When the direct current therapy (DC therapy) was combined with radiation the DC therapy following radiation was more effective than that before radiation. Using TCD 50 assay, the DC therapy enhanced the effect of a single dose of radiation with the dose-modifying factor of 1.2. However, tumor control rates by the combination therapy were more improved at the smaller doses of radiation than at the larger ones. When the single DC therapy (0.6mA, 120min) was applied immediately after the first radiation of fractionated one the combination therapy still showed the enhanced effect. However, both DC therapy and the radiation therapy were divided in three fractions, and the DC therapy (0.6mA, 40min) was applied after each radiation. Tumor growth retardation by the combination therapy was no different from that by radiation alone. This result suggests that there might be a minimum required dose of coulombs to show the effect of the combination therapy. (author)

  9. Model-independent study of light cone current commutators

    International Nuclear Information System (INIS)

    Gautam, S.R.; Dicus, D.A.

    1974-01-01

    An attempt is made to extract information on the nature of light cone current commutators (L. C. C.) in a model independent manner. Using simple assumptions on the validity of the DGS representation for the structure functions of deep inelastic scattering and using the Bjorken--Johnston--Low theorem it is shown that in principle the L. C. C. may be constructed knowing the experimental electron--proton scattering data. On the other hand the scaling behavior of the structure functions is utilized to study the consistency of a vanishing value for various L. C. C. under mild assumptions on the behavior of the DGS spectral moments. (U.S.)

  10. Current CTR-related tritium handling studies at ORNL

    International Nuclear Information System (INIS)

    Watson, J.S.; Bell, J.T.; Clinton, S.D.; Fisher, P.W.; Redman, J.D.; Smith, F.J.; Talbot, J.B.; Tung, C.P.

    1976-01-01

    The Oak Ridge National Laboratory has a comprehensive program concerned with plasma fuel recycle, tritium recovery from blankets, and tritium containment in fusion reactors. Two studies of most current interest are investigations of cryosorption pumping of hydrogen isotopes and measurements of tritium permeation rates through steam generator materials. Cryosorption pumping speeds have been measured for hydrogen, deuterium, and helium at pressures from 10 -8 torr to 3 x 10 -3 torr. Permeation rates through Incoloy 800 have been shown to be drastically reduced when the low pressure side of permeation tubes are exposed to steam. These results will be important considerations in the design of fusion reactor steam generators

  11. Design studies on high current and grid control electron gun

    International Nuclear Information System (INIS)

    Wang Jinnan; Lu Kun; Chi Yunlong; Zhou Zusheng

    2011-01-01

    Electron gun, the source of electrons, is a kind of ultrahigh vacuum device and plays an important role in different kind of accelerators. With the irradiation accelerator demands, describes the design studies on beam optics optimization. The simulation result shows that the beam current is above 5 A with cathode voltage of 80 kV and beam emittance, gun electric field and beam waist radius meet the accelerator needs. The electron gun manufactured and installed in the test stand, the conditioning and test will be done in the near future. (authors)

  12. Autophagy in Drosophila: From Historical Studies to Current Knowledge

    Science.gov (United States)

    Mulakkal, Nitha C.; Nagy, Peter; Takats, Szabolcs; Tusco, Radu; Juhász, Gábor; Nezis, Ioannis P.

    2014-01-01

    The discovery of evolutionarily conserved Atg genes required for autophagy in yeast truly revolutionized this research field and made it possible to carry out functional studies on model organisms. Insects including Drosophila are classical and still popular models to study autophagy, starting from the 1960s. This review aims to summarize past achievements and our current knowledge about the role and regulation of autophagy in Drosophila, with an outlook to yeast and mammals. The basic mechanisms of autophagy in fruit fly cells appear to be quite similar to other eukaryotes, and the role that this lysosomal self-degradation process plays in Drosophila models of various diseases already made it possible to recognize certain aspects of human pathologies. Future studies in this complete animal hold great promise for the better understanding of such processes and may also help finding new research avenues for the treatment of disorders with misregulated autophagy. PMID:24949430

  13. Autophagy in Drosophila: From Historical Studies to Current Knowledge

    Directory of Open Access Journals (Sweden)

    Nitha C. Mulakkal

    2014-01-01

    Full Text Available The discovery of evolutionarily conserved Atg genes required for autophagy in yeast truly revolutionized this research field and made it possible to carry out functional studies on model organisms. Insects including Drosophila are classical and still popular models to study autophagy, starting from the 1960s. This review aims to summarize past achievements and our current knowledge about the role and regulation of autophagy in Drosophila, with an outlook to yeast and mammals. The basic mechanisms of autophagy in fruit fly cells appear to be quite similar to other eukaryotes, and the role that this lysosomal self-degradation process plays in Drosophila models of various diseases already made it possible to recognize certain aspects of human pathologies. Future studies in this complete animal hold great promise for the better understanding of such processes and may also help finding new research avenues for the treatment of disorders with misregulated autophagy.

  14. Current management of bronchiectasis: review and 3 case studies.

    Science.gov (United States)

    Silverman, Enid; Ebright, Linda; Kwiatkowski, Marianne; Cullina, Joanne

    2003-01-01

    Bronchiectasis is the abnormal, irreversible dilatation of diseased bronchi. Permanently dilated airways, usually in the medium-sized bronchi, are inflamed and often obstructed with thick, purulent secretions. Known causative factors include postinfection bronchial damage, postinhalation injury, hypersensitivity reactions, and congenital airway obstructive disorders. Typical symptoms include sputum overproduction, fever, pleurisy, dyspnea, and chronic cough. Diagnosis involves radiographic studies and pulmonary function testing. Treatment includes oral, aerosolized, or intravenous antibiotic therapy according to the severity of the exacerbation, and mucus clearance by means of bronchial hygiene assistive devices, chest physiotherapy, postural drainage, and high-frequency chest compression. We present a review of bronchiectasis and offer 3 case studies illustrating current management of different presentations, including use of aerosolized antibiotics for patients infected with Pseudomonas aeruginosa. Although an adjunctive program of pulmonary rehabilitation may be useful for patients with bronchiectasis, no confirming studies have been performed to date, and additional research in this area is warranted.

  15. Current Mathematical Methods Used in QSAR/QSPR Studies

    Directory of Open Access Journals (Sweden)

    Peixun Liu

    2009-04-01

    Full Text Available This paper gives an overview of the mathematical methods currently used in quantitative structure-activity/property relationship (QASR/QSPR studies. Recently, the mathematical methods applied to the regression of QASR/QSPR models are developing very fast, and new methods, such as Gene Expression Programming (GEP, Project Pursuit Regression (PPR and Local Lazy Regression (LLR have appeared on the QASR/QSPR stage. At the same time, the earlier methods, including Multiple Linear Regression (MLR, Partial Least Squares (PLS, Neural Networks (NN, Support Vector Machine (SVM and so on, are being upgraded to improve their performance in QASR/QSPR studies. These new and upgraded methods and algorithms are described in detail, and their advantages and disadvantages are evaluated and discussed, to show their application potential in QASR/QSPR studies in the future.

  16. CHALLENGES IN THE MANAGEMENT OF GLAUCOMA IN A DEVELOPING COUNTRY; A QUALITATIVE STUDY OF PROVIDERS' PERSPECTIVES.

    Science.gov (United States)

    Adekoya, B J; Adepoju, F G; Moshood, K F; Balarabe, A H

    2015-01-01

    Glaucoma management is challenging to patients as well as to the eye care providers. The study is aimed at describing the challenges faced by providers using qualitative methods. In-depth interviews were conducted with selected Ophthalmologists and resident doctors in ophthalmology at centres offering medical and surgical glaucoma services in Lagos state, Nigeria, according to established qualitative methods. This was done using semi-structured, open ended questions to explore the providers' perspective on glaucoma burden, challenges in the management, surgery for glaucoma, acceptance of glaucoma surgery by patients, and recommendations for improving glaucoma services. The discussions were recorded with the aid of a micro-cassette recorder. Familiarisation was done to identify key ideas in the data, then, the main themes and sub-themes were identified. Quotes that reflect the themes and sub-themes were then identified in the data. In-depth interviews were conducted with a total of 11 ophthalmologists and resident doctors in training. Majority were of the opinion that glaucoma is a significant burden constituting about 35% of outpatient visits. Identified patient related challenges include; late presentation, lack of glaucoma awareness, delay in referral from optometrists, and poor compliance with medications. Shortages in needed equipment were also identified. Availability, affordability and counterfeiting of drugs were the major challenges related to medical treatment. Majority of the participants agreed that surgery should be offered to the patients as soon as the diagnosis of glaucoma is made. However, continuous monitoring of the patient on medical treatment is another line of option for them in early cases; if they are convinced the patients will be compliant. Some respondents considered the current number of glaucoma surgeries as adequate, while some think otherwise. Reasons put forward for reluctance to offer glaucoma surgery include; late presentation, lack

  17. Providing Staff Training and Programming to Support People with Disabilities: An Academic Library Case Study

    Science.gov (United States)

    Brannen, Michelle H.; Milewski, Steven; Mack, Thura

    2017-01-01

    This case study explores services academic libraries provide to students with disabilities and the impact these can have on the success and experience of these students. The study focuses on staff training and outreach programming. The authors examine the academic library literature surrounding these topics, provide examples of programming…

  18. Studies on fast wave current drive in the JAERI tokamaks

    International Nuclear Information System (INIS)

    Kimura, H.; Yamamoto, T.; Fujii, T.; Kawashima, H.; Tamai, H.; Saigusa, M.; Imai, T.; Hamamatsu, K.; Fukuyama, A.

    1991-01-01

    Fast wave electron heating experiment (FWEH) on JFT-2M and JT-60 and analysis of fast wave current drive (FWCD) ability on JT-60U are presented. In the JFT-2M, absorption of fast waves have been investigated by using a phased four-loop antenna array. The absorption of the fast waves has been studied for various plasma parameters by using combination of other additional heating methods such as electron cyclotron heating (ECH) and ion cyclotron heating. It is shown that the absorption efficiency estimated from various methods well correlates with one calculated theoretically in single pass damping. Interaction of the fast waves with fast electrons in combination with ECH has been examined through the measurement of non-thermal electron cyclotron emission (ECE). The observed ECE during FWEH is well explained by the theoretical model, which indicates generation of the appreciable energetic fast electrons by the fast waves. New four-loop array antennas have been employed to improve the absorption of unidirectionally-propagating waves. Characteristics of antenna loading resistance can be reproduced by a coupling calculation code. In JT-60, FWEH experiment in combination with lower hybrid current drive was performed. Power absorption efficiency of fast wave is substantially improved in combination with LHCD of relatively low power for both phasing modes. Bulk electron heating is observed with high-k // mode and coupling with fast electron is confirmed in hard X-ray emission with low-k // mode. The results are consistent with theoretical prediction based on 1.D full wave code. Synergetic effects between FWEH and LHCD are found. Coupling calculation indicates that eight-loop antenna is favourable for keeping high directivity in the required N // -range. Current drive efficiency is calculated with 1-D full wave code including trapped particle effects and higher harmonic ion cyclotron damping

  19. Experimental study of blockage of monochromatic waves by counter currents

    NARCIS (Netherlands)

    Suastika, I.K.

    1999-01-01

    Blockage of waves by a current can occur if waves are propagating on a spatially varying opposing current in which the velocity is increasing in the wave propagation direction. The ongoing waves become shorter and steeper while they are propagating against the current. Blocking occurs at the

  20. CURRENT STUDY ON THE FUNDING SOURCES COVERAGE OF CURRENT ASSETS TO COMPANIES LISTED ON THE BUCHAREST STOCK EXCHANGE

    Directory of Open Access Journals (Sweden)

    Teodor HADA

    2014-06-01

    Full Text Available This paper presents issues about the coverage with financing sources of current assets for 64 companies listed on the Bucharest Stock Exchange. The aim of the study is to see how to calculate indicators specific to current assets and the general framework offered as whole analysis of the financing sources of current assets. The introduction of the paper presents the objective, the research methodology and the novelties brought by this study. Further on, this study shows the various views of the authors about the concept of "current assets", financing sources of current assets, the calculation of net working capital, setting the limits of the normal working capital and determining the speed of rotation. After that was done, based on the theory, a case study was performed, for companies covered in this study. Conclusions focused on determining the final data about what was detailed in the previous paragraphs.

  1. Study on classical and excess eddy currents losses of Terfenol-D

    Energy Technology Data Exchange (ETDEWEB)

    Talebian, Soheil; Hojjat, Yousef [Department of Mechanical Engineering, Tarbiat Modares University, Tehran (Iran, Islamic Republic of); Ghodsi, Mojtaba [Department of Mechanical and Industrial Engineering, Sultan Qaboos University, Muscat (Oman); Karafi, Mohammad Reza [Department of Mechanical Engineering, Tarbiat Modares University, Tehran (Iran, Islamic Republic of)

    2015-08-15

    In the present paper, classical and excess eddy currents losses of Terfenol-D are studied and effects of magnetic field frequency, peak of magnetic flux density and diameter of Terfenol-D on the eddy currents losses are investigated. To provide reliable data for the purpose of the paper, an experimental laboratory is fabricated and used to obtain major and minor hysteresis loops of Terfenol-D at different frequencies. In theoretical study, initially an analytical model based on uniform distribution of magnetic flux is developed which yields to calculation of classical eddy currents losses. Then, another eddy currents model based on non-uniform distribution of magnetic flux and nonlinear diffusion of electromagnetic fields is presented. The difference between output values of the two models is identified as excess eddy currents losses. Obtained results show that the values of excess losses are generally larger than classical losses and applying just classical model leads to wrong calculation of actual value of eddy currents losses. For the results obtained from two above models, empirical models with respect to the magnetic field frequency and the peak value of magnetic flux density are achieved which can predict the eddy currents losses precisely. To validate the empirical relations, experiments are repeated at a new frequency and values of power losses calculated from analytical equations are compared with the predicted values of the empirical models. The results point towards possibility to use the obtained empirical relations in order to calculate the classical and excess eddy currents losses of Terfenol-D at the frequencies below 200 Hz and different values of magnetic flux density. - Highlights: • Classical eddy currents loss of Terfenol-D is studied using Maxwell's laws. • Excess eddy currents loss of Terfenol-D is studied using Mayergoyz nonlinear model. • Effects of Terfenol-D geometry on the eddy currents losses are investigated. • Power

  2. Current status of thermoluminescence studies on minerals and rocks

    International Nuclear Information System (INIS)

    Sankaran, A.V.; Nambi, K.S.V.; Sunta, C.M.

    1982-01-01

    The usefulness of thermoluminescence (TL) in geological studies is being increasingly recognized, as may be judged from the considerable volume of literature accumulated over the past couple of decades; besides, a number of seminars, conferences and specialists' meetings have also been held on the subject of applied TL. However, these publications lie scattered over several periodicals and conference proceedings and an interested worker finds it difficult to obtain the gist of the contributions in one place. The present authors felt a need for this and have, therefore, attempted to bring together in this Report the current status of TL research about different minerals; applications in the fields of geochronology, ore-prospecting, stratigraphic correlation, geothermometry and other useful areas are also included. (author)

  3. SACRI: A measure of situation awareness for use in the evaluation of nuclear power plant control room systems providing information about the current process state

    International Nuclear Information System (INIS)

    Hogg, D.N.; Follesoe, K.; Volden, F.S.; Torralba, B.

    1994-01-01

    Control room operator support systems and their interface designs have as one goal the enhancement of the operators' situation awareness of the dynamically changing process state. This paper describes a technique for measuring situation awareness within the Human Factors evaluation of control room operator-system interfaces. The technique, referred to as SACRI, has been evaluated in four simulator studies and the main findings from these studies are summarized in this paper. It is concluded that SACRI can be a useful supplement to operator performance measures currently existing for use within control room interface evaluations. (author). 16 refs, 2 figs, 3 tabs

  4. Current measurement studies around the Cesme Peninsula (Turkey)

    International Nuclear Information System (INIS)

    Taspinar, N.

    1989-04-01

    In order to design coastal structures and marine vehicles safely, it is required to know current climate which shows the variation of the current characteristics with time. There are a wide variety of current meters designed to measure water flow today. Each current meter is capable of recording the influence of mooring arrangement. Here we describe sea water temperatures, salinities and current velocities at offshore of Akburun, Tatlicak Burnu, Kalem Burnu and Kizil Burun areas in Cesme Peninsula 27 August, 1986 to 19 November, 1986. At the end of the investigations, measured significant maximum and average current velocities have been routinely analysed with micro-computers and also the percentages of current velocity have been calculated. (author). 8 refs, 6 figs, 4 tabs

  5. What is the role of nephrologists and nurses of the dialysis department in providing fertility care to CKD patients? : A questionnaire study among care providers

    NARCIS (Netherlands)

    Van Ek, Gaby F.; Krouwel, Esmée M.; Nicolai, Melianthe P. J.; den Oudsten, B.L.; Den Ouden, Marjolein E. M.; Dieben, Sandra W. M.; Putter, Hein; Pelger, Rob C. M.; Elzevier, Henk W.

    2017-01-01

    Purpose This study evaluated current fertility care for CKD patients by assessing the perspectives of nephrologists and nurses in the dialysis department. Methods Two different surveys were distributed for this cross-sectional study among Dutch nephrologists (N = 312) and dialysis nurses (N = 1211).

  6. Market competition, ownership, payment systems and the performance of health care providers - a panel study among Finnish occupational health services providers.

    Science.gov (United States)

    Kankaanpää, Eila; Linnosmaa, Ismo; Valtonen, Hannu

    2013-10-01

    Many health care reforms rely on competition although health care differs in many respects from the assumptions of perfect competition. Finnish occupational health services provide an opportunity to study empirically competition, ownership and payment systems and the performance of providers. In these markets employers (purchasers) choose the provider and prices are market determined. The price regulation of public providers was abolished in 1995. We had data on providers from 1992, 1995, 1997, 2000 and 2004. The unbalanced panel consisted of 1145 providers and 4059 observations. Our results show that in more competitive markets providers in general offered a higher share of medical care compared to preventive services. The association between unit prices and revenues and market environment varied according to the provider type. For-profit providers had lower prices and revenues in markets with numerous providers. The public providers in more competitive regions were more sensitive to react to the abolishment of their price regulation by raising their prices. Employer governed providers had weaker association between unit prices or revenues and competition. The market share of for-profit providers was negatively associated with productivity, which was the only sign of market spillovers we found in our study.

  7. Self-Study Guide for Florida VPK Provider Improvement Plan Development

    Science.gov (United States)

    Phillips, Beth M.; Mazzeo, Debbie; Smith, Kevin

    2016-01-01

    This Self-Study Guide has been developed to support Florida Voluntary Prekindergarten Providers (VPK) who are required to complete an improvement plan process (i.e., low-performing providers). The guide has sections that can be used during both the process of selecting target areas for an improvement plan and the process of implementing new or…

  8. Affiliation, joint venture or PSO? Case studies show why provider strategies differ.

    Science.gov (United States)

    1998-03-01

    Joint venture, affiliation or PSO? Here are three case studies of providers who chose different paths under Medicare risk, plus some key questions you'll want to ask of your own provider organization. Learn from these examples so you'll make the best contracting decisions.

  9. Causes and Consequences of Choosing Different Assurance Providers: An International Study of Sustainability Reporting

    NARCIS (Netherlands)

    P.M. Perego (Paolo)

    2009-01-01

    textabstractAn increasing number of companies voluntary disclose information about their social and environment performance in sustainability reports. This study investigates the causes and consequences of choosing different assurance providers for companies seeking independent verification of their

  10. Rationing critical care medicine: recent studies and current trends.

    Science.gov (United States)

    Ward, Nicholas S

    2005-12-01

    This paper reviews the literature on the rationing of critical care resources. Although much has been written about the concept of rationing, there have been few scientific studies as to its prevalence. A recent meta-analysis reviewed all previously published studies on rationing access to intensive care units but little is known about practices within the intensive care unit. Much literature in the past few years has focused on the growing use of critical care resources and projections for the future. Several authors suggest there may be a crisis in financial or personnel resources if some rationing does not take place. Other papers have argued that the methods of rationing critical care previously proposed, such as limiting the care of dying patients or using cost-effectiveness analysis to determine care, may not be effective or viewed as ethical by some. Finally, several recent papers review how critical care is practiced and allocated in India and Asian countries that already practice open rationing in their health care systems. There is currently no published evidence that overt rationing is taking place in critical care medicine. There is growing evidence that in the future, the need for critical care may outstrip financial resources unless some form of rationing takes place. It is also clear from the literature that choosing how to ration critical care will be a difficult task.

  11. Solar cycle in current reanalyses: (non)linear attribution study

    Science.gov (United States)

    Kuchar, A.; Sacha, P.; Miksovsky, J.; Pisoft, P.

    2014-12-01

    This study focusses on the variability of temperature, ozone and circulation characteristics in the stratosphere and lower mesosphere with regard to the influence of the 11 year solar cycle. It is based on attribution analysis using multiple nonlinear techniques (Support Vector Regression, Neural Networks) besides the traditional linear approach. The analysis was applied to several current reanalysis datasets for the 1979-2013 period, including MERRA, ERA-Interim and JRA-55, with the aim to compare how this type of data resolves especially the double-peaked solar response in temperature and ozone variables and the consequent changes induced by these anomalies. Equatorial temperature signals in the lower and upper stratosphere were found to be sufficiently robust and in qualitative agreement with previous observational studies. The analysis also pointed to the solar signal in the ozone datasets (i.e. MERRA and ERA-Interim) not being consistent with the observed double-peaked ozone anomaly extracted from satellite measurements. Consequently the results obtained by linear regression were confirmed by the nonlinear approach through all datasets, suggesting that linear regression is a relevant tool to sufficiently resolve the solar signal in the middle atmosphere. Furthermore, the seasonal dependence of the solar response was also discussed, mainly as a source of dynamical causalities in the wave propagation characteristics in the zonal wind and the induced meridional circulation in the winter hemispheres. The hypothetical mechanism of a weaker Brewer Dobson circulation was reviewed together with discussion of polar vortex stability.

  12. A Numerical Modeling for Study Marine Current in the Manado Bay, North Sulawesi

    Directory of Open Access Journals (Sweden)

    Parabelem Tinno Dolf Rompas

    2018-02-01

    Full Text Available This study is investigating about marine currents provided electrical energy through the numerical model. The objective of this study is to know the available power distributions in the Manado Bay, North Sulawesi, Indonesia. The Manado Bay was width 2200 m with 79 m of depth. In computation, we are made grids in x and y horizontal were 7 m respectively, also for z vertical of four layers. The results shown that the available power distributions in the Manado Bay at 0.1 Sv were 0.00-20.00 kW/m2 when low tide currents and when high tide currents were 0.00-105 kW/m2. The values will enable for marine currents power plant in the Manado Bay to future.

  13. Energy Provider: Delivered Energy Efficiency: A global stock-taking based on case studies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-06-01

    In 2011 the IEA and the Regulatory Assistance Project (RAP) took on a work programme focused on the role of energy providers in delivering energy efficiency to end-users. This work was part of the IEA’s contribution to the PEPDEE Task Group, which falls under the umbrella of the International Partnership on Energy Efficiency Cooperation (IPEEC). In addition to organizing regional dialogues between governments, regulators, and energy providers, the PEPDEE work stream conducted global stock-takings of regulatory mechanisms adopted by governments to obligate or encourage energy providers to delivery energy savings and the energy savings activities of energy providers. For its part the IEA conducted a global review of energy provider-delivered energy savings programmes. The IEA reached out to energy providers to identify the energy savings activities they engaged in. Some 250 energy saving activities were considered, and 41 detailed case studies spanning 18 countries were developed. Geographic balance was a major consideration, and much effort was expended identifying energy provider-delivered energy savings case studies from around the world. Taken together these case studies represent over USD 1 billion in annual spending, or about 8% of estimated energy provider spending on energy efficiency.

  14. Multiple sclerosis patients need and want information on exercise promotion from healthcare providers: a qualitative study.

    Science.gov (United States)

    Learmonth, Yvonne C; Adamson, Brynn C; Balto, Julia M; Chiu, Chung-Yi; Molina-Guzman, Isabel; Finlayson, Marcia; Riskin, Barry J; Motl, Robert W

    2017-08-01

    There is growing recognition of the benefits and safety of exercise and its importance in the comprehensive care of persons with multiple sclerosis (MS), yet uptake is low. We explored the needs and wants of patients with MS regarding exercise promotion through healthcare providers. Participants were adults with MS who had mild-or-moderate disability and a range of exercise levels. All participants lived in the Midwest of the United States. Fifty semi-structured interviews were conducted and analysed using thematic analysis. Two themes emerged, namely interactions between patients and healthcare providers and needs and wants of patients. Analysis of participant accounts illustrate that current exercise promotion by healthcare providers does not meet patient needs and wants. The identified needs and wants of persons with MS involved (i) information and knowledge on the benefits of exercise and exercise prescription, (ii) materials to allow home and community exercise and (iii) tools for initiating and maintaining exercise behaviour. Patients with MS frequently interact with healthcare providers and are generally unsatisfied with exercise promotion during interactions. Healthcare providers can address the low uptake of exercise among persons with MS by acting upon the identified unmet needs involving materials, knowledge and behaviour change strategies for exercise. © 2016 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  15. Assessment of the current status of playground safety in the midwestern region of Turkey: an effort to provide a safe environment for children.

    Science.gov (United States)

    Uskun, Ersin; Kişioğlu, Ahmet Nesimi; Altay, Tülin; Cikinlar, Rengül; Kocakaya, Asuman

    2008-01-01

    This study aimed to identify and evaluate the degree of conformity to the playground standards and the level of compliance with current safety specifications of the playgrounds in the midwestern region of Turkey. An observational technique was used at a total of 57 public playgrounds. A playground safety control form was prepared based on the United States National Program for Playground Safety and the Consumer Product Safety Commission security standards, since there is no national law covering playground equipment and safety in Turkey. The study evaluated the surroundings of the playground, arrangement of equipment in the playground, and characteristics of the equipment. The percentage of playgrounds surveyed with inadequate or hard surfacing was 80.7%. Fifty-two percent of the equipment was found to be inappropriate. Equipment was higher than the recommended heights. The results of our study unfortunately point out that playgrounds for children do not meet many of the safety criteria.

  16. Current Highlights on ESA's Planetary Technology Reference Studies

    Science.gov (United States)

    Falkner, P.

    The concept of Technology Reference Studies has been introduced already at EGU05, where the Venus Entry Probe (VEP), the Jupiter Minisat Explorer (JME), the Deimos Sample Return (DSR) and the Interstellar Heliopause Probe (IHP) have been presented in detail. At the EGU06 the new studies in reaction to the Cosmic Vision exercise have been introduced. The formulation of themes and mapping into potential future missions has been taken as basis in the planning of additional new and adaptation of existing TRS's to cover areas, which have not yet been addressed by any TRS. These new ongoing studies are progressing well and current highlights will be presented in the paper in further detail as well as an overview on supporting technology studies and Concurrent Design Facility (CDF) sessions. The Jupiter System Explorer (JSE) study investigates mission concepts with up to two Magnetospheric Orbiters placed in a highly elliptical Jovian orbit and the possibility to deploy a Jovian Entry Probe. The mission profile is based on a solar powered concept launched on a Soyuz-Fregat launcher. Mission analysis and the application of a new Jovian radiation model are supporting the study activities. The Near-Earth Asteroid Sample Return (NEA-SR) concept explores the possibilities of sample return or in-situ mission profiles with visits to up to two NEA targets. Due to the assumed low cost cap a trade between a sample return and remote/in-situ exploration concept has a high attention in the study. The Cross Scale TRS (CS-TRS) is intended to simultaneously investigate magnetospheric and plasma processes in three spatial scales with a formation flight of up to 12 spacecraft, orbiting on deep elliptical orbits around Earth. One of the major challenges is the launch of that number of spacecraft on a single launcher and the collisionless deployment of the formation at the target orbit. The scope if the GeoSail TRS is to demonstrate deployment, attitude control and navigation concepts for a

  17. Maintaining turbidity and current flow in laboratory aquarium studies, a case study using Sabellaria spinulosa

    DEFF Research Database (Denmark)

    Davies, Andrew J.; S. Last, Kim; Attard, Karl

    2009-01-01

    RT) is a simple and reliable system for the resuspension of food or sediments using an enclosed airlift. The particle rain from the lift is mixed in the tank by two water inputs that provide directional current flow across the study organism(s). The vortex mixing creates a turbulent lateral water flow that allows......Many aquatic organisms rely on the suspension of particulate matter for food or for building materials, yet these conditions are difficult to replicate in laboratory mesocosms. Consequently, husbandry and experimental conditions may often be sub-optimal. The Vortex Resuspension Tank (Vo...... the distribution of particulate matter outwards from the sediment outflow. By calibrating a VoRT it is possible to control sedimentation rate by manipulating water and air flow rates. As an example application, three VoRTs were maintained under different sediment loadings to assess the sediment fraction...

  18. Descriptive currents in philosophy of religion for Hebrew Bible studies

    African Journals Online (AJOL)

    2010-09-30

    Sep 30, 2010 ... problematic currents in the English-speaking world and that we find ourselves in the context of developing postmodern, post-analytic and post-empiricist approaches. Even so, analytic philosophy of religion is still the most representative current in the discipline within the English-speaking world.

  19. Study of current instabilities in high resistivity gallium arsenide

    International Nuclear Information System (INIS)

    Barraud, A.

    1968-01-01

    We have shown the existence and made a study of the current oscillations produced in high-resistivity gallium arsenide by a strong electric field. The oscillations are associated with the slow travelling of a region of high electrical field across the whole sample. An experimental study of the properties of these instabilities has made it possible for us to distinguish this phenomenon from the Gunn effect, from acoustic-electric effects and from contact effects. In order to account for this type of instability, a differential trapping mechanism involving repulsive impurities is proposed; this mechanism can reduce the concentration of charge carriers in the conduction band at strong electrical fields and can lead to the production of a high-field domain. By developing this model qualitatively we have been able to account for all the properties of high-resistance gallium arsenide crystals subjected to a strong electrical field: increase of the Hall constant, existence of a voltage threshold for these oscillations, production of domains of high field, low rate of propagation of these domains, and finally the possibility of inverting the direction of the propagation of the domain without destroying the latter. A quantitative development of the model makes it possible to calculate the various characteristic parameters of these instabilities. Comparison with experiment shows that there is a good agreement, the small deviations coming especially from the lack of knowledge concerning transport properties in gallium arsenide subjected to high fields. From a study of this model, it appears that the instability phenomenon can occur over a wide range of repulsive centre concentrations, and also for a large range of resistivities. This is the reason why it appears systematically in gallium arsenide of medium and high resistivity. (authors) [fr

  20. Objectives and current status of the study Mobi-kids

    International Nuclear Information System (INIS)

    Cardis, E.; Eastman, C.

    2012-01-01

    The rapid increase in mobile phone use in young people has generated concern about possible health effects of exposure to radiofrequency (RF) fields. Mobi-Kids, an international study coordinated by CREAL Barcelona, is underway in 15 countries to assess potential effects of childhood and adolescent exposure to electromagnetic fields (EMF) from mobile communications technology (RF and extremely low frequency (ELF) fields) on brain tumour risk. The study aims to recruit over 2,000 cases of brain tumours aged 10 to 24 years and their respective controls (300 cases and 600 controls from Spain). The project builds upon the methodological experience of the INTERPHONE study. Hospital based controls are being selected to reduce potential selection bias related to low response rates of population-based controls, validation of questionnaire responses with recross from network operators will allow characterization of possible recall errors. Extensive work has gone into characterising and modelling ELF and RF exposure from different types of mobile and cordless phones, from different communication systems, and from other environmental sources of EMF. The study will address a public health problem of increasing importance in Spain and provide information on potential health risks from mobile telephone use as well as from EMF in general. (Author) 21 refs.

  1. A study on important factors influencing customer relationship management: A case study of Mobile service provider

    Directory of Open Access Journals (Sweden)

    Naser Azad

    2013-04-01

    Full Text Available Customers are considered as essential assets in any organizations including mobile services. During the past few years, mobile industry is growing rapidly and the competitions among business owners increases steadily. In this paper, we present an empirical investigation to find important factors influencing customer relationship management. The proposed study of this paper designs a questionnaire and distributes it among 253 customers in mobile industry in city of Tehran, Iran. All questions are designed in Likert scale and Cronbach alpha is calculated as 0.816, which is relatively reliable value. There were 28 questions in this survey and the proposed study extracts five important factors including economic factors, communication skills, organizational resources, service capabilities and flexible market.

  2. Provider diversity in the English NHS: a study of recent developments in four local health economies.

    Science.gov (United States)

    Allen, Pauline; Turner, Simon; Bartlett, Will; Perotin, Virginie; Matchaya, Greenwell; Zamora, Bernarda

    2012-01-01

    To assess the impact of provider diversity on quality and innovation in the English NHS by mapping the extent of diverse provider activity and identifying the differences in performance between Third Sector Organisations (TSOs), for-profit private enterprises, and incumbent organizations within the NHS, and the factors that affect the entry and growth of new providers. Case studies of four local health economies. Data included: semi-structured interviews with 48 managerial and clinical staff from NHS organizations and providers from the private and third sector; some documentary evidence; a focus group with service users; and routine data from the Care Quality Commission and Companies House. Data collection was mainly between November 2008 and November 2009. Involvement of diverse providers in the NHS is limited. Commissioners' local strategies influence degrees of diversity. Barriers to entry for TSOs include lack of economies of scale in the bidding process. Private providers have greater concern to improve patient pathways and patient experience, whereas TSOs deliver quality improvements by using a more holistic approach and a greater degree of community involvement. Entry of new providers drives NHS trusts to respond by making improvements. Information sharing diminishes as competition intensifies. There is scope to increase the participation of diverse providers in the NHS but care must be taken not to damage public accountability, overall productivity, equity and NHS providers (especially acute hospitals, which are likely to remain in the NHS) in the process.

  3. Study of non inductive current generation in a plasma

    International Nuclear Information System (INIS)

    Rax, J.M.

    1987-01-01

    The problem of non-thermal bremsstrahlung during lower hybrid current drive is considered. The proposed method shows the role of the Compton effects at low frequencies and allows us to establish the link between the emitted power and the absorbed power at high frequency. The non-thermal emission is considered as a kinematical mode conversion between the absorbed radio-frequency mode and the emitted X ray photons. The fast electrons diagnostics and the ways to reach the wave structure are shown. Kinetic and electromagnetic problems concerning current generation are described. The plasma properties and diagnostics in the case of a non inductive current generation are discussed [fr

  4. Study on UPF Harmonic Current Detection Method Based on DSP

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, H J [Northwestern Polytechnical University, Xi' an 710072 (China); Pang, Y F [Xi' an University of Technology, Xi' an 710048 (China); Qiu, Z M [Xi' an University of Technology, Xi' an 710048 (China); Chen, M [Northwestern Polytechnical University, Xi' an 710072 (China)

    2006-10-15

    Unity power factor (UPF) harmonic current detection method applied to active power filter (APF) is presented in this paper. The intention of this method is to make nonlinear loads and active power filter in parallel to be an equivalent resistance. So after compensation, source current is sinusoidal, and has the same shape of source voltage. Meanwhile, there is no harmonic in source current, and the power factor becomes one. The mathematic model of proposed method and the optimum project for equivalent low pass filter in measurement are presented. Finally, the proposed detection method applied to a shunt active power filter experimental prototype based on DSP TMS320F2812 is developed. Simulation and experiment results indicate the method is simple and easy to implement, and can obtain the real-time calculation of harmonic current exactly.

  5. Theoretical study of a flat eddy current probe

    International Nuclear Information System (INIS)

    Bouchard, A.; Dumont-Fillon, J.; Labbe, G.

    1976-01-01

    A mathematical model for the computation of the impedance of an eddy current probe has been determined in the case of flat product testing. Various applications are discussed with particular emphasis on ferromagnetic materials [fr

  6. Provider Factors and Patient-Reported Healthcare Discrimination in the Diabetes Study of California (DISTANCE)

    Science.gov (United States)

    Lyles, Courtney R.; Karter, Andrew J.; Young, Bessie A.; Spigner, Clarence; Grembowski, David; Schillinger, Dean; Adler, Nancy

    2011-01-01

    Objective We examined provider-level factors and reported discrimination in the healthcare setting. Methods With data from the Diabetes Study of Northern California (DISTANCE)—a race-stratified survey of diabetes patients in Kaiser Permanente Northern California—we analyzed patient-reported racial/ethnic discrimination from providers. Primary exposures were characteristics of the primary care provider (PCP, who coordinates care in this system), including specialty/type, and patient-provider relationship variables including racial concordance. Results Subjects (n=12,151) included 20% black, 20% Latino, 23% Asian, 30% white, and 6% other patients, with 2% to 8% reporting discrimination by racial/ethnic group. Patients seeing nurse practitioners as their PCP (OR=0.09; 95% CI: 0.01–0.67), those rating their provider higher on communication (OR=0.70; 95% CI: 0.66–0.74) were less likely to report discrimination, while those with more visits (OR=1.10; 95% CI: 1.03–1.18) were more likely to report discrimination. Racial concordance was not significant once adjusting for patient race/ethnicity. Conclusions Among diverse diabetes patients in managed care, provider type and communication were significantly related to patient-reported discrimination. Practice Implications Given potential negative impacts on patient satisfaction and treatment decisions, future studies should investigate which interpersonal aspects of the provider-patient relationship reduce patient perceptions of unfair treatment. PMID:21605956

  7. Study of lower hybrid current drive for the demonstration reactor

    Energy Technology Data Exchange (ETDEWEB)

    Molavi-Choobini, Ali Asghar [Dept. of Physics, Faculty of Engineering, Islamic Azad University, Shahr-e-kord Branch, Shahr-e-kord (Iran, Islamic Republic of); Naghidokht, Ahmed [Dept. of Physics, Urmia University, Urmia (Iran, Islamic Republic of); Karami, Zahra [Dept. of Engineering, Islamic Azad University, Zanjan Branch, Zanjan (Iran, Islamic Republic of)

    2016-06-15

    Steady-state operation of a fusion power plant requires external current drive to minimize the power requirements, and a high fraction of bootstrap current is required. One of the external sources for current drive is lower hybrid current drive, which has been widely applied in many tokamaks. Here, using lower hybrid simulation code, we calculate electron distribution function, electron currents and phase velocity changes for two options of demonstration reactor at the launched lower hybrid wave frequency 5 GHz. Two plasma scenarios pertaining to two different demonstration reactor options, known as pulsed (Option 1) and steady-state (Option 2) models, have been analyzed. We perceive that electron currents have major peaks near the edge of plasma for both options but with higher efficiency for Option 1, although we have access to wider, more peripheral regions for Option 2. Regarding the electron distribution function, major perturbations are at positive velocities for both options for flux surface 16 and at negative velocities for both options for flux surface 64.

  8. Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study.

    Science.gov (United States)

    Reese, Jennifer Barsky; Beach, Mary Catherine; Smith, Katherine Clegg; Bantug, Elissa T; Casale, Kristen E; Porter, Laura S; Bober, Sharon L; Tulsky, James A; Daly, Mary B; Lepore, Stephen J

    2017-10-01

    Breast cancer patients commonly experience sexual concerns, yet rarely discuss them with clinicians. The study examined patient and provider experiences and preferences related to communication about breast cancer-related sexual concerns with the goal of informing intervention development. Patient data (n = 28) were derived from focus groups and interviews with partnered and unpartnered women treated for breast cancer reporting sexual concerns. Provider data (n = 11) came from interviews with breast cancer oncologists and nurse practitioners. Patient and provider data were analyzed separately using the framework method of qualitative analysis. Findings revealed individual and institutional barriers to effective communication about sexual concerns and highlighted key communication facilitators (e.g., a positive patient-provider relationship, patient communication as a driver of provider communication, and vice versa). Patients expressed preferences for open, collaborative communication; providers expressed preferences for focused intervention targets (identifying concerns, offering resources/referrals) and convenient format. A model of effective communication of sexual concerns was developed to inform communication interventions. Findings suggest that to improve patient-provider communication about sexual concerns, knowledge and skills-based interventions that activate patients and that equip providers for effective discussions about sexual concerns are needed, as are institutional changes that could incentivize such discussions.

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

    Science.gov (United States)

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

    2015-01-01

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

  10. Trend of environmental radiation protection and its current related studies

    International Nuclear Information System (INIS)

    Yoshida, Satoshi

    2011-01-01

    Reviewed are the international trend of environmental radiation protection (ERP), Japanese studies of radiation effects on environmental livings from aspects of ecosystem to molecular level, and the future view. ERP is particularly closed up toward promotion after its first involvement in the general global conference, UN Conference on Environment and Development (1992). International Commission of Radiological Protection (ICRP) has conducted such actions for the environment as establishing protection essentials for non-human species (2003), organizing Committee 5 (2005), and defining Reference Animals and Plants (2008) where Derived Consideration Reference Levels of 0.1-100 mGy/d are proposed, together with cooperative actions by United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), International Atomic Energy Agency (IAEA), The Organization for Economic Co-operation and Development (OECD)/Nuclear Energy Agency (NEA) and European projects. Japanese NIRS is now enrolled in the project of Environmental Modeling for Radiation Safety-II (IAEA). Major Japanese studies of radiation effects on environmental livings have utilized killifish (medaka: Oryzias latipes), springtail, earthworm, nematode, cultured plant cell (cedar), poplar, etc. Studies of the radiation effect on microcosm consisting of 3 livings have led to establishing a model for mathematical analysis and of 8 livings, have defined 50% affect dose of 5600 Gy gamma-ray. Irradiation of gamma-ray at 1 Gy/d for 5-10 days to the soil has been shown to result in alteration of the composition of natural earth bacterial population by denaturant gradient gel electrophoresis, which being a promising tool for evaluating the alteration of soil composition and function. At molecular levels, transcriptome analysis of various cells from yeast to man, is performed after irradiation of gamma-ray, neutron, heavy particles and others to reveal radiation-induced gene expression; and Hi-CEP (high

  11. Iranian women and care providers' perceptions of equitable prenatal care: A qualitative study.

    Science.gov (United States)

    Gheibizadeh, Mahin; Abedi, Heidar Ali; Mohammadi, Easa; Abedi, Parvin

    2016-06-01

    Equity as a basic human right builds the foundation of all areas of primary healthcare, especially prenatal care. However, it is unclear how pregnant women and their care providers perceive the equitable prenatal care. This study aimed to explore Iranian women's and care providers' perceptions of equitable prenatal care. In this study, a qualitative approach was used. Individual in-depth unstructured interviews were conducted with a purposeful sample of pregnant women and their care providers. Data were analyzed using inductive content analysis method. A total of 10 pregnant women and 10 prenatal care providers recruited from six urban health centers across Ahvaz, a south western city in Iran, were participated in the study. The study was approved by the Ethics Committee affiliated to Ahvaz Jundishapur University of Medical Sciences. The ethical principles of voluntary participation, confidentiality, and anonymity were considered. Analysis of participants' interviews resulted in seven themes: guideline-based care, time-saving care, nondiscriminatory care, privacy-respecting care, affordable comprehensive care, effective client-provider relationships, and caregivers' competency. The findings explain the broader and less discussed dimensions of equitable care that are valuable information for the realization of equity in care. Understanding and focusing on these dimensions will help health policy-makers in designing more equitable healthcare services for pregnant women. © The Author(s) 2015.

  12. Responding to intimate partner violence: Healthcare providers' current practices and views on integrating a safety decision aid into primary care settings.

    Science.gov (United States)

    Alvarez, Carmen; Debnam, Katrina; Clough, Amber; Alexander, Kamila; Glass, Nancy E

    2018-04-01

    Supportive care for survivors of intimate partner violence (IPV) remains limited in primary care settings. Low-income and Spanish-speaking survivors of IPV are even more disadvantaged, given the dearth of linguistically and culturally appropriate interventions for IPV. We conducted semi-structured individual interviews with 17 healthcare workers, including physicians, nurses, and social workers, to describe how healthcare workers serving primarily low-income, Latina populations are currently screening and responding to IPV disclosure, and to explore the acceptability of integrating an interactive, personalized safety decision aid application-myPlan app-into the clinic setting. Despite recognition of IPV as a problem, none of the clinical sites had a protocol to guide screening and response to IPV disclosure. Screening practices varied across the sites, sometimes conducted by medical assistants prior to the provider visit and other times by the physician or nurse provider. When IPV was disclosed, it was often during assessment for a presenting problem such as poor sleep or anxiety. Most healthcare workers felt that clinical and community resources were limited for their patients experiencing IPV. The "warm hand-off" to a social worker was the most common response strategy when possible; otherwise, women were given information about available resources such as hotlines and safe houses. We discuss structural, family, and individual barriers to accessing safety resources for underserved women and review how an easily accessible safety decision app, such as myPlan, could be a resource for women to safely tailor an action plan for her situation. © 2018 Wiley Periodicals, Inc.

  13. Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.

    Science.gov (United States)

    Khoshnood, Narges; Hopwood, Marie-Clare; Lokuge, Bhadra; Kurahashi, Allison; Tobin, Anastasia; Isenberg, Sarina; Husain, Amna

    2018-05-15

    MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. To explore the professional challenges faced by Canadian physicians who provide MAiD. Sixteen physicians from across Canada who provide MAiD completed in-depth, semi-structured telephone interviews. An inductive thematic analysis approach guided data collection and the iterative, interpretive analysis of interview transcripts. Three members of the research team systematically co-coded interview transcripts and the emerging themes were developed with the broader research team. NVivo was used to manage the coded data. Participants described three challenges associated with providing MAiD: 1) their relationships with other MAiD providers were enhanced and relationships with objecting colleagues were sometimes strained, 2) they received inadequate financial compensation for time, and, 3) they experienced increased workload, resulting in sacrifices to personal time. Although these providers did not intend to stop providing MAiD at the time of the interview, they indicated their concerns about whether they would be able to sustain this service over time. Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service. Copyright © 2018. Published by Elsevier Inc.

  14. Communication strategies and accommodations utilized by health care providers with hearing loss: a pilot study.

    Science.gov (United States)

    Trotter, Alanna R; Matt, Susan B; Wojnara, Danuta

    2014-03-01

    Poor communication between health care providers and patients may negatively impact patient outcomes, and enhancing communication is one way to improve outcomes. Effective communication is particularly important for health care providers who have hearing loss. The authors found that a systematic survey of the communication strategies and experiences of health care providers with hearing loss had not yet been conducted. In this pilot study, 32 health care professionals with hearing loss were recruited via the Association of Medical Professionals With Hearing Losses and were asked to complete a 28-question survey. Health care providers with hearing loss already employ strategies that all health care providers are encouraged to use in order to enhance patient–provider communication, and survey participants have found the strategies to be effective. The communication techniques and assistive technologies used by individuals with hearing loss seem to be effective: All participants reported feeling able to communicate effectively with patients at least most of the time. More research is needed to determine if use of these communication techniques has similar results for health care providers without hearing loss.

  15. Exploring How Lay Rescuers Overcome Barriers to Provide Cardiopulmonary Resuscitation: A Qualitative Study.

    Science.gov (United States)

    Mathiesen, Wenche Torunn; Bjørshol, Conrad Arnfinn; Høyland, Sindre; Braut, Geir Sverre; Søreide, Eldar

    2017-02-01

    Survival rates after out-of-hospital cardiac arrest (OHCA) vary considerably among regions. The chance of survival is increased significantly by lay rescuer cardiopulmonary resuscitation (CPR) before Emergency Medical Services (EMS) arrival. It is well known that for bystanders, reasons for not providing CPR when witnessing an OHCA incident may be fear and the feeling of being exposed to risk. The aim of this study was to gain a better understanding of why barriers to providing CPR are overcome. Using a semi-structured interview guide, 10 lay rescuers were interviewed after participating in eight OHCA incidents. Qualitative content analysis was used. The lay rescuers were questioned about their CPR-knowledge, expectations, and reactions to the EMS and from others involved in the OHCA incident. They also were questioned about attitudes towards providing CPR in an OHCA incident in different contexts. The lay rescuers reported that they were prepared to provide CPR to anybody, anywhere. Comprehending the severity in the OHCA incident, both trained and untrained lay rescuers provided CPR. They considered CPR provision to be the expected behavior of any community citizen and the EMS to act professionally and urgently. However, when asked to imagine an OHCA in an unclear setting, they revealed hesitation about providing CPR because of risk to their own safety. Mutual trust between community citizens and towards social institutions may be reasons for overcoming barriers in providing CPR by lay rescuers. A normative obligation to act, regardless of CPR training and, importantly, without facing any adverse legal reactions, also seems to be an important factor behind CPR provision. Mathiesen WT , Bjørshol CA , Høyland S , Braut GS , Søreide E . Exploring how lay rescuers overcome barriers to provide cardiopulmonary resuscitation: a qualitative study. Prehosp Disaster Med. 2017;32(1):27-32.

  16. Program Experiences of Adults with Autism, Their Families, and Providers: Findings from a Focus Group Study

    Science.gov (United States)

    Koffer Miller, Kaitlin H.; Mathew, Mary; Nonnemacher, Stacy L.; Shea, Lindsay L.

    2018-01-01

    A growing number of individuals with autism spectrum disorder are aging into adulthood. In the United States, Medicaid is the primary payer for services for adults with autism spectrum disorder, yet there are few funded programs that provide dedicated supports to this population. This study examined the experiences of adults with autism spectrum…

  17. Organising, Providing and Evaluating Technical Training for Early Career Researchers: A Case Study

    Science.gov (United States)

    van Besouw, Rachel M.; Rogers, Katrine S.; Powles, Christopher J.; Papadopoulos, Timos; Ku, Emery M.

    2013-01-01

    This paper considers the importance of providing technical training opportunities for Early Career Researchers (ECRs) worldwide through the case study of a MATLAB training programme, which was proposed, organised, managed and evaluated by a team of five ECRs at the University of Southampton. The effectiveness of the programme in terms of the…

  18. The Politics of Resistance to Workplace Cultural Diversity Education for Health Service Providers: An Australian Study

    Science.gov (United States)

    Johnstone, Megan-Jane; Kanitsaki, Olga

    2008-01-01

    This qualitative study has as its focus an exploration of health service providers' perceptions and experiences of the processes and implications of delivering workplace cultural diversity education for staff. Data were obtained from conducting in-depth individual and focus group interviews with a purposeful sample of 137 healthcare professionals,…

  19. Teachers Providing Social and Emotional Support: A Study of Advisor Role Enactment in Small High Schools

    Science.gov (United States)

    Phillippo, Kate L.

    2010-01-01

    Background/Context: This study investigates the teacher's role in the student advisory process, which to date has generated limited research literature. Teachers who serve as student advisors assume a role that extends beyond the more traditional instructional role, and includes implied or explicit expectations to provide student advisees with…

  20. West Virginia Women Business Owners: Current Study and Trends Report.

    Science.gov (United States)

    Holup, Linda L.; FitzGerald, Kathleen M.

    This report profiles current West Virginia women business owners and notes significant trends in the last eight years. It highlights a subgroup of women business owners, specifically low income, single women with children. These survey areas are discussed: industry sector, type of ownership, reasons for going/not going into business, planning…

  1. Cultural Competence among Maternal Healthcare Providers in Bahir Dar City Administration, Northwest Ethiopia: Cross sectional Study.

    Science.gov (United States)

    Aragaw, Amanu; Yigzaw, Tegbar; Tetemke, Desalegn; G/Amlak, Wubalem

    2015-09-24

    Cultural competency is now a core requirement for maternal health providers working in multicultural society. However, it has not yet received due attention in Ethiopia. This study aimed to determine the level of cultural competence and its associated factors among maternal health care providers in Bahir Dar City Administration, Northwest Ethiopia. Institution based cross-sectional study was carried out using both quantitative and qualitative methods. Maternal health care providers from all health facilities were our study participants. Structured Questionnaire with some modification of Campinha Bacote's tool was used to collect quantitative data from health workers and semi structured guide line was used for qualitative data among women. While quantitative data analysis was done using SPSS, qualitative data was analyzed using open code software. P-value of less than 0.05 was taken to determine statistical significance. Cronbach's alpha was used to test internal reliability and a factor loading of 0.3 or greater was the criterion used to retain items. Two hundred seventy four health workers and seven women were involved in the study. The overall competency level was 57.3 % thought vary in different subscales or stages. Of the cultural competent health workers near to three fourth (73.0 %) were in awareness stage which is the earliest stage of competence in which individuals were aware only their own culture but not the world view of their clients. The voices of mothers in the qualitative assessment also showed discordance in cultural competence with their healthcare providers. Female health workers almost six times [AOR,5.5; 2.71, 11.30] more competent than male providers and those who got in-service training related to maternal care provided services more culturally competent than their counter parts with [AOR,3.5; 1.4, 8.64]. Reliability Cronbach's α coefficient value of cultural competence subscales showed 0.672,0 .719, 0.658, 0.714, and 0.631 for cultural

  2. Community and Healthcare Providers' Perspectives on Male Circumcision: A Multi-Centric Qualitative Study in India

    OpenAIRE

    Sahay, Seema; Nagarajan, Karikalan; Mehendale, Sanjay; Deb, Sibnath; Gupta, Abhilasha; Bharat, Shalini; Bhatt, Shripad; Kumar, Athokpam Bijesh; Kanthe, Vidisha; Sinha, Anju; Chandhiok, Nomita

    2014-01-01

    Background Although male circumcision (MC) is recommended as an HIV prevention option, the religious, cultural and biomedical dimensions of its feasibility, acceptability and practice in India have not been explored till date. This study explores beliefs, experiences and understanding of the community and healthcare providers (HCPs) about adult MC as an HIV prevention option in India. Methods This qualitative study covered 134 in-depth interviews from Belgaum, Kolkata, Meerut and Mumbai citie...

  3. School health promotion providers' roles in practice and theory: results from a case study.

    Science.gov (United States)

    Teutsch, Friedrich; Gugglberger, Lisa; Dür, Wolfgang

    2015-01-01

    Implementation is critical to the success of health promotion (HP) in schools, but little is known about how schools can best be assisted during this process. This article focuses on Austrian HP providers and aspects their roles incorporate. To investigate the providers' role in the practice of HP implementation and how it differs from its official description. On the basis of these findings, implications are suggested. The data were gathered within the framework of an explorative case study of complex HP interventions. We draw on four interviews with HP organisation staff, five documents from the providers' organisations and seven interviews with school staff from three schools. In practice, providers took up different responsibilities, e.g., acting as emotional support to school staff and supporting the documentation of projects, guided more by the schools' needs than by the programmes they are helping to implement. Providers focused mostly on the implementation of single activities and did little to emphasize the necessity of organisational change. Our findings suggest that providers' background in health should be complemented by a deeper understanding of the importance of organisational change to further support HP implementation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Understanding the cost of dermatologic care: A survey study of dermatology providers, residents, and patients.

    Science.gov (United States)

    Steen, Aaron J; Mann, Julianne A; Carlberg, Valerie M; Kimball, Alexa B; Musty, Michael J; Simpson, Eric L

    2017-04-01

    The American Academy of Dermatology recommends dermatologists understand the costs of dermatologic care. This study sought to measure dermatology providers' understanding of the cost of dermatologic care and how those costs are communicated to patients. We also aimed to understand the perspectives of patients and dermatological trainees on how cost information enters into the care they receive or provide. Surveys were systematically developed and distributed to 3 study populations: dermatology providers, residents, and patients. Response rates were over 95% in all 3 populations. Dermatology providers and residents consistently underestimated the costs of commonly recommended dermatologic medications but accurately predicted the cost of common dermatologic procedures. Dermatology patients preferred to know the cost of procedures and medications, even when covered by insurance. In this population, the costs of dermatologic medications frequently interfered with patients' ability to properly adhere to prescribed regimens. The surveyed population was limited to the northwestern United States and findings may not be generalizable. Cost estimations were based on average reimbursement rates, which vary by insurer. Improving dermatology providers' awareness and communication of the costs of dermatologic care might enhance medical decision-making, improve adherence and outcomes, and potentially reduce overall health care expenditures. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  5. Healthcare providers' perceptions of barriers in implementing of home telecare in Taiwan: a qualitative study.

    Science.gov (United States)

    Chiang, Kuei-Feng; Wang, Hsiu-Hung; Chien, I-Kuang; Liou, Jhao-Kun; Hung, Chung-Lieh; Huang, Chien-Min; Yang, Feng-Yueh

    2015-04-01

    Telecare has not only brought down medical expenses, but has also become an important tool to address healthcare needs. In recent years, the Taiwanese government has been concerned about this healthcare issue. However, only a few hospitals provide telecare. This study aims at investigating the barriers that healthcare providers face while implementing home telecare in Taiwan. A qualitative research design was employed in this study, with semi-structured in-depth interviews. The sample was obtained from five hospitals, including three medical centers and two regional hospitals. A total of 31 healthcare providers were interviewed, including case managers (n=11), administrators (n=7), physicians (n=7), and nurses (n=6). The results were summarized into five themes, including: (1) unsuitable laws and vague policies, (2) the policy implementation fails to meet public needs, (3) lack of organizational support, (4) lack of quality and convenience of the system, and (5) inadequate public perception and attitudes. Obstacles in policy and regulations are the most fundamental difficulties for telecare implementation, therefore the government should provide a clear direction by planning policies, legislate appropriate regulations, and incorporate telecare into the scope of medical insurance, in order to improve the environment and stimulate the telecare service market. In order to improve the success rate of telecare, administrators should be able to identify an appropriate cost-benefit model to build a humane system to satisfy public needs and to provide staff with resources and support. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Key Factors of Quality in the Sector of Tourism Services Providers: Case Study: Czech Republic

    Directory of Open Access Journals (Sweden)

    Ida Vajčnerová

    2014-01-01

    Full Text Available The paper summarizes main results of partial research aimed at detection of the key factors affecting quality in the sector of tourism services providers, namely tour operators and travel agencies. A primary questionnaire survey was conducted; the researched factors were distributed in the context of service quality dimensions (Grönroos model; the dimensions were tested in relation to sex, age and education of the respondents (ANOVA; Brown-Forsythe test. Assurance was identified as the most important dimension. The output of the study is determining the significance of individual quality factors from the perspective of a potential customer when selecting a service provider.

  7. Data Citation Policies of Data Providers within the scope of Longitudinal Studies in Life Course Research

    Energy Technology Data Exchange (ETDEWEB)

    Reinhold, A.; Rittberger, M.; Mahrholz, N.

    2016-07-01

    In this article, a small-scale case study analyzing the nature of data citation policies within the scope of longitudinal studies in life course research is presented. The sample consists of eight data providers from Europe, North-America and Australia and was evaluated with regard to eight criteria which potentially affect data citation behavior of researchers in the field, for example the wording of data citation obligations or sanctions for not citing research data in accordance to given requirements. The study demonstrates that research data providers follow a wide range of approaches to data citation, especially in terms of data citation location within a publication as well as disposal obligations for data-related publications. However, this diversity might lead to inconsistency in data citation behaviour and also to a general lack of comparability of data citation quantity and quality as relevant factors in research evaluation. (Author)

  8. Public-private partnership case studies: Profiles of success in providing environmental services (September 1990)

    International Nuclear Information System (INIS)

    1990-09-01

    The report examines 23 case studies of public-private partnerships throughout the United States. They are organized by three environmental service areas: solid waste, wastewater treatment, and drinking water. The introduction explains the types and benefits of public-private partnerships and Chapter II lists the attributes of successful partnerships. The remainder of the report emphasizes case study examples in solid waste, wastewater treatment, and drinking water. Individual chapters are devoted to each of the three environmental service areas. Each case study is presented in a similar format which provides the reader with basic information on how the partnership was formed and implemented, as well as characteristics of the community

  9. RATIONALIZING TRANSPORTATIONS SERVICE: A CASE STUDY ON THE STANDARDIZATION OF LOGISTICS SERVICE PROVIDERS

    Directory of Open Access Journals (Sweden)

    Clayton de Oliveira Pires

    2016-07-01

    Full Text Available Due to high competitiveness on supply chains, small economies tend to become very important to overall costs reduction and represent marketing gains. The aim of this study is to analyze if the rationalization in low value deliveries, lower than R$ 2,000.00, will be able to generate a considerable cut of costs. To perform this exploratory study, company historic was analyzed and surveys were performed with several suppliers. The studies showed it is possible to reduce freight average impact in relation to the sold value at 44.03%. This result points to the advantages in coordinating more rationally the process of hiring transportation providers.

  10. Public-private partnership case studies: Profiles of success in providing environmental services (September 1990)

    Energy Technology Data Exchange (ETDEWEB)

    1990-09-01

    The report examines 23 case studies of public-private partnerships throughout the United States. They are organized by three environmental service areas: solid waste, wastewater treatment, and drinking water. The introduction explains the types and benefits of public-private partnerships and Chapter II lists the attributes of successful partnerships. The remainder of the report emphasizes case study examples in solid waste, wastewater treatment, and drinking water. Individual chapters are devoted to each of the three environmental service areas. Each case study is presented in a similar format which provides the reader with basic information on how the partnership was formed and implemented, as well as characteristics of the community.

  11. Current Debates in the Study of the Industrial Revolution.

    Science.gov (United States)

    Beaudoin, Steven M.

    2000-01-01

    Provides an overview of the literature on the debates surrounding the industrial revolution using four categories: (1) definition and characteristics; (2) context and causation; (3) impacts and scope; and (4) industrialization as a worldwide phenomenon. (CMK)

  12. Providing supportive care to cancer patients: a study on inter-organizational relationships

    Directory of Open Access Journals (Sweden)

    Kevin Brazil

    2008-02-01

    Full Text Available Background: Supportive cancer care (SCC has historically been provided by organizations that work independently and possess limited inter-organizational coordination. Despite the recognition that SCC services must be better coordinated, little research has been done to examine inter-organizational relationships that would enable this goal. Objective: The purpose of this study was to describe relationships among programs that support those affected by cancer. Through this description the study objective was to identify the optimal approach to coordinating SCC in the community. Methods: Senior administrators in programs that provided care to persons and their families living with or affected by cancer participated in a personal interview. Setting: South-central Ontario, Canada. Study population: administrators from 43 (97% eligible programs consented to participate in the study. Results: Network analysis revealed a diffuse system where centralization was greater in operational than administrative activities. A greater number of provider cliques were present at the operational level than the administrative level. Respondents identified several priorities to improve the coordination of cancer care in the community including: improving standards of care; establishing a regional coordinating body; increasing resources; and improving communication between programs. Conclusion: Our results point to the importance of developing a better understanding on the types of relationships that exist among service programs if effective integrated models of care are to be developed.

  13. Empowering nurses in providing palliative care to cancer patients: Action research study

    Directory of Open Access Journals (Sweden)

    Fariba Taleghani

    2018-01-01

    Full Text Available Background: Chronic diseases such as cancer would lead to various health needs in patients and their families. To meet needs, developing new educational nursing courses is necessary. Therefore this study was conducted to empower nurses through designing and conducting short-term educational courses for training palliative care nurses. Materials and Methods: This study was a community-based action research which was conducted at Isfahan hospitals that provide services for cancer patients during 2015 at four stages (planning, acting, reflection, and evaluation. Participants (33 samples included nurses, head nurses, managers of nursing services, nursing professors and professors of oncology department. Data were gathered through individual and group interviews and analyzed using content analysis. Results: Data analysis resulted in 3 categories of "professional development of nursing in palliative care" which included subcategories of: knowledge-based performance and positive change in attitude, "obstacles to provide palliative care" with subcategories of: insufficient professional responsibility, insufficient ability in managing some of patients' symptoms and inappropriate interaction between nurses and physicians and "strategies for improving provision of palliative care" with subcategories of: improving the interactions between physicians and nurses, continuous trainings for palliative care and the necessity of developing palliative care in the country. Conclusions: To facilitate the process of providing palliative care to cancer patients, necessary actions and measures must be conducted including improvement of interaction between the members of health team, organizing continuing educational courses on palliative care and development of providing palliative care all over the country by managers of health centers.

  14. Retained in HIV Care But Not on Antiretroviral Treatment: A Qualitative Patient-Provider Dyadic Study.

    Directory of Open Access Journals (Sweden)

    Katerina A Christopoulos

    2015-08-01

    Full Text Available Patients retained in HIV care but not on antiretroviral therapy (ART represent an important part of the HIV care cascade in the United States. Even in an era of more tolerable and efficacious ART, decision making in regards to ART offer and uptake remains complex and calls for exploration of both patient and provider perspectives. We sought to understand reasons for lack of ART usage in patients meeting the Health Resources Services Administration definition of retention as well as what motivated HIV primary care appointment attendance in the absence of ART.We conducted a qualitative study consisting of 70 in-depth interviews with ART-naïve and ART-experienced patients off ART and their primary care providers in two urban safety-net HIV clinics in San Francisco and New York. Twenty patients and their providers were interviewed separately at baseline, and 15 dyads were interviewed again after at least 3 mo and another clinic visit in order to understand any ART use in the interim. We applied dyadic analysis to our data. Nearly all patients were willing to consider ART, and 40% of the sample went on ART, citing education on newer antiretroviral drugs, acceptance of HIV diagnosis, social support, and increased confidence in their ability to adhere as facilitators. However, the strength of the provider recommendation of ART played an important role. Many patients had internalized messages from providers that their health was too good to warrant ART. In addition, providers, while demonstrating patient-centered care through sensitivity to patients experiencing psychosocial instability, frequently muted the offer of ART, at times unintentionally. In the absence of ART, lab monitoring, provider relationships, access to social services, opiate pain medications, and acute symptoms motivated care. The main limitations of this study were that treatment as prevention was not explored in depth and that participants were recruited from academic HIV clinics in

  15. Retained in HIV Care But Not on Antiretroviral Treatment: A Qualitative Patient-Provider Dyadic Study

    Science.gov (United States)

    Christopoulos, Katerina A.; Olender, Susan; Lopez, Andrea M.; Lekas, Helen-Maria; Jaiswal, Jessica; Mellman, Will; Geng, Elvin; Koester, Kimberly A.

    2015-01-01

    Background Patients retained in HIV care but not on antiretroviral therapy (ART) represent an important part of the HIV care cascade in the United States. Even in an era of more tolerable and efficacious ART, decision making in regards to ART offer and uptake remains complex and calls for exploration of both patient and provider perspectives. We sought to understand reasons for lack of ART usage in patients meeting the Health Resources Services Administration definition of retention as well as what motivated HIV primary care appointment attendance in the absence of ART. Methods and Findings We conducted a qualitative study consisting of 70 in-depth interviews with ART-naïve and ART-experienced patients off ART and their primary care providers in two urban safety-net HIV clinics in San Francisco and New York. Twenty patients and their providers were interviewed separately at baseline, and 15 dyads were interviewed again after at least 3 mo and another clinic visit in order to understand any ART use in the interim. We applied dyadic analysis to our data. Nearly all patients were willing to consider ART, and 40% of the sample went on ART, citing education on newer antiretroviral drugs, acceptance of HIV diagnosis, social support, and increased confidence in their ability to adhere as facilitators. However, the strength of the provider recommendation of ART played an important role. Many patients had internalized messages from providers that their health was too good to warrant ART. In addition, providers, while demonstrating patient-centered care through sensitivity to patients experiencing psychosocial instability, frequently muted the offer of ART, at times unintentionally. In the absence of ART, lab monitoring, provider relationships, access to social services, opiate pain medications, and acute symptoms motivated care. The main limitations of this study were that treatment as prevention was not explored in depth and that participants were recruited from academic

  16. Automated Studies of Continuing Current in Lightning Flashes

    Science.gov (United States)

    Martinez-Claros, Jose

    Continuing current (CC) is a continuous luminosity in the lightning channel that lasts longer than 10 ms following a lightning return stroke to ground. Lightning flashes following CC are associated with direct damage to power lines and are thought to be responsible for causing lightning-induced forest fires. The development of an algorithm that automates continuing current detection by combining NLDN (National Lightning Detection Network) and LEFA (Langmuir Electric Field Array) datasets for CG flashes will be discussed. The algorithm was applied to thousands of cloud-to-ground (CG) flashes within 40 km of Langmuir Lab, New Mexico measured during the 2013 monsoon season. It counts the number of flashes in a single minute of data and the number of return strokes of an individual lightning flash; records the time and location of each return stroke; performs peak analysis on E-field data, and uses the slope of interstroke interval (ISI) E-field data fits to recognize whether continuing current (CC) exists within the interval. Following CC detection, duration and magnitude are measured. The longest observed C in 5588 flashes was 631 ms. The performance of the algorithm (vs. human judgement) was checked on 100 flashes. At best, the reported algorithm is "correct" 80% of the time, where correct means that multiple stations agree with each other and with a human on both the presence and duration of CC. Of the 100 flashes that were validated against human judgement, 62% were hybrid. Automated analysis detects the first but misses the second return stroke in many cases where the second return stroke is followed by long CC. This problem is also present in human interpretation of field change records.

  17. A EUropean study on effectiveness and sustainability of current Cardiac Rehabilitation programmes in the Elderly

    DEFF Research Database (Denmark)

    Prescott, Eva; Meindersma, Esther P; van der Velde, Astrid E

    2016-01-01

    of EU-CaRE is to map the efficiency of current CR of the elderly in Europe, and to investigate whether mCR is an effective alternative in terms of efficacy, adherence and sustainability. METHODS AND RESULTS: The EU-CaRE study includes patients aged 65 years or older with ischaemic heart disease or who...... on effectiveness and sustainability of current cardiac rehabilitation programmes in the elderly (EU-CaRE) project consists of an observational study and an open prospective, investigator-initiated multicentre randomised controlled trial (RCT) involving mobile telemonitoring guided CR (mCR). OBJECTIVE: The aim...... and sustainability. CONCLUSION: The study will provide important information to improve CR in the elderly. The EU-CaRE RCT is the first European multicentre study of mCR as an alternative for elderly patients not attending usual CR....

  18. Pre-purchase customer experience : multiple case study of leading service providers in Norway

    OpenAIRE

    Kujala, Lisanna Carolina; Citic, Marija

    2015-01-01

    The theory of experience economy presents customer experience as a form of new economic offering and stresses the importance of customer experience for companies that are trying to differentiate from the competitors. Many service providers are increasing their focus on customer experience by putting the customer in the center of their business. This study investigates how experience centricity and customer centricity can be enhanced at prepurchase level. Nowadays, customer a...

  19. Integration of Health Coaching Concepts and Skills into Clinical Practice Among VHA Providers: A Qualitative Study.

    Science.gov (United States)

    Collins, David A; Thompson, Kirsten; Atwood, Katharine A; Abadi, Melissa H; Rychener, David L; Simmons, Leigh Ann

    2018-01-01

    Although studies of health coaching for behavior change in chronic disease prevention and management are increasing, to date no studies have reported on what concepts and skills providers integrate into their clinical practice following participation in health coaching courses. The purpose of this qualitative study was to assess Veterans Health Administration (VHA) providers' perceptions of the individual-level and system-level changes they observed after participating with colleagues in a 6-day Whole Health Coaching course held in 8 VHA medical centers nationwide. Data for this study were from the follow-up survey conducted with participants 2 to 3 months after completing the training. A total of 142 responses about individual-level changes and 99 responses about system-level changes were analyzed using content analysis. Eight primary themes emerged regarding individual changes, including increased emphasis on Veterans' values, increased use of listening and other specific health coaching skills in their clinical role, and adding health coaching to their clinical practice.Four primary themes emerged regarding system-level changes, including leadership support, increased staff awareness/support/learning and sharing, increased use of health coaching skills or tools within the facility, and organizational changes demonstrating a more engaged workforce, such as new work groups being formed or existing groups becoming more active. Findings suggest that VHA providers who participate in health coaching trainings do perceive positive changes within themselves and their organizations. Health coaching courses that emphasize patient-centered care and promote patient-provider partnerships likely have positive effects beyond the individual participants that can be used to promote desired organizational change.

  20. Screaming Body and Silent Healthcare Providers: A Case Study with a Childhood Sexual Abuse Survivor

    Directory of Open Access Journals (Sweden)

    Sigrun Sigurdardottir

    2018-01-01

    Full Text Available Stressful early life experiences cause immune dysregulation across the lifespan. Despite the fact that studies have identified childhood sexual abuse (CSA survivors as a particularly vulnerable group, only a few attempts have been made to study their lived-experience of the physical health consequences of CSA. The aim of this study was to explore a female CSA survivor’s lived-experience of the physical health consequences of CSA and how she experienced the reactions of healthcare providers. Seven interviews were conducted with this 40-year-old woman, Anne, using a phenomenological research approach. Anne was still a young child (two to three years old when her father started to rape her. Since her childhood, she has experienced complex and widespread physical health consequences such as repeated vaginal and abdominal infections, widespread and chronic pain, sleeping problems, digestive problems, chronic back problems, fibromyalgia, musculoskeletal problems, repeated urinary tract infections, cervical dysplasia, inflammation of the Fallopian tubes, menorrhagia, endometrial hyperplasia, chlamydia, ovarian cysts, ectopic pregnancies, uterus problems, severe adhesions, and ovarian cancer. Anne disclosed her CSA experience to several healthcare providers but they were silent and failed to provide trauma-informed care. Anne’s situation, albeit unique, might reflect similar problems in other female CSA survivors.

  1. Mutual Expectations of Mothers of Hospitalized Children and Pediatric Nurses Who Provided Care: Qualitative Study.

    Science.gov (United States)

    Konuk Şener, Dilek; Karaca, Aysel

    This study attempted to identify the mutual expectations of mothers whose children were hospitalized in the pediatric department of a university hospital and nurses who provided care. A descriptive phenomenological design has been used in this study. Data were obtained through tape-recorded semi-structured interviews. This study was conducted at a pediatric clinic, at a university hospital in a small city in Turkey. Participants comprised five nurses working in the children's clinic and 24 mothers who accompanied their children to the hospital. The six major themes that emerged were mothers' feelings and thoughts about the hospital experience, mothers' expectations for attention and support during hospitalization, mothers' expectations for invasive procedures, issues regarding physical comfort and hospital infrastructure, nurses' feelings and thoughts about working in the pediatric clinic, and nurses' expectations of the mothers. Mothers expected nurses to provide physical support including medication administration, and installing/applying IV and nebulizer treatments; and emotional support in terms of having a friendly, rather than critical attitude, and being approachable and receptive of mothers' questions and anxieties. Nurses stated that they were aware of these expectations but needed mothers to be understanding and tolerant, considering their difficult working conditions. Children's hospitalization is a stressful experience for parents. Open and therapeutic communication and relationships between parents and nurses contribute to improving the quality of care provided to children and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Plug-in hybrid electric vehicles as regulating power providers. Case studies of Sweden and Germany

    International Nuclear Information System (INIS)

    Andersson, S.-L.; Goeransson, L.; Karlsson, S.; Johnsson, F.; Elofsson, A.K.; Galus, M.D.; Andersson, G.

    2010-01-01

    This study investigates plug-in hybrid electric vehicles (PHEVs) as providers of regulating power in the form of primary, secondary and tertiary frequency control. Previous studies have shown that PHEVs could generate substantial profits while providing ancillary services. This study investigates under what conditions PHEVs can generate revenues using actual market data, i.e. prices and activations of regulating power, from Sweden and Germany from four months in 2008. PHEV market participation is modelled for individual vehicles in a fleet subject to a simulated movement pattern. Costs for infrastructure and vehicle-to-grid equipment are not included in the analysis. The simulation results indicate that maximum average profits generated on the German markets are in the range 30-80 EUR per vehicle and month whereas the Swedish regulating power markets give no profit. In addition, an analysis is performed to identify strengths, weaknesses, opportunities, and threats (SWOT) of PHEVs as regulating power providers. Based on the simulation results and the SWOT analysis, characteristics for an ideal regulating power market for PHEVs are presented. (author)

  3. The Health Tourists’ Satisfaction Level of Services Provided: A Cross-Sectional Study in Iran

    Science.gov (United States)

    Varzi, Ali Mohammad; Saki, Koroush; Momeni, Khalil; Vasokolaei, Ghasem Rajabi; Khodakaramifard, Zahra; Zouzani, Morteza Arab; Jalilian, Habib

    2016-01-01

    Introduction: Patient satisfaction with provided services is used as an indicator of health care quality. Patient satisfaction is defined as patient perception of provided care compared to expected care. This study was administered to evaluate the health tourists’ satisfaction of provided services in Lorestan University of Medical Sciences affiliated hospitals in 2015. Method: In this descriptive case study, 1800 (696 (54.4%) men and 812 (45.6%) women, 74.5 province native) patients were selected by random sampling from among the patients of Lorestan University of Medical Sciences affiliated hospitals in 2015 spring. The data collection instrument is a semi-structured questionnaire in this study. The questionnaire has 62 general and specific items. Each of the specific items is scaled on four points; satisfied, fairly satisfied, dissatisfied and O.K. In order to analyze the data both descriptive and inferential statistics were used. Results: Poldokhtar Imam Khomeini Hospital had the highest Level of satisfaction of 68 percent in all aspects (hoteling, discharge, paramedical, nurses, medical and admission) among the studied hospitals. Kuhdasht Imam Khomeini hospital had the lowest level of satisfaction of 53 percent. The overall satisfaction level in all hospitals was 61%. Discussion and Conclusion: Despite the shortcomings observed in different areas, the results of the present study are in an intermediate status compared to other studies. While treating patients, patient-centered issue and patients ‘need and preferences should be focused on to enhance health care quality. Considering Patients preferences not only are morally good but also lead to improved care and access to sustainable care practices. Therefore it is needed to drive organizational management approach toward the customer preferences management and needs. PMID:27157181

  4. Study of high-energy neutrino neutral-current interactions

    International Nuclear Information System (INIS)

    Aderholz, M.; Aggarwal, M.M.; Akbari, H.; Allport, P.P.; Badyal, S.K.; Ballagh, H.C.; Barth, M.; Baton, J.P.; Bingham, H.H.; Brucker, E.B.; Burnstein, R.A.; Campbell, J.R.; Cence, R.J.; Chatterjee, T.K.; Clayton, E.F.; Corrigan, G.; Coutures, C.; DeProspo, D.; Devanand; De Wolf, E.A.; Faulkner, P.J.W.; Foeth, H.; Fretter, W.B.; Gupta, V.K.; Hanlon, J.; Harigel, G.; Harris, F.A.; Jabiol, M.A.; Jacques, P.; Jain, V.; Jones, G.T.; Jones, M.D.; Kafka, T.; Kalelkar, M.; Kasper, P.; Kohli, J.M.; Koller, E.L.; Krawiec, R.J.; Lauko, M.; Lys, J.E.; Marage, P.; Milburn, R.H.; Miller, D.B.; Mittra, I.S.; Mobayyen, M.M.; Moreels, J.; Morrison, D.R.O.; Myatt, G.; Nailor, P.; Naon, R.; Napier, A.; Neveu, M.; Passmore, D.; Peters, M.W.; Peterson, V.Z.; Plano, R.; Rao, N.K.; Rubin, H.A.; Sacton, J.; Sambyal, S.S.; Schmitz, N.; Schneps, J.; Singh, J.B.; Smart, W.; Stamer, P.; Varvell, K.E.; Verluyten, L.; Wachsmuth, H.; Wainstein, S.; Willocq, S.; Yost, G.P.

    1992-01-01

    From an exposure of the Fermilab 15-foot bubble chamber to the Tevatron quadrupole triplet neutrino beam, we have determined the ratio of neutral-current (NC) to charged-current (CC) interactions to be 0.288±0.032 for events with visible hadron momentum above 10 GeV/c. The mean ν(bar ν) event energy is 150 (110) GeV, which is higher than that for any previous beam. This result agrees with those from previous experiments at lower energies. The NC/CC ratio is derived for a combined sample of ν and bar ν events. A value of 0.274±0.038 is obtained for the dominant ν component assuming bar ν NC/CC=0.39±0.08. For events with visible hadron momentum above 25 GeV/c, where the neutral hadron contamination remaining in the NC sample is assumed to be negligible, the combined NC/CC is 0.323±0.025 and the K 0 production rates are 0.375±0.064 per CC and 0.322±0.073 per NC event. The corresponding Λ rates are 0.161±0.030 per CC and 0.113±0.030 per NC event. The K 0 and Λ distributions of the fractional hadron energy variable z in NC events are consistent with those in CC events

  5. Study of high-energy neutrino neutral-current interactions

    Science.gov (United States)

    Aderholz, M.; Aggarwal, M. M.; Akbari, H.; Allport, P. P.; Badyal, S. K.; Ballagh, H. C.; Barth, M.; Baton, J. P.; Bingham, H. H.; Brucker, E. B.; Burnstein, R. A.; Campbell, J. R.; Cence, R. J.; Chatterjee, T. K.; Clayton, E. F.; Corrigan, G.; Coutures, C.; Deprospo, D.; Devanand; de Wolf, E. A.; Faulkner, P. J.; Foeth, H.; Fretter, W. B.; Gupta, V. K.; Hanlon, J.; Harigel, G.; Harris, F. A.; Jabiol, M. A.; Jacques, P.; Jain, V.; Jones, G. T.; Jones, M. D.; Kafka, T.; Kalelkar, M.; Kasper, P.; Kohli, J. M.; Koller, E. L.; Krawiec, R. J.; Lauko, M.; Lys, J. E.; Marage, P.; Milburn, R. H.; Miller, D. B.; Mittra, I. S.; Mobayyen, M. M.; Moreels, J.; Morrison, D. R.; Myatt, G.; Nailor, P.; Naon, R.; Napier, A.; Neveu, M.; Passmore, D.; Peters, M. W.; Peterson, V. Z.; Plano, R.; Rao, N. K.; Rubin, H. A.; Sacton, J.; Sambyal, S. S.; Schmitz, N.; Schneps, J.; Singh, J. B.; Smart, W.; Stamer, P.; Varvell, K. E.; Verluyten, L.; Wachsmuth, H.; Wainstein, S.; Willocq, S.; Yost, G. P.

    1992-04-01

    From an exposure of the Fermilab 15-foot bubble chamber to the Tevatron quadrupole triplet neutrino beam, we have determined the ratio of neutral-current (NC) to charged-current (CC) interactions to be 0.288+/-0.032 for events with visible hadron momentum above 10 GeV/c. The mean ν(ν¯) event energy is 150 (110) GeV, which is higher than that for any previous beam. This result agrees with those from previous experiments at lower energies. The NC/CC ratio is derived for a combined sample of ν and ν¯ events. A value of 0.274+/-0.038 is obtained for the dominant ν component assuming ν¯ NC/CC=0.39+/-0.08. For events with visible hadron momentum above 25 GeV/c, where the neutral hadron contamination remaining in the NC sample is assumed to be negligible, the combined NC/CC is 0.323+/-0.025 and the K0 production rates are 0.375+/-0.064 per CC and 0.322+/-0.073 per NC event. The corresponding Λ rates are 0.161+/-0.030 per CC and 0.113+/-0.030 per NC event. The K0 and Λ distributions of the fractional hadron energy variable z in NC events are consistent with those in CC events.

  6. Study of rare earth separation by counter current electromigration

    International Nuclear Information System (INIS)

    Correa, Sergio Machado

    1995-08-01

    The counter current electromigration (CCEM) is an electrophoretic technique where the charged species migrate on an electrical field toward an electrolytic flux. Usually this electrolyte is a complexing agent and is necessary to increase the small differences between the species mobilities. A new column was developed, all made of acrylic, in a cylindrical shape. A set of experiments was carried out with the species Na + /K + , K + /Sm +3 , K + /Eu +3 and K + /Sm +3 /Eu +3 using the α-hydrox i-isobutyric acid o,01 M as the counter current electrolytic flux. From a synthetic mixture of 90% of samarium and 10% of europium was obtained the samarium ion in a purity better than 99,9% where the concentration of Eu was determined by the polarography technique. The potassium ion was used as a leading electrolyte. It was also measured the mobilities of the involved species in the α-HIBA medium. Two models are proposed, a stationary model and a dynamic one. A simulator of a simplified stationary model, prepared in FORTRAN language, was developed and tested toward experimental results. (author)

  7. An exploratory study of factors influencing resuscitation skills retention and performance among health providers.

    Science.gov (United States)

    Curran, Vernon; Fleet, Lisa; Greene, Melanie

    2012-01-01

    Resuscitation and life support skills training comprises a significant proportion of continuing education programming for health professionals. The purpose of this study was to explore the perceptions and attitudes of certified resuscitation providers toward the retention of resuscitation skills, regular skills updating, and methods for enhancing retention. A mixed-methods, explanatory study design was undertaken utilizing focus groups and an online survey-questionnaire of rural and urban health care providers. Rural providers reported less experience with real codes and lower abilities across a variety of resuscitation areas. Mock codes, practice with an instructor and a team, self-practice with a mannequin, and e-learning were popular methods for skills updating. Aspects of team performance that were felt to influence resuscitation performance included: discrepancies in skill levels, lack of communication, and team leaders not up to date on their skills. Confidence in resuscitation abilities was greatest after one had recently practiced or participated in an update or an effective debriefing session. Lowest confidence was reported when team members did not work well together, there was no clear leader of the resuscitation code, or if team members did not communicate. The study findings highlight the importance of access to update methods for improving providers' confidence and abilities, and the need for emphasis on teamwork training in resuscitation. An eclectic approach combining methods may be the best strategy for addressing the needs of health professionals across various clinical departments and geographic locales. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

  8. Patient resources available to bladder cancer patients: a pilot study of healthcare providers.

    Science.gov (United States)

    Lee, Cheryl T; Mei, Minghua; Ashley, Jan; Breslow, Gene; O'Donnell, Michael; Gilbert, Scott; Lemmy, Simon; Saxton, Claire; Sagalowsky, Arthur; Sansgiry, Shubhada; Latini, David M

    2012-01-01

    To survey thought leaders attending an annual bladder cancer conference about resources available to survivors at, primarily, large academic centers treating a high volume of patients. Bladder cancer is a disease with high treatment burden. Support groups and survivorship programs are effective at managing physical and psychosocial impairments experienced by patients. The Institute of Medicine recommends increased resources for cancer survivorship, but no description of current resources exists for bladder cancer patients. Preceding the 4th annual Bladder Cancer Think Tank meeting in August 2009, we carried out an Internet-based survey of registrants that queried respondents about institutional resources and support systems devoted to bladder cancer survivors. Data were collected using SurveyMonkey.com, and descriptive statistics were computed. A total of 43 eligible respondents included urologists (77%), medical oncologists (16%), and other physicians or health professionals (7%). Physician respondents represented 22 academic centers and 2 private groups. Although 63% of respondent institutions had a National Cancer Institute designation, only 33% had an active bladder cancer support group. Survivorship clinics were available in 29% of institutions, and peer support networks, community resources for education, and patient navigation were available in 58%, 13%, and 25% of respondent institutions, respectively. Resources for bladder cancer survivors vary widely and are lacking at several academic centers with high-volume bladder cancer populations. Bladder cancer providers are often unaware of available institutional resources for patients. Urologists need to advocate for additional survivor resources and partner with other disciplines to provide appropriate care. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. An Experimental Study of Energy Consumption in Buildings Providing Ancillary Services

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yashen [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Afshari, Sina [University of Michigan; Wolfe, John [University of Michigan; Nazir, Md Salman [University of Michigan; Hiskens, Ian A. [University of Michigan; Johnson, Jeremiah X. [University of Michigan; Mathieu, Johanna L. [University of Michigan; Barnes, Arthur K. [Los Alamos National Laboratory; Geller, Drew A. [Los Alamos National Laboratory; Backhaus, Scott N. [Los Alamos National Laboratory

    2017-10-03

    Heating, ventilation, and air conditioning (HVAC) systems in commercial buildings can provide ancillary services (AS) to the power grid, but by providing AS their energy consumption may increase. This inefficiency is evaluated using round-trip efficiency (RTE), which is defined as the ratio between the decrease and the increase in the HVAC system's energy consumption compared to the baseline consumption as a result of providing AS. This paper evaluates the RTE of a 30,000 m2 commercial building providing AS. We propose two methods to estimate the HVAC system's settling time after an AS event based on temperature and the air flow measurements from the building. Experimental data gathered over a 4-month period are used to calculate the RTE for AS signals of various waveforms, magnitudes, durations, and polarities. The results indicate that the settling time estimation algorithm based on the air flow measurements obtains more accurate results compared to the temperature-based algorithm. Further, we study the impact of the AS signal shape parameters on the RTE and discuss the practical implications of our findings.

  10. Challenges faced by healthcare providers offering infant feeding counseling to HIV-positive women in sub-Saharan Africa: A review of current research

    OpenAIRE

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

    2014-01-01

    Exclusive breastfeeding (EBF) has been identified as the optimal nutrition and critical behavior in attaining human immunodeficiency virus (HIV)-free infant survival in resource-limited settings. Healthcare providers (HCPs) in clinic- and community-settings throughout sub-Saharan Africa (sSA) provide infant feeding counseling. However, rates of EBF at 6 months of age are suboptimal. Healthcare providers (HCPs) are uniquely positioned to educate HIV-positive mothers and provide support by addr...

  11. Regional Development Fueled by Entrepreneurial Ventures Providing KIBS – Case Study on Romania

    Directory of Open Access Journals (Sweden)

    Vasile Alecsandru Strat

    2016-02-01

    Full Text Available The main goal of the current research paper is to analyze the evolution of the knowledge intensive business services sector from Romania, for the period 2008-2014, from a territorial point of view and to assess its impact in the general economic development. Using a time series of Gini coefficients and other quantitative instruments, the paper provides clear evidences that, during the 2008-2014 period, the domain has increased its concentration, Bucharest and the 10 most attractive counties being responsible for over 88% from the field’s activity at national level, in 2014. Another important fact is that Bucharest which is responsible for almost 66% of the field’s activity, in 2008, is diminishing constantly its importance during the analyzed period. Using panel regression, the presented research brings clear evidence that the main characteristics of the field (KIBS sector: number of companies, total turnover and number of employees can be used, as independent variables, in econometric models designed to estimate the size of the economy of the Romanian counties.

  12. Computer programs for eddy-current defect studies

    International Nuclear Information System (INIS)

    Pate, J.R.; Dodd, C.V.

    1990-06-01

    Several computer programs to aid in the design of eddy-current tests and probes have been written. The programs, written in Fortran, deal in various ways with the response to defects exhibited by four types of probes: the pancake probe, the reflection probe, the circumferential boreside probe, and the circumferential encircling probe. Programs are included which calculate the impedance or voltage change in a coil due to a defect, which calculate and plot the defect sensitivity factor of a coil, and which invert calculated or experimental readings to obtain the size of a defect. The theory upon which the programs are based is the Burrows point defect theory, and thus the calculations of the programs will be more accurate for small defects. 6 refs., 21 figs

  13. Computer programs for eddy-current defect studies

    Energy Technology Data Exchange (ETDEWEB)

    Pate, J. R.; Dodd, C. V. [Oak Ridge National Lab., TN (USA)

    1990-06-01

    Several computer programs to aid in the design of eddy-current tests and probes have been written. The programs, written in Fortran, deal in various ways with the response to defects exhibited by four types of probes: the pancake probe, the reflection probe, the circumferential boreside probe, and the circumferential encircling probe. Programs are included which calculate the impedance or voltage change in a coil due to a defect, which calculate and plot the defect sensitivity factor of a coil, and which invert calculated or experimental readings to obtain the size of a defect. The theory upon which the programs are based is the Burrows point defect theory, and thus the calculations of the programs will be more accurate for small defects. 6 refs., 21 figs.

  14. Important considerations when providing mental health first aid to Iraqi refugees in Australia: a Delphi study.

    Science.gov (United States)

    Uribe Guajardo, Maria Gabriela; Slewa-Younan, Shameran; Santalucia, Yvonne; Jorm, Anthony Francis

    2016-01-01

    Refugees are one of the most vulnerable groups in Australian society, presenting high levels of exposure to traumatic events and consequently high levels of severe psychological distress. While there is a need for professional help, only a small percentage will receive appropriate care for their mental health concerns. This study aimed to determine cultural considerations required when providing mental health first aid to Iraqi refugees experiencing mental health problems or crises. Using a Delphi method, 16 experts were presented with statements about possible culturally-appropriate first aid actions via questionnaires and were encouraged to suggest additional actions not covered by the questionnaire content. Statements were accepted for inclusion in a guideline if they were endorsed by ≥90 % of panellists as 'Essential' or 'Important'. From a total of 65 statements, 38 were endorsed (17 for cultural awareness, 12 for cross-cultural communication, 7 for stigma associated with mental health problems, and 2 for barriers to seeking professional help). Experts were able to reach consensus about how to provide culturally-appropriate first aid for mental health problems to Iraqi refugees, demonstrating the suitability of this methodology in developing cultural considerations guidelines. This specific refugee study provided potentially valuable cultural knowledge required to better equip members of the Australian public on how to respond to and assist Iraqi refugees experiencing mental health problems or crises.

  15. Studies of current-perpendicular-to-plane magnetoresistance (CPP-MR) and current-induced magnetization switching (CIMS)

    Science.gov (United States)

    Kurt, Huseyin

    2005-08-01

    We present two CPP-MR studies of spin-valves based upon ferromagnetic/nonmagnetic/ferromagnetic (F/N/F) trilayers. We measure the spin-diffusion lengths of N = Pd, Pt, and Au at 4.2K, and both the specific resistances (sample area A times resistance R) and spin-memory-loss of N/Cu interfaces. Pd, Pt and Au are of special device interest because they give perpendicular anisotropy when sandwiching very thin Co layers. Comparing our spin-memory-loss data at Pd/Cu and Pt/Cu interfaces with older data for Nb/Cu and W/Cu gives insight into the importance of spin-orbit coupling in producing such loss. We reproduce and extend prior studies by Eid of 'magnetic activity' at the interface of Co and N-metals (or combinations of N-metals), when the other side of the N-metal contacts a superconductor (S). Our data suggest that magnetic activity may require strong spin-flipping at the N/S interface. We present five studies of a new phenomenon, CIMS, in F1/N/F2 trilayers, with F1 a thick 'polarizing' layer and F2 a thin 'switching' layer. In all prior studies of CIMS, positive current caused the magnetization of F2 to switch from parallel (P) to anti-parallel (AP) to that of F1- 'normal' switching. By judicious addition of impurities to F-metals, we are able to controllably produce both 'normal' and 'inverse' switching- where positive current switches the magnetization of F2 from AP to P to that of F1. In the samples studied, whether the switching is normal or inverse is set by the 'net polarization' produced by F1 and is independent of the properties of F2. As scattering in the bulk of F1 and F2 is essential to producing our results, these results cannot be described by ballistic models, which allow scattering only at interfaces. Most CIMS experiments use Cu as the N-layer due to its low resistivity and long spin-diffusion length. We show that Ag and Au have low enough resistivities and long enough spin-diffusion lengths to be useful alternatives to Cu for some devices. While

  16. Descriptive study of external employee assistance program providers (EAP) in Japan.

    Science.gov (United States)

    Muto, Takashi; Haruyama, Yasuo; Higashi, Toshiaki

    2012-01-01

    The mental health problems of employees have become a major occupational health issue in Japan. External employee assistance program providers (EAP) have become important in mental health care for workers, but their activities are poorly documented. This descriptive study was undertaken to clarify the status and future tasks of EAP in Japan. The subjects were all EAP (n=27) registered in the Japanese Chapter of Employee Assistance Professionals Association. The questionnaire survey was conducted in January 2007. We received 13 replies, a response rate of 54.2%. Most EAP provided seminars, stress checks, stress management, counseling, and support for a return to work. The number of EAP contracted with small-scale enterprises was small. EAP communicated infrequently with companies. To promote the use of EAP, their advertising, education and training of staff, accumulation of scientific evidence, development of an official certification system for staff, and improvement of contents of EAP services were cited.

  17. Healthcare providers balancing norms and practice: challenges and opportunities in providing contraceptive counselling to young people in Uganda - a qualitative study.

    Science.gov (United States)

    Paul, Mandira; Näsström, Sara B; Klingberg-Allvin, Marie; Kiggundu, Charles; Larsson, Elin C

    2016-01-01

    Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. This study aims to explore healthcare providers' (HCPs) perceptions and practices regarding contraceptive counselling to young people. We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC) but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A) HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B) highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy with practical guidelines should be implemented alongside in

  18. A Comparative Study of Voltage, Peak Current and Dual Current Mode Control Methods for Noninverting Buck-Boost Converter

    Directory of Open Access Journals (Sweden)

    M. Č. Bošković

    2016-06-01

    Full Text Available This paper presents a comparison of voltage mode control (VMC and two current mode control (CMC methods of noninverting buck-boost converter. The converter control-to-output transfer function, line-to-output transfer function and the output impedance are obtained for all methods by averaging converter equations over one switching period and applying small-signal linearization. The obtained results are required for the design procedure of feedback compensator to keep a system stable and robust. A comparative study of VMC, peak current mode control (PCMC and dual-current mode control (DCMC is performed. Performance evaluation of the closed-loop system with obtained compensator between these methods is performed via numerical simulations.

  19. Safety and tolerability of transcranial direct current stimulation to stroke patients - A phase I current escalation study.

    Science.gov (United States)

    Chhatbar, Pratik Y; Chen, Rong; Deardorff, Rachael; Dellenbach, Blair; Kautz, Steven A; George, Mark S; Feng, Wuwei

    A prior meta-analysis revealed that higher doses of transcranial direct current stimulation (tDCS) have a better post-stroke upper-extremity motor recovery. While this finding suggests that currents greater than the typically used 2 mA may be more efficacious, the safety and tolerability of higher currents have not been assessed in stroke patients. We aim to assess the safety and tolerability of single session of up to 4 mA in stroke patients. We adapted a traditional 3 + 3 study design with a current escalation schedule of 1»2»2.5»3»3.5»4 mA for this tDCS safety study. We administered one 30-min session of bihemispheric montage tDCS and simultaneous customary occupational therapy to patients with first-ever ischemic stroke. We assessed safety with pre-defined stopping rules and investigated tolerability through a questionnaire. Additionally, we monitored body resistance and skin temperature in real-time at the electrode contact site. Eighteen patients completed the study. The current was escalated to 4 mA without meeting the pre-defined stopping rules or causing any major safety concern. 50% of patients experienced transient skin redness without injury. No rise in temperature (range 26°C-35 °C) was noted and skin barrier function remained intact (i.e. body resistance >1 kΩ). Our phase I safety study supports that single session of bihemispheric tDCS with current up to 4 mA is safe and tolerable in stroke patients. A phase II study to further test the safety and preliminary efficacy with multi-session tDCS at 4 mA (as compared with lower current and sham stimulation) is a logical next step. ClinicalTrials.gov Identifier: NCT02763826. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Current Experimental Studies of Gene Therapy in Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Jing-ya Lin

    2017-05-01

    Full Text Available Parkinson's disease (PD was characterized by late-onset, progressive dopamine neuron loss and movement disorders. The progresses of PD affected the neural function and integrity. To date, most researches had largely addressed the dopamine replacement therapies, but the appearance of L-dopa-induced dyskinesia hampered the use of the drug. And the mechanism of PD is so complicated that it's hard to solve the problem by just add drugs. Researchers began to focus on the genetic underpinnings of Parkinson's disease, searching for new method that may affect the neurodegeneration processes in it. In this paper, we reviewed current delivery methods used in gene therapies for PD, we also summarized the primary target of the gene therapy in the treatment of PD, such like neurotrophic factor (for regeneration, the synthesis of neurotransmitter (for prolong the duration of L-dopa, and the potential proteins that might be a target to modulate via gene therapy. Finally, we discussed RNA interference therapies used in Parkinson's disease, it might act as a new class of drug. We mainly focus on the efficiency and tooling features of different gene therapies in the treatment of PD.

  1. Current research efforts of EP study in Korea

    International Nuclear Information System (INIS)

    Ryu, C.M.

    2013-01-01

    After the successful demonstration of H mode on KSTAR, the problem of fast-ion driven MHD modes such as Alfven eigenmodes (AEs) and the reverse effects on fast ions of MHD modes is under study in KSTAR. In this paper, I will briefly describe some recent efforts of KSTAR on energetic particle physics study. (J.P.N.)

  2. Computerized analysis of isometric tension studies provides important additional information about vasomotor activity

    Directory of Open Access Journals (Sweden)

    Vincent M.B.

    1997-01-01

    Full Text Available Concentration-response curves of isometric tension studies on isolated blood vessels are obtained traditionally. Although parameters such as Imax, EC50 and pA2 may be readily calculated, this method does not provide information on the temporal profile of the responses or the actual nature of the reaction curves. Computerized data acquisition systems can be used to obtain average data that represent a new source of otherwise inaccessible information, since early and late responses may be observed separately in detail

  3. Providing mental health first aid in the workplace: a Delphi consensus study

    OpenAIRE

    Bovopoulos, Nataly; Jorm, Anthony F.; Bond, Kathy S.; LaMontagne, Anthony D.; Reavley, Nicola J.; Kelly, Claire M.; Kitchener, Betty A.; Martin, Angela

    2016-01-01

    Background Mental health problems are common in the workplace, but workers affected by such problems are not always well supported by managers and co-workers. Guidelines exist for the public on how to provide mental health first aid, but not specifically on how to tailor one?s approach if the person of concern is a co-worker or employee. A Delphi consensus study was carried out to develop guidelines on additional considerations required when offering mental health first aid in a workplace con...

  4. Study on the Swiss electricity market - the current situation

    International Nuclear Information System (INIS)

    Walti, N. O.

    2007-01-01

    This short article discusses the results of a study made on the opinions of energy suppliers in Switzerland with respect to future power generation in Switzerland. In particular, questions concerning new nuclear power stations and gas-fueled generating facilities are examined. The study was commissioned to tackle questions concerning the liberalisation of the electricity market, a future possible gap in supply, mains regulation and changes in market structure. The article discusses the findings of the study, in which 87 utilities took part, and lists strategic areas for action to be taken by electricity utilities such as efficiency analysis, regulation management, co-operative sourcing and possible mergers and acquisitions

  5. Remote Sensing Studies Of The Current Martian Climate

    Science.gov (United States)

    Taylor, F. W.; McCleese, D. J.; Schofield, J. T.; Calcutt, S. B.; Moroz, V. I.

    A systematic and detailed experimental study of the Martian atmosphere remains to be carried out, despite many decades of intense interest in the nature of the Martian climate system, its interactions, variability and long-term stability. Such a study is planned by the 2005 Mars Reconnaissance Orbiter, using limb-scanning infrared radiometric techniques similar to those used to study trace species in the terrestrial stratosphere. For Mars, the objectives are temperature, humidity, dust and condensate abundances with high vertical resolution and global coverage in the 0 to 80 km height range. The paper will discuss the experiment and its methodology and expectations for the results.

  6. Healthcare providers balancing norms and practice: challenges and opportunities in providing contraceptive counselling to young people in Uganda – a qualitative study

    Directory of Open Access Journals (Sweden)

    Mandira Paul

    2016-05-01

    Full Text Available Background: Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. Objective: This study aims to explore healthcare providers’ (HCPs perceptions and practices regarding contraceptive counselling to young people. Design: We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. Results: The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. Conclusions: Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy

  7. Telemedicine Provides Non-Inferior Research Informed Consent for Remote Study Enrollment: A Randomized Controlled Trial

    Science.gov (United States)

    Bobb, Morgan R.; Van Heukelom, Paul G.; Faine, Brett A.; Ahmed, Azeemuddin; Messerly, Jeffrey T.; Bell, Gregory; Harland, Karisa K.; Simon, Christian; Mohr, Nicholas M.

    2016-01-01

    Objective Telemedicine networks are beginning to provide an avenue for conducting emergency medicine research, but using telemedicine to recruit participants for clinical trials has not been validated. The goal of this consent study is to determine whether patient comprehension of telemedicine-enabled research informed consent is non-inferior to standard face-to-face research informed consent. Methods A prospective, open-label randomized controlled trial was performed in a 60,000-visit Midwestern academic Emergency Department (ED) to test whether telemedicine-enabled research informed consent provided non-inferior comprehension compared with standard consent. This study was conducted as part of a parent clinical trial evaluating the effectiveness of oral chlorhexidine gluconate 0.12% in preventing hospital-acquired pneumonia among adult ED patients with expected hospital admission. Prior to being recruited into the study, potential participants were randomized in a 1:1 allocation ratio to consent by telemedicine versus standard face-to-face consent. Telemedicine connectivity was provided using a commercially available interface (REACH platform, Vidyo Inc., Hackensack, NJ) to an emergency physician located in another part of the ED. Comprehension of research consent (primary outcome) was measured using the modified Quality of Informed Consent (QuIC) instrument, a validated tool for measuring research informed consent comprehension. Parent trial accrual rate and qualitative survey data were secondary outcomes. Results One-hundred thirty-one patients were randomized (n = 64, telemedicine), and 101 QuIC surveys were completed. Comprehension of research informed consent using telemedicine was not inferior to face-to-face consent (QuIC scores 74.4 ± 8.1 vs. 74.4 ± 6.9 on a 100-point scale, p = 0.999). Subjective understanding of consent (p=0.194) and parent trial study accrual rates (56% vs. 69%, p = 0.142) were similar. Conclusion Telemedicine is non-inferior to face

  8. A qualitative study of the challenges of providing pre-prosthetic rehabilitation in rural South Africa.

    Science.gov (United States)

    Ennion, Liezel; Johannesson, Anton

    2018-04-01

    There is a known shortage of rehabilitation staff in rural settings and a sharp increase in the number of lower limb amputations being performed. A lack of adequate pre-prosthetic rehabilitation will result in worse physical and psychological outcomes for a person with a lower limb amputation, and they will not be eligible to be fitted with a prosthesis. To explore therapists' experiences with providing pre-prosthetic rehabilitation in a rural setting. A qualitative descriptive approach was used to collect and analyse data. Data were collected from 17 purposively sampled therapists in five district hospitals in a rural community in South Africa. Data were collected in two rounds of focus groups to explore the challenges of providing pre-prosthetic rehabilitation in rural South Africa. The main themes identified in the study were (1) a lack of government health system support, (2) poor socioeconomic circumstances of patients and (3) cultural factors that influence rehabilitation. These themes all negatively influence the therapists' ability to follow up patients for pre-prosthetic rehabilitation after discharge from hospital. A lack of adequate pre-prosthetic rehabilitation is a substantial barrier to prosthetic fitting in rural South Africa. Patients who do not receive pre-prosthetic rehabilitation have a poorly shaped residuum or other complications such as knee or hip joint contractures which disqualifies them from being referred to prosthetic services. Therapists involved in this study identified the most important barriers to patients having access to prosthetic services. Clinical relevance Pre-prosthetic rehabilitation provides care of the residuum; maintenance or improvement of physical strength, joint range of motion and referral to a prosthetist. By exploring the challenges known to exist in this service, we can identify potential ways to reduce these barriers and improve the lives of those who use it.

  9. Knowledge, attitude & practice on human papillomavirus vaccination: A cross-sectional study among healthcare providers.

    Science.gov (United States)

    Chawla, P Cheena; Chawla, Anil; Chaudhary, Seema

    2016-11-01

    Cervical cancer is a major health problem and a leading cause of death among women in India. Of all the associated risk factors, high-risk human papillomavirus (HPV) infections being the principal aetiologic agent, two HPV vaccines are in use for the control of cervical cancer. The present study was undertaken to explore the knowledge, attitude and practice (KAP) on HPV vaccination among the healthcare providers in India. A cross-sectional study was conducted among 590 healthcare professionals from 232 hospitals and 80 PHCs of nine districts of Delhi-NCR (National Capital Region). A total of 590 (526 female, 64 male) healthcare providers were surveyed. Only 47 per cent of respondents recommended young women to get vaccinated against HPV. Majority of respondents (81%) were found to be aware about the existence of vaccines for cervical cancer prevention. District-wise, highest (88.3%) awareness about the existence of vaccines against HPV was reported from Gautam Budh Nagar and lowest (64%) in Faridabad. Although 86 per cent of gynaecologists were aware about the names of HPV vaccines available in the market, only 27 per cent of paramedical staff had this knowledge. There was a significant difference between the respondents from government and private sectors regarding their awareness about HPV vaccines. Lack of awareness about the principal cause, risk factors and symptoms for cervical cancer and HPV vaccination was significantly (P< 0.05) reported in the respondents from paramedical staff category. The findings reinforce continued medical education of healthcare providers, particularly those from the government sector on HPV vaccination for cervical cancer prevention. Public education is also pertinent for a successful HPV vaccination programme in the country.

  10. Community and Healthcare Providers' Perspectives on Male Circumcision: A Multi-Centric Qualitative Study in India

    Science.gov (United States)

    Sahay, Seema; Nagarajan, Karikalan; Mehendale, Sanjay; Deb, Sibnath; Gupta, Abhilasha; Bharat, Shalini; Bhatt, Shripad; Kumar, Athokpam Bijesh; Kanthe, Vidisha; Sinha, Anju; Chandhiok, Nomita

    2014-01-01

    Background Although male circumcision (MC) is recommended as an HIV prevention option, the religious, cultural and biomedical dimensions of its feasibility, acceptability and practice in India have not been explored till date. This study explores beliefs, experiences and understanding of the community and healthcare providers (HCPs) about adult MC as an HIV prevention option in India. Methods This qualitative study covered 134 in-depth interviews from Belgaum, Kolkata, Meerut and Mumbai cities of India. Of these, 62 respondents were the members of circumcising (CC)/non-circumcising communities (NCC); including medically and traditionally circumcised men, parents of circumcised children, spouses of circumcised men, and religious clerics. Additionally, 58 registered healthcare providers (RHCPs) such as general and pediatric surgeons, pediatricians, skin and venereal disease specialists, general practitioners, and operation theatre nurses were interviewed. Fourteen traditional circumcisers were also interviewed. The data were coded and analyzed in QSR NUD*IST ver. 6.0. The study has not explored the participants' views about neonatal versus adult circumcision. Results Members of CC/NCC, traditional circumcisers and RCHPs expressed sharp religious sensitivities around the issue of MC. Six themes emerged: Male circumcision as the religious rite; Multiple meanings of MC: MC for ‘religious identity/privilege/sacrifice’ or ‘hygiene’; MC inflicts pain and cost; Medical indications outweigh faith; Hesitation exists in accepting ‘foreign’ evidence supporting MC; and communication is the key for acceptance of MCs. Medical indications could make members of NCC accept MC following appropriate counseling. Majority of the RHCPs demanded local in-country evidence. Conclusion HCPs must educate high-risk groups regarding the preventive and therapeutic role of MC. Communities need to discuss and create new social norms about male circumcision for better societal acceptance

  11. Community and healthcare providers' perspectives on male circumcision: a multi-centric qualitative study in India.

    Directory of Open Access Journals (Sweden)

    Seema Sahay

    Full Text Available Although male circumcision (MC is recommended as an HIV prevention option, the religious, cultural and biomedical dimensions of its feasibility, acceptability and practice in India have not been explored till date. This study explores beliefs, experiences and understanding of the community and healthcare providers (HCPs about adult MC as an HIV prevention option in India.This qualitative study covered 134 in-depth interviews from Belgaum, Kolkata, Meerut and Mumbai cities of India. Of these, 62 respondents were the members of circumcising (CC/non-circumcising communities (NCC; including medically and traditionally circumcised men, parents of circumcised children, spouses of circumcised men, and religious clerics. Additionally, 58 registered healthcare providers (RHCPs such as general and pediatric surgeons, pediatricians, skin and venereal disease specialists, general practitioners, and operation theatre nurses were interviewed. Fourteen traditional circumcisers were also interviewed. The data were coded and analyzed in QSR NUD*IST ver. 6.0. The study has not explored the participants' views about neonatal versus adult circumcision.Members of CC/NCC, traditional circumcisers and RCHPs expressed sharp religious sensitivities around the issue of MC. Six themes emerged: Male circumcision as the religious rite; Multiple meanings of MC: MC for 'religious identity/privilege/sacrifice' or 'hygiene'; MC inflicts pain and cost; Medical indications outweigh faith; Hesitation exists in accepting 'foreign' evidence supporting MC; and communication is the key for acceptance of MCs. Medical indications could make members of NCC accept MC following appropriate counseling. Majority of the RHCPs demanded local in-country evidence.HCPs must educate high-risk groups regarding the preventive and therapeutic role of MC. Communities need to discuss and create new social norms about male circumcision for better societal acceptance especially among the NCC. Feasibility

  12. Descriptive currents in philosophy of religion for Hebrew Bible studies

    African Journals Online (AJOL)

    This article argued that the utilisation of philosophy of religion in the study of the Hebrew Bible is possible if we look beyond the stereotype of erroneously equating the auxiliary field with natural theology, apologetics or atheological criticism. Fruitful possibilities for interdisciplinary research are available in the form of ...

  13. Open-label extension studies: do they provide meaningful information on the safety of new drugs?

    Science.gov (United States)

    Day, Richard O; Williams, Kenneth M

    2007-01-01

    The number of open-label extension studies being performed has increased enormously in recent years. Often it is difficult to differentiate between these extension studies and the double-blind, controlled studies that preceded them. If undertaken primarily to gather more patient-years of exposure to the new drug in order to understand and gain confidence in its safety profile, open-label extension studies can play a useful and legitimate role in drug development and therapeutics. However, this can only occur if the open-label extension study is designed, executed, analysed and reported competently. Most of the value accrued in open-label extension studies is gained from a refinement in the perception of the expected incidence of adverse effects that have most likely already been identified as part of the preclinical and clinical trial programme. We still have to rely heavily on post-marketing safety surveillance systems to alert us to type B (unpredictable) adverse reactions because open-label extension studies are unlikely to provide useful information about these types of often serious and relatively rare adverse reactions. Random allocation into test and control groups is needed to produce precise incidence data on pharmacologically expected, or type A, adverse effects. Some increased confidence about incidence rates might result from the open-label extension study; however, as these studies are essentially uncontrolled and biased, the data are not of great value. Other benefits have been proposed to be gained from open-label extension studies. These include ongoing access to an effective but otherwise unobtainable medicine by the volunteers who participated in the phase III pivotal trials. However, there are unappreciated ethical issues about the appropriateness of enrolling patients whose response to previous treatment is uncertain, largely because treatment allocation in the preceding randomised, double-blind, controlled trial has not been revealed at the

  14. Dosimetric Study of Current Treatment Options for Radiotherapy in Retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Eldebawy, Eman [Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada); Department of Radiation Oncology, Children' s Cancer Hospital, Cairo (Egypt); Parker, William, E-mail: william.parker@mcgill.ca [Department of Medical Physics, McGill University Health Centre, Montreal, Quebec (Canada); Abdel Rahman, Wamied [Department of Medical Physics, McGill University Health Centre, Montreal, Quebec (Canada); Freeman, Carolyn R. [Department of Radiation Oncology, McGill University Health Centre, Montreal, Quebec (Canada)

    2012-03-01

    Purpose: To determine the best treatment technique for patients with retinoblastoma requiring radiotherapy to the whole eye. Methods and Materials: Treatment plans for 3 patients with retinoblastoma were developed using 10 radiotherapy techniques including electron beams, photon beam wedge pair (WP), photon beam three-dimensional conformal radiotherapy (3D-CRT), fixed gantry intensity-modulated radiotherapy (IMRT), photon volumetric arc therapy (VMAT), fractionated stereotactic radiotherapy, and helical tomotherapy (HT). Dose-volume analyses were carried out for each technique. Results: All techniques provided similar target coverage; conformity was highest for VMAT, nine-field (9F) IMRT, and HT (conformity index [CI] = 1.3) and lowest for the WP and two electron techniques (CI = 1.8). The electron techniques had the highest planning target volume dose gradient (131% of maximum dose received [D{sub max}]), and the CRT techniques had the lowest (103% D{sub max}) gradient. The volume receiving at least 20 Gy (V{sub 20Gy}) for the ipsilateral bony orbit was lowest for the VMAT and HT techniques (56%) and highest for the CRT techniques (90%). Generally, the electron beam techniques were superior in terms of brain sparing and delivered approximately one-third of the integral dose of the photon techniques. Conclusions: Inverse planned image-guided radiotherapy delivered using HT or VMAT gives better conformity index, improved orbital bone and brain sparing, and a lower integral dose than other techniques.

  15. Women's and care providers' perspectives of quality prenatal care: a qualitative descriptive study

    Science.gov (United States)

    2012-01-01

    Background Much attention has been given to the adequacy of prenatal care use in promoting healthy outcomes for women and their infants. Adequacy of use takes into account the timing of initiation of prenatal care and the number of visits. However, there is emerging evidence that the quality of prenatal care may be more important than adequacy of use. The purpose of our study was to explore women's and care providers' perspectives of quality prenatal care to inform the development of items for a new instrument, the Quality of Prenatal Care Questionnaire. We report on the derivation of themes resulting from this first step of questionnaire development. Methods A qualitative descriptive approach was used. Semi-structured interviews were conducted with 40 pregnant women and 40 prenatal care providers recruited from five urban centres across Canada. Data were analyzed using inductive open and then pattern coding. The final step of analysis used a deductive approach to assign the emergent themes to broader categories reflective of the study's conceptual framework. Results The three main categories informed by Donabedian's model of quality health care were structure of care, clinical care processes, and interpersonal care processes. Structure of care themes included access, physical setting, and staff and care provider characteristics. Themes under clinical care processes were health promotion and illness prevention, screening and assessment, information sharing, continuity of care, non-medicalization of pregnancy, and women-centredness. Interpersonal care processes themes were respectful attitude, emotional support, approachable interaction style, and taking time. A recurrent theme woven throughout the data reflected the importance of a meaningful relationship between a woman and her prenatal care provider that was characterized by trust. Conclusions While certain aspects of structure of care were identified as being key dimensions of quality prenatal care, clinical and

  16. Historical ecology provides new insights for ecosystem management: Eastern Baltic cod case study

    DEFF Research Database (Denmark)

    MacKenzie, Brian; Ojaveer, Henn; Eero, Margit

    2011-01-01

    A recent historical marine ecological case study (cod in the eastern Baltic Sea) is used to show how long-term data and knowledge of fluctuations can contribute to revisions of fishery management policy. The case study first developed new longer analytical time series of spawner biomass and recru......A recent historical marine ecological case study (cod in the eastern Baltic Sea) is used to show how long-term data and knowledge of fluctuations can contribute to revisions of fishery management policy. The case study first developed new longer analytical time series of spawner biomass...... catch data from the late 1500s to early 1600s also contributed new perspectives to cod population dynamics under alternative ecosystem forcings. These new perspectives have contributed, and will likely continue to contribute to new management policies (e.g., revision of fishery management reference...... points), which should lead to higher sustainability of the population and fishery yields, and improved overall ecosystem health. These perspectives will likely continue to provide baseline information as ICES and the EU develop new policies based on maximum sustainable yield concepts....

  17. Providing Appropriate Technology for Emerging Markets: Case Study on China’s Solar Thermal Industry

    Directory of Open Access Journals (Sweden)

    Jianghua Zhou

    2017-01-01

    Full Text Available Building on a case study of five Chinese solar thermal companies and one association, our study aims to understand how the innovator’s choices regarding the use of technology and organizational practices for new product development enable companies to design and diffuse appropriate technology in emerging markets. The study uncovers two critical factors that enhance the appropriateness of technology: redefining the identity of technology and building a local supply system. Our analysis shows that synergic innovation in both architecture and component leads to the appropriate functionalities desired by emerging markets. Moreover, modular design and the building of a local supply system enhance the process appropriateness of technology. Our study provides an empirical basis for advocating going beyond minor adaptations of existing products to creating appropriate technology for emerging markets, and extends our understandings of the upstream process of designing appropriate technology. Moreover, the emphasis on the local supply system reflects a holistic framework for shaping and delivering appropriate technology, expanding the existing research focus on the perspective of the technology itself. Our research also has managerial implications that may help firms tap into emerging markets.

  18. Current status of crushed rock and whole rock column studies

    International Nuclear Information System (INIS)

    Vine, E.N.; Daniels, W.R.; Rundberg, R.S.; Thompson, J.L.

    1980-01-01

    Measurements on a large number of crushed rock columns of tuff, granite, and argillite are discussed. The isotopes 85 Sr, 137 Cs, 133 Ba, 141 Ce, 152 Eu, /sup 95m/Tc, and 233 U were used. Flow rates were varied from approx. 30 to approx. 30000 m/y. Other parameters studied include isotope concentration and atmosphere. The sorption ratios calculated were compared with batch sorption ratios on the same samples. Methods of studying the movement of radionuclides through whole rock cores are described. The problems associated with sealing the cores to prevent leaking along the exterior surface and one possible solution are discussed. The strontium sorption ratio obtained by elution of one solid tuff core is compared with the batch and crushed rock column sorption ratios

  19. Study of efficiency and current use of respiratory protective devices

    International Nuclear Information System (INIS)

    Linauskas, S.H.; Kalos, F.

    1984-12-01

    The efficiency of a helmet-type powered air-purifying respirator was studied in the work environment of an underground uranium mine. Workplace protection factors (WPF) were measured, using approximately 30-minute air sampling periods and repeated sampling throughout the work shifts for six miners during three shifts each. The WPF of the modified Racal AH-5 helmet was 17.8 (geometric mean) with new filters in the respirator; the WPF dropped to 5.3 when four-day-old filters were used. The WPF results were lognormally distributed. The test population appeared to be a homogeneous set: there was no significant difference in the mean WPFs of individual test subjects. The study could not resolve any effect of elapsed time within the work shift or of ambient Working Level on the WPF. The actual use levels and the problems associated with respirator use were studied at the same time, principally via a user survey. The respirators have a high level of acceptance among the user population of underground uranium miners and 72.5 percent of the 207 survey respondents stated six or more hours use with the visor in the correct 'down' position per shift

  20. The current status of glass leaching studies in France

    International Nuclear Information System (INIS)

    Laude, F.

    1983-11-01

    Glass has been selected in France as the material used to confine the activity of fission product solutions, and a continuous vitrification process has been developed at the Marcoule Vitrification Facility (AVM), the first industrial plant. Borosilicate glass was chosen in various compositions for its properties: it is a homogeneous, non-porous material that incorporates appreciable quantities of most of the fission product oxides, and is only alterable at the surface interface layer. Glass thus constitutes the primary radioactivity containment barrier, and it is essential to determine its long-term behavior. Water constitutes the principal hazard during temporary or definitive storage of the glass blocks. Two types of inherent material properties are studied from the standpoint of glass stability under leaching conditions: - chemical durability; - radioactive containability with regard to the various radionuclides, fission products and especially the actinides. Durability tests are carried out in SOXHLET devices and the alteration rates are measured by the weight loss. The containability is measured by the leach rate, i.e. by the rate of activity loss into the water. Leaching tests are conducted for several major objectives: - selection of glass compositions (leach rates); - leaching mechanism studies (hydrolyzed layer characteristics, effects of temperature, pressure, pH, etc.); - long-term behavior studies (glass specimens doped with alpha-emitters); - simulation of geological repository environments [fr

  1. The Commercialisation of Modern Islamic Insurance Providers: A Study of Takaful Business Frameworks in Malaysia

    Directory of Open Access Journals (Sweden)

    Kamaruzaman Noordin

    2014-06-01

    Full Text Available A commercial insurance contract is deemed invalid by many Muslim scholars due to the fact that it is a mu`awada (financial exchange contract, which is overwhelmed by prohibited elements such as gharar (uncertainty, riba (interest, and maysir (gambling. As an alternative, a Shari`acompliant insurance scheme (also known as takaful that supposedly run on the principles of mutual co-operation was proposed by the scholars and subsequently institutionalized in the late 1970s. Nevertheless, after more than 30 years, it appears that the majority of takaful operators currently exist worldwide were established as joint-stock or public limited companies (PLCs. As a result, it could be argued that the original concept of takaful was later overshadowed by the element of profit-making as observed in commercial insurance entities. This paper therefore sets out to examine those issues, which directly relate to this form of commercialisation. It argues that since the establishment of insurance companies based on commercial framework is impermissible, it could possibly affect the validity of present takaful arrangement. This study is mainly qualitative and relies greatly upon the documentation method. It is also based on afieldwork method, since the business models adopted by several takaful operators in Malaysia are carefully examined. In general, it is found that the characteristics of a commercial takaful entity may not necessarily be similar to that of its conventional counterpart.

  2. Primary care providers' experiences caring for complex patients in primary care: a qualitative study.

    Science.gov (United States)

    Loeb, Danielle F; Bayliss, Elizabeth A; Candrian, Carey; deGruy, Frank V; Binswanger, Ingrid A

    2016-03-22

    Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs' experiences providing care for complex patients, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care. Using a general inductive approach, our qualitative research study was guided by an interpretive epistemology, or way of knowing. Our method for understanding included semi-structured in-depth interviews with internal medicine PCPs from two university-based and three community health clinics. We developed an interview guide, which included questions on PCPs' experiences, perceived system barriers and facilitators, and strategies to improve their ability to effectively treat complex patients. To focus interviews on real cases, providers were asked to bring de-identified clinical notes from patients they considered complex to the interview. Interview transcripts were coded and analyzed to develop categories from the raw data, which were then conceptualized into broad themes after team-based discussion. PCPs (N = 15) described complex patients with multidimensional needs, such as socio-economic, medical, and mental health. A vision of optimal care emerged from the data, which included coordinating care, preventing hospitalizations, and developing patient trust. PCPs relied on professional values and individual care strategies to overcome local and system barriers. Team based approaches were endorsed to improve the management of complex patients. Given the barriers to effective care described by PCPs, individual PCP efforts alone are unlikely to meet the needs of complex patients. To fulfill PCP's expressed concepts of

  3. The mental wellbeing of current and retired professional cricketers: an observational prospective cohort study.

    Science.gov (United States)

    Schuring, Nannet; Kerkhoffs, Gino; Gray, Janine; Gouttebarge, Vincent

    2017-11-01

    Scientific knowledge about symptoms of common mental disorders in professional cricket is non-existent. Consequently, the aims of the study were to determine the prevalence and the 6 months incidence of symptoms of common mental disorders (CMD: distress, anxiety/depression, sleep disturbance, adverse alcohol use) among current and former professional cricketers and to explore the association of potential stressors (significant injury, surgery, adverse life events, career dissatisfaction) and CMD. An observational prospective cohort study with a follow-up period of 6 months was conducted among current and former professional cricketers from South Africa. Using validated questionnaires to assess symptoms of common mental disorders as well as several stressors, an electronic questionnaire was set up and distributed by the South African Cricketers Association (SACA). A total of 116 participants enrolled at baseline (overall response rate of 33%) and 76 of those participants completed the 6 month follow-up (follow up rate of 66%). The prevalence of symptoms of CMD in current professional cricketers was 38% for distress, 38% for sleep disturbance, 37% for anxiety/depression and 26% for adverse alcohol use. Among former professional cricketers, baseline prevalence as was 26% for distress, 24% for anxiety/depression, 21% for sleep disturbance and 22% for adverse alcohol use. Career dissatisfaction led to an increased risk of distress, anxiety/depression and sleep disturbance in current professional cricketers. Surgeries and adverse life events led to an increase in reported symptoms of distress and anxiety/depression in current professional cricketers. It was concluded that symptoms of CMD are prevalent in both current and former professional cricketers and the association with surgery, adverse life events and cricket career dissatisfaction may provide some insight into possible mechanisms.

  4. Study of charged current reactions induced by muon antineutrinos

    International Nuclear Information System (INIS)

    Huss, D.

    1979-07-01

    We present in this work a study of antineutrino reactions on light targets. We have used the Gargamelle cloud chamber with a propane-freon mix. In the 2 first chapters we give a brief description of the experimental setting and we present the selection criteria of the events. In the third chapter we analyse the data for the reaction anti-ν + p → μ + + n that preserves strangeness. We have deduced the values of the axial (M A ) and vector (M V ) form factors: M A = (O.92 ± 0.08) GeV and M V = (0.86 ± 0.04) GeV. In the fourth chapter we study reactions in which strange particles appear (ΔS = 1) and we have determined their production cross-sections. The elastic reaction: anti-ν + p → μ + + Λ is studied in a more accurate manner thanks to a 3-constraint adjustment that enables the selection of events occurring on free protons. We have deduced from our data the longitudinal, orthogonal and transverse polarization of Λ, we have got respectively P l = -0.06 ± 0.44; P p = 0.29 ± 0.41; P t 1.05 ± 0.30. We have also deduced the values of the total cross-section as a function of the incident antineutrino energy E: σ (0.27 ± 0.02)*E*10 -38 cm -2 . E has been assessed from the energy deposited in the cloud chamber and we have adjusted the cross-section with a straight line as it is expected under the assumption of scale invariance. (A.C.)

  5. A study of the current group evaporation/combustion theories

    Science.gov (United States)

    Shen, Hayley H.

    1990-01-01

    Liquid fuel combustion can be greatly enhanced by disintegrating the liquid fuel into droplets, an effect achieved by various configurations. A number of experiments carried out in the seventies showed that combustion of droplet arrays and sprays do not form individual flames. Moreover, the rate of burning in spray combustion greatly deviates from that of the single combustion rate. Such observations naturally challenge its applicability to spray combustion. A number of mathematical models were developed to evaluate 'group combustion' and the related 'group evaporation' phenomena. This study investigates the similarity and difference of these models and their applicability to spray combustion. Future work that should be carried out in this area is indicated.

  6. A case study about the transformation of a traditional carrier in a logistic provider

    Directory of Open Access Journals (Sweden)

    Gabriel Sperandio Milan

    2013-11-01

    Full Text Available Logistics operation outsourcing has become a regular practice for many companies strategy. As result, the use of specialized services provided by logistic operators appears as a way to increase company’s competitiveness. In order to respond to this need and add value to services offered, many cargo transport companies have changed their business to logistic operators. Thus, this article presents an analysis related to the organization, adaptation and evolution of a traditional cargo transport company to become a logistic operator. A qualitative-exploratory methodology, implemented by means a single case study, was used to develop this research. To data collection, in depth individual interviews were done, with a semi-structured approached. In addition, data were used from direct observation and documental research. The techniques used to analyze the results are understood by content analysis. As result of the transformation process, the organization increased its competitiveness, by value aggregation to its services and looking for long term relationship with its customers. Also, optimization of available and existing resources and quality improvement of provided services were perceived by company during the transformation process. The company transformation into a logistic operator reflected in greater credibility and expansion of the services offered, resulting in billing and profitability increase and a differential against the competitors.

  7. Does the Internet provide patients or clinicians with useful information regarding faecal incontinence? An observational study.

    Science.gov (United States)

    Leo, C A; Murphy, J; Hodgkinson, J D; Vaizey, C J; Maeda, Y

    2018-01-01

    The Internet has become an important platform for information communication. This study aim to investigate the utility of social media and search engines to disseminate faecal incontinence information. We looked into Social media platforms and search engines. There was not a direct patient recruitment and any available information from patients was already on public domain at the time of search. A quantitative analysis of types and volumes of information regarding faecal incontinence was made. Twelve valid pages were identified on Facebook: 5 (41%) pages were advertising commercial incontinence products, 4 (33%) pages were dedicated to patients support groups and 3 (25%) pages provided healthcare information. Also we found 192 Facebook posts. On Twitter, 2890 tweets were found of which 51% tweets provided healthcare information; 675 (45%) were sent by healthcare professionals to patients, 530 tweets (35.3%) were between healthcare professionals, 201 tweets (13.4%) were from medical journals or scientific books and 103 tweets (7%) were from hospitals or clinics with information about events and meetings. The second commonest type of tweets was advertising commercial incontinence products 27%. Patients tweeted to exchange information and advice between themselves (20.5%). In contrast, search engines as Google/Yahoo/Bing had a higher proportion of healthcare information (over 70%). Internet appears to have potential to be a useful platform for patients to learn about faecal incontinence and share information; however, given one lack of focus of available data, patients may struggle to identify valid and useful information.

  8. A diagnostic study of Department of Health training courses for family planning providers.

    Science.gov (United States)

    Rood, S; Raquepo, M; Ladia, M A

    1993-01-01

    A study in the Philippines sought to observe and describe the family planning (FP) training program in two regions. This program trains physicians, nurses, and midwives as a team and includes a Basic/Comprehensive (B/C) course in FP with didactic and practicum elements, training in interpersonal communication skills (ICS) for those who have completed with B/C course, and a Preceptors Course for those who will supervise the practicum phase of the B/C course. The study gathered specific information on 1) trainee absenteeism and drop-out rates, 2) course content and effects, 3) the trainee selection process, 4) the practicum requirement for the B/C course, and 5) service delivery values and quality of care. Data were collected through observations, questionnaires, exit interviews with clients during the practicum phase, interviews with supervisors and public officials (mayors), and focus group discussions with regional trainers. This assessment led to the following recommendations: 1) maintain the current team approach; 2) reserve basic orientation-type subjects for office-based training to allow more time for FP topics in the training programs; 3) use caution in making a switch to "competency-based" training because of the possibility that supervision is inadequate for such a training method; 4) improve scheduling; 5) enforce the prerequisites for participation in the ICS and Preceptors Courses; 6) assign only one trainee to a preceptor area during the practicum and reduce the quota of IUD insertions to reduce pressure to obtain IUD acceptors; 7) create a "model" FP clinic each time a preceptor is trained; 8) pay more attention to natural FP methods; and 9) maintain an emphasis on quality of care.

  9. Current tritium chemical studies at Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Smith, F.J.; Redman, J.D.; Strehlow, R.A.; Bell, J.T.

    1975-01-01

    The equilibrium pressures of hydrogen isotopes in the Li-LiH-H 2 , Li-LiD-D 2 and Li-LiT-T 2 systems are being measured. The solubility of hydrogen in lithium was studied and the data are in reasonable agreement with the literature values. The Li-LiD-D 2 system is now being studied. The first experimental measurements of the equilibrium pressures of tritium between 700 and 1000 0 C as a function of the LiT concentration in the Li-LiT-T 2 system have also been completed. The permeation of tritium through clean metals and through metals under simulated steam generator conditions is being investigated. Measurements of tritium permeation through clean nickel at temperatures between 636 and 910 0 K were made using a mixed isotope technique. The tritium permeability, DK/sub s/', as a function of temperature was determined to be ln DK/sub s/' [cc(NTP).mm.min -1 .torr/sup -1/2/.cm -2 ] = -0.906 - 6360/T( 0 K). The measured permeation activation energy was 12.6 +- 0.4 kcal/mole. (MOW)

  10. TELECOMMUTING AND HRM: A CASE STUDY OF AN INFORMATION TECHNOLOGY SERVICE PROVIDER

    Directory of Open Access Journals (Sweden)

    André Fernandes Bernardino

    2012-08-01

    Full Text Available With the development in information technology resources, a way of working has been standing out: telecommuting. This manner of working from a distance may offer a competitive advantage in attracting and retaining highly skilled professionals. The purpose of the research presented in this article is to identify guidelines for the implementation and management of telecommuting, as an alternative to overcome the shortage of qualified professionals in Information Technology (IT. The results, based on a case study of a Brazilian subsidiary of a multinational organization that provides IT services, shown that telecommuting (1 contributes to attracting and retaining qualified professionals in IT, (2 should be based on trustworthy relationships, (3 has to be supported by a strategy of decentralization of both structure and organizational assets.

  11. A study for providing additional storage spaces to ET-RR-1 spent fuel

    International Nuclear Information System (INIS)

    El-Kady, A.; Ashoub, N.; Saleh, H.G.

    1995-01-01

    The ET-RR-1 reactor spent fuel storage pool is a trapezoidal aluminum tank concrete shield and of capacity 10 m 3 . It can hold up to 60 fuel assemblies. The long operation history of the ET-RR-1 reactor resulted in a partially filled spent fuel storage with the remaining spaces not enough to host a complete load from the reactor. This work have been initiated to evaluate possible alternative solutions for providing additional storage spaces to host the available EK-10 fuel elements after irradiation and any foreseen fuel in case of reactor upgrading. Several alternate solutions have been reviewed and decision on the most suitable one is under study. These studies include criticality calculation of some suggested alternatives like reracking the present spent fuel storage pool and double tiering by the addition of a second level storage rack above the existing rack. The two levels may have different factor. Criticality calculation of the double tiering possible accident was also studied. (author)

  12. Expert advice provided through telemedicine improves healing of chronic wounds: prospective cluster controlled study.

    Science.gov (United States)

    Zarchi, Kian; Haugaard, Vibeke B; Dufour, Deirdre N; Jemec, Gregor B E

    2015-03-01

    Telemedicine is widely considered as an efficient approach to manage the growing problem of chronic wounds. However, to date, there is no convincing evidence to support the clinical efficacy of telemedicine in wound management. In this prospective cluster controlled study, we tested the hypothesis that advice on wound management provided by a team of wound-care specialists through telemedicine would significantly improve the likelihood of wound healing compared with the best available conventional practice. A total of 90 chronic wound patients in home care met all study criteria and were included: 50 in the telemedicine group and 40 in the conventional group. Patients with pressure ulcers, surgical wounds, and cancer wounds were excluded. During the 1-year follow-up, complete wound healing was achieved in 35 patients (70%) in the telemedicine group compared with 18 patients (45%) in the conventional group. After adjusting for important covariates, offering advice on wound management through telemedicine was associated with significantly increased healing compared with the best available conventional practice (telemedicine vs. conventional practice: adjusted hazard ratio 2.19; 95% confidence interval: 1.15-4.17; P=0.017). This study strongly supports the use of telemedicine to connect home-care nurses to a team of wound experts in order to improve the management of chronic wounds.

  13. The epidemiology of skin care provided by nurses at home: a multicentre prevalence study.

    Science.gov (United States)

    Kottner, Jan; Boronat, Xavier; Blume-Peytavi, Ulrike; Lahmann, Nils; Suhr, Ralf

    2015-03-01

    The aim of this study was to estimate the frequencies and patterns of skin care and applied skin care products in the home care nursing setting in Germany. Skin care belongs to the core activities of nursing practice. Especially in aged and long-term care settings, clients are vulnerable to various skin conditions. Dry skin is one of the most prevalent problems. Using mild skin cleansers and the regular application of moisturizing leave-on products is recommended. Until today, there are no quantitative empirical data about nursing skin care practice at home in the community. A multicentre cross-sectional study was conducted in July 2012. Home care clients from the German home care nursing setting were randomly selected. Instructed nurse raters performed the data collection using standardized forms. Variables included demographics, skin care needs and skin caring activities. Approximately 60% of home care clients received skin care interventions. The majority were washed and two-thirds received a leave-on product once daily. There was large heterogeneity in cleansing and skin care product use. Most often the product labels were unknown or product types were selected haphazardly. Skin care interventions play a significant role in home care and nurses have a considerable responsibility for skin health. Skin care provided does not meet recent recommendations. The importance of targeted skin cleansing and care might be underestimated. There are a confusing variety of skin care products available and often the labels provide little information regarding the ingredients or guidance about how they affect skin health. © 2014 John Wiley & Sons Ltd.

  14. Provider perceptions concerning use of chest x-ray studies in adult blunt trauma assessments.

    Science.gov (United States)

    Calderon, Georgina; Perez, Daniel; Fortman, Jonathan; Kea, Bory; Rodriguez, Robert M

    2012-10-01

    Although they infrequently lead to management changing diagnoses, chest x-rays (CXRs) are the most commonly ordered imaging study in blunt trauma evaluation. To determine: 1) the reasons physicians order chest X-ray studies (CXRs) in blunt trauma assessments; 2) what injuries they expect CXRs to reveal; and 3) whether physicians can accurately predict low likelihood of injury on CXR. At a Level I Trauma Center, we asked resident and attending physicians treating adult blunt trauma patients: 1) the primary reason(s) for getting CXRs; 2) what, if any, significant intrathoracic injuries (SITI) they expected CXRs to reveal; and 3) the likelihood of these injuries. An expert panel defined SITI as two or more rib fractures, sternal fracture, pulmonary contusion, pneumothorax, hemothorax, or aortic injury on official CXR readings. There were 484 patient encounters analyzed--65% of participating physicians were residents and 35% were attendings; 16 (3.3%) patients had SITI. The most common reasons for ordering CXRs were: "enough concern for significant injury" (62.9%) and belief that CXR is a "standard part of trauma work-up" (24.8%). Residents were more likely than attendings to cite "standard trauma work-up" (mean difference = 13.5%, p = 0.003). When physicians estimated a 25% likelihood, 9.1% (95% CI 3.0-20.0%) had SITI. Physicians order CXRs in blunt trauma patients because they expect to find injuries and believe that CXRs are part of a "standard" work-up. Providers commonly do not expect CXRs to reveal SITI. When providers estimated low likelihood of SITI, the rate of SITI was very low. Published by Elsevier Inc.

  15. Current state of epidemiological studies in Belarus about Chernobyl sufferers

    Energy Technology Data Exchange (ETDEWEB)

    Matsko, V.P. [Institute of Radiobiology, Academy Sciences of Belarus, Minsk (Belarus)

    1998-03-01

    The present paper is an analysis of the results of epidemiological studies in Belarus about the after-effects of the accident at the Chernobyl atomic power station (ChAPS), based on published data at scientific institutes, organs and institutions of Ministry of Health. In the last years the affected population showed thereby more significant - as compared with republican indices - growth of incidence in the majority of diseases (first of all: digestion, urogenital, nervous, endocrine systems, diseases of ear, throat, nose both among adults and among children). Aggravation of health state continues in the participants of liquidation of the ChAPS accident consequences and the evacuees from the alienation zone which have obtained considerable radiation load to organism (rise of incidence of diseases of endocrine, cardiovascular, nervous system etc.). Considerable growth of thyroid cancer incidence is registered in Belarus children and adolescents, especially in the Gomel and Brest regions. This is conditioned by dose commitments on thyroid gland due to iodine radionuclides in first period after the accident, incorrect iodine prophylaxy, and goitre endemic. The rise of hereditary pathology is registered too. An expressed increase of oncological diseases is observed therewith mainly in the Gomel region, especially in the districts with high level of radiocontamination and, consequently, significant radiation load. First of all, this relates to the growth of incidence of cancer of lungs, mammary gland, bladder. The analysis of epidemiological studies performed in Belarus after the ChAPS catastrophe and comparison of them with data obtained in the pre-Chernobyl period testify to the aggravation of health state of Belarus population. The specialists unambiguously recognize the direct influence of radioactive pollution in the environment on rise of thyroid pathologies, hereditary and congenial diseases, and cancers of different localizations. There is no unique opinion

  16. The knowledge, efficacy, and practices instrument for oral health providers: a validity study with dental students.

    Science.gov (United States)

    Behar-Horenstein, Linda S; Garvan, Cyndi W; Moore, Thomas E; Catalanotto, Frank A

    2013-08-01

    Valid and reliable instruments to measure and assess cultural competence for oral health care providers are scarce in the literature, and most published scales have been contested due to a lack of item analysis and internal estimates of reliability. The purposes of this study were, first, to develop a standardized instrument to measure dental students' knowledge of diversity, skills in culturally competent patient-centered communication, and use of culture-centered practices in patient care and, second, to provide preliminary validity support for this instrument. The initial instrument used in this study was a thirty-six-item Likert-scale survey entitled the Knowledge, Efficacy, and Practices Instrument for Oral Health Providers (KEPI-OHP). This instrument is an adaption of an initially thirty-three-item version of the Multicultural Awareness, Knowledge, and Skills Scale-Counselor Edition (MAKSS-CE), a scale that assesses factors related to social justice, cultural differences among clients, and cross-cultural client management. After the authors conducted cognitive and expert interviews, focus groups, pilot testing, and item analysis, their initial instrument was reduced to twenty-eight items. The KEPI-OHP was then distributed to 916 dental students (response rate=48.6 percent) across the United States to measure its reliability and assess its validity. Both exploratory and confirmatory factor analyses were conducted to test the scale's validity. The modification of the survey into a sensible instrument with a relatively clear factor structure using factor analysis resulted in twenty items. A scree test suggested three expressive factors, which were retained for rotation. Bentler's comparative fit and Bentler and Bonnett's non-normed indices were 0.95 and 0.92, respectively. A three-factor solution, including efficacy of assessment, knowledge of diversity, and culture-centered practice subscales, comprised of twenty-items was identified. The KEPI-OHP was found to

  17. Molecular structure-adsorption study on current textile dyes.

    Science.gov (United States)

    Örücü, E; Tugcu, G; Saçan, M T

    2014-01-01

    This study was performed to investigate the adsorption of a diverse set of textile dyes onto granulated activated carbon (GAC). The adsorption experiments were carried out in a batch system. The Langmuir and Freundlich isotherm models were applied to experimental data and the isotherm constants were calculated for 33 anthraquinone and azo dyes. The adsorption equilibrium data fitted more adequately to the Langmuir isotherm model than the Freundlich isotherm model. Added to a qualitative analysis of experimental results, multiple linear regression (MLR), support vector regression (SVR) and back propagation neural network (BPNN) methods were used to develop quantitative structure-property relationship (QSPR) models with the novel adsorption data. The data were divided randomly into training and test sets. The predictive ability of all models was evaluated using the test set. Descriptors were selected with a genetic algorithm (GA) using QSARINS software. Results related to QSPR models on the adsorption capacity of GAC showed that molecular structure of dyes was represented by ionization potential based on two-dimensional topological distances, chromophoric features and a property filter index. Comparison of the performance of the models demonstrated the superiority of the BPNN over GA-MLR and SVR models.

  18. A Study on the Current Oil and Gas Price Formula and Its Improvement

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chang Won; Lee, Young Koo [Korea Energy Economics Institute, Euiwang (Korea)

    2000-12-01

    The object of this study is to suggest some improvements on current price formulas on oil and gas which have been pivotal roles in the process of Korean economic growth. This study first examines basic frames and transition of oil and gas pricing in Korea and then finds some suggestions on them by scrutinizing their theoretical backgrounds. This study finds several problems on oil and gas pricing formulas. (a) In a model that is now studied to evaluate the current domestic oil price, the costs associated with oil security such as oil stockpile are fully penetrated into oil price without their fair evaluations. There is no evaluation principle on the costs occurred in oil supply security. (b) The Rate Of Equity(ROE), a crucial factor in town-gas pricing which is strictly controlled, is directly connected to the average interest rate on saving accounts of domestic commercial banks. Some arguments may have rise about inclusion a risk factor on ROE in order to compensate the uncertainty of town-gas business. (c) New demand for natural gas which is generated by new technologies or machinery and tools can help reduce the costs occurred from seasonal imbalance between power sector and gas sector. So it is also important to decide how to include the beneficiary of cost reduction in town-gas pricing. In order to evaluate the proper price levels, this study tests energy supply security by adopting methodologies such as Herfindahl Index and Portfolio Variance Risk. They can help develop the method to effectively improve the energy security and include the proper energy security costs into energy prices. This study also provides some suggestions for betterment of current ROE decision rule in town-gas business and for improvement of current town-gas policy that government subsidizes newly developed demand for strengthening price competitiveness in the early stage. (author). 145 refs., 16 figs., 49 tabs.

  19. Current Research at the Endeavour Ridge 2000 Integrated Studies Site

    Science.gov (United States)

    Butterfield, D. A.; Kelley, D. S.; Ridge 2000 Community, R.

    2004-12-01

    Integrated geophysical, geological, chemical, and biological studies are being conducted on the Endeavour segment with primary support from NSF, the W.M. Keck Foundation, and NSERC (Canada). The research includes a seismic network, physical and chemical sensors, high-precision mapping and time-series sampling. Several research expeditions have taken place at the Endeavour ISS in the past year. In June 2003, an NSF-sponsored cruise with R.V. al T.G.Thompson/ROV al Jason2 installed microbial incubators in drill-holes in the sides of active sulfide chimneys and sampled rocks, fluids, and microbes in the Mothra and Main Endeavour Field (MEF). In July 2003, with al Thompson/Jason2, an NSF-LEXEN project at Baby Bare on Endeavour east flank conducted sampling through seafloor-penetrating probes, plus time-series sampling of fluids, microbes, and rocks at the MEF. In September 2003, with al Thompson/ROV al ROPOS, the Keck Proto-Neptune project installed a seismic network consisting of 1 broadband and 7 short-period seismometers, installation of chemical/physical sensors and time-series samplers for chemistry and microbiology in the MEF and Clam Bed sites, collection of rocks, fluids, animals, and microbes. In May/June 2004, an NSF-sponsored al Atlantis/Alvin cruise recovered sulfide incubators installed in 2003, redeployed a sulfide incubator, mapped MEF and Mothra vent fields with high-resolution Imagenix sonar, sampled fluids from MEF, Mothra, and Clam Bed, recovered year-long time-series fluid and microbial samplers from MEF and Clam Bed, recovered and installed hot vent temperature-resistivity monitors, cleaned up the MEF and deployed new markers at major sulfide structures. In August 2004, there were two MBARI/Keck-sponsored cruises with R.V. al Western Flyer/ROV al Tiburon. The first cruise completed the seismic network with addition of two more broadband seismometers and serviced all 7 short-period seismometers. al Tiburon then performed microbial and chemical

  20. Efficacy of musculoskeletal injections by primary care providers in the office: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Bhagra A

    2013-04-01

    Full Text Available Anjali Bhagra,1 Husnain Syed,1 Darcy A Reed,1 Thomas H Poterucha,1 Stephen S Cha,2 Tammy J Baumgartner,1 Paul Y Takahashi1 1Department of Internal Medicine, 2Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA Background: Musculoskeletal joint pain of varied etiology can be diagnosed and treated with joint and soft-tissue corticosteroid injections. Purpose: The purpose of our study was to compare patients’ bodily pain and quality of life (QOL, in addition to the procedural benefit and patient satisfaction, before and after musculoskeletal injections in the office setting. Patients and methods: Patients were eligible for recruitment if they were over age 18 and had an injection for musculoskeletal pain from a primary care provider in an office procedural practice. Included in our analysis were knee joint/bursa, trochanteric bursa, and shoulder joint/bursa injection sites. The variables measured were pain, benefit from the injection, QOL physical and mental components, and patient satisfaction. This was a retrospective cohort study approved by the institutional review board. Results: Patients’ pain was assessed by the patients using a six-point Likert scale (none, very mild, mild, moderate, severe, and very severe. We noted that self-perception of pain decreased from 3.10 (± standard deviation at baseline 0.96 before to 2.36 (± standard deviation after the infection 1.21 (P = 0.0001 after the injection. In terms of the impact on QOL, our patients had a pre-injection physical score of 37.25 ± 8.39 and a mental score at 52.81 ± 8.98. After the injections, the physical score improved to 42.35 ± 9.07 (P = 0.0001 and the mental to 53.54 ± 8.20 (P = 0.0001 for the overall group. Ninety-six percent of the patients reported they were satisfied or extremely satisfied in the procedure clinic. Conclusion: In this study, we found significant pain relief and improved physical QOL in patients undergoing an injection in the knee

  1. Swedish healthcare providers' perceptions of preconception expanded carrier screening (ECS)-a qualitative study.

    Science.gov (United States)

    Matar, A; Kihlbom, U; Höglund, A T

    2016-07-01

    Reproductive autonomy, medicalization, and discrimination against disabled and parental responsibility are the main ongoing ethical debates concerning reproductive genetic screening. To examine Swedish healthcare professionals' views on preconception expanded carrier screening (ECS), a qualitative study involving academic and clinical institutions in Sweden was conducted in September 2014 to February 2015. Eleven healthcare professionals including clinicians, geneticists, a midwife, and a genetic counselor were interviewed in depth using a semi-structured interview guide. The questionnaire was constructed after reviewing the main literature and meetings with relevant healthcare providers. The interviews were recorded, transcribed verbatim, and content analyzed for categories and subcategories. Participants nurtured many ethical and non-ethical concerns regarding preconception ECS. Among the ethical concerns were the potential for discrimination, medicalization, concerns with prioritization of healthcare resources, and effects on reproductive freedom. The effects of implementation of preconception ECS, its stakeholders, regulations, and motivation are some of non-ethical concerns. These concerns, if not addressed, may affect the uptake and usage of carrier screening within Swedish healthcare system. As this is a qualitative study with a small non-random sample size, the findings cannot be generalized. The participants had little to no working experience with expanded screening panels. Moreover, the interviews were conducted in English, a second language for the participants, which might have limited the expression of their views. However, the authors claim that the findings may be pertinent to similar settings in other Scandinavian countries.

  2. The design briefing process matters: a case study on telehealthcare device providers in the UK.

    Science.gov (United States)

    Yang, Fan; Renda, Gianni

    2018-01-23

    The telehealthcare sector has been expanding steadily in the UK. However, confusing, complex and unwieldy designs of telehealthcare devices are at best, less effective than they could be, at worst, they are potentially dangerous to the users. This study investigated the factors within the new product development process that hindered satisfactory product design outcomes, through working collaboratively with a leading provider based in the UK. This study identified that there are too many costly late-stage design changes; a critical and persistent problem area ripe for improvement. The findings from analyzing 30 recent devices, interviewing key stakeholders and observing on-going projects further revealed that one major cause of the issue was poor practice in defining and communicating the product design criteria and requirements. Addressing the characteristics of the telehealthcare industry, such as multiple design commissioners and frequent deployment of design subcontracts, this paper argues that undertaking a robust process of creating the product design brief is the key to improving the outcomes of telehealthcare device design, particularly for the small and medium-sized enterprises dominating the sector. Implications for rehabilitation Product design criteria and requirements are frequently ill-defined and ineffectively communicated to the designers within the processes of developing new telehealthcare devices. The absence of a (robust) process of creating the design brief is the root cause of the identified issues in defining and communicating the design task. Deploying a formal process of creating the product design brief is particularly important for the telehealthcare sector.

  3. Community pharmacists providing emergency contraception give little advice about future contraceptive use: a mystery shopper study.

    Science.gov (United States)

    Glasier, Anna; Manners, Rachel; Loudon, Joanna C; Muir, Aileen

    2010-12-01

    UK women increasingly prefer to attend a pharmacy for emergency contraception (EC) rather than a doctor. Most women who use EC do not conceive and remain at risk of pregnancy unless they start regular contraception. We undertook a study to evaluate the quality of service provision in community pharmacies in Lothian, Scotland, and to determine what advice is given about contraception after EC use. Mystery shopper study. EC was unobtainable from 5/40 pharmacies (12.5%), refused because of "contraindications" in 7 (17.5%) and offered in 28 (70%). Most pharmacists appeared nonjudgemental, over 75% asked appropriate questions about eligibility, and over 90% gave appropriate advice about use. EC was universally refused beyond 72 h after sex but universally provided when the date of the last menstrual period was uncertain. Ongoing contraception after EC use was discussed in only 32.5% of all pharmacies and only 43% of those issuing EC. The quality of consultations for EC in pharmacies is generally good but only a minority discuss ongoing contraception after EC use. The implications for contraceptive use and unintended pregnancy rates are worrying. Copyright © 2010 Elsevier Inc. All rights reserved.

  4. Comparative study of microcontroller controlled four-wire voltage and current source shunt active power filters

    Energy Technology Data Exchange (ETDEWEB)

    Pettersson, S.

    2009-07-01

    During the past two decades, active power filters have increasingly grown their popularity as a viable method for improving electric power quality. The main reasons for this have been the advent of fast self-commutating solid-state devices, the progression of digital technology and the improved sensor technology. Four-wire active power filters provide an efficient solution for improving the quality of supply in grounded three-phase systems or three-phase systems with neutral conductors, which are commonly used for powering residential, office and public buildings. Four-wire active power filters are applicable in compensating current harmonics, reactive power, neutral current and load phase imbalance.This thesis presents a comparative study of microcontroller controlled four-wire voltage and current source shunt active power filters. The study includes two voltage source topologies and a current source topology with two different dc-link energy storage structures, which are compared on the basis of their filtering properties, filtering performance and efficiency. The obtained results are used for determining the suitability of current source technology for four-wire active power filtering and finding the most viable four-wire shunt active power filter topology. One commonly recognized disadvantage of the current source active power filter has always been the bulky dc-link inductor. To reduce the size of the dc-link inductor, an alternative dc-link structure for current source active power filters was introduced in the late 80's. The hybrid energy storage consists of both inductive and capacitive energy storage elements, two diodes and two controllable semiconductor switching devices. Since the capacitive element is used as a main storage unit, the inductance of the dc-link inductor can be considerably reduced. However, the original dc current control method proposed is not able to utilize the full potential of the hybrid energy storage and the inductance

  5. Numerical studies of the flux-to-current ratio method in the KIPT neutron source facility

    International Nuclear Information System (INIS)

    Cao, Y.; Gohar, Y.; Zhong, Z.

    2013-01-01

    The reactivity of a subcritical assembly has to be monitored continuously in order to assure its safe operation. In this paper, the flux-to-current ratio method has been studied as an approach to provide the on-line reactivity measurement of the subcritical system. Monte Carlo numerical simulations have been performed using the KIPT neutron source facility model. It is found that the reactivity obtained from the flux-to-current ratio method is sensitive to the detector position in the subcritical assembly. However, if multiple detectors are located about 12 cm above the graphite reflector and 54 cm radially, the technique is shown to be very accurate in determining the k eff this facility in the range of 0.75 to 0.975. (authors)

  6. The health and healthcare impact of providing insurance coverage to uninsured children: A prospective observational study

    Directory of Open Access Journals (Sweden)

    Glenn Flores

    2017-05-01

    Full Text Available Abstract Background Of the 4.8 million uninsured children in America, 62–72% are eligible for but not enrolled in Medicaid or CHIP. Not enough is known, however, about the impact of health insurance on outcomes and costs for previously uninsured children, which has never been examined prospectively. Methods This prospective observational study of uninsured Medicaid/CHIP-eligible minority children compared children obtaining coverage vs. those remaining uninsured. Subjects were recruited at 97 community sites, and 11 outcomes monitored monthly for 1 year. Results In this sample of 237 children, those obtaining coverage were significantly (P 6 months at baseline were associated with remaining uninsured for the entire year. In multivariable analysis, children who had been uninsured for >6 months at baseline (odds ratio [OR], 3.8; 95% confidence interval [CI], 1.4–10.3 and African-American children (OR, 2.8; 95% CI, 1.1–7.3 had significantly higher odds of remaining uninsured for the entire year. Insurance saved $2886/insured child/year, with mean healthcare costs = $5155/uninsured vs. $2269/insured child (P = .04. Conclusions Providing health insurance to Medicaid/CHIP-eligible uninsured children improves health, healthcare access and quality, and parental satisfaction; reduces unmet needs and out-of-pocket costs; and saves $2886/insured child/year. African-American children and those who have been uninsured for >6 months are at greatest risk for remaining uninsured. Extrapolation of the savings realized by insuring uninsured, Medicaid/CHIP-eligible children suggests that America potentially could save $8.7–$10.1 billion annually by providing health insurance to all Medicaid/CHIP-eligible uninsured children.

  7. Analisa Kinerja Jaringan Provider untuk Aplikasi Video Chatting (Studi Kasus di Daerah Marpoyan)

    OpenAIRE

    Danur, Jeri Dwi; ', Febrizal '

    2016-01-01

    Video chat is a communication that allows users to chat and can see the other person's face directly. Video chatting requires a good network to transmit audio and video data in a short time. This paper examines the performance of three mobile network provider (Provider A and Provider B Provider C) in a video chat in the area Marpoyan and the effect of time when doing video chat on the performance of each provider. The method used is the method using packet sniffing software wireshark to see Q...

  8. A mixed methods study of patient-provider communication about opioid analgesics.

    Science.gov (United States)

    Hughes, Helen Kinsman; Korthuis, Philip Todd; Saha, Somnath; Eggly, Susan; Sharp, Victoria; Cohn, Jonathan; Moore, Richard; Beach, Mary Catherine

    2015-04-01

    To describe patient-provider communication about opioid pain medicine and explore how these discussions affect provider attitudes toward patients. We audio-recorded 45 HIV providers and 423 patients in routine outpatient encounters at four sites across the country. Providers completed post-visit questionnaires assessing their attitudes toward patients. We identified discussions about opioid pain management and analyzed them qualitatively. We used logistic regression to assess the association between opioid discussion and providers' attitudes toward patients. 48 encounters (11% of the total sample) contained substantive discussion of opioid-related pain management. Most conversations were initiated by patients (n=28, 58%) and ended by the providers (n=36, 75%). Twelve encounters (25%) contained dialog suggesting a difference of opinion or conflict. Providers more often agreed than disagreed to give the prescription (50% vs. 23%), sometimes reluctantly; in 27% (n=13) of encounters, no decision was made. Fewer than half of providers (n=20, 42%) acknowledged the patient's experience of pain. Providers had a lower odds of positive regard for the patient (adjusted OR=0.51, 95% CI: 0.27-0.95) when opioids were discussed. Pain management discussions are common in routine outpatient HIV encounters and providers may regard patients less favorably if opioids are discussed during visits. The sometimes-adversarial nature of these discussions may negatively affect provider attitudes toward patients. Empathy and pain acknowledgment are tools that clinicians can use to facilitate productive discussions of pain management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. The power of a collaborative relationship between technical assistance providers and community prevention teams: A correlational and longitudinal study.

    Science.gov (United States)

    Chilenski, Sarah M; Perkins, Daniel F; Olson, Jonathan; Hoffman, Lesa; Feinberg, Mark E; Greenberg, Mark; Welsh, Janet; Crowley, D Max; Spoth, Richard

    2016-02-01

    Historically, effectiveness of community collaborative prevention efforts has been mixed. Consequently, research has been undertaken to better understand the factors that support their effectiveness; theory and some related empirical research suggests that the provision of technical assistance is one important supporting factor. The current study examines one aspect of technical assistance that may be important in supporting coalition effectiveness, the collaborative relationship between the technical assistance provider and site lead implementer. Four and one-half years of data were collected from technical assistance providers and prevention team members from the 14 community prevention teams involved in the PROSPER project. Spearman correlation analyses with longitudinal data show that the levels of the collaborative relationship during one phase of collaborative team functioning associated with characteristics of internal team functioning in future phases. Results suggest that community collaborative prevention work should consider the collaborative nature of the technical assistance provider - prevention community team relationship when designing and conducting technical assistance activities, and it may be important to continually assess these dynamics to support high quality implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Views of Dental Providers on Primary Care Coordination at Chairside: A Pilot Study

    Science.gov (United States)

    Northridge, Mary E.; Birenz, Shirley; Gomes, Danni; Golembeski, Cynthia A.; Greenblatt, Ariel Port; Shelley, Donna; Russell, Stefanie L.

    2016-01-01

    Purpose There is a need for research to facilitate the widespread implementation, dissemination, and sustained utilization of evidence-based primary care screening, monitoring, and care coordination guidelines, thereby increasing the impact of dental hygienists’ actions on patients’ oral and general health. The aims of this formative study are to: (1) explore dental hygienists’ and dentists’ perspectives regarding the integration of primary care activities into routine dental care; and (2) assess the needs of dental hygienists and dentists regarding primary care coordination activities and use of information technology to obtain clinical information at chairside. Methods This qualitative study recruited ten hygienists and six dentists from ten New York City area dental offices with diverse patient mixes and volumes. A New York University faculty hygienist conducted semi-structured, in-depth interviews, which were digitally recorded and transcribed verbatim. Data analysis consisted of multilevel coding based on the Consolidated Framework for Implementation Research, resulting in emergent themes with accompanying categories. Results The dental hygienists and dentists interviewed as part of this study fail to use evidence-based guidelines to screen their patients for primary care sensitive conditions. Overwhelmingly, dental providers believe that tobacco use and poor diet contribute to oral disease, and report using electronic devices at chairside to obtain web-based health information. Conclusion Dental hygienists are well positioned to help facilitate greater integration of oral and general health care. Challenges include lack of evidence-based knowledge, coordination between dental hygienists and dentists, and systems-level support, with opportunities for improvement based upon a theory-driven framework. PMID:27340183

  11. Metastatic breast cancer: do current treatments improve quality of life? A prospective study

    Directory of Open Access Journals (Sweden)

    Fernanda Amado

    Full Text Available CONTEXT AND OBJECTIVE: In metastatic breast cancer cases, the currently available therapeutic approaches provide minimal improvement in survival. As such, quality of life (QOL becomes one of the main objectives of treatment. It is not known whether current treatments derived from trials improve QOL. The aim was to evaluate changes in QOL among metastatic breast cancer patients receiving treatment derived from trials. DESIGN AND SETTING: Prospective observational QOL survey in a tertiary cancer center. METHODS: To evaluate the influence of current treatments on patients' QOL, the Medical Outcomes Study Short Form-36 (SF-36 and the Beck Depression Inventory (BDI were applied on three occasions: before starting treatment and at the 6th and 12th weeks, to consecutive metastatic breast cancer patients over a one-year period. RESULTS: We found an improvement in QOL in the sample evaluated (n = 40, expressed by changes in the overall SF-36 score (p = 0.002 and the BDI (p = 0.004. Taken individually, the SF-36 components Pain, Social Functioning and Mental Health also improved significantly. Patients with worse initial performance status and secondary symptoms displayed greater improvement than those with better initial performance status and asymptomatic disease (p < 0.001. Patients who received more than one type of therapy showed larger gains than those given only one type (p = 0.038. CONCLUSIONS: In our environment, current metastatic breast cancer treatments can improve QOL, especially among symptomatic patients and those with low performance status.

  12. Qualitative study investigating the commissioning process for older people's services provided by third sector organisations: SOPRANO study protocol.

    Science.gov (United States)

    Sands, Gina; Chadborn, Neil; Craig, Chris; Gladman, John

    2016-05-18

    The commissioning of third sector services for older people may influence the quality, availability and coordination of services for older people. The SOPRANO study aims to understand the relationships between and processes of commissioning bodies and third sector organisations providing health and social care services for older people. This qualitative study will be based in the East Midlands region of England. An initial scoping survey of commissioners will give an overview of services to maintain the health and well-being of older people in the community that are commissioned. Following this, semistructured interviews will be conducted with 4 sample groups: health and social care commissioners, service provider managers, service provider case workers and older service users. A sample size of 10-15 participants in each of the 4 groups is expected to be sufficient to reach data saturation, resulting in a final expected sample size of 40-60 participants. Informed consent will be gained from all participants, and those unable to provide informed consent will be excluded. The interview data will be analysed by 2 researchers using framework content analysis. Approval for the study has been gained from the University of Nottingham School of Medicine ethical review board, and the relevant approvals have been gained from the National Health Service (NHS) research and development departments for interviewing NHS staff. Early engagement with a wide range of stakeholders will ensure that the research findings are extensively disseminated to relevant stakeholders (including commissioners and third sector providers) in an accessible format using the extensive communication networks available to the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care CLAHRCs (applied health research organisations covering all of England). The study will also be disseminated through academic routes such as conference presentations and

  13. Strengthening diabetes retinopathy services in India: Qualitative insights into providers' perspectives: The India 11-city 9-state study

    Directory of Open Access Journals (Sweden)

    Nanda Kishore Kannuri

    2016-01-01

    Full Text Available Context: There is a lack of evidence on the subjective aspects of the provider perspective regarding diabetes and its complications in India. Objectives: The study was undertaken to understand the providers' perspective on the delivery of health services for diabetes and its complications, specifically the eye complications in India. Settings and Design: Hospitals providing diabetic services in government and private sectors were selected in 11 of the largest cities in India, based on geographical distribution and size. Methods: Fifty-nine semi-structured interviews conducted with physicians providing diabetes care were analyzed all interviews were recorded, transcribed, and translated. Nvivo 10 software was used to code the transcripts. Thematic analysis was conducted to analyze the data. Results: The results are presented as key themes: “Challenges in managing diabetes patients,” “Current patient management practices,” and “Strengthening diabetic retinopathy (DR services at the health systems level.” Diabetes affects people early across the social classes. Self-management was identified as an important prerequisite in controlling diabetes and its complications. Awareness level of hospital staff on DR was low. Advances in medical technology have an important role in effective management of DR. A team approach is required to provide comprehensive diabetic care. Conclusions: Sight-threatening DR is an impending public health challenge that needs a concerted effort to tackle it. A streamlined, multi-dimensional approach where all the stakeholders cooperate is important to strengthening services dealing with DR in the existing health care setup.

  14. Patient and provider perceptions of care for diabetes: results of the cross-national DAWN Study

    DEFF Research Database (Denmark)

    Peyrol, Mark; Rubin, Richard R.; Lauritzen, Torsten

    2006-01-01

    the relationships between outcomes and both country and respondent characteristics, and the interaction between these two factors. Results Providers rated chronic-care systems and remuneration for chronic care as mediocre. Patients reported that ease of access to care was high, but not without financial barriers....... Patients reported moderate levels of collaboration among providers, and providers indicated that several specialist disciplines were not readily available to them. Patients reported high levels of collaboration with providers in their own care. Provider endorsement of primary prevention strategies for type...... 2 diabetes was high. Patients with fewer socio-economic resources and more diabetes complications had lower access (and/or higher barriers) to care and lower quality of patient–provider collaboration. Countries differed significantly for all outcomes, and the relationships between respondent...

  15. Implementing community-based provider participation in research: an empirical study

    Science.gov (United States)

    2012-01-01

    Background Since 2003, the United States National Institutes of Health (NIH) has sought to restructure the clinical research enterprise in the United States by promoting collaborative research partnerships between academically-based investigators and community-based physicians. By increasing community-based provider participation in research (CBPPR), the NIH seeks to advance the science of discovery by conducting research in clinical settings where most people get their care, and accelerate the translation of research results into everyday clinical practice. Although CBPPR is seen as a promising strategy for promoting the use of evidence-based clinical services in community practice settings, few empirical studies have examined the organizational factors that facilitate or hinder the implementation of CBPPR. The purpose of this study is to explore the organizational start-up and early implementation of CBPPR in community-based practice. Methods We used longitudinal, case study research methods and an organizational model of innovation implementation to theoretically guide our study. Our sample consisted of three community practice settings that recently joined the National Cancer Institute’s (NCI) Community Clinical Oncology Program (CCOP) in the United States. Data were gathered through site visits, telephone interviews, and archival documents from January 2008 to May 2011. Results The organizational model for innovation implementation was useful in identifying and investigating the organizational factors influencing start-up and early implementation of CBPPR in CCOP organizations. In general, the three CCOP organizations varied in the extent to which they achieved consistency in CBPPR over time and across physicians. All three CCOP organizations demonstrated mixed levels of organizational readiness for change. Hospital management support and resource availability were limited across CCOP organizations early on, although they improved in one CCOP organization

  16. Patient-provider interaction during medication encounters: A study in outpatient pharmacies in the Netherlands.

    Science.gov (United States)

    Koster, Ellen S; van Meeteren, Marijke M; van Dijk, Marloes; van de Bemt, Bart J F; Ensing, Hendrikus T; Bouvy, Marcel L; Blom, Lyda; van Dijk, Liset

    2015-07-01

    To describe communication between pharmacy staff and patients at the counter in outpatient pharmacies. Both content and communication style were investigated. Pharmaceutical encounters in three outpatient pharmacies in the Netherlands were video-recorded. Videos were analyzed based on an observation protocol for the following information: content of encounter, initiator of a theme and pharmacy staff's communication style. In total, 119 encounters were recorded which concerned 42 first prescriptions, 16 first refill prescriptions and 61 follow-up refill prescriptions. During all encounters, discussion was mostly initiated by pharmacy staff (85%). In first prescription encounters topics most frequently discussed included instructions for use (83%) and dosage instructions (95%). In first refill encounters, patient experiences such as adverse effects (44%) and beneficial effects (38%) were regularly discussed in contrast to follow-up refills (7% and 5%). Patients' opinion on medication was hardly discussed. Pharmacy staff in outpatient pharmacies generally provide practical information, less frequently they discuss patients' experiences and seldom discuss patients' perceptions and preferences about prescribed medication. This study shows there is room for improvement, as communication is still not according to professional guidelines. To implement professional guidelines successfully, it is necessary to identify underlying reasons for not following the guidelines. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Neurophysiological Studies May Provide a Misleading Picture of How Perceptual-Motor Interactions are Coordinated

    Directory of Open Access Journals (Sweden)

    David Mann

    2013-02-01

    Full Text Available Neurophysiological measurement techniques like fMRI and TMS are increasingly being used to examine the perceptual-motor processes underpinning the ability to anticipate the actions of others. Crucially, these techniques invariably restrict the experimental task that can be used and consequently limit the degree to which the findings can be generalised. These limitations are discussed based on a recent paper by Tomeo et al. (2012 who sought to examine responses to fooling actions by using TMS on participants who passively observed spliced video clips where bodily information was, and was not, linked to the action outcome. We outline two particular concerns with this approach. First, spliced video clips that show physically impossible actions are unlikely to simulate a “fooling” action. Second, it is difficult to make meaningful inferences about perceptual-motor expertise from experiments where participants cannot move. Taken together, we argue that wider generalisations based on these findings may provide a misunderstanding of the phenomenon such a study is designed to explore.

  18. Neurophysiological studies may provide a misleading picture of how perceptual-motor interactions are coordinated.

    Science.gov (United States)

    Mann, David; Dicks, Matt; Cañal-Bruland, Rouwen; van der Kamp, John

    2013-01-01

    Neurophysiological measurement techniques like fMRI and TMS are increasingly being used to examine the perceptual-motor processes underpinning the ability to anticipate the actions of others. Crucially, these techniques invariably restrict the experimental task that can be used and consequently limit the degree to which the findings can be generalised. These limitations are discussed based on a recent paper by Tomeo et al. (2012) who sought to examine responses to fooling actions by using TMS on participants who passively observed spliced video clips where bodily information was, and was not, linked to the action outcome. We outline two particular concerns with this approach. First, spliced video clips that show physically impossible actions are unlikely to simulate a "fooling" action. Second, it is difficult to make meaningful inferences about perceptual-motor expertise from experiments where participants cannot move. Taken together, we argue that wider generalisations based on these findings may provide a misunderstanding of the phenomenon such a study is designed to explore.

  19. Work-related stress and reward: an Australian study of multidisciplinary pediatric oncology healthcare providers.

    Science.gov (United States)

    Bowden, M J; Mukherjee, S; Williams, L K; DeGraves, S; Jackson, M; McCarthy, M C

    2015-11-01

    Managing staff stress and preventing long-term burnout in oncology staff are highly important for both staff and patient well-being. Research addressing work-related stress in adult oncology is well documented; however, less is known about this topic in the pediatric context. This study examined sources of work-related stress and reward specific to multidisciplinary staff working in pediatric oncology in Australia. Participants were 107 pediatric oncology clinicians, including medical, nursing, and allied health staff from two Australian pediatric oncology centers. Participants completed an online survey using two newly developed measures: the work stressors scale-pediatric oncology and the work rewards scale-pediatric oncology. The most commonly reported sources of both stress and reward are related to patient care and interactions with children. Results indicated that levels of work-related stress and reward were similar between the professional disciplines and between the two hospitals. Regression analyses revealed no demographic or organizational factors that were associated with either stress or reward. Work-related stress and reward are not mutually exclusive; particular situations and events can be simultaneously stressful and rewarding for healthcare providers. Although patient care and interactions with children was found to be the most stressful aspect of working in this speciality, it was also the greatest source of reward. Results are discussed in relation to workplace approaches to staff well-being and stress reduction. Copyright © 2015 John Wiley & Sons, Ltd.

  20. Does Endoscopic Piriformis Tenotomy Provide Safe and Complete Tendon Release? A Cadaver Study.

    Science.gov (United States)

    Coulomb, Rémy; Khelifi, Anis; Bertrand, Martin; Mares, Olivier; May, Olivier; Marchand, Philippe; Kouyoumdjian, Pascal

    2018-05-28

    Endoscopic piriformis release (EPR) is among the available treatments for piriformis syndrome. This procedure typically involves dividing the muscle near the sciatic nerve in the sub-gluteal space, which contains numerous blood vessels and nerves. The objectives of this prospective cadaver study were: 1) to assess the reproducibility and quality of endoscopic piriformis tenotomy near the greater trochanter; 2) to detect iatrogenic injuries to the lateral hip rotators, nerves, and vessels; 3) and to define the surgical safety margins relative to the sciatic nerve and inferior gluteal bundle. EPR at the greater trochanter ensures full release of the muscle with a limited risk of neuro-vascular injury. EPR was performed via two portals on 10 cadaver hips preserved in zinc chloride and placed in the prone position. A third, ancillary portal was required in 7 cases. The area was then dissected with the Kocher-Langenbeck approach to allow an assessment of the tenotomy, detect iatrogenic injuries, and measure the distances separating the tenotomy site from the sciatic nerve and inferior gluteal artery. Complete tenotomy was achieved in 9 (90%) cases. The tendon adhered to the capsule in 2 (20%) cases and showed acquired avulsion in 1 case. No injuries to the sciatic nerve or inferior gluteal artery occurred. Mean distances from the tenotomy site were 5.21±0.59cm (range, 4.5-6.6cm) for the sciatic nerve and 7.1±0.89cm (range, 5.4-8.5cm) for the inferior gluteal artery. EPR by a tenotomy at the greater trochanter without sciatic nerve release provides full release of the muscle with satisfactory safety margins and a short learning curve. III, prospective cadaver case-control study. Copyright © 2018. Published by Elsevier Masson SAS.

  1. Care provided by general practitioners to patients with psychotic disorders: a cohort study

    Directory of Open Access Journals (Sweden)

    Slooff Cees J

    2010-11-01

    Full Text Available Abstract Background Patients suffering from psychotic disorders have an increased risk of comorbid somatic diseases such as cardiovascular disorders and diabetes mellitus. Doctor-related factors, such as unfamiliarity with these patients, as well as patient-related factors, such as cognitive disturbance and negative symptoms, contribute to suboptimal health care for these patients. General practitioners (GPs could play a key role in diagnosing and treating this somatic comorbidity as in the Netherlands, almost all residents are registered at a general practice. This study aims to find out whether there are any differences between the levels of health care provided by GPs to patients with psychotic disorders, compared to other types of patients. Methods A cohort of patients with an ICPC code of psychosis and two matched control groups, one consisting of patients with other mental problems and the other one of patients without any mental problems, were followed over a period of 5 years. Results Patients with psychotic disorders (N = 734 contacted the GP practice more often than patients in the control groups. These patients, both adults (p = 0.051 and the elderly (p 65 years old (p = 0.007. With regard to chronic illnesses, elderly psychosis patients had fewer contacts related to cardiovascular diseases or chronic lung diseases. Conclusion Patients with psychotic disorders contact the GP practice more frequently than other types of patients. Adult psychosis patients with diabetes mellitus, cardiovascular diseases or chronic lung diseases receive the same amount of health care for these diseases as other primary care patients. The finding that older patients with psychotic disorders are diagnosed with cardiovascular diseases and obstructive lung diseases less frequently than other types of elderly patients requires further study.

  2. Care provided by general practitioners to patients with psychotic disorders: a cohort study.

    Science.gov (United States)

    Oud, Marian J T; Schuling, Jan; Groenier, Klaas H; Verhaak, Peter F M; Slooff, Cees J; Dekker, Janny H; Meyboom-de Jong, Betty

    2010-11-25

    Patients suffering from psychotic disorders have an increased risk of comorbid somatic diseases such as cardiovascular disorders and diabetes mellitus. Doctor-related factors, such as unfamiliarity with these patients, as well as patient-related factors, such as cognitive disturbance and negative symptoms, contribute to suboptimal health care for these patients.General practitioners (GPs) could play a key role in diagnosing and treating this somatic comorbidity as in the Netherlands, almost all residents are registered at a general practice. This study aims to find out whether there are any differences between the levels of health care provided by GPs to patients with psychotic disorders, compared to other types of patients. A cohort of patients with an ICPC code of psychosis and two matched control groups, one consisting of patients with other mental problems and the other one of patients without any mental problems, were followed over a period of 5 years. Patients with psychotic disorders (N = 734) contacted the GP practice more often than patients in the control groups. These patients, both adults (p = 0.051) and the elderly (p 65 years old (p = 0.007). With regard to chronic illnesses, elderly psychosis patients had fewer contacts related to cardiovascular diseases or chronic lung diseases. Patients with psychotic disorders contact the GP practice more frequently than other types of patients. Adult psychosis patients with diabetes mellitus, cardiovascular diseases or chronic lung diseases receive the same amount of health care for these diseases as other primary care patients. The finding that older patients with psychotic disorders are diagnosed with cardiovascular diseases and obstructive lung diseases less frequently than other types of elderly patients requires further study.

  3. Providing Data Management Support to NASA Airborne Field Studies through Streamlined Usability Design

    Science.gov (United States)

    Beach, A. L., III; Northup, E. A.; Early, A. B.; Chen, G.

    2016-12-01

    Airborne field studies are an effective way to gain a detailed understanding of atmospheric processes for scientific research on climate change and air quality relevant issues. One major function of airborne project data management is to maintain seamless data access within the science team. This allows individual instrument principal investigators (PIs) to process and validate their own data, which requires analysis of data sets from other PIs (or instruments). The project's web platform streamlines data ingest, distribution processes, and data format validation. In May 2016, the NASA Langley Research Center (LaRC) Atmospheric Science Data Center (ASDC) developed a new data management capability to help support the Korea U.S.-Air Quality (KORUS-AQ) science team. This effort is aimed at providing direct NASA Distributed Active Archive Center (DAAC) support to an airborne field study. Working closely with the science team, the ASDC developed a scalable architecture that allows investigators to easily upload and distribute their data and documentation within a secure collaborative environment. The user interface leverages modern design elements to intuitively guide the PI through each step of the data management process. In addition, the new framework creates an abstraction layer between how the data files are stored and how the data itself is organized(i.e. grouping files by PI). This approach makes it easy for PIs to simply transfer their data to one directory, while the system itself can automatically group/sort data as needed. Moreover, the platform is "server agnostic" to a certain degree, making deployment and customization more straightforward as hardware needs change. This flexible design will improve development efficiency and can be leveraged for future field campaigns. This presentation will examine the KORUS-AQ data portal as a scalable solution that applies consistent and intuitive usability design practices to support ingest and management of airborne

  4. Experiences of primary care professionals providing healthcare to recently arrived migrants: a qualitative study.

    Science.gov (United States)

    Lindenmeyer, Antje; Redwood, Sabi; Griffith, Laura; Teladia, Zaheera; Phillimore, Jenny

    2016-09-22

    The main objectives of the study were to explore the experiences of primary care professionals providing care to recent migrants in a superdiverse city and to elicit barriers and facilitators to meeting migrants' care needs. This paper focuses on a strong emergent theme: participants' descriptions and understandings of creating a fit between patients and practices. An exploratory, qualitative study based on the thematic analysis of semistructured interviews. A purposive sample of 10 practices. We interviewed 6 general practitioners, 5 nurses and 6 administrative staff; those based at the same practice opted to be interviewed together. 10 interviewees were from an ethnic minority background; some discussed their own experiences of migration. Creating a fit between patients and practice was complex and could be problematic. Some participants defined this in a positive way (reaching out, creating rapport) while others also focused on ways in which patients did not fit in, for example, different expectations or lack of medical records. A small but vocal minority put the responsibility to fit in on to migrant patients. Some participants believed that practice staff and patients sharing a language could contribute to achieving a fit but others outlined the disadvantages of over-reliance on language concordance. A clearly articulated, team-based strategy to create bridges between practice and patients was often seen as preferable. Although participants agreed that a fit between patients and practice was desirable, some aimed to adapt to the needs of recently arrived migrants, while others thought that it was the responsibility of migrants to adapt to practice needs; a few viewed migrant patients as a burden to the system. Practices wishing to improve fit might consider developing strategies such as introducing link workers and other 'bridging' people; however, they could also aim to foster a general stance of openness to diversity. Published by the BMJ Publishing Group

  5. Lessons learned from implementation of computerized provider order entry in 5 community hospitals: a qualitative study.

    Science.gov (United States)

    Simon, Steven R; Keohane, Carol A; Amato, Mary; Coffey, Michael; Cadet, Bismarck; Zimlichman, Eyal; Bates, David W

    2013-06-24

    Computerized Provider Order Entry (CPOE) can improve patient safety, quality and efficiency, but hospitals face a host of barriers to adopting CPOE, ranging from resistance among physicians to the cost of the systems. In response to the incentives for meaningful use of health information technology and other market forces, hospitals in the United States are increasingly moving toward the adoption of CPOE. The purpose of this study was to characterize the experiences of hospitals that have successfully implemented CPOE. We used a qualitative approach to observe clinical activities and capture the experiences of physicians, nurses, pharmacists and administrators at five community hospitals in Massachusetts (USA) that adopted CPOE in the past few years. We conducted formal, structured observations of care processes in diverse inpatient settings within each of the hospitals and completed in-depth, semi-structured interviews with clinicians and staff by telephone. After transcribing the audiorecorded interviews, we analyzed the content of the transcripts iteratively, guided by principles of the Immersion and Crystallization analytic approach. Our objective was to identify attitudes, behaviors and experiences that would constitute useful lessons for other hospitals embarking on CPOE implementation. Analysis of observations and interviews resulted in findings about the CPOE implementation process in five domains: governance, preparation, support, perceptions and consequences. Successful institutions implemented clear organizational decision-making mechanisms that involved clinicians (governance). They anticipated the need for education and training of a wide range of users (preparation). These hospitals deployed ample human resources for live, in-person training and support during implementation. Successful implementation hinged on the ability of clinical leaders to address and manage perceptions and the fear of change. Implementation proceeded smoothly when institutions

  6. Family building using embryo adoption: relationships and contact arrangements between provider and recipient families-a mixed-methods study.

    Science.gov (United States)

    Frith, Lucy; Blyth, Eric; Lui, Steve

    2017-05-01

    What contact arrangements are established between providers and recipients of embryos using Snowflakes® Embryo Adoption Program? Contact arrangements varied considerably and were generally positively described, although some challenges were acknowledged. Reproductive technologies create new and diverse family forms, and the ways in which families created by embryo adoption are negotiated in practice have not been extensively investigated. This exploratory, mixed-methods study had two phases: (i) an online survey (open May-September 2013) and (ii) qualitative semi-structured interviews by email (conducted between 2014 and 2015), exploring participants' experiences of contact with their embryo provider or recipient. Phase I included 17 providers (14 women and 3 men) and 28 recipients (27 women and 1 man). Phase II included 8 providers (5 women and 3 men) and 12 recipients (10 women and 2 men). All participants, except one, were located in the US. This study illustrates how embryo adoption in the US, as a form of conditional donation, can operate and how the participants define and negotiate these emerging relationships. All families were open with their children about how they were conceived and early contact between recipients and providers (frequently before birth) was valued. On the whole, participants were happy with the amount and type of contact they had, and where the current contact did not involve the children, it was seen as a way of keeping the channels open for future contact when the children were older. Participants often portrayed the opportunities for contact as being in the best interests of the child. The study participants are a particular group who had chosen to either receive or give their embryos via a conditional embryo adoption agency in the US and had established contact. Therefore, this is not a representative sample of those who provide or receive embryos for family building. This embryo adoption model clearly fulfils a need; some people

  7. Electron-beam-induced current measurements with applied bias provide insight to locally resolved acceptor concentrations at p-n junctions

    Directory of Open Access Journals (Sweden)

    D. Abou-Ras

    2015-07-01

    Full Text Available Electron-beam-induced current (EBIC measurements have been employed for the investigation of the local electrical properties existing at various types of electrical junctions during the past decades. In the standard configuration, the device under investigation is analyzed under short-circuit conditions. Further insight into the function of the electrical junction can be obtained when applying a bias voltage. The present work gives insight into how EBIC measurements at applied bias can be conducted at the submicrometer level, at the example of CuInSe2 solar cells. From the EBIC profiles acquired across ZnO/CdS/CuInSe2/Mo stacks exhibiting p-n junctions with different net doping densities in the CuInSe2 layers, values for the width of the space-charge region, w, were extracted. For all net doping densities, these values decreased with increasing applied voltage. Assuming a linear relationship between w2 and the applied voltage, the resulting net doping densities agreed well with the ones obtained by means of capacitance-voltage measurements.

  8. The terms 'current scientific knowledge', and 'precautionary measures to provide protection' in the provisions governing the licensing procedure under the Atomic Energy Act

    International Nuclear Information System (INIS)

    Renneberg, W.

    1986-01-01

    Under the Atomic Energy Act, a licence may be granted for a nuclear installation provided that 'every precaution which is necessary in the light of existing scientific knowledge and technology has been taken to provide adequate protection against damage due to the erection or operation of the installation' (section 7, sub-sec. (2), no. 3 of the Atomic Energy Act). This condition can be split off into two specific problem fields, and for each a rather unspecific legal concept is to be more exactly defined. The author explains the technique of the law hitherto applied in the weighting and evaluation of hazards and risks and comes to the conclusion that the technique adopted has been subject to pre-legal appraisals: the result in terms of the law is not the final step in the process of legal evaluation, but quite to the contrary, the legal technique applied has been derived from the wanted result. This, the author says, is a crisis of legitimation of the law. (HSCH) [de

  9. What is a good health check? An interview study of health check providers' views and practices

    NARCIS (Netherlands)

    Y. Stol (Yrrah); E.C.A. Asscher (Eva); M.H.N. Schermer (Maartje)

    2017-01-01

    markdownabstract__Background:__ Health checks identify (risk factors for) disease in people without symptoms. They may be offered by the government through population screenings and by other providers to individual users as 'personal health checks'. Health check providers' perspective of 'good'

  10. Towards culturally competent paediatric oncology care. A qualitative study from the perspective of care providers.

    Science.gov (United States)

    Suurmond, J; Lieveld, A; van de Wetering, M; Schouten-van Meeteren, A Y N

    2017-11-01

    In order to gain more insight on the influence of ethnic diversity in paediatric cancer care, the perspectives of care providers were explored. Semi-structured interviews were conducted among 12 paediatric oncologists and 13 nurses of two different paediatric oncology wards and were analysed using a framework method. We found that care providers described the contact with Turkish and Moroccan parents as more difficult. They offered two reasons for this: (1) language barriers between care provider and parents hindered the exchange of information; (2) cultural barriers between care provider and parents about sharing the diagnosis and palliative perspective hindered communication. Care providers reported different solutions to deal with these barriers, such as using an interpreter and improving their cultural knowledge about their patients. They, however, were not using interpreters sufficiently and were unaware of the importance of eliciting parents' perspectives. Communication techniques to overcome dilemmas between parents and care providers were not used and care providers were unaware of stereotypes and prejudice. Care providers should be offered insight in cultural barriers they are unaware of. Training in cultural competence might be a possibility to overcome manifest barriers. © 2017 John Wiley & Sons Ltd.

  11. Behavioral Health Providers and Electronic Health Records: An Exploratory Beliefs Elicitation and Segmentation Study

    Science.gov (United States)

    Shank, Nancy

    2011-01-01

    The widespread adoption of electronic health records (EHRs) is a public policy strategy to improve healthcare quality and reduce accelerating health care costs. Much research has focused on medical providers' perceptions of EHRs, but little is known about those of behavioral health providers. This research was informed by the theory of reasoned…

  12. Informed consent for phase I studies: evaluation of quantity and quality of information provided to patients.

    Science.gov (United States)

    Tomamichel, M; Sessa, C; Herzig, S; de Jong, J; Pagani, O; Willems, Y; Cavalli, F

    1995-04-01

    The process by which patients are informed and their consent is obtained in phase I trials has thus far been only marginally studied. Since 1986 we have followed an oral procedure, consisting of three consecutive conversations in which the investigator responsible for phase I studies, the research nurse and the patients' relatives and/or friends also participate, followed by the patients signing of a written consent form. It is required that six items of information considered essential by our staff be conveyed to patients by the responsible investigator. Meerwein's model, which defines three main dimensions of the informing process (the information itself, the emotional and interactive aspects), has been studied to ascertain whether it can be applied to evaluate the quality of the information proffered. Thirty-two conversations were taped, transcribed and evaluated by one psychiatrist and one psychologist. A quantitative analysis of information was performed by calculating the number of patients to whom the essential items of information had been conveyed. The qualitative analysis was performed by rating on a five-point scoring system, from 1 (very bad) to 5 (excellent), the three dimensions of the informing process for each patient and by calculating for each dimension the mean score of the constituent items. Complete information about the characteristics of the phase I drug and the modalities of the treatment and follow up was given to almost 80% of the patients. All but one of the items of the information dimension scored 3.5 or higher, with the one related to the assessment by the doctor of the patient's understanding at the end of the consultation scoring less than 3 in 53% of the patients. All items of the emotional dimension scored higher than 3.5. Greater difficulty was encountered by the physician with the interactive dimension, the lowest mean scores being reported on the items related to the doctor's awareness of the indirectly expressed anxieties of

  13. What is a good health check? An interview study of health check providers' views and practices.

    Science.gov (United States)

    Stol, Yrrah H; Asscher, Eva C A; Schermer, Maartje H N

    2017-10-02

    Health checks identify (risk factors for) disease in people without symptoms. They may be offered by the government through population screenings and by other providers to individual users as 'personal health checks'. Health check providers' perspective of 'good' health checks may further the debate on the ethical evaluation and possible regulation of these personal health checks. In 2015, we interviewed twenty Dutch health check providers on criteria for 'good' health checks, and the role these criteria play in their practices. Providers unanimously formulate a number of minimal criteria: Checks must focus on (risk factors for) treatable/preventable disease; Tests must be reliable and clinically valid; Participation must be informed and voluntary; Checks should provide more benefits than harms; Governmental screenings should be cost-effective. Aspirational criteria mentioned were: Follow-up care should be provided; Providers should be skilled and experienced professionals that put the benefit of (potential) users first; Providers should take time and attention. Some criteria were contested: People should be free to test on any (risk factor for) disease; Health checks should only be performed in people at high risk for disease that are likely to implement health advice; Follow up care of privately funded tests should not drain on collective resources. Providers do not always fulfil their own criteria. Their reasons reveal conflicts between criteria, conflicts between criteria and other ethical values, and point to components in the (Dutch) organisation of health care that hinder an ethical provision of health checks. Moreover, providers consider informed consent a criterion that is hard to establish in practice. According to providers, personal health checks should meet the same criteria as population screenings, with the exception of cost-effectiveness. Providers do not always fulfil their own criteria. Results indicate that in thinking about the ethics of health

  14. High-Definition transcranial direct current stimulation in early onset epileptic encephalopathy: a case study.

    Science.gov (United States)

    Meiron, Oded; Gale, Rena; Namestnic, Julia; Bennet-Back, Odeya; David, Jonathan; Gebodh, Nigel; Adair, Devin; Esmaeilpour, Zeinab; Bikson, Marom

    2018-01-01

    Early onset epileptic encephalopathy is characterized by high daily seizure-frequency, multifocal epileptic discharges, severe psychomotor retardation, and death at infancy. Currently, there are no effective treatments to alleviate seizure frequency and high-voltage epileptic discharges in these catastrophic epilepsy cases. The current study examined the safety and feasibility of High-Definition transcranial direct current stimulation (HD-tDCS) in reducing epileptiform activity in a 30-month-old child suffering from early onset epileptic encephalopathy. HD-tDCS was administered over 10 intervention days spanning two weeks including pre- and post-intervention video-EEG monitoring. There were no serious adverse events or side effects related to the HD-tDCS intervention. Frequency of clinical seizures was not significantly reduced. However, interictal sharp wave amplitudes were significantly lower during the post-intervention period versus baseline. Vital signs and blood biochemistry remained stable throughout the entire study. These exploratory findings support the safety and feasibility of 4 × 1 HD-tDCS in early onset epileptic encephalopathy and provide the first evidence of HD-tDCS effects on paroxysmal EEG features in electroclinical cases under the age of 36 months. Extending HD-tDCS treatment may enhance electrographic findings and clinical effects.

  15. Current therapeutic interventions in the glycation pathway: evidence from clinical studies.

    Science.gov (United States)

    Engelen, L; Stehouwer, C D A; Schalkwijk, C G

    2013-08-01

    The increased formation of advanced glycation endproducts (AGEs) constitutes a potential mechanism of hyperglycaemia-induced micro- and macrovascular disease in diabetes. In vitro and animal experiments have shown that various interventions can inhibit formation and/or actions of AGEs, in particular the specific AGE inhibitor aminoguanidine and the AGEs crosslink breaker alagebrium, and the B vitamins pyridoxamine and thiamine, and the latter's synthetic derivative, benfotiamine. The potential clinical value of these interventions, however, remains to be established. The present review provides, from the clinical point of view, an overview of current evidence on interventions in the glycation pathway relating to (i) the clinical benefits of specific AGE inhibitors and AGE breakers and (ii) the potential AGE-inhibiting effects of therapies developed for purposes unrelated to the glycation pathway. We found that safety and/or efficacy in clinical studies with the specific AGE inhibitor, aminoguanidine and the AGE breaker, alagebrium, appeared to be a concern. The clinical evidence on the potential AGE-inhibiting effects of B vitamins is still limited. Finally, current evidence for AGE inhibition by therapies developed for purposes unrelated to glycation is limited due to a large heterogeneity in study designs and/or measurement techniques, which have often been sub-optimal. We conclude that, clinical evidence on interventions to inhibit formation and/or action of AGEs is currently weak and unconvincing. © 2012 Blackwell Publishing Ltd.

  16. Adolescent Perspectives on Patient-Provider Sexual Health Communication: A Qualitative Study.

    Science.gov (United States)

    Hoopes, Andrea J; Benson, Samantha K; Howard, Heather B; Morrison, Diane M; Ko, Linda K; Shafii, Taraneh

    2017-10-01

    Adolescents in the United States are disproportionately affected by sexually transmitted infections and unintended pregnancy. Adolescent-centered health services may reduce barriers to health care; yet, limited research has focused on adolescents' own perspectives on patient-provider communication during a sexual health visit. Twenty-four adolescents (14-19 years old) seeking care in a public health clinic in Washington State participated in one-on-one qualitative interviews. Interviews explored participants' past experiences with medical providers and their preferences regarding provider characteristics and communication strategies. Interviews revealed that (1) individual patient dynamics and (2) patient-provider interaction dynamics shape the experience during a sexual health visit. Individual patient dynamics included evolving level of maturity, autonomy, and sexual experience. Patient-provider interaction dynamics were shaped by adolescents' perceptions of providers as sources of health information who distribute valued sexual health supplies like contraception and condoms. Participant concerns about provider judgment, power differential, and lack of confidentiality also emerged as important themes. Adolescents demonstrate diverse and evolving needs for sexual health care and interactions with clinicians as they navigate sexual and emotional development.

  17. Expanding the Abortion Provider Workforce: A Qualitative Study of Organizations Implementing a New California Policy.

    Science.gov (United States)

    Battistelli, Molly Frances; Magnusson, Sara; Biggs, M Antonia; Freedman, Lori

    2018-03-01

    Access to abortion care in the United States varies according to multiple factors, including location, state regulation and provider availability. In 2013, California enacted a law that authorized nurse practitioners (NPs), certified nurse-midwives (CNMs) and physician assistants (PAs) to provide first-trimester aspiration abortions; little is known about organizations' experiences in implementing this policy change. Beginning 10 and 24 months after implementation of the new law, semistructured interviews were conducted with 20 administrators whose five organizations trained and employed NPs, CNMs and PAs as providers of aspiration abortions. Interview data on the organizations' experiences were analyzed thematically, and facilitators of and barriers to implementation were identified. Administrators were committed to the provision of aspiration abortions by NPs, CNMs and PAs, and nearly all identified improved access to care and complication management as clear benefits of the policy change. However, integration of the new providers was uneven and depended on a variety of circumstances. Organizational disincentives included financial and logistical costs incurred in trying to deploy and integrate the different types of providers. Some administrators found that increased costs were outweighed by improved patient care, whereas others did not. In general, having a strong administrative champion within the organization made a critical difference. California's expansion of the abortion-providing workforce had a positive impact on patient care in the sampled organizations. However, various organizational obstacles must be addressed to more fully realize the benefits of having NPs, CNMs and PAs provide aspiration abortions. Copyright © 2018 by the Guttmacher Institute.

  18. Providing mental health first aid in the workplace: a Delphi consensus study.

    Science.gov (United States)

    Bovopoulos, Nataly; Jorm, Anthony F; Bond, Kathy S; LaMontagne, Anthony D; Reavley, Nicola J; Kelly, Claire M; Kitchener, Betty A; Martin, Angela

    2016-08-02

    Mental health problems are common in the workplace, but workers affected by such problems are not always well supported by managers and co-workers. Guidelines exist for the public on how to provide mental health first aid, but not specifically on how to tailor one's approach if the person of concern is a co-worker or employee. A Delphi consensus study was carried out to develop guidelines on additional considerations required when offering mental health first aid in a workplace context. A systematic search of websites, books and journal articles was conducted to develop a questionnaire with 246 items containing actions that someone may use to offer mental health first aid to a co-worker or employee. Three panels of experts from English-speaking countries were recruited (23 consumers, 26 managers and 38 workplace mental health professionals), who independently rated the items over three rounds for inclusion in the guidelines. The retention rate of the expert panellists across the three rounds was 61.7 %. Of the 246 items, 201 items were agreed to be important or very important by at least 80 % of panellists. These 201 endorsed items included actions on how to approach and offer support to a co-worker, and additional considerations where the person assisting is a supervisor or manager, or is assisting in crisis situations such as acute distress. The guidelines outline strategies for a worker to use when they are concerned about the mental health of a co-worker or employee. They will be used to inform future tailoring of Mental Health First Aid training when it is delivered in workplace settings and could influence organisational policies and procedures.

  19. Provider Experiences with Chronic Care Management (CCM) Services and Fees: A Qualitative Research Study.

    Science.gov (United States)

    O'Malley, Ann S; Sarwar, Rumin; Keith, Rosalind; Balke, Patrick; Ma, Sai; McCall, Nancy

    2017-12-01

    Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits. To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward. Semi-structured telephone interviews from January to April 2016 with 71 respondents. Sixty billing and non-billing providers and practice staff knowledgeable about their practices' CCM services, and 11 professional society representatives. Practice respondents noted that most patients expressed positive views of CCM services. Practice respondents also perceived several patient benefits, including improved adherence to treatment, access to care team members, satisfaction, care continuity, and care coordination. Facilitators of CCM provision included having an in-practice care manager, patient-centered medical home recognition, experience developing care plans, patient trust in their provider, and supplemental insurance to cover CCM copayments. Most billing practices reported few problems obtaining patients' consent for CCM, though providers felt that CMS could better facilitate consent by marketing CCM's goals to beneficiaries. Barriers reported by professional society representatives and by billing and non-billing providers included inadequacy of CCM payments to cover upfront investments for staffing, workflow modification, and time needed to manage complex patients. Other barriers included inadequate infrastructure for health information exchange with other providers and limited electronic health record capabilities for documenting and updating care plans. Practices owned by hospital systems and large medical groups faced greater bureaucracy in implementing CCM than did smaller, independent practices

  20. Tree Mortality Undercuts Ability of Tree-Planting Programs to Provide Benefits: Results of a Three-City Study

    Directory of Open Access Journals (Sweden)

    Sarah Widney

    2016-03-01

    Full Text Available Trees provide numerous benefits for urban residents, including reduced energy usage, improved air quality, stormwater management, carbon sequestration, and increased property values. Quantifying these benefits can help justify the costs of planting trees. In this paper, we use i-Tree Streets to quantify the benefits of street trees planted by nonprofits in three U.S. cities (Detroit, Michigan; Indianapolis, Indiana, and Philadelphia, Pennsylvania from 2009 to 2011. We also use both measured and modeled survival and growth rates to “grow” the tree populations 5 and 10 years into the future to project the future benefits of the trees under different survival and growth scenarios. The 4059 re-inventoried trees (2864 of which are living currently provide almost $40,000 (USD in estimated annual benefits ($9–$20/tree depending on the city, the majority (75% of which are increased property values. The trees can be expected to provide increasing annual benefits during the 10 years after planting if the annual survival rate is higher than the 93% annual survival measured during the establishment period. However, our projections show that with continued 93% or lower annual survival, the increase in annual benefits from tree growth will not be able to make up for the loss of benefits as trees die. This means that estimated total annual benefits from a cohort of planted trees will decrease between the 5-year projection and the 10-year projection. The results of this study indicate that without early intervention to ensure survival of planted street trees, tree mortality may be significantly undercutting the ability of tree-planting programs to provide benefits to neighborhood residents.

  1. Multi-Lab EV Smart Grid Integration Requirements Study. Providing Guidance on Technology Development and Demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Markel, T. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Meintz, A. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Hardy, K. [Argonne National Lab. (ANL), Argonne, IL (United States); Chen, B. [Argonne National Lab. (ANL), Argonne, IL (United States); Bohn, T. [Argonne National Lab. (ANL), Argonne, IL (United States); Smart, J. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Scoffield, D. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hovsapian, R. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Saxena, S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); MacDonald, J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Kiliccote, S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Kahl, K. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Pratt, R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-05-28

    The report begins with a discussion of the current state of the energy and transportation systems, followed by a summary of some VGI scenarios and opportunities. The current efforts to create foundational interface standards are detailed, and the requirements for enabling PEVs as a grid resource are presented. Existing technology demonstrations that include vehicle to grid functions are summarized. The report also includes a data-based discussion on the magnitude and variability of PEVs as a grid resource, followed by an overview of existing simulation tools that vi This report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications. can be used to explore the expansion of VGI to larger grid functions that might offer system and customer value. The document concludes with a summary of the requirements and potential action items that would support greater adoption of VGI.

  2. A Study of Relationship Building in the Context of Franchising for A Service Provider

    OpenAIRE

    Sakaguchi, Yoshie

    2010-01-01

    The findings of this research are presented to the business development of a UK-based translation service firm specifically for its strategic marketing plan to enter other markets beyond the current operational scope. Supported by the optimistic future outlook of the UK translation industry and the robust growth of UK franchise market, this research investigates how the franchisors of service industry can establish the productive relationships with the franchisees who are self-motivated and e...

  3. Impact of wood burning on outdoor air quality: existing French data and current studies

    International Nuclear Information System (INIS)

    Leoz-Garziandia, E.; Mandin, C.; Collet, S.; Besombes, J.L.; Pissot, N.; Allemand, N.; Riberon, J.; Jaffrezo, J.L.

    2009-01-01

    French source apportionment studies of air quality including the wood combustion source become widespread. Quantify a single source contribution to air quality requires to be provided with a specific measurable data to this source. For that reason, numerous studies have focused on the determination, in the atmospheric samples, of the source-specific compounds, usually called molecular tracers. Since 2000, trend works focused on the 'wood combustion' contribution to air quality have been based on the use of some tracers such as levoglucosan and metoxyphenols. Obtained results have been compared to atmospheric particles global characteristics: organic carbon (OC), elementary carbon (EC), PM 10 , PM 2.5 and polycyclic aromatic hydrocarbons (PAH). The results presented in this article show not only the interest but also the limits of such an approach, as well as the need to develop and complete the current studies in order to quantify the different sources contribution to air quality. (author)

  4. Current status and future of non-invasive studies of human brain functions

    International Nuclear Information System (INIS)

    Shibasaki, Hiroshi

    2008-01-01

    Currently available non-invasive studies are divided into two groups: electrophysiological studies and functional neuroimaging based on the hemodynamic principle. The former includes electroencephalography (EEG), magnetoencephalography (MEG) and transcranial magnetic stimulation, and the latter includes functional MRI, positron emission tomography (PET), single photon emission computed tomography (SPECT) and near-infrared spectroscopy. The hemodynamic response has been shown to be correlated with neuronal electrical activity, especially with synaptic activity rather than spiking activity, within a certain range. Since each technique has advantage and disadvantage, it is important to apply the most appropriate technique to solve each specific question. The combined use of more than one techniques of different principles, if possible, provides data of higher spatial and temporal resolution. Functional connectivity among different brain areas can be studied by using some of these techniques either alone or in combination. (author)

  5. Customized power quality service provided by converter interfaced microgrids — Voltage harmonics as a study case

    DEFF Research Database (Denmark)

    Meng, Lexuan; Chaudhary, Sanjay K.; Guerrero, Josep M.

    2017-01-01

    Customers may have different power quality requirements, thus, the economic operational strategy can try to provide them with distinctive quality levels as customized service. An optimization based method is proposed in this paper to realize this functionality, offering the possibility...

  6. Home Visit Services Provided for Elderly Dwellers in Isfahan Province: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Zamane Vafaei

    2015-06-01

    Conclusion: As the home visit services might be effective for providing health care for the aged people and increasing their quality of life, policymaking to spread these services seems to be crucial especially for Iran.

  7. Knowledge, attitude & practice on human papillomavirus vaccination: A cross-sectional study among healthcare providers

    Directory of Open Access Journals (Sweden)

    P Cheena Chawla

    2016-01-01

    Interpretation & conclusions: The findings reinforce continued medical education of healthcare providers, particularly those from the government sector on HPV vaccination for cervical cancer prevention. Public education is also pertinent for a successful HPV vaccination programme in the country.

  8. Etanercept provides an effective, safe and flexible short- and long-term treatment regimen for moderate-to-severe psoriasis: a systematic review of current evidence.

    Science.gov (United States)

    Strohal, Robert; Chimenti, Sergio; Vena, Gino Antonio; Girolomoni, Giampiero

    2013-06-01

    The treatment of psoriasis requires long-lasting intervention. Conventional treatments for psoriasis comprise topical, phototherapeutic and systemic modalities, such as methotrexate or cyclosporine. Biological therapies are advocated by treatment guidelines for the use in moderate-to-severe psoriasis, when conventional treatments have failed, are contraindicated or are associated with severe adverse events. Etanercept is an anti-TNF recombinant fusion protein that has emerged as a standard biologic treatment option for moderate-to-severe psoriasis. The present review summarizes data from pivotal and post-marketing randomized controlled etanercept trials to treat moderate-to-severe psoriasis for 24 weeks and longer. During the first 12 weeks, etanercept can be administered in different dosing regimens: 50 mg twice weekly (BIW) and 50 mg once weekly. Although both regimens are effective, it has been shown that the 50 mg BIW dosage leads to higher response rates at week 24. In addition, after 24 weeks' treatment etanercept provides the unique possibility of continuous or intermittent long-term treatment programmes. The medium- to long-term efficacy of etanercept was consistent, regardless of whether etanercept therapy was interrupted or continuous. Taking the chronic nature of psoriasis into account, this flexibility in dosing regimen bestows a key advantage in facilitating individualisation of long-term treatment according to patient needs.

  9. TeleWound care – providing remote wound assessment and treatment in the home care setting: current status and future directions

    Directory of Open Access Journals (Sweden)

    Santamaria N

    2013-11-01

    Full Text Available Nick Santamaria,1 Suzanne Kapp2 1University of Melbourne and Melbourne Health, Royal Melbourne Hospital, Melbourne, VIC, Australia; 2Royal District Nursing Service Institute, Melbourne, VIC, Australia Abstract: The use of wound telemedicine systems in the home care environment has been expanding for the last decade. These systems can generally be grouped into two main types: store and forward systems and video conference type systems; additionally, there are also hybrid systems available that include elements of both. Evidence to date suggests that these systems provide significant benefits to patients, clinicians, and to the health care system generally. Reductions in resource use, visit substitution, costs, and high patient and clinician satisfaction have been reported; however, there is a lack of integration with existing health care technology and no clearly defined technical or clinical standards as yet. Similarly, the legalities associated with wound telemedicine and remote consultation remain unclear. As wound telemedicine systems continue to evolve and be deployed in different locations, there remains significant potential to harness their power to benefit patients being treated at home. Keywords: telemedicine, home care, e-health

  10. Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

    Science.gov (United States)

    Mutanga, Jane N; Raymond, Juliette; Towle, Megan S; Mutembo, Simon; Fubisha, Robert Captain; Lule, Frank; Muhe, Lulu

    2012-01-01

    Provider-initiated testing and counselling (PITC) is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS) uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074), 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983), 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR) testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342), 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early infant diagnosis. The hospital's bolstered antiretroviral

  11. Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

    Directory of Open Access Journals (Sweden)

    Jane N Mutanga

    Full Text Available BACKGROUND: Provider-initiated testing and counselling (PITC is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. METHODS AND PRINCIPAL FINDINGS: Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074, 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983, 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342, 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early

  12. Equity perceptions and marital satisfaction in former and current marriage: A study among the remarried

    NARCIS (Netherlands)

    Buunk, A.P.; Mutsaers, W

    A study among 290 remarried individuals examined equity perceptions in the former and the current marriage. The results showed that equity in the former and the current marriage were not related to each other. In general, respondents perceived much more inequity in the former than in the current

  13. A study comparing public and medical librarians' perceptions of the role and duties of health information-providing librarians.

    Science.gov (United States)

    Noh, Younghee

    2015-12-01

    This study proposed to define the role and duties of librarians who provide health information service in public and medical libraries. Appropriate education, career experience and starting salary for this position are also presented. This study analysed previous research and job advertisements to understand the current needs for this position. Almost all job advertisements studied were eventually retrieved from Salary.com (US job posting site). Public libraries seeking to fill health informationist positions were even more difficult to find in any of the above locations. Therefore, the researcher attempted to find cases using various search engines, including Google, and noticed that public libraries usually post job advertisements on their website. Finally, 32 job postings were selected as suitable. Fifty-four public and medical librarians were surveyed to validate the results in Korea. Public librarians chose 'health information librarian' as the most appropriate title for this position, while medical librarians answered 'medical librarian'. Therefore, librarians providing health information service in public libraries should be called 'health information librarians', while the position in medical libraries should be called 'medical librarian'. Accordingly, job postings and academic articles will be easily accessible. Both groups marked that the position should require a bachelor's degree in both LIS and a health science field, 2 years library experience and health-related user training. Other requirements included knowledge of health resources and medical terminology, search capabilities and a focus on user-centric service. For required duties, public librarians chose accessing information resources, while medical librarians selected collection management. Health information librarians will play a vital role in the future and must therefore be educated accordingly. © 2015 Health Libraries Group.

  14. Providing Co-Curricular Support: A Multi-Case Study of Engineering Student Support Centers

    Science.gov (United States)

    Lee, Walter C., Jr.

    2015-01-01

    In response to the student retention and diversity issues that have been persistent in undergraduate engineering education, many colleges have developed Engineering Student Support Centers (ESSCs) such as Minority Engineering Programs (MEPs) and Women in Engineering Programs (WEPs). ESSCs provide underrepresented students with co-curricular…

  15. Providing Internet Access to the Ohio Career Information System for All Residents: A Feasibility Study.

    Science.gov (United States)

    Lewis, Morgan V.

    Expanded Internet access to the Ohio Career Information System (OCIS) would provide adults in Ohio who need to or wish to make career changes with the best available information about occupations, education and training programs, and financial aid. In order to determine the feasibility of improving access without cost to users, an advisory group,…

  16. The Making and Breaking of Trust in Pension Providers : An Empirical Study of Dutch Pension Participants

    NARCIS (Netherlands)

    van Dalen, Harry; Henkens, Kene

    2017-01-01

    Trust in pension institutions is pivotal in making pension decisions, like saving or enrolling in pension programs. But which traits of pension institutions matter in making or breaking trust in providers like pension funds, banks or insurance companies? This paper presents an empirical analysis of

  17. The making and breaking of trust in pension providers : An empirical study of pension participants

    NARCIS (Netherlands)

    van Dalen, Harry; Henkens, Kene

    2018-01-01

    Trust in pension institutions is pivotal in making pension decisions, like saving or enrolling in pension programs. But which traits of pension institutions matter in making or breaking trust in providers like pension funds, banks or insurance companies? This paper presents an empirical analysis of

  18. The practice of commissioning healthcare from a private provider: learning from an in-depth case study.

    Science.gov (United States)

    Chambers, Naomi; Sheaff, Rod; Mahon, Ann; Byng, Richard; Mannion, Russell; Charles, Nigel; Exworthy, Mark; Llewellyn, Sue

    2013-01-01

    The direction of health service policy in England is for more diversification in the design, commissioning and provision of health care services. The case study which is the subject of this paper was selected specifically because of the partnering with a private sector organisation to manage whole system redesign of primary care and to support the commissioning of services for people with long term conditions at risk of unplanned hospital admissions and associated service provision activities. The case study forms part of a larger Department of Health funded project on the practice of commissioning which aims to find the best means of achieving a balance between monitoring and control on the one hand, and flexibility and innovation on the other, and to find out what modes of commissioning are most effective in different circumstances and for different services. A single case study method was adopted to explore multiple perspectives of the complexities and uniqueness of a public-private partnership referred to as the "Livewell project". 10 single depth interviews were carried out with key informants across the GP practices, the PCT and the private provider involved in the initiative. The main themes arising from single depth interviews with the case study participants include a particular understanding about the concept of commissioning in the context of primary care, ambitions for primary care redesign, the importance of key roles and strong relationships, issues around the adoption and spread of innovation, and the impact of the current changes to commissioning arrangements. The findings identified a close and high trust relationship between GPs (the commissioners) and the private commissioning support and provider firm. The antecedents to the contract for the project being signed indicated the importance of leveraging external contacts and influence (resource dependency theory). The study has surfaced issues around innovation adoption in the healthcare context

  19. Measurement of current distribution in a proton exchange membrane fuel cell with various flow arrangements – A parametric study

    International Nuclear Information System (INIS)

    Alaefour, Ibrahim; Karimi, G.; Jiao, Kui; Li, X.

    2012-01-01

    Highlights: ► Spatial local current distributions in a single PEMFC are measured. ► Effects of key operating conditions on the local current density are investigated. ► Increasing air and hydrogen stoichiometries improves local current density distributions. ► Operating pressure and temperature have negligible impact on local current distribution. - Abstract: Understanding of current distributions in proton exchange membrane fuel cells (PEMFCs) is crucial for designing cell components such as the flow field plates and the membrane electrode assembly (MEA). In this study, the spatial current density distributions in a single PEMFC with three serpentine flow channels are measured using a segmented bipolar plate and printed circuit board technique. The effects of key operating conditions such as stoichiometry ratios, inlet humidity levels, cell pressure and temperature on the local current density distributions for co-, counter-, and cross-flow arrangements are examined. It is observed that the local current density distribution over the MEA is directly affected by the cell operating conditions along with the configuration of the flow arrangement. It is also found that among the different flow configurations tested under the various operating conditions, the counter flow arrangement provides the optimum average current density and the lowest variations in the local current densities along the flow channels.

  20. NIH Study Provides Clarity on Supplements for Protection Against Blinding Eye Disease

    Science.gov (United States)

    ... vision. Before the AREDS2 study finished, manufacturers began marketing supplements based on the study design. In AREDS2, ... Feed Connect with Us Contact Us Twitter Facebook Instagram YouTube Flickr More Social Media from NIH Footer ...

  1. 'On the doctor's orders': A pilot study of the effects of website marketing for medical specialist providers under gatekeeping arrangements

    NARCIS (Netherlands)

    Zwier, S.

    2017-01-01

    Websites from medical specialist providers are becoming increasingly marketing oriented, but there exists a paucity of empirical research on the effects. This experimental study explored effects of exposure to real websites from medical specialist providers among Dutch adults under physician

  2. Design study of primary ion provider for relativistic heavy ion collider electron beam ion source.

    Science.gov (United States)

    Kondo, K; Kanesue, T; Tamura, J; Okamura, M

    2010-02-01

    Brookhaven National Laboratory has developed the new preinjector system, electron beam ion source (EBIS) for relativistic heavy ion collider (RHIC) and National Aeronautics and Space Administration Space Radiation Laboratory. Design of primary ion provider is an essential problem since it is required to supply beams with different ion species to multiple users simultaneously. The laser ion source with a defocused laser can provide a low charge state and low emittance ion beam, and is a candidate for the primary ion source for RHIC-EBIS. We show a suitable design with appropriate drift length and solenoid, which helps to keep sufficient total charge number with longer pulse length. The whole design of primary ion source, as well as optics arrangement, solid targets configuration and heating about target, is presented.

  3. School Transitions: A Qualitative Study of the Supports Provided by Washington State Special Education Administrators

    Science.gov (United States)

    Lewinsohn, Kari

    2013-01-01

    This study investigated the role of special education administrators in the transition planning process for children with disabilities ages 3-21 in selected Washington school districts. A basic qualitative study was selected to construct meaning from a described phenomenon. The study sought to identify and explain how special education…

  4. Community and provider perceptions of traditional and skilled birth attendants providing maternal health care for pastoralist communities in Kenya: a qualitative study.

    Science.gov (United States)

    Byrne, Abbey; Caulfield, Tanya; Onyo, Pamela; Nyagero, Josephat; Morgan, Alison; Nduba, John; Kermode, Michelle

    2016-03-01

    Kenya has a high burden of maternal and newborn mortality. Consequently, the Government of Kenya introduced health system reforms to promote the availability of skilled birth attendants (SBAs) and proscribed deliveries by traditional birth attendants (TBAs). Despite these changes, only 10% of women from pastoralist communities are delivered by an SBA in a health facility, and the majority are delivered by TBAs at home. The aim of this study is to better understand the practices and perceptions of TBAs and SBAs serving the remotely located, semi-nomadic, pastoralist communities of Laikipia and Samburu counties in Kenya, to inform the development of an SBA/TBA collaborative care model. This descriptive qualitative study was undertaken in 2013-14. We conducted four focus group discussions (FGDs) with TBAs, three with community health workers, ten with community women, and three with community men. In-depth interviews were conducted with seven SBAs and eight key informants. Topic areas covered were: practices and perceptions of SBAs and TBAs; rewards and challenges; managing obstetric complications; and options for SBA/TBA collaboration. All data were translated, transcribed and thematically analysed. TBAs are valued and accessible members of their communities who adhere to traditional practices and provide practical and emotional support to women during pregnancy, delivery and post-partum. Some TBA practices are potentially harmful to women e.g., restricting food intake during pregnancy, and participants recognised that TBAs are unable to manage obstetric complications. SBAs are acknowledged as having valuable technical skills and resources that contribute to safe and clean deliveries, especially in the event of complications, but there is also a perception that SBAs mistreat women. Both TBAs and SBAs identified a range of challenges related to their work, and instances of mutual respect and informal collaborations between SBAs and TBAs were described. These findings

  5. A Qualitative Study of Patient and Provider Experiences during Preoperative Care Transitions

    Science.gov (United States)

    MALLEY, ANN; YOUNG, GARY J.

    2017-01-01

    Aims To explore the issues and challenges of care transitions in the preoperative environment. Background Ineffective transitions play a role in a majority of serious medical errors. There is a paucity of research related to the preoperative arena and the multiple inherent transitions in care that occur there. Design Qualitative descriptive design was used. Methods Semi-structured interviews were conducted in a 975 bed academic medical center. Results 30 providers and 10 preoperative patients participated. Themes that arose were: (1) Need for clarity of purpose of preoperative care (2) Care coordination (3) Inter-professional boundaries of care (4) Inadequate time and resources. Conclusion Effective transitions in the preoperative environment require that providers bridge scope of practice barriers to promote good teamwork. Preoperative care that is a product of well-informed providers and patients can improve the entire perioperative care process and potentially influence post-operative patient outcomes. Relevance to Clinical Practice Nurses are well positioned to bridge the gaps within transitions of care and accordingly affect health outcomes. PMID:27706872

  6. Providing Consistent (A)ATSR Solar Channel Radiometry for Climate Studies

    Science.gov (United States)

    Smith, D.; Latter, B. G.; Poulsen, C.

    2012-04-01

    Data from the solar reflectance channels of the Along Track Scanning Radiometer (ATSR) series of instruments are being used in applications for monitoring trends in clouds and aerosols. In order to provide quantitative information, the radiometric calibrations of the sensors must be consistent, stable and ideally traced to international standards. This paper describes the methods used to monitor the calibrations of the ATSR instruments to provide consistent Level 1b radiometric data sets. Comparisons of the in-orbit calibrations are made by reference to data from quasi stable sites such as DOME-C in Antarctica or Saharan Desert sites. Comparisons are performed either by time coincident match-ups of the radiometric data for sensors having similar spectral bands and view/solar geometry and overpass times as for AATSR and MERIS; or via a reference BRDF model derived from averages of measurements over the site from a reference sensor where there is limited or no temporal overlap (e.g. MODIS-Aqua, ATSR-1 and ATSR-2). The results of the intercomparisons provide values of the long term calibration drift and systematic biases between the sensors. Look-up tables based on smoothed averages of the drift measurements are used to provide the corrections to Level 1b data. The uncertainty budgets for the comparisons are provided. It is also possible to perform comparisons of measurements against high spectral resolution instruments that are co-located on the same platform, i.e. AATSR/SCIA on ENVISAT and ATSR-2/GOME on ERS-2. The comparisons are performed by averaging the spectrometer data to the spectral response of the filter radiometer, and averaging the radiometer data to the spatial resolution of the spectrometer. In this paper, the authors present the results of the inter-comparisons to achieve a consistent calibration for the solar channels of the complete ATSR dataset. An assessment of the uncertainties associated with the techniques will be discussed. The impacts of the

  7. Hepatitis B virus vaccination booster does not provide additional protection in adolescents: a cross-sectional school-based study.

    Science.gov (United States)

    Chang, Yung-Chieh; Wang, Jen-Hung; Chen, Yu-Sheng; Lin, Jun-Song; Cheng, Ching-Feng; Chu, Chia-Hsiang

    2014-09-23

    Current consensus does not support the use of a universal booster of hepatitis B virus (HBV) vaccine because there is an anamnestic response in almost all children 15 years after universal infant HBV vaccination. We aimed to provide a booster strategy among adolescents as a result of their changes in lifestyle and sexual activity. This study comprised a series of cross-sectional serological surveys of HBV markers in four age groups between 2004 and 2012. The seropositivity rates of hepatitis B surface antigen (HBsAg) and its reciprocal antibody (anti-HBs) for each age group were collected. There were two parts to this study; age-specific HBV seroepidemiology and subgroup analysis, including effects of different vaccine types, booster response for immunogenicity at 15 years of age, and longitudinal follow-up to identify possible additional protection by HBV booster. Within the study period, data on serum anti-HBs and HBsAg in a total of 6950 students from four age groups were collected. The overall anti-HBs and HBsAg seropositivity rates were 44.3% and 1.2%, respectively. The anti-HBs seropositivity rate in the plasma-derived subgroup was significantly higher in both 15- and 18-year age groups. Overall response rate in the double-seronegative recipients at 15 years of age was 92.5% at 6 weeks following one recombinant HBV booster dose. Among the 24 recipients showing anti-HBs seroconversion at 6 weeks after booster, seven subjects (29.2%) had lost their anti-HBs seropositivity again within 3 years. Increased seropositivity rates and titers of anti-HBs did not provide additional protective effects among subjects comprehensively vaccinated against HBV in infancy. HBV booster strategy at 15 years of age was the main contributor to the unique age-related phenomenon of anti-HBs seropositivity rate and titer. No increase in HBsAg seropositivity rates within different age groups was observed. Vaccination with plasma-derived HBV vaccines in infancy provided higher

  8. MEDXVIEWER: PROVIDING A WEB-ENABLED WORKSTATION ENVIRONMENT FOR COLLABORATIVE AND REMOTE MEDICAL IMAGING VIEWING, PERCEPTION STUDIES AND READER TRAINING.

    Science.gov (United States)

    Looney, P T; Young, K C; Halling-Brown, M D

    2016-06-01

    MedXViewer (Medical eXtensible Viewer) has been developed to address the need for workstation-independent, picture archiving and communication system (PACS)-less viewing and interaction with anonymised medical images. The aim of this paper is to describe the design and features of MedXViewer as well as to introduce the new features available in the latest release (version 1.2). MedXViewer currently supports digital mammography and tomosynthesis. The flexible software design used to develop MedXViewer allows it to be easily extended to support other imaging modalities. Regions of interest can be drawn by a user, and any associated information about a mark, an image or a study can be added. The questions and settings can be easily configured depending on the need of the research allowing both ROC and FROC studies to be performed. Complex tree-like questions can be asked where a given answer presents the user to new questions. The hanging protocol can be specified for each study. Panning, windowing, zooming and moving through slices are all available while modality-specific features can be easily enabled, e.g. quadrant zooming in digital mammography and tomosynthesis studies. MedXViewer can integrate with a web-based image database OPTIMAM Medical Image Database allowing results and images to be stored centrally. The software can, alternatively, run without a network connection where the images and results can be encrypted and stored locally on a machine or external drive. MedXViewer has been used for running remote paper-less observer studies and is capable of providing a training infrastructure and coordinating remote collaborative viewing sessions. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Reliability of Current Biokinetic and Dosimetric Models for Radionuclides: A Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Leggett, Richard Wayne [ORNL; Eckerman, Keith F [ORNL; Meck, Robert A. [U.S. Nuclear Regulatory Commission

    2008-10-01

    This report describes the results of a pilot study of the reliability of the biokinetic and dosimetric models currently used by the U.S. Nuclear Regulatory Commission (NRC) as predictors of dose per unit internal or external exposure to radionuclides. The study examines the feasibility of critically evaluating the accuracy of these models for a comprehensive set of radionuclides of concern to the NRC. Each critical evaluation would include: identification of discrepancies between the models and current databases; characterization of uncertainties in model predictions of dose per unit intake or unit external exposure; characterization of variability in dose per unit intake or unit external exposure; and evaluation of prospects for development of more accurate models. Uncertainty refers here to the level of knowledge of a central value for a population, and variability refers to quantitative differences between different members of a population. This pilot study provides a critical assessment of models for selected radionuclides representing different levels of knowledge of dose per unit exposure. The main conclusions of this study are as follows: (1) To optimize the use of available NRC resources, the full study should focus on radionuclides most frequently encountered in the workplace or environment. A list of 50 radionuclides is proposed. (2) The reliability of a dose coefficient for inhalation or ingestion of a radionuclide (i.e., an estimate of dose per unit intake) may depend strongly on the specific application. Multiple characterizations of the uncertainty in a dose coefficient for inhalation or ingestion of a radionuclide may be needed for different forms of the radionuclide and different levels of information of that form available to the dose analyst. (3) A meaningful characterization of variability in dose per unit intake of a radionuclide requires detailed information on the biokinetics of the radionuclide and hence is not feasible for many infrequently

  10. Motivation and challenges for use of malaria rapid diagnostic tests among informal providers in Myanmar: a qualitative study.

    Science.gov (United States)

    Sudhinaraset, May; Briegleb, Christina; Aung, Moe; Khin, Hnin Su Su; Aung, Tin

    2015-02-06

    Rapid diagnostic tests (RDTs) for malaria enable proper diagnosis and have been shown to reduce overuse of artemisinin combination therapy. Few studies have evaluated the feasibility and use of RDTs in the private sector in Myanmar. The objectives of the study were to: 1) understand the acceptability of using RDTs in the informal sector in Myanmar; 2) examine motivations for use among informal providers; and, 3) highlight decision-making and knowledge of providers for diagnostic testing and treatment. Qualitative interviews were conducted with 30 informal providers. Purposeful sampling was used to enrol study participants in the Mon and Shan State in Myanmar. All interviews were conducted in Burmese, translated into English, and two researchers coded all interviews using Atlas ti. Major themes identified included: 1) informal provider and outlet characteristics, including demographic and background characteristics; 2) the benefits and challenges of using RDTs according to providers; 3) provider experiences with using RDTs, including motivations for using the RDT; 4) adherence to test results, either positive or negative; and, 5) recommendations from informal providers to promote increased use of RDTs in their communities. This study found that introducing RDTs to informal providers in Myanmar was feasible, resulting in improved provider empowerment and patient-provider relationships. Specific challenges included facility infrastructure to use and dispose RDTs and provider knowledge. This varied across the type of informal provider, with itinerant drug vendors more comfortable and knowledgeable about RDTs compared to general retail sellers and medical drug representatives. This study found informal providers in Myanmar found the introduction of RDTs to be highly acceptable. Providers discussed improvement in service quality including provider empowerment and patient-provider relationships. The study also highlighted a number of challenges that informal providers

  11. A framework for providing telecommuting as a reasonable accommodation: some considerations on a comparative case study.

    Science.gov (United States)

    Kaplan, Shelley; Weiss, Sally; Moon, Nathan W; Baker, Paul

    2006-01-01

    Telecommuting, whether full time, part time, or over short periods when the need arises, can be an important accommodation for employees with disabilities. Indeed, telecommuting may be the only form of accommodation that offers employees whose disabilities fluctuate a means to stay consistently and gainfully employed. This article describes one employer's experience in considering a request for telecommuting as a reasonable accommodation for a particular employee. Drawing on real-life examples, both positive and negative, this article provides a win/win framework for decision-making that can help employers evaluate the use of telecommuting as a possible accommodation and facilitates open and ongoing communication between employer and employee.

  12. A preferred provider organization (PPO) case study for mental health and substance abuse.

    Science.gov (United States)

    Gomillion, I; Self, D R

    1988-01-01

    The Preferred Provider Organization concept is quickly becoming more popular because of its relative cost-effectiveness and recent successes. Managed care through means of this mental health and substance abuse PPO may well serve as the prototype for the general health care cost containment efforts of the future for the self-insured insurance plans for Alabama state employees and teachers. The first year also revealed several problems in the original proposal especially with respect to the unintended attractiveness of inpatient/residential care. Consequently, copayment plans were added to dissuade unnecessary lengthy stays (see Table 2). Second, a new quality assurance mechanism has been added to further evaluate the need for admissions to facilities, as well as for the need for continued inpatient treatment. The Alabama Quality Assurance Foundation (AQAF) began on January 1, 1988, conducting the preadmission certification on all admissions based upon criteria established jointly by AQAF and the PPO providers. In addition, AQAF will conduct continuing stay reviews at predetermined time periods to ensure that continued treatment in an inpatient setting is indeed necessary.

  13. Doulas' Perspectives about Providing Support to Incarcerated Women: A Feasibility Study.

    Science.gov (United States)

    Shlafer, Rebecca J; Hellerstedt, Wendy L; Secor-Turner, Molly; Gerrity, Erica; Baker, Rae

    2015-01-01

    To document the logistical feasibility of a doula program for pregnant incarcerated women and to assess doulas' perceptions of their achievements. Six doulas provided written case notes ("birth stories") about their experiences with 18 pregnant women in one Midwestern state prison. The birth stories were analyzed by two coders to identify major themes related to doulas' perceptions about providing support to incarcerated women. Analyses involved coder consensus about major themes and doula affirmation of findings. All doulas reported that they met key objectives for a successful relationship with each of their clients. Key themes were their ability to empower clients, establish a trusting relationship, normalize the delivery, and support women as they were separated from their newborns. The intervention was logistically feasible, suggesting that doulas can adapt their practice for incarcerated women. Doulas may need specific training to prepare themselves for institutional restrictions that may conflict with the traditional roles of doula care. It may be important for doulas to understand the level of personal and professional resources they may have to expend to support incarcerated women if they are separated from their infants soon after delivery. © 2014 Wiley Periodicals, Inc.

  14. Neoclassical current studies in high beta plasmas. Technical progress report, October 1, 1982-September 31, 1983

    International Nuclear Information System (INIS)

    1983-01-01

    During the 12-month period, October 1, 1982 to September 30, 1983 the Levitated Octupole has been dedicated to a study of neoclassical currents. At beta values of a few percent, both the Pfirsch-Schlueter current and the bootstrap current have been observed and compared with theoretical predictions. The spatial variation of the current both radially and poloidally are found to agree with the prediction over a wide range of collisionality. A four megawatt ICRH capability exists for sustaining the current in steady state

  15. Characterization of Patient Interest in Provider-Based Consumer Health Information Technology: Survey Study.

    Science.gov (United States)

    Featherall, Joseph; Lapin, Brittany; Chaitoff, Alexander; Havele, Sonia A; Thompson, Nicolas; Katzan, Irene

    2018-04-19

    Consumer health information technology can improve patient engagement in their health care and assist in navigating the complexities of health care delivery. However, the consumer health information technology offerings of health systems are often driven by provider rather than patient perspectives and inadequately address patient needs, thus limiting their adoption by patients. Consideration given to patients as stakeholders in the development of such technologies may improve adoption, efficacy, and consumer health information technology resource allocation. The aims of this paper were to measure patient interest in different health system consumer health information technology apps and determine the influence of patient characteristics on consumer health information technology interest. Patients seen at the Cleveland Clinic Neurological Institute were electronically surveyed on their interest in using different consumer health information technology apps. A self-efficacy scale, Patient Health Questionnaire-9 depression screen, and EuroQol 5 dimensions health-related quality of life scale were also completed by patients. Logistic regression was used to determine the influence of patient characteristics on interest in consumer health information technology in the categories of self-management, education, and communication. The majority of 3852 patient respondents had an interest in all technology categories assessed in the survey. The highest interest was in apps that allow patients to ask questions of providers (3476/3852, 90.24%) and to schedule appointments (3211/3839, 83.64%). Patient interest in consumer health information technology was significantly associated with greater depression symptoms, worse quality of life, greater health self-efficacy, and smartphone ownership (Pinformation technology development and their perspectives should consistently guide development efforts. Health systems should consider focusing on consumer health information technologies

  16. Towards successful Dissemination of Psychological First Aid: a study of provider training preferences.

    Science.gov (United States)

    Hambrick, Erin P; Rubens, Sonia L; Vernberg, Eric M; Jacobs, Anne K; Kanine, Rebecca M

    2014-04-01

    Dissemination of Psychological First Aid (PFA) is challenging considering the complex nature of disaster response and the various disaster mental health (DMH) trainings available. To understand challenges to dissemination in community mental health centers (CMHCs), interviews were conducted with nine DMH providers associated with CMHCs. Consensual qualitative analysis was used to analyze data. Interviews were targeted toward understanding organizational infrastructure, DMH training requirements, and training needs. Results clarified challenges to DMH training in CMHCs and factors that may promote buy-in for trainings. For example, resources are limited and thus allocated for state and federal training requirements. Therefore, including PFA in these requirements could promote adoption. Additionally, a variety of training approaches that differ in content, style, and length would be useful. To conclude, a conceptual model for ways to promote buy-in for the PFA Guide is proposed.

  17. Complementation studies with the novel "Bungowannah" virus provide new insights in the compatibility of pestivirus proteins.

    Science.gov (United States)

    Richter, Maria; Reimann, Ilona; Wegelt, Anne; Kirkland, Peter D; Beer, Martin

    2011-09-30

    In recent years several atypical pestiviruses have been described. Bungowannah virus is the most divergent virus in this group. Therefore, heterologous complementation was used to clarify the phylogenetic relationship and to analyze the exchangeability of genome regions encoding structural proteins. Using a BVDV type 1 backbone, chimeric constructs with substituted envelope proteins E(rns), E1 and E2, were investigated. While all constructs replicated autonomously, infectious high titer chimeric virus could only be observed after exchanging the complete E1-E2 encoding region. The complementation of E1 and E2 alone resulted only in replicons. Complementation of BVDV-E(rns) was only efficient if Bungowannah virus-E(rns) was expressed from a bicistronic construct. Our data provide new insights in the compatibility of pestivirus proteins and demonstrate that heterologous complementation could be useful to characterize new pestiviruses. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Healthcare Hackathons Provide Educational and Innovation Opportunities: A Case Study and Best Practice Recommendations.

    Science.gov (United States)

    Silver, Julie K; Binder, David S; Zubcevik, Nevena; Zafonte, Ross D

    2016-07-01

    Physicians and other healthcare professionals are often the end users of medical innovation; however, they are rarely involved in the beginning design stages. This often results in ineffective healthcare solutions with poor adoption rates. At the early design stage, innovation would benefit from input from healthcare professionals. This report describes the first-ever rehabilitation hackathon-an interdisciplinary and competitive team event aimed at accelerating and improving healthcare solutions and providing an educational experience for participants. Hackathons are gaining traction as a way to accelerate innovation by bringing together a diverse group of interdisciplinary professionals from different industries who work collaboratively in teams and learn from each other, focus on a specific problem ("pain point"), develop a solution using design thinking techniques, pitch the solution to participants, gather fast feedback and quickly alter the prototype design ("pivoting"). 102 hackers including 19 (18.6 %) physicians and other professionals participated, and over the course of 2 days worked in teams, pitched ideas and developed design prototypes. Three awards were given for prototypes that may improve function in persons with disabilities. 43 hackers were women (42.2 %) and 59 men (57.8 %); they ranged in age from 16 to 79 years old; and, of the 75 hackers who reported their age, 63 (84 %) were less than 40 years old and 12 (16 %) were 40 years or older. This report contributes to the emerging literature on healthcare hackathons as a means of providing interdisciplinary education and training and supporting innovation.

  19. Family planning providers' perspectives on family planning service delivery in Ibadan and Kaduna, Nigeria: a qualitative study.

    Science.gov (United States)

    Hebert, Luciana Estelle; Schwandt, Hilary Megan; Boulay, Marc; Skinner, Joanna

    2013-01-01

    In Nigeria, fertility continues to be high and contraceptive prevalence remains low. This study was conducted in order to understand the perceptions of, experiences with and challenges of delivering family planning services in two urban areas of Nigeria from the perspectives of family planning service providers. A qualitative study using 59 in-depth interviews was conducted among family planning providers working in hospitals, primary health centres, clinics, pharmacies and patent medicine vendors in Ibadan and Kaduna, Nigeria. Providers support a mix of individuals and organisations involved in family planning provision, including the government of Nigeria. The Nigerian government's role can take a variety of forms, including providing promotional materials for family planning facilities as well as facilitating training and educational opportunities for providers, since many providers lack basic training in family planning provision. Providers often describe their motivation to provide in terms of the health benefits offered by family planning methods. Few providers engage in any marketing of their services and many providers exclude youth and unmarried individuals from their services. The family planning provider community supports a diverse network of providers, but needs further training and support in order to improve the quality of care and market their services. Adolescents, unmarried individuals and women seeking post-abortion care are vulnerable populations that providers need to be better educated about and trained in how to serve. The perspectives of providers should be considered when designing family planning interventions in urban areas of Nigeria.

  20. Man's Basic Needs. Resource Units, Grade 1. Providence Social Studies Curriculum Project.

    Science.gov (United States)

    Providence Public Schools, RI.

    GRADES OR AGES: Grade 1. SUBJECT MATTER: Social studies; man's basic needs. ORGANIZATION AND PHYSICAL APPEARANCE: The guide is divided into 11 chapters, five of which outline the basic curriculum subunits. These five chapters are laid out in three columns, one each for topics, activities, and materials. Other chapters are in list form. The guide…

  1. The LifeLines Cohort Study : a resource providing new opportunities for environmental epidemiology

    NARCIS (Netherlands)

    Zijlema, Wilma L; Smidt, Nynke; Klijs, Bart; Morley, David W; Gulliver, John; de Hoogh, Kees; Scholtens, Salome; Rosmalen, Judith G M; Stolk, Ronald P

    2016-01-01

    BACKGROUND: Lifelines is a prospective population-based cohort study investigating the biological, behavioral and environmental determinants of healthy ageing among 167,729 participants from the North East region of the Netherlands. The collection and geocoding of (history of) home and work

  2. Study on Providing Professors with Efficient Service Based on Time Management Strategy

    Science.gov (United States)

    Li, Chunlin; Liu, Mengchao; Wang, Yining

    2016-01-01

    Time management is the study to use time scientifically by deploying skills, techniques and means, and maximizing time value to help individuals or organizations efficiently complete tasks and achieve goals. University professor as a body is an important force in teaching and research. In order to ensure high-quality teaching, productive research,…

  3. A Study on Family Opinions Concerning Services Provided in Special Education Centres

    Science.gov (United States)

    Ugurlu, Necla Isikdogan; Kayhan, Nilay

    2017-01-01

    This study is to diagnose and evaluate children with different special needs medically and educationally and, as a result of those evaluations, to identify families' expectations, opinions and suggestions concerning the special education process, services and the functioning of special education institutions. The mothers of five children who…

  4. Study of the tomographic image quality provided by a conical beam system kilo voltage

    International Nuclear Information System (INIS)

    Garayoa Roca, J.; Castro Tejero, P.

    2011-01-01

    Imaging systems play an increasingly important role in radiotherapy, and to ensure the quality of the process, you must know the characteristics and limitations of available imaging systems. In this study we sought to evaluate the image quality of an IGRT system based on a kilo voltage cone beam.

  5. A cost-effectiveness analysis of provider interventions to improve health worker practice in providing treatment for uncomplicated malaria in Cameroon: a study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Wiseman Virginia

    2012-01-01

    Full Text Available Abstract Background Governments and donors all over Africa are searching for sustainable, affordable and cost-effective ways to improve the quality of malaria case management. Widespread deficiencies have been reported in the prescribing and counselling practices of health care providers treating febrile patients in both public and private health facilities. Cameroon is no exception with low levels of adherence to national guidelines, the frequent selection of non-recommended antimalarials and the use of incorrect dosages. This study evaluates the effectiveness and cost-effectiveness of introducing two different provider training packages, alongside rapid diagnostic tests (RDTs, designed to equip providers with the knowledge and practical skills needed to effectively diagnose and treat febrile patients. The overall aim is to target antimalarial treatment better and to facilitate optimal use of malaria treatment guidelines. Methods/Design A 3-arm stratified, cluster randomized trial will be conducted to assess whether introducing RDTs with provider training (basic or enhanced is more cost-effective than current practice without RDTs, and whether there is a difference in the cost effectiveness of the provider training interventions. The primary outcome is the proportion of patients attending facilities that report a fever or suspected malaria and receive treatment according to malaria guidelines. This will be measured by surveying patients (or caregivers as they exit public and mission health facilities. Cost-effectiveness will be presented in terms of the primary outcome and a range of secondary outcomes, including changes in provider knowledge. Costs will be estimated from a societal and provider perspective using standard economic evaluation methodologies. Trial Registration ClinicalTrials.gov: NCT00981877

  6. The use of telehealth for diabetes management: a qualitative study of telehealth provider perceptions

    Directory of Open Access Journals (Sweden)

    Woodbridge Peter A

    2007-05-01

    Full Text Available Abstract Background Monitoring and Messaging Devices (MMDs are telehealth systems used by patients in their homes, and are designed to promote patient self-management, patient education, and clinical monitoring and follow-up activities. Although these systems have been widely promoted by health care systems, including the Veterans Health Administration, very little information is available on factors that facilitate use of the MMD system, or on barriers to use. Methods We conducted in-depth qualitative interviews with clinicians using MMD-based telehealth programs at two Veterans Affairs Medical Centers in the Midwestern United States. Results Findings suggest that MMD program enrollment is limited by both clinical and non-clinical factors, and that patients have varying levels of program participation and system use. Telehealth providers see MMDs as a useful tool for monitoring patients who are interested in working on management of their disease, but are concerned with technical challenges and the time commitment required to use MMDs. Conclusion Telehealth includes a rapidly evolving and potentially promising range of technologies for meeting the growing number of patients and clinicians who face the challenges of diabetes care, and future research should explore the most effective means of ensuring successful program implementation.

  7. A holistic evolutionary and structural study of flaviviridae provides insights into the function and inhibition of HCV helicase

    Directory of Open Access Journals (Sweden)

    Dimitrios Vlachakis

    2013-05-01

    Full Text Available Viral RNA helicases are involved in duplex unwinding during the RNA replication of the virus. It is suggested that these helicases represent very promising antiviral targets. Viruses of the flaviviridae family are the causative agents of many common and devastating diseases, including hepatitis, yellow fever and dengue fever. As there is currently no available anti-Flaviviridae therapy, there is urgent need for the development of efficient anti-viral pharmaceutical strategies. Herein, we report the complete phylogenetic analysis across flaviviridae alongside a more in-depth evolutionary study that revealed a series of conserved and invariant amino acids that are predicted to be key to the function of the helicase. Structural molecular modelling analysis revealed the strategic significance of these residues based on their relative positioning on the 3D structures of the helicase enzymes, which may be used as pharmacological targets. We previously reported a novel series of highly potent HCV helicase inhibitors, and we now re-assess their antiviral potential using the 3D structural model of the invariant helicase residues. It was found that the most active compound of the series, compound C4, exhibited an IC50 in the submicromolar range, whereas its stereoisomer (compound C12 was completely inactive. Useful insights were obtained from molecular modelling and conformational search studies via molecular dynamics simulations. C12 tends to bend and lock in an almost “U” shape conformation, failing to establish vital interactions with the active site of HCV. On the contrary, C4 spends most of its conformational time in a straight, more rigid formation that allows it to successfully block the passage of the oligonucleotide in the ssRNA channel of the HCV helicase. This study paves the way and provides the necessary framework for the in-depth analysis required to enable the future design of new and potent anti-viral agents.

  8. Comparison of Provider Types Who Performed Prehospital Lifesaving Interventions: A Prospective Study

    Science.gov (United States)

    2014-12-01

    In less than 2 hours, 15 critically ill children were triaged and admitted to the PICU or surge spaces. Conclusions:Identified strengths included...details increasing telemedicine uti - lization during a 4 year period and outlines program structural changes that improved utilization. Methods: The study...population survival. CSC ICU resource- allocation algorithms (ALGs) exist for adults. Our goal was to evaluate a CSC pandemic ALG for children . Methods

  9. Mobile Manufacturer or Service provider? An Empirical Study on Consumers’ Adoption Intention

    OpenAIRE

    Feng Hu; Xiaoyi Du; Yong Liu

    2010-01-01

    As mobile manufacturers today seek to attract consumers by increasingly integrating mobile services into their products, little research is available regarding whether and to what degree this new feature of mobile phone would motivate consumers’ purchase intention.Concerning m-learning, this study investigates the relationship among users’ intentions to adopt mobile service, service-enabled-phone as well as intention to pay for the new phone functionality. Based on 209 useful responses, this ...

  10. Therapeutic patient education in heart failure: do studies provide sufficient information about the educational programme?

    Science.gov (United States)

    Albano, Maria Grazia; Jourdain, Patrick; De Andrade, Vincent; Domenke, Aukse; Desnos, Michel; d'Ivernois, Jean-François

    2014-05-01

    Therapeutic patient education programmes on heart failure have been widely proposed for many years for heart failure patients, but their efficiency remains questionable, partly because most articles lack a precise programme description, which makes comparative analysis of the studies difficult. To analyse the degree of precision in describing therapeutic patient education programmes in recent randomized controlled trials. Three major recent recommendations on therapeutic patient education in heart failure inspired us to compile a list of 23 relevant items that an 'ideal' description of a therapeutic patient education programme should contain. To discover the extent to which recent studies into therapeutic patient education in heart failure included these items, we analysed 19 randomized controlled trials among 448 articles published in this field from 2005 to 2012. The major elements required to describe a therapeutic patient education programme were present, but some other very important pieces of information were missing in most of the studies we analysed: the patient's educational needs, health literacy, projects, expectations regarding therapeutic patient education and psychosocial status; the educational methodology used; outcomes evaluation; and follow-up strategies. Research into how therapeutic patient education can help heart failure patients will be improved if more precise descriptions of patients, educational methodology and evaluation protocols are given by authors, ideally in a standardized format. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  11. Communicating about eating behaviors. A qualitative study of Chilean women and their health-care providers.

    Science.gov (United States)

    Gálvez, Patricia; Valencia, Alejandra; Palomino, Ana M; Cataldo, Marjorie; Schwingel, Andiara

    2015-01-01

    Good communication between health care providers (HCPs) and patients is critical in achieving positive health outcomes. The purpose of this article was to compare the perceptions of Chilean woman and their HCPs with respect to determinants of eating behaviors. Semi-structured interviews were conducted with women (n=15) visiting a public health care center in Chile and with their HCPs (n=8) who were in charge of promoting healthy eating behaviors among women. Data from the interviews indicated similarities and inconsistencies in determinants of eating behaviors between the groups. Both mentioned many important factors that influence women's eating behaviors, including food preferences, dietary knowledge, self-control and self-efficacy, family, food cost, and food availability. HCPs appeared to be less aware of the role that personality traits and past experiences play as potential determinants which women mentioned. In contrast, women were less aware of the influence of anxiety and low self-esteem on eating choices, which HCPs noted as key factors. Although it was encouraging to see agreement between women and their HCPs in some areas, it is important to work on increasing understanding among the groups with respect to the important role psychological factors play in influencing eating behavior. We suggest that HCPs should focus on the importance of women's personality traits and past eating behaviors, as well as work on improving women's self-esteem and helping to decrease their anxiety levels. HCPs should be encouraged to develop good communication with each person in order to help them understand the roles that external and internal factors play in eating behaviors.

  12. Willingness to provide behavioral health recommendations: a cross-sectional study of entering medical students

    Directory of Open Access Journals (Sweden)

    McCurdy Stephen A

    2012-05-01

    Full Text Available Abstract Background Behavioral factors contribute importantly to morbidity and mortality, and physicians are trusted sources for information on reducing associated risks. Unfortunately, many clinical encounters do not include prevention counseling, and medical school curriculum plays an important role in training and promoting such counseling among medical students. Methods We surveyed all 93 freshman medical students at entry to the University of California, Davis School of Medicine in 2009 to evaluate baseline knowledge of population health principles and examine their approach to clinical situations involving four common behavioral risk factors illustrated in brief clinical vignettes: smoking, alcohol use in a patient with indications of alcoholism, diet and exercise in an overweight sedentary patient, and a 16-year-old contemplating initiation of sexual intercourse. Based on vignette responses, we assessed willingness to (1 provide information on risks, (2 recommend elimination of the behavior as the most efficacious means for reducing risk, (3 include strategies apart from elimination of the behavior for lowering risk (i.e., harm reduction, and (4 assure of their intention to continue care whether or not recommendations are accepted. Results Students answered correctly 71.4 % (median; interquartile range 66.7 % - 85.7 % of clinical prevention and population health knowledge questions; men scored higher than women (median 83.3 % vs. 66.7 %, p Conclusion Students showed high willingness to educate and respect patient autonomy. There was high willingness to recommend elimination of risk behaviors for smoking, alcohol, and poor diet/exercise, but not for sexual intercourse in an adolescent considering sexual debut. Further research should address promoting appropriate science-based preventive health messages, and curriculum should include explicit discussion of content of recommendations.

  13. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  14. Factors influencing the current practice of self-medication consultations in Eastern Indonesian community pharmacies: a qualitative study.

    Science.gov (United States)

    Brata, Cecilia; Fisher, Colleen; Marjadi, Brahmaputra; Schneider, Carl R; Clifford, Rhonda M

    2016-05-13

    Research has shown that the current practice of pharmacy staff when providing self-medication consultations in Indonesia is suboptimal. To improve the performance of pharmacy staff when providing self-medication consultations in community pharmacies, the factors that influence current practice need to be understood. The aim of this study is to identify the factors that influence current practice of pharmacy staff when handling self-medication consultations in Eastern Indonesian community pharmacies. Fifteen in-depth interviews were conducted with pharmacists, pharmacy technicians, pharmacy owners, and counter attendants. Thematic analysis was used to generate findings. The current practice of pharmacy staff when handling self-medication consultations is directly influenced by the professionalism of pharmacy staff and patient responses to the consultations. These factors are in turn affected by the organisational context of the pharmacy and the external pharmacy environment. The organisational context of the pharmacy includes staffing, staff affordability, and the availability of time and facilities in which to provide consultations. The external pharmacy environment includes the number of trained pharmacy staff in the research setting, the relevance of pharmacy education to the needs of pharmacy practice, the support offered by the Indonesian Pharmacists Association, a competitive business environment, and the policy environment. Complex and inter-related factors influence the current practice of pharmacy staff when providing self-medication consultations in community pharmacies in this research setting. Multiple strategies will be required to improve consultation practices.

  15. A renormalization group study of persistent current in a quasiperiodic ring

    Energy Technology Data Exchange (ETDEWEB)

    Dutta, Paramita [Theoretical Condensed Matter Physics Division, Saha Institute of Nuclear Physics, Sector-I, Block-AF, Bidhannagar, Kolkata-700 064 (India); Maiti, Santanu K., E-mail: santanu.maiti@isical.ac.in [Physics and Applied Mathematics Unit, Indian Statistical Institute, 203 Barrackpore Trunk Road, Kolkata-700 108 (India); Karmakar, S.N. [Theoretical Condensed Matter Physics Division, Saha Institute of Nuclear Physics, Sector-I, Block-AF, Bidhannagar, Kolkata-700 064 (India)

    2014-04-01

    We propose a real-space renormalization group approach for evaluating persistent current in a multi-channel quasiperiodic Fibonacci tight-binding ring based on a Green's function formalism. Unlike the traditional methods, the present scheme provides a powerful tool for the theoretical description of persistent current with a very high degree of accuracy in large periodic and quasiperiodic rings, even in the micron scale range, which emphasizes the merit of this work.

  16. An exploratory study: prolonged periods of binocular stimulation can provide an effective treatment for childhood amblyopia.

    Science.gov (United States)

    Knox, Pamela J; Simmers, Anita J; Gray, Lyle S; Cleary, Marie

    2012-02-21

    The purpose of the present study was to explore the potential for treating childhood amblyopia with a binocular stimulus designed to correlate the visual input from both eyes. Eight strabismic, two anisometropic, and four strabismic and anisometropic amblyopes (mean age, 8.5 ± 2.6 years) undertook a dichoptic perceptual learning task for five sessions (each lasting 1 hour) over the course of a week. The training paradigm involved a simple computer game, which required the subject to use both eyes to perform the task. A statistically significant improvement (t(₁₃) = 5.46; P = 0.0001) in the mean visual acuity (VA) of the amblyopic eye (AE) was demonstrated, from 0.51 ± 0.27 logMAR before training to 0.42 ± 0.28 logMAR after training with six subjects gaining 0.1 logMAR or more of improvement. Measurable stereofunction was established for the first time in three subjects with an overall significant mean improvement in stereoacuity after training (t(₁₃) =2.64; P = 0.02). The dichoptic-based perceptual learning therapy employed in the present study improved both the monocular VA of the AE and stereofunction, verifying the feasibility of a binocular approach in the treatment of childhood amblyopia.

  17. An electron beam induced current study of gallium nitride and diamond materials

    International Nuclear Information System (INIS)

    Cropper, A.D.; Moore, D.J.; Scott, C.S.; Green, R.

    1995-01-01

    The continual need for microelectronic devices that operate under severe electronic and environmental conditions (high temperature, high frequency, high power, and radiation tolerance) has sustained research in wide bandgap semiconductor materials. The properties suggest these wide-bandgap semiconductor materials have tremendous potential for military and commercial applications. High frequency bipolar transistors and field effect transistors, diodes, and short wavelength optical devices have been proposed using these materials. Although research efforts involving the study of transport properties in Gallium Nitride (GaN) and Diamond have made significant advances, much work is still needed to improve the material quality so that the electrophysical behavior of device structures can be further understood and exploited. Electron beam induced current (EBIC) measurements can provide a method of understanding the transport properties in Gallium Nitride (GaN) and Diamond. This technique basically consists of measuring the current or voltage transient response to the drift and diffusion of carriers created by a short-duration pulse of radiation. This method differs from other experimental techniques because it is based on a fast transient electron beam probe created from a high speed, laser pulsed photoemission system

  18. Dark current and radiation shielding studies for the ILC main linac

    Energy Technology Data Exchange (ETDEWEB)

    Mokhov, Nikolai V. [Fermilab; Rakhno, I. L. [Fermilab; Solyak, N. A. [Fermilab; Sukhanov, A. [Fermilab; Tropin, I. S. [Fermilab

    2016-12-05

    Electrons of dark current (DC), generated in high-gradient superconducting RF cavities (SRF) due to field emission, can be accelerated up to very high energies—19 GeV in the case of the International Linear Collider (ILC) main linac—before they are removed by focusing and steering magnets. Electromagnetic and hadron showers generated by such electrons can represent a significant radiation threat to the linac equipment and personnel. In our study, an operational scenario is analysed which is believed can be considered as the worst case scenario for the main linac regarding the DC contribution to the radiation environment in the main linac tunnel. A detailed modelling is performed for the DC electrons which are emitted from the surface of the SRF cavities and can be repeatedly accelerated in the high-gradient fields in many SRF cavities. Results of MARS15 Monte Carlo calculations, performed for the current main linac tunnel design, reveal that the prompt dose design level of 25 μSv/hr in the service tunnel can be provided by a 2.3-m thick concrete wall between the main and service ls.

  19. A study of some political problems considering current geographical analytical parameters

    Directory of Open Access Journals (Sweden)

    Héctor Adolfo Dupuy

    2008-01-01

    Full Text Available This paper intends to study some of the main problems presented, on different scales, by current politics, considering the spatial implications as well as various parameters offered lately by the geographical science. The proposal is supported by the theoretical bases developed from Emmanuel Wallerstein and Peter Taylor's statement about a world system structured as a world economy, based on the capitalist mode of production. Conversely, it attempts to provide a theoretical explanation for the dynamics experienced by the territories upon thee basis of such world system's mechanics. According to these assumptions, an analysis is proposed of some of the main phenomena resulting from the previous analysis and its spatial implications, such as the current power relations in the system, the subsistence of traditional power factors (Nation-states, ethnically based cultural configurations and the appearance of new ones (the forming of transnational blocs and associations, new social movements, new forms of local participation, the importance of hegemonic and counter-hegemonic discourses in the construction of symbolic representations and of the mass media in such processes or the new cultural identity and hybridization chart from population mobility.

  20. Theoretical and experimental studies on ionic currents in nanopore-based biosensors.

    Science.gov (United States)

    Liu, Lei; Li, Chu; Ma, Jian; Wu, Yingdong; Ni, Zhonghua; Chen, Yunfei

    2014-12-01

    Novel generation of analytical technology based on nanopores has provided possibilities to fabricate nanofluidic devices for low-cost DNA sequencing or rapid biosensing. In this paper, a simplified model was suggested to describe DNA molecule's translocation through a nanopore, and the internal potential, ion concentration, ionic flowing speed and ionic current in nanopores with different sizes were theoretically calculated and discussed on the basis of Poisson-Boltzmann equation, Navier-Stokes equation and Nernst-Planck equation by considering several important parameters, such as the applied voltage, the thickness and the electric potential distributions in nanopores. In this way, the basic ionic currents, the modulated ionic currents and the current drops induced by translocation were obtained, and the size effects of the nanopores were carefully compared and discussed based on the calculated results and experimental data, which indicated that nanopores with a size of 10 nm or so are more advantageous to achieve high quality ionic current signals in DNA sensing.

  1. Perspectives on leadership in organizations providing services to people with disabilities: an exploratory study.

    Science.gov (United States)

    Brady, Laura Thompson; Fong, Lisa; Waninger, Kendra N; Eidelman, Steven

    2009-10-01

    As leaders from the Baby Boomer generation prepare for retirement over the next decade, emerging leaders must be identified and supported in anticipation of a major organizational transition. Authentic leadership is a construct that informs the development of values-driven leaders who will bring organizations into the future, just as the previous generation of leaders oversaw the movement of services away from state institutions and into networks of community-based service delivery organizations. The purpose of this exploratory study was to examine executive and emerging leaders' opinions about the unique leadership values, skills, and challenges in organizations that serve individuals with intellectual and developmental disabilities. Themes of defining, developing, and sustaining leaders emerged from the data and are explored through an authentic leadership framework.

  2. Transcriptome and proteome exploration to provide a resource for the study of Agrocybe aegerita.

    Directory of Open Access Journals (Sweden)

    Man Wang

    Full Text Available BACKGROUND: Agrocybe aegerita, the black poplar mushroom, has been highly valued as a functional food for its medicinal and nutritional benefits. Several bioactive extracts from A. aegerita have been found to exhibit antitumor and antioxidant activities. However, limited genetic resources for A. aegerita have hindered exploration of this species. METHODOLOGY/PRINCIPAL FINDINGS: To facilitate the research on A. aegerita, we established a deep survey of the transcriptome and proteome of this mushroom. We applied high-throughput sequencing technology (Illumina to sequence A. aegerita transcriptomes from mycelium and fruiting body. The raw clean reads were de novo assembled into a total of 36,134 expressed sequences tags (ESTs with an average length of 663 bp. These ESTs were annotated and classified according to Gene Ontology (GO, Clusters of Orthologous Groups (COG, and Kyoto Encyclopedia of Genes and Genomes (KEGG metabolic pathways. Gene expression profile analysis showed that 18,474 ESTs were differentially expressed, with 10,131 up-regulated in mycelium and 8,343 up-regulated in fruiting body. Putative genes involved in polysaccharide and steroid biosynthesis were identified from A. aegerita transcriptome, and these genes were differentially expressed at the two stages of A. aegerita. Based on one-dimensional gel electrophoresis (1-DGE coupled with electrospray ionization liquid chromatography tandem MS (LC-ESI-MS/MS, we identified a total of 309 non-redundant proteins. And many metabolic enzymes involved in glycolysis were identified in the protein database. CONCLUSIONS/SIGNIFICANCE: This is the first study on transcriptome and proteome analyses of A. aegerita. The data in this study serve as a resource of A. aegerita transcripts and proteins, and offer clues to the applications of this mushroom in nutrition, pharmacy and industry.

  3. Detection and study of photo-generated spin currents in nonmagnetic semiconductor materials

    International Nuclear Information System (INIS)

    Miah, M. Idrish; Kityk, I.V.; Gray, E. MacA.

    2007-01-01

    The longitudinal current in Si-doped gallium arsenide was spin-polarized using circularly polarized light. The spin current was detected by the extraordinary Hall effect. An enhancement of Hall conductivity with increasing moderately Si-doping was found, indicating that the introduction of dopants increases the electronic spin polarization. This finding may provide an opportunity for controlling and manipulating nonmagnetic semiconductors via electron spin for operating device applications. Band energy calculations using pseudopotentials confirm the influence of Si content and electron-phonon interaction on the behaviour of the spin current and hence on the spin-dependent Hall voltage

  4. Detection and study of photo-generated spin currents in nonmagnetic semiconductor materials

    Energy Technology Data Exchange (ETDEWEB)

    Miah, M. Idrish [Nanoscale Science and Technology Centre, Griffith University, Nathan, Brisbane, QLD 4111 (Australia); Department of Physics, University of Chittagong, Chittagong 4331 (Bangladesh)], E-mail: m.miah@griffith.edu.au; Kityk, I.V. [Institute of Physics, J. Dlugosz University Czestochowa, PL-42201 Czestochowa (Poland); Gray, E. MacA. [Nanoscale Science and Technology Centre, Griffith University, Nathan, Brisbane, QLD 4111 (Australia)

    2007-10-15

    The longitudinal current in Si-doped gallium arsenide was spin-polarized using circularly polarized light. The spin current was detected by the extraordinary Hall effect. An enhancement of Hall conductivity with increasing moderately Si-doping was found, indicating that the introduction of dopants increases the electronic spin polarization. This finding may provide an opportunity for controlling and manipulating nonmagnetic semiconductors via electron spin for operating device applications. Band energy calculations using pseudopotentials confirm the influence of Si content and electron-phonon interaction on the behaviour of the spin current and hence on the spin-dependent Hall voltage.

  5. Genomic Sequencing of Japanese Plum (Prunus salicina Lindl. Mutants Provides a New Model for Rosaceae Fruit Ripening Studies

    Directory of Open Access Journals (Sweden)

    Angel Fernandez i Marti

    2018-02-01

    Full Text Available It has recently been described that the Japanese plum “Santa Rosa” bud sport series contains variations in ripening pattern: climacteric, suppressed-climacteric and non-climacteric types. This provides an interesting model to study the role of ethylene and other key mechanisms governing fruit ripening, softening and senescence. The aim of the current study was to investigate such differences at the genomic level, using this series of plum bud sports, with special reference to genes involved in ethylene biosynthesis, signal transduction, and sugar metabolism. Genomic DNA, isolated from leaf samples of six Japanese plum cultivars (“Santa Rosa”, “July Santa Rosa”, “Late Santa Rosa”, “Sweet Miriam”, “Roysum”, and “Casselman”, was used to construct paired-end standard Illumina libraries. Sequences were aligned to the Prunus persica genome, and genomic variations (SNPs, INDELS, and CNV's were investigated. Results determined 12 potential candidate genes with significant copy number variation (CNV, being associated with ethylene perception and signal transduction components. Additionally, the Maximum Likelihood (ML phylogenetic tree showed two sorbitol dehydrogenase genes grouping into a distinct clade, indicating that this natural group is well-defined and presents high sequence identity among its members. In contrast, the ethylene group, which includes ACO1, ACS1, ACS4, ACS5, CTR1, ERF1, ERF3, and ethylene-receptor genes, was widely distributed and clustered into 10 different groups. Thus, ACS, ERF, and sorbitol dehydrogenase proteins potentially share a common ancestor for different plant genomes, while the expansion rate may be related to ancestral expansion rather than species-specific events. Based on the distribution of the clades, we suggest that gene function diversification for the ripening pathway occurred prior to family extension. We herein report all the frameshift mutations in genes involved in sugar transport

  6. Genomic Sequencing of Japanese Plum (Prunus salicina Lindl.) Mutants Provides a New Model for Rosaceae Fruit Ripening Studies.

    Science.gov (United States)

    Fernandez I Marti, Angel; Saski, Christopher A; Manganaris, George A; Gasic, Ksenija; Crisosto, Carlos H

    2018-01-01

    It has recently been described that the Japanese plum "Santa Rosa" bud sport series contains variations in ripening pattern: climacteric, suppressed-climacteric and non-climacteric types. This provides an interesting model to study the role of ethylene and other key mechanisms governing fruit ripening, softening and senescence. The aim of the current study was to investigate such differences at the genomic level, using this series of plum bud sports, with special reference to genes involved in ethylene biosynthesis, signal transduction, and sugar metabolism. Genomic DNA, isolated from leaf samples of six Japanese plum cultivars ("Santa Rosa", "July Santa Rosa", "Late Santa Rosa", "Sweet Miriam", "Roysum", and "Casselman"), was used to construct paired-end standard Illumina libraries. Sequences were aligned to the Prunus persica genome, and genomic variations (SNPs, INDELS, and CNV's) were investigated. Results determined 12 potential candidate genes with significant copy number variation (CNV), being associated with ethylene perception and signal transduction components. Additionally, the Maximum Likelihood (ML) phylogenetic tree showed two sorbitol dehydrogenase genes grouping into a distinct clade, indicating that this natural group is well-defined and presents high sequence identity among its members. In contrast, the ethylene group, which includes ACO1, ACS1, ACS4, ACS5, CTR1, ERF1, ERF3, and ethylene-receptor genes, was widely distributed and clustered into 10 different groups. Thus, ACS, ERF, and sorbitol dehydrogenase proteins potentially share a common ancestor for different plant genomes, while the expansion rate may be related to ancestral expansion rather than species-specific events. Based on the distribution of the clades, we suggest that gene function diversification for the ripening pathway occurred prior to family extension. We herein report all the frameshift mutations in genes involved in sugar transport and ethylene biosynthesis detected as well

  7. Providing an information prescription in veterinary medical clinics: a pilot study.

    Science.gov (United States)

    Kogan, Lori R; Schoenfeld-Tacher, Regina; Gould, Lauren; Viera, Ann R; Hellyer, Peter W

    2014-01-01

    The study assesses the impact on client behavior and attitudes toward receiving an information prescription as part of a veterinary office visit. A random sample of veterinary clinics from a Western US metropolitan area was asked to distribute an information prescription in addition to their customary veterinary services. All clients, regardless of the reason for their visit, were presented with an information prescription: a handout that included the uniform resource locator (URL) to a general veterinary medicine website and several tips to help their clients make more informed choices about where to seek pet health information online. Nearly 40% of clients who reported that they remembered receiving the information prescription accessed the website at least once. Of the clients who reported accessing the suggested website, 86.3% reported finding it "very helpful" or "somewhat helpful." Nearly all the clients (87.9%) reported feeling the information on the site helped them make better decisions for their pets. Most clients reported that it helped them talk to their veterinarians (89.9%) and added to the information they received during their veterinary visits (83.5%). Clients appreciate and utilize veterinary prescriptions, suggesting that this is a tool that both veterinarians and librarians can use to improve animal health and client relations. The value placed on reliable Internet information by veterinary clients suggests several opportunities for librarians to become more proactive in partnering with veterinarians to facilitate the education of pet owners.

  8. The current status of usability studies of information technologies in China: a systematic study.

    Science.gov (United States)

    Lei, Jianbo; Xu, Lufei; Meng, Qun; Zhang, Jiajie; Gong, Yang

    2014-01-01

    To systematically review and analyze the current status and characteristics of usability studies in China in the field of information technology in general and in the field of healthcare in particular. We performed a quantitative literature analysis in three major Chinese academic databases and one English language database using Chinese search terms equivalent to the concept of usability. Six hundred forty-seven publications were selected for analysis. We found that in China the literature on usability in the field of information technology began in 1994 and increased thereafter. The usability definitions from ISO 9241-11:1998 and Nielsen (1993) have been widely recognized and cited. Authors who have published several publications are rare. Fourteen journals have a publishing rate over 1%. Only nine publications about HIT were identified. China's usability research started relatively late. There is a lack of organized research teams and dedicated usability journals. High-impact theoretical studies are scarce. On the application side, no original and systematic research frameworks have been developed. The understanding and definition of usability is not well synchronized with international norms. Besides, usability research in HIT is rare. More human and material resources need to be invested in China's usability research, particularly in HIT.

  9. "On the doctor's orders": A pilot study of the effects of website marketing for medical specialist providers under gatekeeping arrangements.

    Science.gov (United States)

    Zwier, Sandra

    2017-01-01

    Websites from medical specialist providers are becoming increasingly marketing oriented, but there exists a paucity of empirical research on the effects. This experimental study explored effects of exposure to real websites from medical specialist providers among Dutch adults under physician gatekeeper arrangements. Exposure led to a stronger intention to seek treatment from the specialist provider and motivation to rely on the providers' claims. Weaker to absent effects were found for intention to question the physician gatekeeper's referral and this was chiefly motivated by the belief that "the doctor knows best." Implications for specialist provider marketing under gatekeeping arrangements are discussed.

  10. Does anodal transcranial direct current stimulation modulate sensory perception and pain? A meta-analysis study.

    Science.gov (United States)

    Vaseghi, B; Zoghi, M; Jaberzadeh, S

    2014-09-01

    The primary aim of this systematic review was to evaluate the effects of anodal transcranial direct current stimulation (a-tDCS) on sensory (STh) and pain thresholds (PTh) in healthy individuals and pain levels (PL) in patients with chronic pain. Electronic databases were searched for a-tDCS studies. Methodological quality was examined using the PEDro and Downs and Black (D&B) assessment tools. a-tDCS of the primary motor cortex (M1) increases both STh (Psensory cortex (S1) (P<0.05 with an effect size of 4.34). Likewise, PL decreased significantly in the patient group following application of a-tDCS to both the M1 and dorsolateral prefrontal cortex (DLPFC). The average decrease in visual analogue score was 14.9% and 19.3% after applying a-tDCS on the M1 and DLPFC. Moreover, meta-analysis showed that in all subgroups (except a-tDCS of S1) active a-tDCS and sham stimulation produced significant differences. This review provides evidence for the effectiveness of a-tDCS in increasing STh/PTh in healthy group and decreasing PL in patients. However, due to small sample sizes in the included studies, our results should be interpreted cautiously. Given the level of blinding did not considered in inclusion criteria, the result of current study should be interpreted with caution. Site of stimulation should have a differential effect over pain relief. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Oxygen distribution in tumors: A qualitative analysis and modeling study providing a novel Monte Carlo approach

    International Nuclear Information System (INIS)

    Lagerlöf, Jakob H.; Kindblom, Jon; Bernhardt, Peter

    2014-01-01

    end, due to anoxia, but smaller tumors showed undisturbed oxygen distributions. The six different models with correlated parameters generated three classes of oxygen distributions. The first was a hypothetical, negative covariance between vessel proximity and pO 2 (VPO-C scenario); the second was a hypothetical positive covariance between vessel proximity and pO 2 (VPO+C scenario); and the third was the hypothesis of no correlation between vessel proximity and pO 2 (UP scenario). The VPO-C scenario produced a distinctly different oxygen distribution than the two other scenarios. The shape of the VPO-C scenario was similar to that of the nonvariable DOC model, and the larger the tumor, the greater the similarity between the two models. For all simulations, the mean oxygen tension decreased and the hypoxic fraction increased with tumor size. The absorbed dose required for definitive tumor control was highest for the VPO+C scenario, followed by the UP and VPO-C scenarios. Conclusions: A novel MC algorithm was presented which simulated oxygen distributions and radiation response for various biological parameter values. The analysis showed that the VPO-C scenario generated a clearly different oxygen distribution from the VPO+C scenario; the former exhibited a lower hypoxic fraction and higher radiosensitivity. In future studies, this modeling approach might be valuable for qualitative analyses of factors that affect oxygen distribution as well as analyses of specific experimental and clinical situations

  12. Insights into iron sources and pathways in the Amazon River provided by isotopic and spectroscopic studies

    Science.gov (United States)

    Mulholland, Daniel Santos; Poitrasson, Franck; Boaventura, Geraldo Resende; Allard, Thierry; Vieira, Lucieth Cruz; Santos, Roberto Ventura; Mancini, Luiz; Seyler, Patrick

    2015-02-01

    The present study investigated the weathering and transport mechanisms of Fe in the Amazon River. A particular emphasis was placed on Fe partitioning, speciation, and isotopic fractionation in the contrasting waters of the Solimões and Negro rivers and their mixing zone at the beginning of the Amazon River. Samples collected in the end-member rivers and thirteen sites distributed throughout the mixing zone were processed through frontal vacuum filtration and tangential-flow ultrafiltration to separate the different suspended solid fractions, i.e., particulate (P > 0.45 μm and P > 0.22 μm), colloidal (0.22 μm > C > 5 kDa) and truly dissolved elements (TD particulate fractions yielded light isotopic compositions of -0.344‰ for P > 0.22 μm and -0.104‰ for P > 0.45 μm fractions). The mineral particulate-rich waters of the Solimões River had dissolved and colloidal fractions with light isotopic composition (-0.532‰ and -0.176‰, respectively), whereas the particulate fractions yielded δ57Fe values close to those of the continental crust (i.e., -0.029‰ for P > 0.22 μm and 0.028‰ for P > 0.45 μm). Ten kilometers downstream from the Negro and Solimões junction, the concentrations of colloidal and dissolved Fe species deviate markedly from conservative mixing. A maximum Fe loss of 43 μg/L (i.e., 50% of the dissolved and colloidal Fe) is observed 110 km downstream from the rivers junction. The contrasting Negro and Solimões Rivers isotopic compositions along the pore-sized water fractions is attributable to the biogeochemical processes involving different types of upland soils and parental materials. For instance, the isotopic composition of colloidal and dissolved Fe from the Negro River are consistent with Fe oxidation and complexation mechanisms at the interface between waterlogged podzols and river networks, as supported by strong organo-Fe complexes signals observed by EPR. Conversely, the particulate and colloidal fractions from the Solim

  13. Transcranial direct-current stimulation induced in stroke patients with aphasia: a prospective experimental cohort study

    OpenAIRE

    Santos,Michele Devido; Gagliardi,Rubens José; Mac-Kay,Ana Paula Machado Goyano; Boggio,Paulo Sergio; Lianza,Roberta; Fregni,Felipe

    2013-01-01

    CONTEXT AND OBJECTIVE: Previous animal and human studies have shown that transcranial direct current stimulation can induce significant and lasting neuroplasticity and may improve language recovery in patients with aphasia. The objective of the study was to describe a cohort of patients with aphasia after stroke who were treated with transcranial direct current stimulation. DESIGN AND SETTING: Prospective cohort study developed in a public university hospital. METHODS: Nineteen patients with ...

  14. Study of single pion production in antineutrino induced charged current interactions

    International Nuclear Information System (INIS)

    Bolognese, Teresa.

    1978-01-01

    Results are presented on the exclusive charged current antineutrino production of one pion using the data of the Gargamelle propane experiment at CERN PS. The isospin structure of the charged weak current is studied as well as the energy dependence of the total cross section for π - antineutrino production, which is compared with the prediction of Adler's model [fr

  15. A numerical study of the South China Sea Warm Current during winter monsoon relaxation

    Science.gov (United States)

    Zhang, Cong; Ding, Yang; Bao, Xianwen; Bi, Congcong; Li, Ruixiang; Zhang, Cunjie; Shen, Biao; Wan, Kai

    2018-03-01

    Using a Finite-Volume Community Ocean Model, we investigated the dynamic mechanism of the South China Sea Warm Current (SCSWC) in the northern South China Sea (NSCS) during winter monsoon relaxation. The model reproduces the mean surface circulation of the NSCS during winter, while model-simulated subtidal currents generally capture its current pattern. The model shows that the current over the continental shelf is generally southwestward, under a strong winter monsoon condition, but a northeastward counter-wind current usually develops between 50-and 100-m isobaths, when the monsoon relaxes. Model experiments, focusing on the wind relaxation process, show that sea level is elevated in the northwestern South China Sea (SCS), related to the persistent northeasterly monsoon. Following wind relaxation, a high sea level band builds up along the mid-shelf, and a northeastward current develops, having an obvious vertical barotropic structure. Momentum balance analysis indicates that an along-shelf pressure gradient provides the initial driving force for the SCSWC during the first few days following wind relaxation. The SCSWC subsequently reaches a steady quasi-geostrophic balance in the cross-shelf direction, mainly linked to sea level adjustment over the shelf. Lagrangian particle tracking experiments show that both the southwestward coastal current and slope current contribute to the northeastward movement of the SCSWC during winter monsoon relaxation.

  16. The perspective of healthcare providers and patients on health literacy: a systematic review of the quantitative and qualitative studies.

    Science.gov (United States)

    Rajah, Retha; Ahmad Hassali, Mohamed Azmi; Jou, Lim Ching; Murugiah, Muthu Kumar

    2018-03-01

    Health literacy (HL) is a multifaceted concept, thus understanding the perspective of healthcare providers, patients, and the system is vital. This systematic review examines and synthesises the available studies on HL-related knowledge, attitude, practice, and perceived barriers. CINAHL and Medline (via EBSCOhost), Google Scholar, PubMed, ProQuest, Sage Journals, and Science Direct were searched. Both quantitative and/or qualitative studies in the English language were included. Intervention studies and studies focusing on HL assessment tools and prevalence of low HL were excluded. The risk of biasness reduced with the involvement of two reviewers independently assessing study eligibility and quality. A total of 30 studies were included, which consist of 19 quantitative, 9 qualitative, and 2 mixed-method studies. Out of 17 studies, 13 reported deficiency of HL-related knowledge among healthcare providers and 1 among patients. Three studies showed a positive attitude of healthcare providers towards learning about HL. Another three studies demonstrated patients feel shame exposing their literacy and undergoing HL assessment. Common HL communication techniques reported practiced by healthcare providers were the use of everyday language, teach-back method, and providing patients with reading materials and aids, while time constraint was the most reported HL perceived barriers by both healthcare providers and patients. Significant gaps exists in HL knowledge among healthcare providers and patients that needs immediate intervention. Such as, greater effort placed in creating a health system that provides an opportunity for healthcare providers to learn about HL and patients to access health information with taking consideration of their perceived barriers.

  17. Effect of current density on the anodic behaviour of zircaloy-4 and niobium: a comparative study

    International Nuclear Information System (INIS)

    Raghunath Reddy, G.; Lavanya, A.; Ch Anjaneyulu

    2004-01-01

    The kinetics of anodic oxidation of zircaloy-4 and niobium have been studied at current densities ranging from 2 to 14 mA.cm -2 at room temperature in order to investigate the dependence of ionic current density on the field across the oxide film. Thickness of the anodic films were estimated from capacitance data. The formation rate, current efficiency and differential field were found to increase with increase in the ionic current density for both zircaloy-4 and niobium. Plots of the logarithm of formation rate vs. logarithm of the current density are fairly linear. From linear plots of logarithm of ionic current density vs. differential field, and applying the Cabrera-Mott theory, the half-jump distance and the height of the energy barrier are deduced and compared. (author)

  18. Private Finance Initiative (PFI for Road Projects in UK: Current Practice with a Case Study

    Directory of Open Access Journals (Sweden)

    Rifat Akbiyikli

    2011-05-01

    Full Text Available The long-term sustainable provision of new and high quality maintained road stock is vitally important, especially in times of economic constraint such as Europe is currently experiencing. The Private Finance Initiative (PFI is one method of financing such large-scale, capital intensive projects. An important aspect of this form of financing projects is that the risks are borne not only by the sponsors but are shared by different types of investors such as equity holders, debt providers, and quasi-equity investors. Consequently, a comprehensive and heuristic risk management process is essential for the success of the project. The proposition made within this paper is that the PFI mechanism provides a Value-for-Money and effective mechanism to achieve this. The structure of this PFI finance and investment on a particular road project therefore enables all project stakeholders to take a long-term perspective. This long-term perspective is reflected in the mechanism of a case study of UK – Class A trunk roads which are examined in detail. This paper presents a novel solution to a modern dilemma.

  19. Barriers to communication between HIV care providers (HCPs) and women living with HIV about child bearing: A qualitative study.

    Science.gov (United States)

    Ddumba-Nyanzi, Ismael; Kaawa-Mafigiri, David; Johannessen, Helle

    2016-05-01

    In the context of HIV clinical care, open discussion regarding sexual health and reproductive plans has become increasingly relevant. The aim of this paper is to explore barriers to communication between providers and women living with HIV regarding childbearing. In-depth interviews (IDIs) were conducted with 48 HIV infected women receiving ART at 7 different HIV clinics providing comprehensive HIV care services in four districts in Uganda, between July and August 2012. All women were aware of their HIV diagnosis prior to pregnancy or had given birth while living with HIV. Four themes emerged describing barriers to communication, from the HIV-positive women's point of view: (i) provider indifference or opposition to childbearing post HIV diagnosis, (ii) anticipation of negative response from provider, (iii) provider's emphasis on 'scientific' facts, (iv) 'accidental pregnancy'. Existing evidence regarding effective provider-patient communication should be considered for its application for reproductive counseling among HIV infected women. These data demonstrate the need for current counseling guidelines to explore approaches that encourage open, non-judgmental, non-directive discussions with HIV positive individuals around their reproductive desires and intentions in a health care setting. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Exploring current and potential roles of Australian community pharmacists in gout management: a qualitative study.

    Science.gov (United States)

    Counsell, Allyce B; Nguyen, Amy D; Baysari, Melissa T; Kannangara, Diluk R W; McLachlan, Andrew J; Day, Richard O

    2018-05-09

    Gout is an increasingly prevalent form of inflammatory arthritis. Although effective treatments for gout exist, current management is suboptimal due to low medication adherence rates and treatments that are non-concordant with guidelines. Medications are the mainstay and most effective form of gout management. Thus, there is potential for community pharmacists to play an important primary health care role in gout management, however their current role and their potential to improve management of gout treatment is currently unclear. The purpose of the study is to explore the views of Australian pharmacists on their roles in gout management and to identify factors influencing their involvement in gout management. A convenience sample of community pharmacists were invited to participate using a snowballing recruitment strategy. Semi-structured, face-to-face interviews were conducted with 15 pharmacists of varying age, gender and pharmacy experience. Interviews focused on pharmacists' experiences of managing gout, interactions with people living with gout and their perceived roles and responsibilities in gout management. Interviews were transcribed verbatim and independently analysed by two reviewers to identify themes. The main role of pharmacists reported in gout management was providing patient education. The greatest facilitator to pharmacists involvement in gout management was identified to be pharmacists' good understanding of gout and its management. Barriers to pharmacists involvement were identified to be difficulties in monitoring adherence to gout medications, low priority given to gout in the pharmacy compared to other chronic health conditions, and lack of specific training and/or continuing education in gout prevention and management. Pharmacists can expand their primary health care role in gout management, particularly in the area of ongoing provision of education to people living with gout and in monitoring medication adherence in patients. However, a

  1. Perceptions of methicillin-resistant Staphylococcus aureus and hand hygiene provider training and patient education: results of a mixed method study of health care providers in Department of Veterans Affairs spinal cord injury and disorder units.

    Science.gov (United States)

    Hill, Jennifer N; Hogan, Timothy P; Cameron, Kenzie A; Guihan, Marylou; Goldstein, Barry; Evans, Martin E; Evans, Charlesnika T

    2014-08-01

    The goal of this study was to assess current practices for training of spinal cord injury and disorder (SCI/D) health care workers and education of veterans with SCI/D in Department of Veterans Affairs (VA) spinal cord injury (SCI) centers on methicillin-resistant Staphylococcus aureus (MRSA) prevention. Mixed methods. A Web-based survey was distributed to 673 VA SCI/D providers across 24 SCI centers; 21 acute care and 1 long-term care facility participated. There were 295 that responded, 228 had complete data and were included in this analysis. Semistructured interviews were conducted with 30 SCI/D providers across 9 SCI centers. Nurses, physicians, and therapists represent most respondents (92.1%, n = 210); over half (56.6%, n = 129) were nurses. Of providers, 75.9% (n = 173) reported receiving excellent or good training on how to educate patients about MRSA. However, nurses were more likely to report having excellent or good training for how to educate patients about MRSA (P = .005). Despite this, only 63.6% (n = 82) of nurses perceived the education they provide patients on how MRSA is transmitted as excellent or good. Despite health care workers reporting receiving excellent or good training on MRSA-related topics, this did not translate to excellent or good education for patients, suggesting that health care workers need additional training for educating patients. Population-specific MRSA prevention educational materials may also assist providers in educating patients about MRSA prevention for individuals with SCI/D. Published by Mosby, Inc.

  2. Study of current and planned high occupancy vehicle lane use: performance and prospects

    Energy Technology Data Exchange (ETDEWEB)

    Southworth, F.; Westbrook, F.

    1985-12-01

    This report details the results of a nationwide study of HOV lanes: their characteristics and performance as traffic congestion mitigating and rideshare enhancing facilities. The study took the form of telephone interviews with a variety of planning agencies in each of the 48 contiguous states and Hawaii over the period April through June 1985, with subsequent receipt of the most current documentation on regional HOV lane operations. The most up-to-date evidence on each lane's performance is presented: its hourly and peak period person throughput vis-a-vis the highway's adjacent, conventional mixed traffic lane(s), its vehicle throughput and occupancy, travel speed and travel time savings for HOVs, lane rule violation rates, lane construction and maintenance costs and accident data. Estimates are provided of the growth in ridesharing over the life of the HOV-only lanes, of the number of vehicles removed from the highway through ridesharing, and of the subsequent fuel savings attributable to HOV lane projects. The relationship between bus patronage and carpool/vanpool mode adoption is looked at, and it is concluded that both forms of HOV can do well on properly planned lanes. The authors also point out the very partial nature of the existing evidence upon which to base HOV lane project evaluation, and the subsequent difficulty associated with ''selling'' the HOV lane concept to many planners and members of the public. They identify those characteristics associated with clearly successful HOV lane projects. Finally, the current state of planning for new HOV lanes in cities around the nation is described, and the major reasons given for rejection or abandonment of HOV lane projects are discussed.

  3. Together and Alone a Study of Interactions between Toddlers and Childcare Providers during Mealtime in Norwegian Childcare Centres

    Science.gov (United States)

    Klette, Trine; Drugli, May Britt; Aandahl, Ann Mari

    2018-01-01

    The study investigated the quality of interactions between childcare providers and toddlers during a lunch in childcare centres. Meals in childcare centres are semi-structured adult-led situations where the children not only eat, but are also provided with opportunities for implicit learning and interactions. Participants were 13 toddlers aged…

  4. A qualitative study of English community pharmacists' experiences of providing lifestyle advice to patients with cardiovascular disease

    OpenAIRE

    Morton, Kirsty; Pattison, Helen; Langley, Chris; Powell, Rachael

    2015-01-01

    Background - Cardiovascular disease (CVD) progression is modifiable through lifestyle behaviors. Community pharmacists are ideally placed to facilitate self-management of cardiovascular health however research shows varied pharmacist engagement in providing lifestyle advice. Objective - This study explored community pharmacists' experiences and perceptions of providing lifestyle advice to patients with CVD. Methods - Semi-structured interviews were conducted with fifteen pharmacists (1 superm...

  5. A Qualitative Study of Providers' Perception of Adherence of Women Living with HIV/AIDS in Puerto Rico

    Science.gov (United States)

    Rivero-Mendez, Marta; Dawson-Rose, Carol S.; Solis-Baez, Solymar S.

    2010-01-01

    This study examines healthcare providers' perceptions regarding experiences and factors that contribute to adherent and non-adherent behaviors to HIV treatment among women living with HIV infection in Puerto Rico and describes strategies implemented to improve adherence. Providers' accounts revealed that women with HIV infection are living…

  6. Service provider perceptions of telerehabilitation as an additional service delivery option within an Australian neurosurgical and orthopaedic physiotherapy screening clinic: A qualitative study.

    Science.gov (United States)

    Cottrell, Michelle A; Hill, Anne J; O'Leary, Shaun P; Raymer, Maree E; Russell, Trevor G

    2017-12-01

    The Neurosurgical & Orthopaedic Physiotherapy Screening Clinic and Multidisciplinary Service (N/OPSC&MDS) originated as a complementary, non-surgical pathway for patients referred to public neurosurgical and orthopaedic specialist services. Patient access to the N/OPSC&MDS could potentially be improved with the implementation of telerehabilitation as an additional method of service delivery. To evaluate service provider's views on (1) current barriers to patients' accessing N/OPSC & MD services, and (2) the implementation of telerehabilitation within the N/OPSC&MDS. Qualitative descriptive study design. Healthcare providers (n = 26) were recruited from six N/OPSC&MD services located throughout Queensland, Australia. Semi-structured interviews were conducted to explore service providers' views with respect to existing barriers to patients accessing the N/OPSC&MDS, and if telerehabilitation could be feasibly adopted to address current barriers. Template analysis resulted in six themes: (1) barriers to some patients' accessing current N/OPSC&MD services are complex & multifaceted; (2) telerehabilitation could improve patient access to appropriate management for their musculoskeletal condition; (3) telerehabilitation may have limitations when compared to face-to-face healthcare; (4) the delivery of telerehabilitation needs to be flexible; (5) perceived barriers, and (6) facilitators to the successful implementation of telerehabilitation within the N/OPSC&MDS. This study represents a critical step in determining the readiness of service providers for the implementation of telerehabilitation within the N/OPSC&MDS. Although cautious, service providers are overall accepting of the implementation of telerehabilitation, acknowledging that it could eliminate several current barriers, subsequently achieving more equitable access to the service. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  7. Studies of non-inductive current drive in the CDX-U tokamak

    International Nuclear Information System (INIS)

    Hwang, Y.S.

    1993-01-01

    Two types of novel, non-inductive current drive concepts for starting-up and maintaining tokamak discharges, dc-helicity injection and internally-generated pressure-driven currents, have been developed on the CDX-U tokamak. To study the equilibrium and transport of these plasmas, a full set of magnetic diagnostics was installed. By applying a finite element method and a least squares error fitting technique, internal plasma current distributions are reconstructed from the measurements. Electron density distributions were obtained from 2 mm interferometer measurements by a similar least squares error technique utilizing magnetic flux configurations obtained by the magnetic analysis. Neoclassical pressure-driven currents in ECH plasmas are modeled with the reconstructed magnetic structure, using the electron density distribution and the electron temperature profile measured by a Langmuir probe. In the dc-helicity injection scheme, the need to increase injection current and maintain plasma equilibrium restricts possible arrangements. Several injection configurations were investigated, with the best found to be outside injection with a single divertor configuration, where the cathode is placed at the low field side of the x-point. Both pressure-driven and dc-helicity injected tokamaks show the importance of plasma equilibrium in obtaining high plasma current. Programmed vertical field operation has proven to be very important in achieving high plasma current. These non-inductive current drive techniques show great potential as efficient current drive methods for future steady-state and/or long-pulse fusion reactors

  8. A scoping study for an environmental impact field programme in tidal current energy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    This report summarises the results of a study to identify the environmental impacts of tidal current energy with the aim of prioritising research. The background to the study is traced, and the interaction between tidal current energy technology and the marine environment, the modeling of the consequences of the environmental interactions, the quantification of the environmental impacts of key environmental interactions, and the formulation of a programme of research are discussed. Recommendations are given and research needs are highlighted.

  9. Study of leakage current behaviour on artificially polluted surface of ceramic insulator

    International Nuclear Information System (INIS)

    Subba Reddy, B.; Nagabhushana, G.R.

    2003-01-01

    This paper presents the results of the study concerning to the leakage current behaviour on artificially polluted ceramic insulator surface. From the present study it was observed that there is a reasonably well-defined inception of current i.e. scintillations at a finite voltage. The corresponding voltages for extinction of the current are in the range of 0.8 kV to 2.1 kV. Obviously, the dry band formed in the immediate vicinity of the pin prevents smooth current flow as the voltage rises from zero. Only when the voltage is adequate it causes a flashover of the dray band and current starts flowing. As is common in similar current extinction phenomena, here also, the extinction voltages are significantly lower than the inception voltages. Further, the voltage-current curves invariably show hysteresis-the leakage currents are lower in the reducing portion of the voltage. This is obviously due to drying of the wet pollutant layer thereby increasing its resistance. It is believed that this is the first time that such a direct quantitative evidence of drying in individual half cycles is experimentally visualized

  10. Fast Food Pattern and Cardiometabolic Disorders: A Review of Current Studies.

    Science.gov (United States)

    Bahadoran, Zahra; Mirmiran, Parvin; Azizi, Fereidoun

    2015-01-01

    There are growing concern globally regarding the alarming trend of fast food consumption and its related cardiometabolic outcomes including overweight and obesity. This study aimed to review the current evidences available in relation to adverse effects of fast food pattern on cardiometa-bolic risk factors. Relevant articles including epidemiological and clinical studies with appropriate design and good quality were obtained through searches of the Medline, PubMed, Scopus databases and Google scholar with related key words including "fast foods", "processed foods", "obesity", "overweight", "insulin resistance", "diabetes", "cardiovascular disease", "metabolic syndrome", "dyslipidemia" and "hypertension". Fast food consumption and out-of-home eating behavior is a main risk factor for lower diet quality, higher calorie and fat intake and lower micronutrients density of diet. Frequent consumption of fast foods was accompanied with overweight and abdominal fat gain, impaired insulin and glucose homeostasis, lipid and lipoprotein disorders, induction of systemic inflammation and oxidative stress. Higher fast food consumption also increases the risk of developmental diabetes, metabolic syndrome and cardiovascular disease. This review provides further evidence warning us against the irreparable effects of fast food consumption on public health especially the increasing global burden of obesity and cardiovascu-lar diseases.

  11. Fast Food Pattern and Cardiometabolic Disorders: A Review of Current Studies

    Directory of Open Access Journals (Sweden)

    Zahra Bahadoran

    2015-12-01

    Full Text Available Background: There are growing concern globally regarding the alarming trend of fast food consump­tion and its related cardiometabolic outcomes including overweight and obesity. This study aimed to review the current evidences available in relation to adverse effects of fast food pattern on cardiometa­bolic risk factors. Methods: Relevant articles including epidemiological and clinical studies with appropriate design and good quality were obtained through searches of the Medline, PubMed, Scopus databases and Google scholar with related key words including "fast foods", "processed foods", "obesity", "overweight", "insulin resistance", "diabetes", "cardiovascular disease", "metabolic syndrome", "dyslipidemia" and "hypertension". Results: Fast food consumption and out-of-home eating behavior is a main risk factor for lower diet quality, higher calorie and fat intake and lower micronutrients density of diet. Frequent consumption of fast foods was accompanied with overweight and abdominal fat gain, impaired insulin and glucose homeostasis, lipid and lipoprotein disorders, induction of systemic inflammation and oxidative stress. Higher fast food consumption also increases the risk of developmental diabetes, metabolic syndrome and cardiovascular disease. Conclusion: This review provides further evidence warning us against the irreparable effects of fast food consumption on public health especially the increasing global burden of obesity and cardiovascu­lar diseases.

  12. Community health center provider ability to identify, treat and account for the social determinants of health: a card study.

    Science.gov (United States)

    Lewis, Joy H; Whelihan, Kate; Navarro, Isaac; Boyle, Kimberly R

    2016-08-27

    The social determinants of health (SDH) are conditions that shape the overall health of an individual on a continuous basis. As momentum for addressing social factors in primary care settings grows, provider ability to identify, treat and assess these factors remains unknown. Community health centers care for over 20-million of America's highest risk populations. This study at three centers evaluates provider ability to identify, treat and code for the SDH. Investigators utilized a pre-study survey and a card study design to obtain evidence from the point of care. The survey assessed providers' perceptions of the SDH and their ability to address them. Then providers filled out one anonymous card per patient on four assigned days over a 4-week period, documenting social factors observed during encounters. The cards allowed providers to indicate if they were able to: provide counseling or other interventions, enter a diagnosis code and enter a billing code for identified factors. The results of the survey indicate providers were familiar with the SDH and were comfortable identifying social factors at the point of care. A total of 747 cards were completed. 1584 factors were identified and 31 % were reported as having a service provided. However, only 1.2 % of factors were associated with a billing code and 6.8 % received a diagnosis code. An obvious discrepancy exists between the number of identifiable social factors, provider ability to address them and documentation with billing and diagnosis codes. This disparity could be related to provider inability to code for social factors and bill for related time and services. Health care organizations should seek to implement procedures to document and monitor social factors and actions taken to address them. Results of this study suggest simple methods of identification may be sufficient. The addition of searchable codes and reimbursements may improve the way social factors are addressed for individuals and populations.

  13. Feasibility of the current-duration approach to studying human fecundity

    DEFF Research Database (Denmark)

    Slama, Rémy; Ducot, Béatrice; Carstensen, Lisbeth

    2006-01-01

    of unprotected intercourse was defined for 69 women (5.7%). An additional 15 women (1.2%) were planning to start trying to become pregnant within the next 6 months. Parametric methods allowed, based on current duration of unprotected intercourse, estimation of fecundity as if the couples had been followed...... up (current-duration design). To illustrate the feasibility of the current-duration design, we contacted a random sample of 1204 French women age 18 to 44 years in 2004 and recruited those who were currently having unprotected sexual intercourse. The current duration since the beginning...... prospectively. The estimated proportion of couples not pregnant after 12 months of unprotected intercourse was 34% (95% confidence interval [CI] = 15-54%). The accelerated-failure time model allows study of the influence of environmental factors on fecundity. As an illustration, tobacco smoking by the woman...

  14. Multiday Transcranial Direct Current Stimulation Causes Clinically Insignificant Changes in Childhood Dystonia: A Pilot Study.

    Science.gov (United States)

    Bhanpuri, Nasir H; Bertucco, Matteo; Young, Scott J; Lee, Annie A; Sanger, Terence D

    2015-10-01

    Abnormal motor cortex activity is common in dystonia. Cathodal transcranial direct current stimulation may alter cortical activity by decreasing excitability while anodal stimulation may increase motor learning. Previous results showed that a single session of cathodal transcranial direct current stimulation can improve symptoms in childhood dystonia. Here we performed a 5-day, sham-controlled, double-blind, crossover study, where we measured tracking and muscle overflow in a myocontrol-based task. We applied cathodal and anodal transcranial direct current stimulation (2 mA, 9 minutes per day). For cathodal transcranial direct current stimulation (7 participants), 3 subjects showed improvements whereas 2 showed worsening in overflow or tracking error. The effect size was small (about 1% of maximum voluntary contraction) and not clinically meaningful. For anodal transcranial direct current stimulation (6 participants), none showed improvement, whereas 5 showed worsening. Thus, multiday cathodal transcranial direct current stimulation reduced symptoms in some children but not to a clinically meaningful extent, whereas anodal transcranial direct current stimulation worsened symptoms. Our results do not support transcranial direct current stimulation as clinically viable for treating childhood dystonia. © The Author(s) 2015.

  15. Factors affecting the intention of providers to deliver more effective continuing medical education to general practitioners: a pilot study

    Directory of Open Access Journals (Sweden)

    Higginbotham Nick

    2003-12-01

    Full Text Available Abstract Background Despite the importance of continuing medical education (CME for GPs, there has been little research into how providers decide what types of CME to deliver to GPs. This study aimed to identify factors affecting the intention of providers to provide more effective types of CME; and to design a survey instrument which can be used to test the applicability of Triandis' model of social behaviour to the provision of CME to general practitioners. Methods This was a cross-sectional study on a convenience sample of 11 Australian providers of CME for interviews and a random sample of 25 providers for the pilot test. Open-ended interviews structured on Triandis' theory were performed with key informants who provide CME to GPs. These were used to develop a pilot survey instrument to measure the factors affecting intention, resulting in a revised instrument for use in further research. Results There was a broad range of factors affecting providers' intention to deliver more effective forms of CME identified, and these were classifiable in a manner which was consistent with Triandis' model. Key factors affecting providers' intention were the attitude toward CME within organisations and the time and extra work involved. Conclusions We identified a range of potential factors influencing the intention of providers to provide more effective forms of CME, in all categories of Triandis model. Those interested in increasing the choice of more effective CME activities available to GPs may need to broaden the methods used in working with providers to influence them to use more effective CME techniques. The interview material and questionnaire analysis of the pilot survey support the use of Triandis model. Further research is needed to validate Triandis'model for the intention to deliver more effective forms of CME. Such research will inform future strategies aimed at increasing the amount and choice of effective CME activities available for GPs.

  16. Subminiature eddy-current transducers designed to study welded joints of titanium alloys

    Science.gov (United States)

    Malikov, V. N.; Dmitriev, S. F.; Katasonov, A. O.; Sagalakov, A. M.; Ishkov, A. V.

    2017-12-01

    Eddy current transducers (ECT) are used to construct a sensor for investigating titanium sheets connected by a welded joint. The paper provides key technical information about the eddy current transducer used and describes the procedure of measurements that makes it possible to control defects in welded joints of titanium alloys. It is capable of automatically changing the filtering cutoff frequency and operating frequency of the device. Experiments were conducted on welded VT1-0 titanium plates. The paper contains the results of these measurements. The dependence data facilitates the assessment of the quality of the welded joints and helps make an educated conclusion about welding quality.

  17. Four studies on how past and current suicidality relate even when "everything but the kitchen sink" is covaried.

    Science.gov (United States)

    Joiner, Thomas E; Conwell, Yeates; Fitzpatrick, Kathleen Kara; Witte, Tracy K; Schmidt, Norman B; Berlim, Marcelo T; Fleck, Marcelo P A; Rudd, M David

    2005-05-01

    T. E. Joiner's (2004, in press) theory of suicidal behavior suggests that past suicidal behavior plays an important role in future suicidality. However, the mechanism by which this risk is transferred and the causal implications have not been well studied. The current study provides evaluation of the nature and limits of this relationship across 4 populations, with varying degrees of suicidal behavior. Across settings, age groups, and impairment levels, the association between past suicidal behavior and current suicidal symptoms held, even when controlling for strong covariates like hopelessness and symptoms of various Axis I and II syndromes. Results provide additional support for the importance of past suicidality as a substantive risk factor for later suicidal behavior. Copyright 2005 APA, all rights reserved.

  18. Study of plasma equilibrium during the AC current reversal phase in STOR-M

    International Nuclear Information System (INIS)

    Xiao, C.

    2002-01-01

    Alternating current (AC) tokamak operation and equilibrium studies have been performed on the STOR-M tokamak. The recent experiments have achieved consistent smooth current reversal through the implementation of a hybrid digital-analog position controller and by careful density control. In order to study the plasma equilibrium during the current reversal phase with negligible rotational transform, a segmented limiter with four isolated conducting plates has been installed. The plates can be connected outside the vacuum vessel, which allows measurements of currents flowing between limiter plates. When the current reversal is smooth with zero dwell time, the hydrogen line emission level and electron density remain finite, indicating a finite particle confinement. The current from the top to the bottom limiter plate is also finite and its direction is consistent with that of the grad-B drift. The observation suggests that the limiter and other conducting structures surrounding the plasmas plays the role, during the current reversal phase of AC tokamak operation, to short out the charge separation arising from the grad-B drift and to maintain a finite particle confinement. (author)

  19. A statistical study of current-sheet formation above solar active regions based on selforganized criticality

    Science.gov (United States)

    Dimitropoulou, M.; Isliker, H.; Vlahos, L.; Georgoulis, M.; Anastasiadis, A.; Toutountzi, A.

    2013-09-01

    We treat flaring solar active regions as physical systems having reached the self-organized critical state. Their evolving magnetic configurations in the low corona may satisfy an instability criterion, related to the excession of a specific threshold in the curl of the magnetic field. This imposed instability criterion implies an almost zero resistivity everywhere in the solar corona, except in regions where magnetic-field discontinuities and. hence, local currents, reach the critical value. In these areas, current-driven instabilities enhance the resistivity by many orders of magnitude forming structures which efficiently accelerate charged particles. Simulating the formation of such structures (thought of as current sheets) via a refined SOC cellular-automaton model provides interesting information regarding their statistical properties. It is shown that the current density in such unstable regions follows power-law scaling. Furthermore, the size distribution of the produced current sheets is best fitted by power laws, whereas their formation probability is investigated against the photospheric magnetic configuration (e.g. Polarity Inversion Lines, Plage). The average fractal dimension of the produced current sheets is deduced depending on the selected critical threshold. The above-mentioned statistical description of intermittent electric field structures can be used by collisional relativistic test particle simulations, aiming to interpret particle acceleration in flaring active regions and in strongly turbulent media in astrophysical plasmas. The above work is supported by the Hellenic National Space Weather Research Network (HNSWRN) via the THALIS Programme.

  20. Current practices in treatment of female genital fistula: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Ruminjo Joseph

    2010-11-01

    Full Text Available Abstract Background Maternal outcomes in most countries of the developed world are good. However, in many developing/resource-poor countries, maternal outcomes are bleaker: Every year, more than 500,000 women die in childbirth, mostly in resource-poor countries. Those who survive often suffer from severe and long-term morbidities. One of the most devastating injuries is obstetric fistula, occurring most often in south Asia and sub-Saharan Africa. Fistula treatment and care are available in many countries across Africa and Asia, but there is a lack of reliable data around clinical factors associated with the success of fistula repair surgery. Most published research has been retrospective. While these studies have provided useful information about the care and treatment of fistula, they are limited by the design. This study was designed to identify practices in care that could lead to the design of prospective and randomized controlled trials. Methods Self-administered questionnaires were completed by 40 surgeons known to provide fistula treatment services in Africa and Asia at private and government hospitals. The questionnaire was divided into three parts to address the following issues: prophylactic use of antibiotics before, during, and after fistula surgery; urethral catheter management; and management practices for patients with urinary incontinence following fistula repair. Results The results provide a glimpse into current practices in fistula treatment and care across a wide swath of geographic, economic, and organizational considerations. There is consensus in treatment in some areas (routine use of prophylactic antibiotics, limited bed rest until the catheter is removed, nonsurgical treatment for postsurgical incontinence, while there are wide variations in practice in other areas (duration of catheter use, surgical treatments for postsurgical incontinence. These findings are based on a small sample and do not allow for recommending

  1. Current practices in treatment of female genital fistula: a cross sectional study.

    Science.gov (United States)

    Arrowsmith, Steven D; Ruminjo, Joseph; Landry, Evelyn G

    2010-11-10

    Maternal outcomes in most countries of the developed world are good. However, in many developing/resource-poor countries, maternal outcomes are bleaker: Every year, more than 500,000 women die in childbirth, mostly in resource-poor countries. Those who survive often suffer from severe and long-term morbidities. One of the most devastating injuries is obstetric fistula, occurring most often in south Asia and sub-Saharan Africa. Fistula treatment and care are available in many countries across Africa and Asia, but there is a lack of reliable data around clinical factors associated with the success of fistula repair surgery. Most published research has been retrospective. While these studies have provided useful information about the care and treatment of fistula, they are limited by the design. This study was designed to identify practices in care that could lead to the design of prospective and randomized controlled trials. Self-administered questionnaires were completed by 40 surgeons known to provide fistula treatment services in Africa and Asia at private and government hospitals. The questionnaire was divided into three parts to address the following issues: prophylactic use of antibiotics before, during, and after fistula surgery; urethral catheter management; and management practices for patients with urinary incontinence following fistula repair. The results provide a glimpse into current practices in fistula treatment and care across a wide swath of geographic, economic, and organizational considerations. There is consensus in treatment in some areas (routine use of prophylactic antibiotics, limited bed rest until the catheter is removed, nonsurgical treatment for postsurgical incontinence), while there are wide variations in practice in other areas (duration of catheter use, surgical treatments for postsurgical incontinence). These findings are based on a small sample and do not allow for recommending changes in clinical care, but they point to issues for

  2. The Role of Strategic Human Resources Management in the Performance of Logistic Service Provider Firms: A Case Study of Owerri

    OpenAIRE

    G.N. Okeudo

    2012-01-01

    Owing to the continuous changes in the external business environment, the function of Strategic Human Resources Management in organizations is of paramount importance. The function of the human resource (HR) department has over time, evolved from personnel management to Strategic Human Resource Management (SHRM) currently seen as a new breed in the management of human resource of organizations. Prior studies have found substantial positive evidence for statistical associations between SHRM pr...

  3. Education Websites and Their Benefits to Potential International Students: A Case Study of Higher Education Service Providers in Malaysia

    Science.gov (United States)

    Ooi, Teik Chooi; Ho, Henry Wai Leong; Amri, Siti

    2010-01-01

    This paper looks at criteria on how education service providers' websites could benefit their potential students from overseas. Effective design of education website is important as web users are typically fastidious and want information fast--this serves as the background of this study. The study focuses on three selected education institutions'…

  4. Investigation of the current situation of massive blood transfusion in different surgical departments: a large multicenter study in China

    OpenAIRE

    Sun, Yang; Jin, Zhan-Kui; Xu, Cui-Xiang; Dang, Qian-Li; Zhang, Li-Jie; Chen, Hong-Nan; Song, Yao-Jun; Yang, Jiang-Cun

    2015-01-01

    Objective: This study aims to learn about the current situation of surgical massive blood transfusion of different surgical departments in China’s Tertiary hospitals, which could provide the basis for the formulation of guidelines on massive blood transfusion. Method: A multicenter retrospective research on the application status of blood constituents during massive blood transfusion was conducted and a comparative analyses of survival and length of hospitalization in patients from different ...

  5. Experimental study of a high-current FEM with a broadband microwave system

    Energy Technology Data Exchange (ETDEWEB)

    Denisov, G.G.; Bratman, V.L.; Ginzburg, N.S. [Institute of Applied Physics, Nizhny Novgorod (Russian Federation)] [and others

    1995-12-31

    One of the main features of FELs and FEMs is the possibility of fast and wideband tuning of the resonant frequency of active media, which can be provided by changing the particle energy. For a frequency adjustable FEM-oscillator, a broadband microwave system, which is simply combined with an electron-optical FEM system and consists of an oversized waveguide and reflectors based on the microwave beams multiplication effect has been proposed and studied successfully in {open_quotes}cold{close_quotes} measurements. Here, the operating ability of a cavity, that includes some key elements of the broadband microwave system, was tested in the presence of an electron beam. To provide large particle oscillation velocities in a moderate undulator field and the presence of a guide magnetic field, the FEM operating regime of double resonance was chosen. In this regime the cyclotron as well as undulator resonance conditions were satisfied. The FEM-oscillator was investigated experimentally on a high-current accelerator {open_quotes}Sinus-6{close_quotes} that forms an electron beam with particle energy 500keV and pulse duration 25ns. The aperture with a diameter 2.5mm at the center of the anode allows to pass through only the central fraction of the electron beam with a current about 100A and a small spread of longitudinal velocities of the particles. Operating transverse velocity was pumped into the electron beam in the pulse plane undulator of a 2.4cm period. The cavity with a frequency near 45GHz consists of a square waveguide and two reflectors. The broadband up-stream reflector based on the multiplication effect had the power reflectivity coefficient more than 90% in the frequency band 10% for the H{sup 10} wave of the square waveguide with the maximum about 100% at a frequency 45GHz. The down-stream narrow-band Bragg reflector had the power reflection coefficient approximately 80% in the frequency band of 4% near 45GHz for the operating mode.

  6. Stimulating thought: a functional MRI study of transcranial direct current stimulation in schizophrenia.

    Science.gov (United States)

    Orlov, Natasza D; O'Daly, Owen; Tracy, Derek K; Daniju, Yusuf; Hodsoll, John; Valdearenas, Lorena; Rothwell, John; Shergill, Sukhi S

    2017-09-01

    Individuals with schizophrenia typically suffer a range of cognitive deficits, including prominent deficits in working memory and executive function. These difficulties are strongly predictive of functional outcomes, but there is a paucity of effective therapeutic interventions targeting these deficits. Transcranial direct current stimulation is a novel neuromodulatory technique with emerging evidence of potential pro-cognitive effects; however, there is limited understanding of its mechanism. This was a double-blind randomized sham controlled pilot study of transcranial direct current stimulation on a working memory (n-back) and executive function (Stroop) task in 28 individuals with schizophrenia using functional magnetic resonance imaging. Study participants received 30 min of real or sham transcranial direct current stimulation applied to the left frontal cortex. The 'real' and 'sham' groups did not differ in online working memory task performance, but the transcranial direct current stimulation group demonstrated significant improvement in performance at 24 h post-transcranial direct current stimulation. Transcranial direct current stimulation was associated with increased activation in the medial frontal cortex beneath the anode; showing a positive correlation with consolidated working memory performance 24 h post-stimulation. There was reduced activation in the left cerebellum in the transcranial direct current stimulation group, with no change in the middle frontal gyrus or parietal cortices. Improved performance on the executive function task was associated with reduced activity in the anterior cingulate cortex. Transcranial direct current stimulation modulated functional activation in local task-related regions, and in more distal nodes in the network. Transcranial direct current stimulation offers a potential novel approach to altering frontal cortical activity and exerting pro-cognitive effects in schizophrenia. © The Author (2017). Published by Oxford

  7. Studies of micromorphology and current efficiency of zinc electrodeposited from flowing chloride electrolytes

    Energy Technology Data Exchange (ETDEWEB)

    Mc Vay, Laura [Univ. of California, Berkeley, CA (United States); Muller, Rolf H. [Univ. of California, Berkeley, CA (United States); Tobias, Charles W. [Univ. of California, Berkeley, CA (United States)

    1986-05-01

    Results of a study of the micromorphology and current efficiency of zinc electrodeposited from flowing, acidic chloride solutions are reported. The effects of six variables were examined: flow rate, current density, zinc and hydrogen ion concentration, concentrations of nickel, iron and cadmium impurity ions, and the nature of the substrate. The development of micromorphology was studied in-situ by means of videomicrography and ex-situ by means of scanning electron microscopy. This investigation focused on the formation of grooved deposits, which are found under a wide range of deposition conditions. The major conclusions of this study are: the most important variable determining whether grooved deposits form is the interfacial concentration; large protrusions orient themselves parallel to the flow direction with the orientation starting upstream and progressing downstream; large protrusions become ridges due to growth of the highest current density portions of the electrode under mass transport control. The current efficiency was measured using EDTA titration and weight measurements. The fraction of the current taken by zinc deposition increased with zinc concentration, ranging up to 100%, and decreased with pH. The efficiency of zinc deposition was affected by the flow rate and the substrate employed. Impurities lowered the current efficiency.

  8. Transcranial direct current stimulation for depression in Alzheimer's disease: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Narita, Zui; Yokoi, Yuma

    2017-06-19

    Patients with Alzheimer's disease frequently elicit neuropsychiatric symptoms as well as cognitive deficits. Above all, depression is one of the most common neuropsychiatric symptoms in Alzheimer's disease but antidepressant drugs have not shown significant beneficial effects on it. Moreover, electroconvulsive therapy has not ensured its safety for potential severe adverse events although it does show beneficial clinical effect. Transcranial direct current stimulation can be the safe alternative of neuromodulation, which applies weak direct electrical current to the brain. Although transcranial direct current stimulation has plausible evidence for its effect on depression in young adult patients, no study has explored it in older subjects with depression in Alzheimer's disease. Therefore, we present a study protocol designed to evaluate the safety and clinical effect of transcranial direct current stimulation on depression in Alzheimer's disease in subjects aged over 65 years. This is a two-arm, parallel-design, randomized controlled trial, in which patients and assessors will be blinded. Subjects will be randomized to either an active or a sham transcranial direct current stimulation group. Participants in both groups will be evaluated at baseline, immediately, and 2 weeks after the intervention. This study investigates the safety and effect of transcranial direct current stimulation that may bring a significant impact on both depression and cognition in patients with Alzheimer's disease, and may be useful to enhance their quality of life. ClinicalTrials.gov, NCT02351388 . Registered on 27 January 2015. Last updated on 30 May 2016.

  9. An image-guided transcranial direct current stimulation system: a pilot phantom study

    International Nuclear Information System (INIS)

    Jung, Young-Jin; Kim, Jung-Hoon; Kim, Daejeong; Im, Chang-Hwan

    2013-01-01

    In this study, an image-guided transcranial direct current stimulation (IG-tDCS) system that can deliver an increased stimulation current to a target brain area without the need to adjust the location of an active electrode was implemented. This IG-tDCS system was based on the array-type tDCS concept, which was validated through computer simulations in a previous study. Unlike a previous study, the present IG-tDCS system adopts a single reference electrode and an active electrode array consisting of 16 (4 × 4) sub-electrodes. The proposed IG-tDCS system is capable of shaping current flow inside the human head by controlling the input currents of the arrayed electrodes. Once a target brain area has been selected, the optimal injection current of each arrayed sub-electrode is evaluated automatically using a genetic algorithm in order to deliver the maximum available current to the target area. The operation of our pilot system was confirmed through a simple phantom experiment. (paper)

  10. Utilization of free dental health care services provided to the perinatally infected human immunodeficiency virus children in Bangalore: Longitudinal study

    OpenAIRE

    Beena Javaregowda Parvathy

    2014-01-01

    Background: Use of Highly active anti-retroviral therapy have increased the life expectancy of human immunodeficiency virus (HIV) infected patients and hence it is imperative that all efforts have to be made by Pediatric dentists to provide a better oral health for these children. Aim: The aim of this study was to evaluate the rate of utilization of free dental treatment provided to these perinatally infected HIV positive children who were previously screened as a part of oral health survey. ...

  11. Healthcare providers' experiences screening for intimate partner violence among migrant and seasonal farmworking women: A phenomenological study.

    Science.gov (United States)

    Wilson, Jonathan B; Rappleyea, Damon L; Hodgson, Jennifer L; Brimhall, Andrew S; Hall, Tana L; Thompson, Alyssa P

    2016-12-01

    Migrant and seasonal farmworking (MSFW) women patients experience substantially more intimate partner violence (IPV) than the general population, but few health-care providers screen patients for IPV. While researchers have examined screening practices in health-care settings, none have exclusively focused on MSFW women. The aim of this phenomenological study was to explore the experiences of health-care providers who have screened for and/or addressed IPV with MSFW women patients. Researchers utilized descriptive phenomenology to capture the lived experiences of these health-care providers. Data were analysed using Colaizzi's seven-stage framework. Interviews were conducted with nine female participants - all of whom: (i) were clinically active health-care providers within the MSFW community, (ii) were bilingual in English and Spanish or had access to a translator, (iii) had treated MSFW patients who had experienced IPV and (iv) were at least 18 years of age. Participants' experiences were reflected in four emergent themes: (i) provider-centered factors, (ii) patient-centered factors, (iii) clinic-centered factors and (iv) community-centered factors. Participants described barriers to establish routine IPV assessment, decrease patient ambivalence and increase on-site support and community resources. This study aimed to generate a greater understanding of the experiences of health-care providers with screening for and addressing IPV with MSFW patients. Implications and recommendations for research, clinical practice and policy are provided. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  12. Presentations provided

    Energy Technology Data Exchange (ETDEWEB)

    Hashemian, H; Beverly, D [Analysis and Measurement Services Corp., Knoxville, TN (United States)

    1999-12-31

    The following topics covered in detail at the workshop included: temperature instrumentation; pressure instrumentation; in-situ calibration and response time testing of RTDs and pressure transmitters; on-line performance monitoring and preventive maintenance of critical equipment; automated measurement of critical parameters; nuclear power plant infrastructure, management and Quality Assurance issues and recent developments for WWER and RBMK reactors. Conclusions drawn were: aging can adversely affect the performance of nuclear plant pressure transmitters; current testing interval of once in every fuel cycle is adequate for aging management; in-situ response time measurements and on-line calibration testing methods have been developed and validated for nuclear plant pressure transmitters; NUREG/CR-5851 should be taken into account for details of aging research on pressure transmitters

  13. Presentations provided

    International Nuclear Information System (INIS)

    Hashemian, H.; Beverly, D.

    1998-01-01

    The following topics covered in detail at the workshop included: temperature instrumentation; pressure instrumentation; in-situ calibration and response time testing of RTDs and pressure transmitters; on-line performance monitoring and preventive maintenance of critical equipment; automated measurement of critical parameters; nuclear power plant infrastructure, management and Quality Assurance issues and recent developments for WWER and RBMK reactors. Conclusions drawn were: aging can adversely affect the performance of nuclear plant pressure transmitters; current testing interval of once in every fuel cycle is adequate for aging management; in-situ response time measurements and on-line calibration testing methods have been developed and validated for nuclear plant pressure transmitters; NUREG/CR-5851 should be taken into account for details of aging research on pressure transmitters

  14. Partial discharge measurements on 110kV current transformers. Setting the control value. Case study

    Science.gov (United States)

    Dan, C.; Morar, R.

    2017-05-01

    The case study presents a series of partial discharge measurements, reflecting the state of insulation of 110kV CURRENT TRANSFORMERS located in Sibiu county substations. Measurements were performed based on electrical method, using MPD600: an acquisition and analysis toolkit for detecting, recording, and analyzing partial discharges. MPD600 consists of one acquisition unit, an optical interface and a computer with dedicated software. The system allows measurements of partial discharge on site, even in presence of strong electromagnetic interferences because it provides synchronous acquisition from all measurement points. Therefore, measurements, with the ability to be calibrated, do render: - a value subject to interpretation according to IEC 61869-1:2007 + IEC 61869-2:2012 + IEC 61869-3:2011 + IEC 61869-5:2011 and IEC 60270: 2000; - the possibility to determine the quantitative limit of PD (a certain control value) to which the equipment can be operated safely and repaired with minimal costs (relative to the high costs implied by eliminating the consequences of a failure) identified empirically (process in which the instrument transformer subjected to the tests was completely destroyed).

  15. Design Studies for a High Current Bunching System for CLIC Test Facility (CTF3) Drive Beam

    CERN Document Server

    Thiery, Y.; Le Duff, J.

    2000-01-01

    A bunching system is proposed for the initial stage of CTF3 which consists of one (two) 3 GHz prebunchers and one 3 GHz travelling wave (TW) buncher with variable phase velocities. The electron beam is emitted from a 140 KV DC gun. Since the macropulse beam current (3.5 A) at the exit of the TW buncher is rather high, inside the TW buncher one has to take the beam loading effect into consideration. By using PARMELA, it is shown numerically that the bunching system can provide the bunches whose properties satisfy the design requirement of CTF3. The 0.8 m long TW buncher working at 2pi/3 mode has two phase velocities, 0.75 and 1. The dimensions of the caities in the two phase velocity regions are proposed considering the beam loading effect. The transient beam loading effect and the multibunch transverse instabilities are studied numerically, and it is concluded that higher order mode couplers should be installed in the TW buncher with the loaded quality factor of the dipole mode lower than 80.

  16. A Study on the Current Status and Prospects of Development of the Tourism Services Market

    Directory of Open Access Journals (Sweden)

    Miroshnyk Mariia V.

    2017-06-01

    Full Text Available The article considers the world trends in the developmet of services market, and it has been determined that the service sector is about 70% of the world’s gross domestic product (GDP. It has been noted that the tourism sector is one of the largest in the world economy, and its market in terms of investment efficiency is among the highly profitable markets along with the gas and oil producing, industrial, and automotive markets. The tourism market in Ukraine is only about 2% of the country’s GDP, but has great potential for innovation development and tourism perspectives. Such a situation requires constant monitoring and analyzing, which makes the selected study relevant. The purpose of the article was to provide a comprehensive analysis of the current status of the market for tourism services in Ukraine and to determine the main tendencies in its further development. It has been found that the tourism industry sector in Ukraine is formed by three components: outbound (international, internal, and inbound (foreign tourism, the quantitative increase of which will increase the efficiency of the country’s tourism potential and reinforce its positive image abroad.

  17. [Current provision of cardiac rehabilitation intervention in the Lombardy Region, Italy: a benchmark study].

    Science.gov (United States)

    Ambrosetti, Marco; Porazzi, Emanuele; Diaco, Tommaso; Febo, Oreste; Tramarin, Roberto; Malinverni, Claudio; Zaniboni, Daniela; Passera, Martina; Marchetti, Paolo

    2010-11-01

    Benchmarking is a process of comparison between the performance characteristics of separate, often competing organizations, intended to enable each participant to improve its own performance in the marketplace. Benchmarking could be translated to the health system from the management field, in order to improve quality and health outcomes. This benchmarking study focused on structural and process aspects regarding the current delivery of cardiac rehabilitation (CR) interventions in the Lombardy Region. Data for analysis were derived from the ISYDE-2008 (Italian Survey on Cardiac Rehabilitation) project of the Italian Association for Cardiovascular Prevention, Rehabilitation, and Epidemiology. Thirty-eight CR units accepted to provide open information about types of supply of CR interventions, organization, location, number of active beds, personnel, duty services, expectancy days before admission, and complexity of patient populations. As a major finding, in-hospital programs actually represent the largest part of CR interventions delivered in the Lombardy Region, generally in well-defined cardiovascular departments, and patients are mostly referred in the short period after a major cardiovascular event. This model could help healthcare organizations to understand where they have strengths and weaknesses depending upon changes in supply, demand and market conditions.

  18. Influences on Intentions to Place Long-Acting Reversible Contraceptives: A Pilot Study Comparing According to Provider Specialty in Ohio.

    Science.gov (United States)

    Thompson, Charee M; Broecker, Jane; Dade, Maggie; Nottingham, Kelly

    2018-03-23

    had more deliberate training. For pediatricians in particular, perhaps encouraging those who do not currently provide LARC methods to begin with training in implant placement would be a way to capitalize on their more favorable attitudes about implants. For pediatricians who do not feel comfortable providing device placement themselves, other strategies should be encouraged to facilitate provision of LARCs. Copyright © 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  19. Exploring challenges in the patient's discharge process from the internal medicine service: A qualitative study of patients' and providers' perceptions.

    Science.gov (United States)

    Pinelli, Vincent; Stuckey, Heather L; Gonzalo, Jed D

    2017-09-01

    In hospital-based medicine units, patients have a wide range of complex medical conditions, requiring timely and accurate communication between multiple interprofessional providers at the time of discharge. Limited work has investigated the challenges in interprofessional collaboration and communication during the patient discharge process. In this study, authors qualitatively assessed the experiences of internal medicine providers and patients about roles, challenges, and potential solutions in the discharge process, with a phenomenological focus on the process of collaboration. Authors conducted interviews with 87 providers and patients-41 providers in eight focus-groups, 39 providers in individual interviews, and seven individual patient interviews. Provider roles included physicians, nurses, therapists, pharmacists, care coordinators, and social workers. Interviews were audio-recorded and transcribed verbatim, followed by iterative review of transcripts using qualitative coding and content analysis. Participants identified several barriers related to interprofessional collaboration during the discharge process, including systems insufficiencies (e.g., medication reconciliation process, staffing challenges); lack of understanding others' roles (e.g., unclear which provider should be completing the discharge summary); information-communication breakdowns (e.g., inaccurate information communicated to the primary medical team); patient issues (e.g., patient preferences misaligned with recommendations); and poor collaboration processes (e.g., lack of structured interprofessional rounds). These results provide context for targeting improvement in interprofessional collaboration in medicine units during patient discharges. Implementing changes in care delivery processes may increase potential for accurate and timely coordination, thereby improving the quality of care transitions.

  20. Current transport modeling and experimental study of THz room temperature ballistic deflection transistors

    Energy Technology Data Exchange (ETDEWEB)

    Kaushal, Vikas; Margala, Martin [Department of Electrical and Computer Engineering, University of Massachusetts Lowell, MA, 01854 (United States); Yu Qiaoyan; Ampadu, Paul; Guarino, Gregg; Sobolewski, Roman, E-mail: vikas_kaushal@student.uml.ed [Department of Electrical and Computer Engineering, University of Rochester, NY, 14627 (United States)

    2009-11-15

    In this paper, two different theoretical models, Comsol Multiphysics{sup TM} (a Finite Element Analysis tool), and a field solver Atlas/Blaze from Silvaco, are compared qualitatively to study the effect of the deflector position, its size and electric field on the charge transport and its distribution along the channel, resulting in current outputs and leakages in ballistic deflection transistors (BDT). Silvaco simulations and experimental results were then used to study the lateral charge transport as a result of variation in electric field distribution, which controls the charge current along the channel in BDT. The electric field dependence of gain is also studied with experimental and theoretical results.

  1. Current transport modeling and experimental study of THz room temperature ballistic deflection transistors

    International Nuclear Information System (INIS)

    Kaushal, Vikas; Margala, Martin; Yu Qiaoyan; Ampadu, Paul; Guarino, Gregg; Sobolewski, Roman

    2009-01-01

    In this paper, two different theoretical models, Comsol Multiphysics TM (a Finite Element Analysis tool), and a field solver Atlas/Blaze from Silvaco, are compared qualitatively to study the effect of the deflector position, its size and electric field on the charge transport and its distribution along the channel, resulting in current outputs and leakages in ballistic deflection transistors (BDT). Silvaco simulations and experimental results were then used to study the lateral charge transport as a result of variation in electric field distribution, which controls the charge current along the channel in BDT. The electric field dependence of gain is also studied with experimental and theoretical results.

  2. Ocean Science for Decision-Making: Current Activities of the National Research Council's Ocean Studies Board

    Science.gov (United States)

    Roberts, S.; Glickson, D.; Mengelt, C.; Forrest, S.; Waddell, K.

    2012-12-01

    The National Research Council is a private, nonprofit organization chartered by Congress in 1916 as an expansion of the U.S. National Academy of Sciences. Its mission is to improve the use of science in government decision making and public policy, increase public understanding, and promote the acquisition and dissemination of knowledge in matters involving science, engineering, technology, and health. Within the National Research Council, the Ocean Studies Board (OSB) mission is to explore the science, policies, and infrastructure needed to understand, manage, and conserve coastal and marine environments and resources. OSB undertakes studies and workshops on emerging scientific and policy issues at the request of federal agencies, Congress, and others; provides program reviews and guidance; and facilitates communication on oceanographic issues among different sectors. OSB also serves as the U.S. National Committee to the international, nongovernmental Scientific Committee on Oceanic Research (SCOR). OSB has produced reports on a wide range of topics of interest to researchers and educators, the federal government, the non-profit sector, and industry. Recent reports have focused on ecosystem services in the Gulf of Mexico after the Deepwater Horizon oil spill, sea level rise on the U.S. west coast, scientific ocean drilling needs and accomplishments, requirements for sustained ocean color measurements, critical infrastructure for ocean research, tsunami warning and preparedness, ocean acidification, and marine and hydrokinetic power resource assessments. Studies that are currently underway include responding to oil spills in the Arctic, evaluating the effectiveness of fishery stock rebuilding plans, and reviewing the National Ocean Acidification Research Plan. OSB plays an important role in helping create policy decisions and disseminating important information regarding various aspects of ocean science.

  3. Experimental study on the evolution of Peregrine breather with uniform-depth adverse currents

    Science.gov (United States)

    Liao, B.; Ma, Y.; Ma, X.; Dong, G.

    2018-05-01

    A series of laboratory experiments were performed to study the evolution of Peregrine breather (PB) in a wave flume in finite depth, and wave trains were initially generated in a region of quiescent water and then propagated into an adverse current region for which the current velocity strength gradually increased from zero to an approximately stable value. The PB is often considered as a prototype of oceanic freak waves that can focus wave energy into a single wave packet. In the experiment, the cases were selected with the relative water depths k0h (k0 is the wave number in quiescent water and h is the water depth) varying from 3.11 through 8.17, and the initial wave steepness k0a0 (a0 is the background wave amplitude) ranges between 0.065 and 0.120. The experimental results show the persistence of the breather evolution dynamics even in the presence of strong opposing currents. We have shown that the characteristic spectrum of the PB persists even on strong currents, thus making it a viable characteristic for prediction of freak waves. It was also found that the adverse currents tend to shift the focusing point upstream compared to the cases without currents. Furthermore, it was found that uniform-depth adverse currents can reduce the breather extension in time domain.

  4. A study of direct- and pulse-current chromium electroplating on rotating cylinder electrode (RCE)

    International Nuclear Information System (INIS)

    Chang, J.H.; Hsu, F.Y.; Liao, M.J.; Huang, C.A.

    2007-01-01

    Direct- and pulse-current (DC and PC) chromium electroplating on Cr-Mo steel were performed in a sulfate-catalyzed chromic acid solution at 50 deg. C using a rotating cylinder electrode (RCE). The electroplating cathodic current densities were at 30, 40, 50 and 60 A dm -2 , respectively. The relationship between electroplating current efficiency and the rotating speed of the RCE was studied. The cross-sectional microstructure of Cr-deposit was examined by transmission electron microscope (TEM). Results showed that DC-plating exhibited higher current efficiency than the PC-plating under the same conditions of electroplating current density and the rotating speed. We found the critical rotating speed of RCE used in the chromium electroplating, above this rotating speed the chromium deposition is prohibited. At the same plating current density, the critical rotating speed for DC-plating was higher than that for PC-plating. The higher plating current density is, the larger difference in critical rotating speeds appears between DC- and PC-electroplating. Equiaxed grains, in a nanoscale size with lower dislocation density, nucleate on the cathodic surface in both DC- and PC-electroplating. Adjacent to the equiaxed grains, textured grains were found in other portion of chromium deposit. Fine columnar grains were observed in the DC-electroplated deposit. On the other hand, very long slender grains with high degree of preferred orientation were detected in PC-electroplated deposit

  5. Numerical and experimental studies of stack shunt current for vanadium redox flow battery

    International Nuclear Information System (INIS)

    Yin, Cong; Guo, Shaoyun; Fang, Honglin; Liu, Jiayi; Li, Yang; Tang, Hao

    2015-01-01

    Highlights: • A coupled three-dimensional model of VRB cell stack is developed. • Shunt current of the stack is studied with the model and experiment. • Increased electrolyte resistance in channel and manifold lowers the shunt current. • Shunt current loss increases with stack cell number nonlinearly. - Abstract: The stack shunt current of VRB (vanadium redox flow battery) was investigated with experiments and 3D (three-dimensional) simulations. In the proposed model, cell voltages and electrolyte conductivities were calculated based on electrochemical reaction distributions and SOC (state of charge) values, respectively, while coulombic loss was estimated according to shunt current and vanadium ionic crossover through membrane. Shunt current distributions and coulombic efficiency are analyzed in terms of electrolyte conductivities and stack cell numbers. The distributions of cell voltages and shunt currents calculated with proposed model are validated with single cell and short stack tests. The model can be used to optimize VRB stack manifold and channel designs to improve VRB system efficiency

  6. Current generation time-of-flight 18F-FDG PET/CT provides higher SUVs for normal adrenal glands, while maintaining an accurate characterization of benign and malignant glands

    NARCIS (Netherlands)

    Koopman, Daniëlle; Koopman, Daniëlle; van Dalen, Jorn A.; Stigt, Jos A.; Slump, Cornelis H.; Knollema, Siert; Jager, Pieter L.

    ObjectiveModern PET/CT scanners have significantly improved detectors and fast time-of-flight (TOF) performance and this may improve clinical performance. The aim of this study was to analyze the impact of a current generation TOF PET/CT scanner on standardized uptake values (SUV), lesion-background

  7. Spin current

    CERN Document Server

    Valenzuela, Sergio O; Saitoh, Eiji; Kimura, Takashi

    2012-01-01

    In a new branch of physics and technology called spin-electronics or spintronics, the flow of electrical charge (usual current) as well as the flow of electron spin, the so-called 'spin current', are manipulated and controlled together. This book provides an introduction and guide to the new physics and application of spin current.

  8. Study of Co-Current and Counter-Current Gas-Liquid Two-Phase Flow Through Packed Bed in Microgravity

    Science.gov (United States)

    Revankar, Shripad T.

    2002-11-01

    The main goal of the project is to obtain new experimental data and development of models on the co-current and counter-current gas-liquid two-phase flow through a packed bed in microgravity and characterize the flow regime transition, pressure drop, void and interfacial area distribution, and liquid hold up. Experimental data will be obtained for earth gravity and microgravity conditions. Models will be developed for the prediction of flow regime transition, void fraction distribution and interfacial area concentration, which are key parameters to characterize the packed bed performance. Thus the specific objectives of the proposed research are to: (1) Develop experiments for the study of the gas liquid two-phase flow through the packed bed with three different flow combinations: co-current down flow, co-current upflow and counter current flow. (2) Develop pore scale and bed scale two-phase instrumentation for measurement of flow regime transition, void distribution and gas-liquid interfacial area concentration in the packed bed. (3) Obtain database on flow regime transition, pressure drop, void distribution, interfacial area concentration and liquid hold up as a function of bed characteristics such as bed particle size, porosity, and liquid properties such as viscosity and surface tension. (4) Develop mathematical model for flow regime transition, void fraction distribution and interfacial area concentration for co-current gas-liquid flow through the porous bed in gravity and micro gravity conditions.(4) Develop mathematical model for the flooding phenomena in counter-current gas-liquid flow through the porous bed in gravity and micro gravity conditions. The present proposal addresses the most important topic of HEDS-specific microgravity fluid physics research identified by NASA 's one of the strategic enterprises, OBPR Enterprise. The proposed project is well defined and makes efficient use of the ground-based parabolic flight research aircraft facility. The

  9. Transcranial Direct Current Stimulation and Power Spectral Parameters: a tDCS/EEG co-registration study

    Directory of Open Access Journals (Sweden)

    Anna Lisa Mangia

    2014-08-01

    Full Text Available Transcranial direct current stimulation (tDCS delivers low electric currents to the brain through the scalp. Constant electric currents induce shifts in neuronal membrane excitability, resulting in secondary changes in cortical activity. Concomitant electroencephalography (EEG monitoring during tDCS can provide valuable information on the tDCS mechanisms of action. This study examined the effects of anodal tDCS on spontaneous cortical activity in a resting brain to disclose possible modulation of spontaneous oscillatory brain activity. EEG activity was measured in ten healthy subjects during and after a session of anodal stimulation of the postero-parietal cortex to detect the tDCS-induced alterations. Changes in the theta, alpha, beta and gamma power bands were investigated. Three main findings emerged: 1 an increase in theta band activity during the first minutes of stimulation; 2 an increase in alpha and beta power during and after stimulation; 3 a widespread activation in several brain regions.

  10. Study of local currents in low dimension materials using complex injecting potentials

    Science.gov (United States)

    He, Shenglai; Covington, Cody; Varga, Kálmán

    2018-04-01

    A complex potential is constructed to inject electrons into the conduction band, mimicking electron currents in nanoscale systems. The injected electrons are time propagated until a steady state is reached. The local current density can then be calculated to show the path of the conducting electrons on an atomistic level. The method allows for the calculation of the current density vectors within the medium as a function of energy of the conducting electron. Using this method, we investigate the electron pathway of graphene nanoribbons in various structures, molecular junctions, and black phosphorus nanoribbons. By analyzing the current flow through the structures, we find strong dependence on the structural geometry and the energy of the injected electrons. This method may be of general use in the study of nano-electronic materials and interfaces.

  11. Numerical studies on the stabilization of neoclassical tearing modes by radio frequency current drive

    International Nuclear Information System (INIS)

    Yu, Q.; Zhang, X.D.; Guenter, S.

    2004-01-01

    Numerical modeling on the stabilization of neoclassical tearing modes by localized radio frequency (rf) current drive has been carried out to study the effects of various wave and plasma parameters on the stabilization and the associated physics. The change of the rf current profile due to the magnetic island has been taken into account by modeling the two-dimensional transport of the fast electrons induced by the rf wave. It is found that, when the rf deposition width is much larger than the island width, the modulated rf current drive to deposit the rf current around the island's o point has a stronger stabilizing effect than a nonmodulated one. The slowing down time of the fast electrons and the initial island width when applying the rf wave are also found to be important in determining the stabilizing effect

  12. Transcranial direct-current stimulation induced in stroke patients with aphasia: a prospective experimental cohort study

    Directory of Open Access Journals (Sweden)

    Michele Devido Santos

    Full Text Available CONTEXT AND OBJECTIVE: Previous animal and human studies have shown that transcranial direct current stimulation can induce significant and lasting neuroplasticity and may improve language recovery in patients with aphasia. The objective of the study was to describe a cohort of patients with aphasia after stroke who were treated with transcranial direct current stimulation. DESIGN AND SETTING: Prospective cohort study developed in a public university hospital. METHODS: Nineteen patients with chronic aphasia received 10 transcranial direct current stimulation sessions lasting 20 minutes each on consecutive days, using a current of 2 mA. The anode was positioned over the supraorbital area and the cathode over the contralateral motor cortex. The following variables were analyzed before and after the 10 neuromodulation sessions: oral language comprehension, copying, dictation, reading, writing, naming and verbal fluency. RESULTS: There were no adverse effects in the study. We found statistically significant differences from before to after stimulation in relation to simple sentence comprehension (P = 0.034, naming (P = 0.041 and verbal fluency for names of animals (P = 0.038. Improved scores for performing these three tasks were seen after stimulation. CONCLUSIONS: We observed that excitability of the primary motor cortex through transcranial direct current stimulation was associated with effects on different aspects of language. This can contribute towards future testing in randomized controlled trials.

  13. Transcranial direct-current stimulation induced in stroke patients with aphasia: a prospective experimental cohort study.

    Science.gov (United States)

    Santos, Michele Devido; Gagliardi, Rubens José; Mac-Kay, Ana Paula Machado Goyano; Boggio, Paulo Sergio; Lianza, Roberta; Fregni, Felipe

    2013-01-01

    Previous animal and human studies have shown that transcranial direct current stimulation can induce significant and lasting neuroplasticity and may improve language recovery in patients with aphasia. The objective of the study was to describe a cohort of patients with aphasia after stroke who were treated with transcranial direct current stimulation. Prospective cohort study developed in a public university hospital. Nineteen patients with chronic aphasia received 10 transcranial direct current stimulation sessions lasting 20 minutes each on consecutive days, using a current of 2 mA. The anode was positioned over the supraorbital area and the cathode over the contralateral motor cortex. The following variables were analyzed before and after the 10 neuromodulation sessions: oral language comprehension, copying, dictation, reading, writing, naming and verbal fluency. There were no adverse effects in the study. We found statistically significant differences from before to after stimulation in relation to simple sentence comprehension (P = 0.034), naming (P = 0.041) and verbal fluency for names of animals (P = 0.038). Improved scores for performing these three tasks were seen after stimulation. We observed that excitability of the primary motor cortex through transcranial direct current stimulation was associated with effects on different aspects of language. This can contribute towards future testing in randomized controlled trials.

  14. Transcutaneous spinal direct current stimulation of the lumbar and sacral spinal cord: a modelling study

    Science.gov (United States)

    Fernandes, Sofia R.; Salvador, Ricardo; Wenger, Cornelia; de Carvalho, Mamede; Miranda, Pedro C.

    2018-06-01

    Objective. Our aim was to perform a computational study of the electric field (E-field) generated by transcutaneous spinal direct current stimulation (tsDCS) applied over the thoracic, lumbar and sacral spinal cord, in order to assess possible neuromodulatory effects on spinal cord circuitry related with lower limb functions. Approach. A realistic volume conductor model of the human body consisting of 14 tissues was obtained from available databases. Rubber pad electrodes with a metallic connector and a conductive gel layer were modelled. The finite element (FE) method was used to calculate the E-field when a current of 2.5 mA was passed between two electrodes. The main characteristics of the E-field distributions in the spinal grey matter (spinal-GM) and spinal white matter (spinal-WM) were compared for seven montages, with the anode placed either over T10, T8 or L2 spinous processes (s.p.), and the cathode placed over right deltoid (rD), umbilicus (U) and right iliac crest (rIC) areas or T8 s.p. Anisotropic conductivity of spinal-WM and of a group of dorsal muscles near the vertebral column was considered. Main results. The average E-field magnitude was predicted to be above 0.15 V m-1 in spinal cord regions located between the electrodes. L2-T8 and T8-rIC montages resulted in the highest E-field magnitudes in lumbar and sacral spinal segments (>0.30 V m-1). E-field longitudinal component is 3 to 6 times higher than the ventral-dorsal and right-left components in both the spinal-GM and WM. Anatomical features such as CSF narrowing due to vertebrae bony edges or disks intrusions in the spinal canal correlate with local maxima positions. Significance. Computational modelling studies can provide detailed information regarding the electric field in the spinal cord during tsDCS. They are important to guide the design of clinical tsDCS protocols that optimize stimulation of application-specific spinal targets.

  15. Current level of training, experience and perceptions of emergency physicians as expert witnesses: a pilot study.

    Science.gov (United States)

    Cunningham, Nicola Y; Weiland, Tracey J

    2009-12-01

    The objective of the present study was to determine emergency physicians' training, experience and perceptions as expert witnesses. Emergency physicians of an adult tertiary referral and teaching hospital participated in a pilot survey regarding their experiences in report writing and in court as expert witnesses. The 28-item survey also examined the amount of formalized forensic medical teaching that emergency physicians had received during their training. Of the participants, 41% (95% CI 21.6-64.1; 7/17) had never received any undergraduate or postgraduate training in forensic medicine, 11/17 (65%, 95% CI 41.2-82.8) had provided a written expert opinion for court, and 12/17 (71%, 95% CI 46.6-87.0) had attended court as an expert witness. All participants considered themselves 'skilled in attending an emergency resuscitation', whereas 3/13 (23%, 95% CI 7.5-50.9) considered themselves 'skilled in attending a courtroom trial'. Nearly 90% (95% CI 64.7-98.0; 15/17) thought that medical evidence training should be a requirement of emergency speciality training. The most commonly preferred forms of medical evidence training were mock court sessions (76%, 95% CI 52.2-91.0; 13/17) and forensic workshops (76%, 95% CI 52.2-91.0; 13/17). From 10 non-technical skills required of an EP, 'appearing in court as an expert witness' was perceived to be the second most difficult skill by most respondents. Emergency physicians in this pilot study have limited training for the role of expert witness and see it as one of the most difficult non-technical skills they have to perform. Further research is required regarding the current and future scope of forensic training.

  16. A simulation study on burning profile tailoring of steady state, high bootstrap current tokamaks

    International Nuclear Information System (INIS)

    Nakamura, Y.; Takei, N.; Tobita, K.; Sakamoto, Y.; Fujita, T.; Fukuyama, A.; Jardin, S.C.

    2007-01-01

    From the aspect of fusion burn control in steady state DEMO plant, the significant challenges are to maintain its high power burning state of ∝3-5 GW without burning instability, hitherto well-known as ''thermal stability'', and also to keep its desired burning profile relevant with internal transport barrier (ITB) that generates high bootstrap current. The paper presents a simulation modeling of the burning stability coupled with the self-ignited fusion burn and the structure-formation of the ITB. A self-consistent simulation, including a model for improved core energy confinement, has pointed out that in the high power fusion DEMO plant there is a close, nonlinear interplay between the fusion burnup and the current source of non-inductive, ITB-generated bootstrap current. Consequently, as much distinct from usual plasma controls under simulated burning conditions with lower power (<<1 GW), the selfignited fusion burn at a high power burning state of ∝3-5 GW becomes so strongly selforganized that any of external means except fuelling can not provide the effective control of the stable fusion burn.It is also demonstrated that externally applied, inductive current perturbations can be used to control both the location and strength of ITB in a fully noninductive tokamak discharge. We find that ITB structures formed with broad noninductive current sources such as LHCD are more readily controlled than those formed by localized sources such as ECCD. The physics of the inductive current is well known. Consequently, we believe that the controllability of the ITB is generic, and does not depend on the details of the transport model (as long as they can form an ITB for sufficiently reversed magnetic shear q-profile). Through this external control of the magnetic shear profile, we can maintain the ITB strength that is otherwise prone to deteriorate when the bootstrap current increases. These distinguishing capabilities of inductive current perturbation provide steady

  17. When Terminal Illness Is Worse Than Death: A Multicenter Study of Health-Care Providers' Resuscitation Desires.

    Science.gov (United States)

    Chavez, Luis O; Einav, Sharon; Varon, Joseph

    2017-11-01

    To investigate how a terminal illness may affect the health-care providers' resuscitation preferences. We conducted a cross-sectional survey in 9 health-care institutions located in 4 geographical regions in North and Central America, investigating attitudes toward end-of-life practices in health-care providers. Statistical analysis included descriptive statistics and χ 2 test for the presence of associations ( P < 0.05 being significant) and Cramer V for the strength of the association. The main outcome measured the correlation between the respondents' present code status and their preference for cardiopulmonary resuscitation (CPR) in case of terminal illness. A total of 852 surveys were completed. Among the respondents, 21% (n = 180) were physicians, 36.9% (n = 317) were nurses, 10.5% (n = 90) were medical students, and 265 participants were other staff members of the institutions. Most respondents (58.3%; n = 500) desired "definitely full code" (physicians 73.2%; n = 131), only 13.8% of the respondents (physicians 8.33%; n = 15) desired "definitely no code" or "partial support," and 20.9% of the respondents (n = 179; among physicians 18.4%; n = 33) had never considered their code status. There was an association between current code status and resuscitation preference in case of terminal illness ( P < .001), but this association was overall quite weak (Cramer V = 0.180). Subgroup analysis revealed no association between current code status and terminal illness code preference among physicians ( P = .290) and nurses ( P = .316), whereupon other hospital workers were more consistent ( P < .01, Cramer V = .291). Doctors and nurses have different end-of-life preferences than other hospital workers. Their desire to undergo CPR may change when facing a terminal illness.

  18. Use of electronic personal health record systems to encourage HIV screening: an exploratory study of patient and provider perspectives

    Directory of Open Access Journals (Sweden)

    McInnes D Keith

    2011-08-01

    Full Text Available Abstract Background When detected, HIV can be effectively treated with antiretroviral therapy. Nevertheless in the U.S. approximately 25% of those who are HIV-infected do not know it. Much remains unknown about how to increase HIV testing rates. New Internet outreach methods have the potential to increase disease awareness and screening among patients, especially as electronic personal health records (PHRs become more widely available. In the US Department of Veterans' Affairs medical care system, 900,000 veterans have indicated an interest in receiving electronic health-related communications through the PHR. Therefore we sought to evaluate the optimal circumstances and conditions for outreach about HIV screening. In an exploratory, qualitative research study we examined patient and provider perceptions of Internet-based outreach to increase HIV screening among veterans who use the Veterans Health Administration (VHA health care system. Findings We conducted two rounds of focus groups with veterans and healthcare providers at VHA medical centers. The study's first phase elicited general perceptions of an electronic outreach program to increase screening for HIV, diabetes, and high cholesterol. Using phase 1 results, outreach message texts were drafted and then presented to participants in the second phase. Analysis followed modified grounded theory. Patients and providers indicated that electronic outreach through a PHR would provide useful information and would motivate patients to be screened for HIV. Patients believed that electronic information would be more convenient and understandable than information provided verbally. Patients saw little difference between messages about HIV versus about diabetes and cholesterol. Providers, however, felt patients would disapprove of HIV-related messages due to stigma. Providers expected increased workload from the electronic outreach, and thus suggested adding primary care resources and devising

  19. A Pilot Study Exploring After-School Care Providers' Response to the Incredible Years Classroom Management Program

    Science.gov (United States)

    Hicks-Hoste, Taylor B.; Carlson, John S.; Tiret, Holly B.

    2015-01-01

    The need for and importance of bringing evidence-based interventions into school settings has been firmly established. Adapting and adjusting intervention programs to meet the unique needs of a school district requires personnel to use a data-based approach to implementation. This pilot study is the first to report on after-school care providers'…

  20. 21 CFR 20.106 - Studies and reports prepared by or with funds provided by the Food and Drug Administration.

    Science.gov (United States)

    2010-04-01

    ... Administration. (a) The following types of reports and studies prepared by or with funds provided by the Food and... needs and performance. (3) Surveys, compilations, and summaries of data and information. (4) Consumer surveys. (5) Compliance surveys. (6) Compliance programs, except that names of specific firms, the...

  1. How Providing Mentoring Relates to Career Success and Organizational Commitment: A Study in the General Managerial Population

    Science.gov (United States)

    Bozionelos, Nikos; Bozionelos, Giorgos; Kostopoulos, Konstantinos; Polychroniou, Panagiotis

    2011-01-01

    Purpose: This study aims to investigate the relationship of mentoring provided with career success and organizational commitment in the general managerial population. Design/methodology/approach: Participants were 194 native British who were employed in a variety of jobs, professions and industries in the United Kingdom. Findings: Mentoring…

  2. The Impact of Providing Web-Based PowerPoint Slides as Study Guides in Undergraduate Business Classes

    Science.gov (United States)

    Frank, Jonathan; Shaw, Lewis; Wilson, Elizabeth

    2009-01-01

    This study examines undergraduate business students' use of PowerPoint slides provided as a supplement to class attendance, textbook reading, and other traditional course resources. We survey students in 4 diverse (accounting, marketing, management, and information systems) lower-level undergraduate courses in which the instructor provided…

  3. Field aligned current study during the solar declining- extreme minimum of 23 solar cycle

    Science.gov (United States)

    Nepolian, Jeni Victor; Kumar, Anil; C, Panneerselvam

    Field Aligned Current (FAC) density study has been carried out during the solar declining phase from 2004 to 2006 of the 23rd solar cycle and the ambient terrestrial magnetic field of the extended minimum period of 2008 and 2009. We mainly depended on CHAMP satellite data (http://isdc.gfz-potsdam.de/) for computing the FAC density with backup of IGRF-10 model. The study indicates that, the FAC is controlled by quasi-viscous processes occurring at the flank of the earth’s magnetosphere. The dawn-dusk conventional pattern enhanced during disturbed days. The intensity of R1 current system is higher than the R2 current system. Detailed results will be discussed in the conference.

  4. Study of the antineutrino-induced elastic semi-leptonic neutral current reaction

    International Nuclear Information System (INIS)

    Racca, C.

    1978-01-01

    A study of the elastic neutral current reaction antiνsub(μ)p→antiνsub(μ)p has been done using Gargamelle filled with propane and the antineutrino beam of the CERN P.S. The space-time structure of the weak neutral current is discussed, the predictions of various V-A models for the ratio of neutral to charged current elastic cross-sections Rsup(antiν) are given. The experimental set-up, the scanning criteria and the program of reconstruction are described. The background due to the contamination by the reaction np→np principally is studied. Cuts are defined to resorbe these backgrounds and corrections are made for other backgrounds and losses. The results are compared with those of the reaction antiνsub(μ)p→μ + n and the ratio Rsup(antiν) is calculated. An upper limit of this ratio is given and the results are discussed [fr

  5. A Qualitative Study of Multidisciplinary Providers' Experiences With the Transfer Process for Injured Children and Ideas for Improvement.

    Science.gov (United States)

    Gawel, Marcie; Emerson, Beth; Giuliano, John S; Rosenberg, Alana; Minges, Karl E; Feder, Shelli; Violano, Pina; Morrell, Patricia; Petersen, Judy; Christison-Lagay, Emily; Auerbach, Marc

    2018-02-01

    Most injured children initially present to a community hospital, and many will require transfer to a regional pediatric trauma center. The purpose of this study was 1) to explore multidisciplinary providers' experiences with the process of transferring injured children and 2) to describe proposed ideas for process improvement. This qualitative study involved 26 semistructured interviews. Subjects were recruited from 6 community hospital emergency departments and the trauma and transport teams of a level I pediatric trauma center in New Haven, Conn. Participants (n = 34) included interprofessional providers from sending facilities, transport teams, and receiving facilities. Using the constant comparative method, a multidisciplinary team coded transcripts and collectively refined codes to generate recurrent themes across interviews until theoretical saturation was achieved. Participants reported that the transfer process for injured children is complex, stressful, and necessitates collaboration. The transfer process was perceived to involve numerous interrelated components, including professions, disciplines, and institutions. The 5 themes identified as areas to improve this transfer process included 1) Creation of a unified standard operating procedure that crosses institutions/teams, 2) Enhancing 'shared sense making' of all providers, 3) Improving provider confidence, expertise, and skills in caring for pediatric trauma transfer cases, 4) Addressing organization and environmental factors that may impede/delay transfer, and 5) Fostering institutional and personal relationships. Efforts to improve the transfer process for injured children should be guided by the experiences of and input from multidisciplinary frontline emergency providers.

  6. A qualitative study of English community pharmacists' experiences of providing lifestyle advice to patients with cardiovascular disease.

    Science.gov (United States)

    Morton, Kirsty; Pattison, Helen; Langley, Chris; Powell, Rachael

    2015-01-01

    Cardiovascular disease (CVD) progression is modifiable through lifestyle behaviors. Community pharmacists are ideally placed to facilitate self-management of cardiovascular health however research shows varied pharmacist engagement in providing lifestyle advice. This study explored community pharmacists' experiences and perceptions of providing lifestyle advice to patients with CVD. Semi-structured interviews were conducted with fifteen pharmacists (1 supermarket; 7 multiple; 7 independent) recruited through multiple methods from community pharmacies across the Midlands, England. A thematic analysis was conducted using a Framework approach. Pharmacists categorized patients according to their perceptions of the patients' ability to benefit from advice. Many barriers to providing lifestyle advice were identified. Confidence to provide lifestyle advice varied, with pharmacists most comfortable providing lifestyle advice in conjunction with conversations about medicines. Some pharmacists felt lifestyle advice was an integral part of their role whilst others questioned whether pharmacists should give lifestyle advice at all, particularly when receiving no remuneration for doing so. Pharmacists viewed providing lifestyle advice as important but identified many barriers to doing so. Lifestyle advice provision was influenced by pharmacists' perceptions of patients. Professional identity and associated role conflict appeared to underpin many of the barriers to pharmacists providing lifestyle advice. Pharmacists may benefit from enhanced training to: increase their confidence to provide lifestyle advice; integrate lifestyle advice with regular pharmaceutical practice and challenge their perceptions of some patients' receptiveness to lifestyle advice and behavior change. Changes to the way UK pharmacists are remunerated may increase the provision of lifestyle advice. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Provider and pharmacist responses to warfarin drug–drug interaction alerts: a study of healthcare downstream of CPOE alerts

    Science.gov (United States)

    Boro, Maureen S; Korman, Nancy E; Davoren, J Ben

    2011-01-01

    Objective To categorize the appropriateness of provider and pharmacist responses to warfarin critical drug–drug interaction (cDDI) alerts, assess responses and actions to the cDDI, and determine the occurrence of warfarin adverse drug events (ADE) after alerts. Design An 18-month, retrospective study of acute care admissions at a single Veterans Affairs medical center using computerized provider order entry (CPOE). Measurements Patients included had at least one warfarin cDDI alert. Chart reviews included baseline laboratory values and demographics, provider actions, patient outcomes, and associated factors, including other interacting medications and number of simultaneously processed alerts. Results 137 admissions were included (133 unique patients). Amiodarone, vitamin E in a multivitamin, sulfamethoxazole, and levothyroxine accounted for 75% of warfarin cDDI. Provider responses were clinically appropriate in 19.7% of admissions and pharmacist responses were appropriate in 9.5% of admissions. There were 50 ADE (36.6% of admissions) with warfarin; 80% were rated as having no or mild clinical effect. An increased number of non-critical alerts at the time of the reference cDDI alert was the only variable associated with an inappropriate provider response (p=0.01). Limitations This study was limited by being a retrospective review and the possibility of confounding variables, such as other interacting medications. Conclusion The large number of CPOE alerts may lead to inappropriate responses by providers and pharmacists. The high rate of ADE suggests a need for improved medication management systems for patients on warfarin. This study highlights the possibility of alert fatigue contributing to the high prevalence of inappropriate alert over-ride text responses. PMID:22037888

  8. Analysis techniques of charging damage studied on three different high-current ion implanters

    Science.gov (United States)

    Felch, S. B.; Larson, L. A.; Current, M. I.; Lindsey, D. W.

    1989-02-01

    One of the Greater Silicon Valley Implant Users' Group's recent activities has been to sponsor a round-robin on charging damage, where identical wafers were implanted on three different state-of-the-art, high-current ion implanters. The devices studied were thin-dielectric (250 Å SiO2), polysilicon-gate MOS capacitors isolated by thick field oxide. The three implanters involved were the Varian/Extrion 160XP, the Eaton/Nova 10-80, and the Applied Materials PI9000. Each implanter vendor was given 48 wafers to implant with 100 keV As+ ions at a dose of 1 × 1016 cm-2. Parameters that were varied include the beam current, electron flood gun current, and chamber pressure. The charge-to-breakdown, breakdown voltage, and leakage current of several devices before anneal have been measured. The results from these tests were inconclusive as to the physical mechanism of charging and as to the effectiveness of techniques to reduce its impact on devices. However, the methodology of this study is discussed in detail to aid in the planning of future experiments. Authors' industrial affiliations: S.B. Felch, Varian Research Center, 611 Hansen Way, Palo Alto, CA 94303, USA; L.A. Larson, National Semiconductor Corp., P.O. Box 58090, Santa Clara, CA 95052-8090, USA; M.I. Current, Applied Materials, 3050 Bowers Ave., Santa Clara, CA 95054, USA; D.W. Lindsey, Eaton/NOVA, 931 Benicia Ave, Sunnyvale, CA 94086, USA.

  9. A Focus Group Study of Child Nutrition Professionals' Attitudes about Food Allergies and Current Training Practices

    Science.gov (United States)

    Lee, Yee Ming; Kwon, Junehee; Sauer, Kevin

    2014-01-01

    Purpose/Objectives: The purpose of this study was to explore child nutrition professionals' (CNPs) attitudes about food allergies, current practices of food allergy training, and operational issues related to food allergy training in school foodservice operations. Methods: Three focus groups were conducted with 21 CNPs with managerial…

  10. Examining Current Beliefs, Practices and Barriers about Technology Integration: A Case Study

    Science.gov (United States)

    Hsu, Pi-Sui

    2016-01-01

    The purpose of this mixed-methods study was to examine the current beliefs, practices and barriers concerning technology integration of Kindergarten through Grade Six teachers in the midwestern United States. The three data collection methods were online surveys with 152 teachers as well as interviews and observations with 8 teachers. The findings…

  11. Study of transient current induced by heavy-ion microbeams in Si and GaAs

    Energy Technology Data Exchange (ETDEWEB)

    Hirao, Toshio; Nashiyama, Isamu; Kamiya, Tomihiro; Suda, Tamotu [Japan Atomic Energy Research Inst., Takasaki, Gunma (Japan). Takasaki Radiation Chemistry Research Establishment

    1997-03-01

    Heavy-ion microbeams were applied to the study of mechanism of single event upset (SEU). Transient current induced in p{sup +}n junction diodes by strike of heavy ion microbeam were measured by using a high-speed digitizing sampling system. (author)

  12. To What Extent Does Current Scientific Research and Textbook Content Align? A Methodology and Case Study

    Science.gov (United States)

    Bierema, Andrea M.-K.; Schwartz, Renee S.; Gill, Sharon A.

    2017-01-01

    Recent calls for reform in education recommend science curricula to be based on central ideas instead of a larger number of topics and for alignment between current scientific research and curricula. Because alignment is rarely studied, especially for central ideas, we developed a methodology to discover the extent of alignment between primary…

  13. Current and Emerging Ethical Issues in Counseling: A Delphi Study of Expert Opinions

    Science.gov (United States)

    Herlihy, Barbara; Dufrene, Roxane L.

    2011-01-01

    A Delphi study was conducted to ascertain the opinions of panel experts regarding the most important current and emerging ethical issues facing the counseling profession. Expert opinions on ethical issues in counselor preparation also were sought. Eighteen panelists responded to 3 rounds of data collection interspersed with feedback. Themes that…

  14. Correlations and currents in 3He studied with the (e, e'pp) reaction

    NARCIS (Netherlands)

    Groep, David Leo

    2000-01-01

    Nucleon-nucleon correlations, especially those of short-range character, can be well studied with electron-induced two-nucleon knockout reactions at intermediate electron energies. However, these reactions are not only driven by one-body currents, i.e., coupling of the virtual photon to one of

  15. Parametric study of lower-hybrid current drive in the FED-A design

    International Nuclear Information System (INIS)

    Iida, H.; Ehst, D.A.; Peng, Y.K.M.

    1983-08-01

    In the FED-A concept, a quasi-steady-state operating scenario is conceived in which the plasma current is maintained by the transformer coil during burn at high density and by the lower hybrid wave during transformer recharge at low density. A parametric study is carried out to obtain optimum plasma and wave parameters in the recharging phase

  16. A qualitative study of patient and provider perspectives on using web-based pain coping skills training to treat persistent cancer pain.

    Science.gov (United States)

    Rini, Christine; Vu, Maihan B; Lerner, Hannah; Bloom, Catherine; Carda-Auten, Jessica; Wood, William A; Basch, Ethan M; Voorhees, Peter M; Reeder-Hayes, Katherine E; Keefe, Francis J

    2018-04-01

    Persistent pain is common and inadequately treated in cancer patients. Behavioral pain interventions are a recommended part of multimodal pain treatments, but they are underused in clinical care due to barriers such as a lack of the resources needed to deliver them in person and difficulties coordinating their use with clinical care. Pain coping skills training (PCST) is an evidence-based behavioral pain intervention traditionally delivered in person. Delivering this training via the web would increase access to it by addressing barriers that currently limit its use. We conducted a patient pilot study of an 8-week web-based PCST program to determine the acceptability of this approach to patients and the program features needed to meet their needs. Focus groups with healthcare providers identified strategies for coordinating the use of web-based PCST in clinical care. Participants included 7 adults with bone pain due to multiple myeloma or metastasized breast or prostate cancer and 12 healthcare providers (4 physicians and 8 advanced practice providers) who treat cancer-related bone pain. Patients completed web-based PCST at home and then took part in an in-depth qualitative interview. Providers attended focus groups led by a trained moderator. Qualitative analyses identified themes in the patient and provider data. Patients reported strongly favorable responses to web-based PCST and described emotional and physical benefits. They offered suggestions for adapting the approach to better fit their needs and to overcome barriers to completion. Focus groups indicated a need to familiarize healthcare providers with PCST and to address concerns about overburdening patients. Providers would recommend the program to patients they felt could benefit. They suggested applying a broad definition of cancer pain and having various types of providers help coordinate program its use with clinical care. Web-based PCST was acceptable to patients and providers. Our findings suggest

  17. A qualitative study of diverse providers' behaviour in response to commissioners, patients and innovators in England: research protocol.

    Science.gov (United States)

    Sheaff, Rod; Halliday, Joyce; Exworthy, Mark; Allen, Pauline; Mannion, Russell; Asthana, Sheena; Gibson, Alex; Clark, Jonathan

    2016-05-13

    The variety of organisations providing National Health Service (NHS)-funded services in England is growing. Besides NHS hospitals and general practitioners (GPs), they include corporations, social enterprises, voluntary organisations and others. The degree to which these organisational types vary, however, in the ways they manage and provide services and in the outcomes for service quality, patient experience and innovation, remains unclear. This research will help those who commission NHS services select among the different types of organisation for different tasks. The main research questions are how organisationally diverse NHS-funded service providers vary in their responsiveness to patient choice, NHS commissioning and policy changes; and their patterns of innovation. We aim to assess the implications for NHS commissioning and managerial practice which follow from these differences. Systematic qualitative comparison across a purposive sample (c.12) of providers selected for maximum variety of organisational type, with qualitative studies of patient experience and choice (in the same sites). We focus is on NHS services heavily used by older people at high risk of hospital admission: community health services; out-of-hours primary care; and secondary care (planned orthopaedics or ophthalmology). The expected outputs will be evidence-based schemas showing how patterns of service development and delivery typically vary between different organisational types of provider. We will ensure informants' organisational and individual anonymity when dealing with high profile case studies and a competitive health economy. The frail elderly is a key demographic sector with significant policy and financial implications. For NHS commissioners, patients, doctors and other stakeholders, the main outcome will be better knowledge about the relative merits of different kinds of healthcare provider. Dissemination will make use of strategies suggested by patient and public

  18. An experimental study of particle-driven gravity currents on steep slopes with entrainment of particles

    Directory of Open Access Journals (Sweden)

    M. Rastello

    2002-01-01

    Full Text Available Results of laboratory experiments are presented in which a finite suspension of sawdust particles was released instantaneously into a rectangular channel immersed in a water tank. Two kinds of gravity currents were studied: currents with or without entrainment of particles from the bed. Experiments were repeated for two slopes: 30° and 45°. We observed that the velocity of the front was significantly in-creased as particle entrainment occurred. In addition, our experiments showed that the front kept a quasi-constant velocity for both runs. This might suggest that the flow regime corresponded to the "slumping regime" or "adjustment phase" described earlier by Huppert and Simpson (1980.

  19. Study on ICT specification devices compared with needs and current technologies at Nuclear Malaysia

    International Nuclear Information System (INIS)

    Mohd Fauzi Haris; Raja Murzaferi Raja Moktar; Mohd Hafez Mohd Tahir

    2012-01-01

    In line with current development of ICT, Malaysian government has planned and introduced several initiatives based on ICT strategies. In Economic Transformation Programs, these matters were mentioned in Chapter 13 entitled Communication Content and Infrastructure. In order to make these plans successful, sustainability and preparedness of ICT are required. ICT devices were not focused only on computer but also others components that supported and increased the performance of computer itself. This paper discussed on data produced from study of current ICT needs in line with technology and in future hopefully it can support all the planning made by the government. (author)

  20. The Patient-Provider Relationship Is Associated with Hepatitis C Treatment Eligibility: A Prospective Mixed-Methods Cohort Study.

    Directory of Open Access Journals (Sweden)

    Shari S Rogal

    Full Text Available Hepatitis C virus (HCV treatment has the potential to cure the leading cause of cirrhosis and hepatocellular carcinoma. However, only those deemed eligible for treatment have the possibility of this cure. Therefore, understanding the determinants of HCV treatment eligibility is critical. Given that effective communication with and trust in healthcare providers significantly influences treatment eligibility decisions in other diseases, we aimed to understand patient-provider interactions in the HCV treatment eligibility process. This prospective cohort study was conducted in the VA Pittsburgh Healthcare System. Patients were recruited after referral for gastroenterology consultation for HCV treatment with interferon and ribavirin. Consented patients completed semi-structured interviews and validated measures of depression, substance and alcohol use, and HCV knowledge. Two coders analyzed the semi-structured interviews. Factors associated with patient eligibility for interferon-based therapy were assessed using multivariate logistic regression. Of 339 subjects included in this analysis, only 56 (16.5% were deemed eligible for HCV therapy by gastroenterology (GI providers. In the multivariate logistic regression, patients who were older (OR = 0.96, 95%CI = 0.92-0.99, p = .049, reported concerns about the GI provider (OR = 0.40, 95%CI = 0.10-0.87, p = 0.02 and had depression symptoms (OR = 0.32, 95%CI = 0.17-0.63, p = 0.001 were less likely to be eligible. Patients described barriers that included feeling stigmatized and poor provider interpersonal or communication skills. In conclusion, we found that patients' perceptions of the relationship with their GI providers were associated with treatment eligibility. Establishing trust and effective communication channels between patients and providers may lower barriers to potential HCV cure.

  1. The trajectory of experience of critical care nurses in providing end-of-life care: A qualitative descriptive study.

    Science.gov (United States)

    Ong, Keh Kiong; Ting, Kit Cheng; Chow, Yeow Leng

    2018-01-01

    To understand the perceptions of critical care nurses towards providing end-of-life care. There has been an increasing interest in end-of-life care in the critical care setting. In Singapore, approximately half of deaths in the hospital occur during critical care. While nurses are well positioned to provide end-of-life care to patients and their family members, they faced barriers to providing end-of-life care. Also, providing end-of-life care has profound positive and negative psychological effects on nurses, with the latter being more prominent. Qualitative descriptive design. Data collection was performed in a medical intensive care unit of a public tertiary hospital in Singapore. Ten registered nurses were purposively sampled and interviewed individually using a semi-structured interview guide. A codebook was developed to guide coding, and data were thematically analysed. Rigour was maintained. Nurses went through a trajectory of experience. They experienced the culture of care and developed dissatisfaction with it. The tension shaped their perception and meaning of life and death, and they developed mechanisms to reach resolution. This study provides insight on nurses' perception as a trajectory of experience and raised several implications on clinical practice, policy and research. There is a need to alleviate the tension nurses face and to facilitate coming to terms with the tension by improving the culture of care and supporting nurses. Nurses could be involved more in decision-making and empowered to start end-of-life care conversations within the team and with family members. Communication with family members and between nurses and doctors could be improved. Support for nurses providing end-of-life care could be enhanced through promoting social networks, education and bereavement support. Further research is needed to explore ways to support and empower nurses to provide end-of-life care in critical care. © 2017 John Wiley & Sons Ltd.

  2. Insights Into Care Providers' Understandings of Life Story Work With Persons With Dementia: Findings From a Qualitative Study.

    Science.gov (United States)

    Berendonk, Charlotte; Caine, Vera

    2017-08-01

    In Germany, life story work, an approach which acknowledges humans as narrative beings and honors biographies, is required by health authorities to be integrated in care provided in nursing homes. Insufficient attention to life story work could place residents at risk of dehumanization, particularly residents with dementia, who depend on support of others to tell and make meaning of their life experiences. We conducted a qualitative study to gain insights into care providers' perceptions and practices of life story work with persons with dementia. Thirty-six care providers in 7 nursing homes participated in semistructured interviews or group discussions. We derived subjective theories (individual understandings) of care providers and higher-order concept patterns following the principles and processes of grounded theory. We found a great variation in participants' understandings of life story work. Some participants were unsure if and how life story work impacts persons with dementia. Starting points for improving the integration of life story work into practice are discussed. We conclude that care providers need a better understanding of life story work as a nursing intervention. The importance of the notion of humans as narrative beings and the multiple ways in which we story our lives as well as embody life stories needs to be further developed. Knowledge is required about the practical and systemic challenges of integrating life story work in the care of persons with dementia.

  3. Quality of Care in Contraceptive Services Provided to Young People in Two Ugandan Districts: A Simulated Client Study

    Science.gov (United States)

    Nalwadda, Gorrette; Tumwesigye, Nazarius M.; Faxelid, Elisabeth; Byamugisha, Josaphat; Mirembe, Florence

    2011-01-01

    Background Low and inconsistent use of contraceptives by young people contributes to unintended pregnancies. This study assessed quality of contraceptive services for young people aged 15–24 in two rural districts in Uganda. Methods Five female and two male simulated clients (SCs) interacted with 128 providers at public, private not-for-profit (PNFP), and private for profit (PFP) health facilities. After consultations, SCs were interviewed using a structured questionnaire. Six aspects of quality of care (client's needs, choice of contraceptive methods, information given to users, client-provider interpersonal relations, constellation of services, and continuity mechanisms) were assessed. Descriptive statistics and factor analysis were performed. Results Means and categorized quality scores for all aspects of quality were low in both public and private facilities. The lowest quality scores were observed in PFP, and medium scores in PNFP facilities. The choice of contraceptive methods and interpersonal relations quality scores were slightly higher in public facilities. Needs assessment scores were highest in PNFP facilities. All facilities were classified as having low scores for appropriate constellation of services. Information given to users was suboptimal and providers promoted specific contraceptive methods. Minority of providers offered preferred method of choice and showed respect for privacy. Conclusions The quality of contraceptive services provided to young people was low. Concurrent quality improvements and strengthening of health systems are needed. PMID:22132168

  4. A study on socio-demographic profile and feasibility of DOTS provider registered under RNTCP in Varanasi district Uttar Pradesh

    Directory of Open Access Journals (Sweden)

    Mohd. Afzalul Haque

    2014-03-01

    Full Text Available Introduction: Tuberculosis is a major chronic disorder affecting the larger population more than any other disease in the country. DOTS was introduced in India in 1993 as part of the Revised National Tuberculosis Programme (RNTCP following a review of India’s National Tuberculosis Programme (NTP a year earlier (1 .Patient satisfaction is an important parameter for assessing the quality of patient care services. There is need to assess the health care provider regarding the consumer satisfaction as often as possible, this paper summarizes our experience about role of DOTS provider in the management of TB patient in rural population of Varanasi districts Utter Pradesh. Objective: (1 To assess the perception of registered tuberculosis patients regarding DOTS provider for the treatment of tuberculosis. (2 To assess the accessibility, acceptability & availability of community DOTS provider. Design: A longitudinal study. Setting: Three microscopic centre of Cholapur Tuberculosis unit of Varanasi districts. Methods: Registered patients were interviewed twice: once in the beginning and another at the completion of the treatment or after the permanent discontinuation of the treatment. Patients were interviewed for their socio-demographic profiles, opinion about DOTS and its providers. Side effects experienced and action taken etc. Data was collected on a semi-structured, pre-tested questionnaire. DOTS providers were interviewed and treatment cards analyzed for any interruption of treatment and action taken. Data was collected from 1st June 2004 to 31th June 2005 till the completion of the regimen. Results: Majority of DOTS providers were young males (82.7% of 26 years to 40 years, while the representation of females was only 5 (17.3%. Almost more than 80% of the patients started their treatment within 1-10 days. For majority of cases (83% the distance of DOTS provider from patient’s house was within 1 km. Mean time spent to go to DOTS provider was 27

  5. Longitudinal study of spatially heterogeneous emphysema progression in current smokers with chronic obstructive pulmonary disease.

    Directory of Open Access Journals (Sweden)

    Naoya Tanabe

    Full Text Available BACKGROUND: Cigarette smoke is the main risk factor for emphysema, which is a key pathology in chronic obstructive pulmonary disease (COPD. Low attenuation areas (LAA in computed tomography (CT images reflect emphysema, and the cumulative size distribution of LAA clusters follows a power law characterized by the exponent D. This property of LAA clusters can be explained by model simulation, where mechanical force breaks alveolar walls causing local heterogeneous lung tissue destruction. However, a longitudinal CT study has not investigated whether continuous smoking causes the spatially heterogeneous progression of emphysema. METHODS: We measured annual changes in ratios of LAA (LAA%, D and numbers of LAA clusters (LAN in CT images acquired at intervals of ≥ 3 years from 22 current and 31 former smokers with COPD to assess emphysema progression. We constructed model simulations using CT images to morphologically interpret changes in current smokers. RESULTS: D was decreased in current and former smokers, whereas LAA% and LAN were increased only in current smokers. The annual changes in LAA%, D, and LAN were greater in current, than in former smokers (1.03 vs. 0.37%, p=0.008; -0.045 vs. -0.01, p=0.004; 13.9 vs. 1.1, p=0.007, respectively. When LAA% increased in model simulations, the coalescence of neighboring LAA clusters decreased D, but the combination of changes in D and LAN in current smokers could not be explained by the homogeneous emphysema progression model despite cluster coalescence. Conversely, a model in which LAAs heterogeneously increased and LAA clusters merged somewhat in relatively advanced emphysematous regions could reflect actual changes. CONCLUSIONS: Susceptibility to parenchymal destruction induced by continuous smoking is not uniform over the lung, but might be higher in local regions of relatively advanced emphysema. These could result in the spatially heterogeneous progression of emphysema in current smokers.

  6. Study of Security Attributes of Smart Grid Systems- Current Cyber Security Issues

    Energy Technology Data Exchange (ETDEWEB)

    Wayne F. Boyer; Scott A. McBride

    2009-04-01

    This document provides information for a report to congress on Smart Grid security as required by Section 1309 of Title XIII of the Energy Independence and Security Act of 2007. The security of any future Smart Grid is dependent on successfully addressing the cyber security issues associated with the nation’s current power grid. Smart Grid will utilize numerous legacy systems and technologies that are currently installed. Therefore, known vulnerabilities in these legacy systems must be remediated and associated risks mitigated in order to increase the security and success of the Smart Grid. The implementation of Smart Grid will include the deployment of many new technologies and multiple communication infrastructures. This report describes the main technologies that support Smart Grid and summarizes the status of implementation into the existing U.S. electrical infrastructure.

  7. Perspectives on Research Participation and Facilitation Among Dialysis Patients, Clinic Personnel, and Medical Providers: A Focus Group Study.

    Science.gov (United States)

    Flythe, Jennifer E; Narendra, Julia H; Dorough, Adeline; Oberlander, Jonathan; Ordish, Antoinette; Wilkie, Caroline; Dember, Laura M

    2017-12-19

    Most prospective studies involving individuals receiving maintenance dialysis have been small, and many have had poor clinical translatability. Research relevance can be enhanced through stakeholder engagement. However, little is known about dialysis clinic stakeholders' perceptions of research participation and facilitation. The objective of this study was to characterize the perspectives of dialysis clinic stakeholders (patients, clinic personnel, and medical providers) on: (1) research participation by patients and (2) research facilitation by clinic personnel and medical providers. We also sought to elucidate stakeholder preferences for research communication. Qualitative study. 7 focus groups (59 participants: 8 clinic managers, 14 nurses/patient care technicians, 8 social workers/dietitians, 11 nephrologists/advanced practice providers, and 18 patients/care partners) from 7 North Carolina dialysis clinics. Clinics and participants were purposively sampled. Focus groups were recorded and transcribed. Thematic analysis. We identified 11 themes that captured barriers to and facilitators of research participation by patients and research facilitation by clinic personnel and medical providers. We collapsed these themes into 4 categories to create an organizational framework for considering stakeholder (narrow research understanding, competing personal priorities, and low patient literacy and education levels), relationship (trust, buy-in, and altruistic motivations), research design (convenience, follow-up, and patient incentives), and dialysis clinic (professional demands, teamwork, and communication) aspects that may affect stakeholder interest in participating in or facilitating research. These themes appear to shape the degree of research readiness of a dialysis clinic environment. Participants preferred short research communications delivered in multiple formats. Potential selection bias and inclusion of English-speaking participants only. Our findings

  8. Reporting Multiple Individual Injuries in Studies of Team Ball Sports: A Systematic Review of Current Practice

    OpenAIRE

    Fortington, Lauren V; van der Worp, Henk; van den Akker-Scheek, Inge; Finch, Caroline F

    2017-01-01

    Background To identify and prioritise targets for injury prevention efforts, injury incidence studies are widely reported. The accuracy and consistency in calculation and reporting of injury incidence is crucial. Many individuals experience more than one injury but multiple injuries are not consistently reported in sport injury incidence studies. Objective The aim of this systematic review was to evaluate current practice of how multiple injuries within individuals have been defined and repor...

  9. A Qualitative Study Examining Young Adults' Experiences of Disclosure and Nondisclosure of LGBTQ Identity to Health Care Providers.

    Science.gov (United States)

    Rossman, Kinton; Salamanca, Paul; Macapagal, Kathryn

    2017-01-01

    Shifting cultural attitudes and legislation have increased focus on the health care needs of lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients. However, patient nondisclosure of LGBTQ identity creates a barrier to accessing care. This qualitative study examined a diverse sample of LGBTQ young adults and their experiences of disclosure and nondisclosure to medical providers. Participants (n = 206, age range 18-27) completed questionnaires assessing health care access and use as part of a larger study. Participants' responses to open-ended items asking about experiences of LGBTQ identity disclosure to medical providers and reasons for nondisclosure were analyzed thematically. Results revealed intra- and interpersonal factors related to patient disclosure and nondisclosure of LGBTQ identity. Reasons for participant nondisclosure included providers not asking about identity, internalized stigma, and belief that health and LGBTQ identity are not related. When participants did disclose, they experienced reactions ranging from discrimination and disbelief to affirmation and respect. Findings confirm and extend previous research on young adults' identity disclosure and provide avenues for health professionals' continuing education when working with LGBTQ patients.

  10. Cultural acceptance of robotic telestroke medicine among patients and healthcare providers in Saudi Arabia. Results of a pilot study.

    Science.gov (United States)

    Al-Khathaami, Ali M; Alshahrani, Saeed M; Kojan, Suleiman M; Al-Jumah, Mohammed A; Alamry, Ahmed A; El-Metwally, Ashraf A

    2015-01-01

    To determine the degree of satisfaction and acceptance of stroke patients, their relatives, and healthcare providers toward using telestroke technology in Saudi Arabia. A cross-sectional study was conducted between October and December 2012 at King Abdulaziz Medical City, Ministry of National Guard Affairs, Riyadh, Saudi Arabia. The Remote Presence Robot (RPR), the RP-7i (FDA- cleared) provided by InTouch Health was used in the study. Patients and their relatives were informed that the physician would appear through a screen on top of a robotic device, as part of their clinical care. Stroke patients admitted through the emergency department, and their relatives, as well as healthcare providers completed a self-administered satisfaction questionnaire following the telestroke consultation sessions. Fifty participants completed the questionnaire. Most subjects agreed that the remote consultant interview was useful and that the audiovisual component of the intervention was of high quality; 98% agreed that they did not feel shy or embarrassed during the remote interview, were able to understand the instruction of the consultant, and recommended its use in stroke management. Furthermore, 92% agreed or strongly agreed that the use of this technology can efficiently replace the physical presence of a neurologist. Results suggest that the use of telestroke medicine is culturally acceptable among stroke patients and their families in Saudi Arabia and favorably received by healthcare providers.

  11. Strategic logistics service provider selection influenced by relationships, cost and market dynamics - a multi-factorial case study

    DEFF Research Database (Denmark)

    Tambo, Torben

    2012-01-01

    Selection of logistics service providers (LSPs) is regarded critical and complex. Relationships tend to last for many years and have a critical role in the architecting of supply chains. Occasionally, relationships between buyer and LSP come to a crossroad of termination, extension or change......; attrition of relationships can be caused by poor quality, changed market conditions, changed management, changed operational conditions on either side, and moves from competitors. This study uses a case-based methodology to provide an in-depth account of business motivations in relationship development...... in LSP selection. The study presents a tendering process as a fulcrum of "non-conformant‟ behaviour and unexpected outcome. Major findings are that contract-bound services and cost structures seem to drift into less transparent and informal patterns of interactions over time; this is wearing...

  12. Navy Speciality Physician Study: Historical Overview, Retention Analysis, and Synopsis of Current Civilian-Sector Practices

    National Research Council Canada - National Science Library

    Christensen, Eric

    2002-01-01

    .... The objective of the study was to further explore retention of Navy physicians, by identifying and tracking critical indicators of Navy physician retention, to provide BUMED information for improving...

  13. Coping and compromise: a qualitative study of how primary health care providers respond to health reform in China.

    Science.gov (United States)

    Zhang, Mingji; Wang, Wei; Millar, Ross; Li, Guohong; Yan, Fei

    2017-08-04

    Health reform in China since 2009 has emphasized basic public health services to enhance the function of Community Health Services as a primary health care facility. A variety of studies have documented these efforts, and the challenges these have faced, yet up to now the experience of primary health care (PHC) providers in terms of how they have coped with these changes remains underdeveloped. Despite the abundant literature on psychological coping processes and mechanisms, the application of coping research within the context of human resources for health remains yet to be explored. This research aims to understand how PHC providers coped with the new primary health care model and the job characteristics brought about by these changes. Semi-structured interviews with primary health care workers were conducted in Jinan city of Shandong province in China. A maximum variation sampling method selected 30 PHC providers from different specialties. Thematic analysis was used drawing on a synthesis of theories related to the Job Demands-Resources model, work adjustment, and the model of exit, voice, loyalty and neglect to understand PHC providers' coping strategies. Our interviews identified that the new model of primary health care significantly affected the nature of primary health work and triggered a range of PHC providers' coping processes. The results found that health workers perceived their job as less intensive than hospital medical work but often more trivial, characterized by heavy workload, blurred job description, unsatisfactory income, and a lack of professional development. However, close relationship with community and low work pressure were satisfactory. PHC providers' processing of job demands and resources displayed two ways of interaction: aggravation and alleviation. Processing of job demands and resources led to three coping strategies: exit, passive loyalty, and compromise with new roles and functions. Primary health care providers employed coping

  14. Acute care patient portals: a qualitative study of stakeholder perspectives on current practices.

    Science.gov (United States)

    Collins, Sarah A; Rozenblum, Ronen; Leung, Wai Yin; Morrison, Constance Rc; Stade, Diana L; McNally, Kelly; Bourie, Patricia Q; Massaro, Anthony; Bokser, Seth; Dwyer, Cindy; Greysen, Ryan S; Agarwal, Priyanka; Thornton, Kevin; Dalal, Anuj K

    2017-04-01

    To describe current practices and stakeholder perspectives of patient portals in the acute care setting. We aimed to: (1) identify key features, (2) recognize challenges, (3) understand current practices for design, configuration, and use, and (4) propose new directions for investigation and innovation. Mixed methods including surveys, interviews, focus groups, and site visits with stakeholders at leading academic medical centers. Thematic analyses to inform development of an explanatory model and recommendations. Site surveys were administered to 5 institutions. Thirty interviews/focus groups were conducted at 4 site visits that included a total of 84 participants. Ten themes regarding content and functionality, engagement and culture, and access and security were identified, from which an explanatory model of current practices was developed. Key features included clinical data, messaging, glossary, patient education, patient personalization and family engagement tools, and tiered displays. Four actionable recommendations were identified by group consensus. Design, development, and implementation of acute care patient portals should consider: (1) providing a single integrated experience across care settings, (2) humanizing the patient-clinician relationship via personalization tools, (3) providing equitable access, and (4) creating a clear organizational mission and strategy to achieve outcomes of interest. Portals should provide a single integrated experience across the inpatient and ambulatory settings. Core functionality includes tools that facilitate communication, personalize the patient, and deliver education to advance safe, coordinated, and dignified patient-centered care. Our findings can be used to inform a "road map" for future work related to acute care patient portals. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  15. IT Audit of IT Service Provider Using COBIT 4.1 Framework: Case Study at PT. XYZ

    Directory of Open Access Journals (Sweden)

    Muhammad Malik Hakim

    2017-11-01

    Full Text Available IT service providers often campaign for the importance of having a high level of IT maturity to its customers. However, not all IT companies have a high commitment to IT management within their own organisation. As a case study, this paper attempts to measure the IT maturity level of PT. XYZ that now is a growing IT services provider. Data collection is done by interview, document study, and direct field observation. The measurement of IT maturity level is conducted using 4 domains of COBIT 4.1 Framework, consists of Plan and Organize (PO, Deliver and Support (DS, Acquire and Implement (AI, and Monitor and Evaluate (ME. The result shows a value of 2.5 which indicates that IT maturity level is at level 2 (Repeatable but Intuitive which means low enough for companies that should have a high awareness of IT governance and commitment. This study shows that the level of IT maturity in IT service provider is not always as high as its campaign.

  16. Patient-provider interaction from the perspectives of type 2 diabetes patients in Muscat, Oman: a qualitative study

    Directory of Open Access Journals (Sweden)

    Östenson Claes-Göran

    2007-10-01

    Full Text Available Abstract Background Patients' expectations and perceptions of the medical encounter and interactions are important tools in diabetes management. Some problems regarding the interaction during encounters may be related to a lack of communication skills on the part of either the physician or the patient. This study aimed at exploring the perceptions of type 2 diabetes patients regarding the medical encounters and quality of interactions with their primary health-care providers. Methods Four focus group discussions (two women and two men groups were conducted among 27 purposively selected patients (13 men and 14 women from six primary health-care centres in Muscat, Oman. Qualitative content analysis was applied. Results The patients identified some weaknesses regarding the patient-provider communication like: unfriendly welcoming; interrupted consultation privacy; poor attention and eye contact; lack of encouraging the patients to ask questions on the providers' side; and inability to participate in medical dialogue or express concerns on the patients' side. Other barriers and difficulties related to issues of patient-centeredness, organization of diabetes clinics, health education and professional competency regarding diabetes care were also identified. Conclusion The diabetes patients' experiences with the primary health-care providers showed dissatisfaction with the services. We suggest appropriate training for health-care providers with regard to diabetes care and developing of communication skills with emphasis on a patient-centred approach. An efficient use of available resources in diabetes clinics and distributing responsibilities between team members in close collaboration with patients and their families seems necessary. Further exploration of the providers' work situation and barriers to good interaction is needed. Our findings can help the policy makers in Oman, and countries with similar health systems, to improve the quality and

  17. Attitudes, beliefs, and perceptions of caregivers and rehabilitation providers about disabled children's sleep health: a qualitative study.

    Science.gov (United States)

    Chen, Xiaoli; Gelaye, Bizu; Velez, Juan Carlos; Pepper, Micah; Gorman, Sara; Barbosa, Clarita; Zafonte, Ross D; Redline, Susan; Williams, Michelle A

    2014-10-01

    Children with disabilities are more likely to have sleep disturbances than children without disabilities. Identifying attitudes, beliefs, knowledge, and perceptions of caregivers and health professionals is essential in developing effective intervention programs to improve disabled children's sleep health. However, no such qualitative data about adults who have key roles in the life and daytime activities of children with disabilities are available. This qualitative study aimed to understand attitudes, beliefs, knowledge, and perceptions about disabled children's sleep hygiene among caregivers and rehabilitation providers of children with disabilities. Twenty seven adults, including nine primary caregivers and eighteen rehabilitation providers, participated in five focus group discussions between September and December 2012 at the Rehabilitation Center in Punta Arenas, Chile. A trained facilitator guided focus group discussions using a semi-structured script. Audiotapes and transcripts of focus group discussions were reviewed and analyzed for recurrent themes. Participants identified seven themes related to children's sleep hygiene: lifestyle behaviors, family factors, children's disabilities and/or comorbidities, environmental factors, adults' responsibilities for children's sleep, perception of good sleep, and parental distress about children's sleep problems. While both caregivers and rehabilitation providers recognized the importance of sleep for children's health and functioning, they differed in their understanding of how sleep hygiene practices influence sleep. Rehabilitation providers recognized the negative influence of electronics on sleep and the positive influence of sleep routines. In contrast, caregivers reported use of television/movie watching and stimulants as coping strategies for managing children's sleep problems. Caregivers may benefit from better understanding the influence of electronics and stimulant use on child sleep health. Rehabilitation

  18. Studies of Current Induced Magnetization reversal and generation of GHz radiation in magnetic nanopillars

    Science.gov (United States)

    Alhajdarwish, Mustafa Yousef

    This thesis describes studies of two phenomena: Current-Induced Magnetization Switching (CIMS), and Current-Induced Generation of GHz Radiation. The CIMS part contains results of measurements of current-perpendicular-to-plane (CPP) magnetoresistance (MR) and CIMS behavior on Ferromagnetic/Nonmetal/Ferromagnetic (F1/N/F2) nanopillars. Judicious combinations of F1 and F2 metals with different bulk scattering asymmetries, and with F1/N and N/F2 interfaces having different interfacial scattering asymmetries, are shown to be able to controllably, and independently, 'invert' both the CPP-MR and the CIMS. In 'normal' CPP-MR, R(AP) > R(P), where R(AP) and R(P) are the nanopillar resistances for the anti-parallel (AP) and parallel (P) orientations of the Fi and F2 magnetic moments. In 'inverse' CPP-MR, R(P) > R(AP). In 'normal' CIMS, positive current switches the nanopillar from the P to the AP state. In 'inverse' CIMS, positive current switches the nanopillar from AP to P. All four possible combinations of CPP-MR and CIMS---(a) 'normal'-'normal', (b) 'normal'- 'inverse', 'inverse'-'normal', and (d) 'inverse'-'inverse' are shown and explained. These results rule out the self-Oersted field as the switching source, since the direction of that field is independent of the bulk or interfacial scattering asymmetries. Successful use of impurities to reverse the bulk scattering asymmetry shows the importance of scattering off of impurities within the bulk F1 and F2 metals---i.e. that the transport must be treated as 'diffusive' rather than 'ballistic'. The GHz studies consist of five parts: (1) designing a sample geometry that allows reliable measurements; (2) making nanopillar samples with this geometry; (3) constructing a system for measuring frequencies up to 12 GHz and measuring current-driven GHz radiation data with it; (4) showing 'scaling' behavior of GHz data with the critical fields and currents for nominally identical (but actually slightly different) samples, and

  19. Development and early experience from an intervention to facilitate teamwork between general practices and allied health providers: the Team-link study.

    Science.gov (United States)

    Harris, Mark F; Chan, Bibiana C; Daniel, Christopher; Wan, Qing; Zwar, Nick; Davies, Gawaine Powell

    2010-04-27

    This paper describes the development and implementation of an intervention to facilitate teamwork between general practice and outside allied and community health services and providers. A review of organizational theory and a qualitative study of 9 practices was used to design an intervention which was applied in four Divisions of General Practice and 26 urban practices. Clinical record review and qualitative interviews with participants were used to determine the key lessons from its implementation. Facilitating teamwork across organizational boundaries was very challenging. The quality of the relationship between professionals was of key importance. This was enabled by joint education and direct communication between providers. Practice nurses were key links between general practices and allied and community health services. Current arrangements for Team Care planning provide increased opportunities for access to allied health. However the current paper based system is insufficient to build relationships or effectively share roles as part of a patient care team. Facilitation is feasible but constrained by barriers to communication and trust.

  20. Studying the effects of classic hallucinogens in the treatment of alcoholism: rationale, methodology, and current research with psilocybin.

    Science.gov (United States)

    Bogenschutz, Michael P

    2013-03-01

    Recent developments in the study of classic hallucinogens, combined with a re-appraisal of the older literature, have led to a renewal of interest in possible therapeutic applications for these drugs, notably their application in the treatment of addictions. This article will first provide a brief review of the research literature providing direct and indirect support for the possible therapeutic effects of classic hallucinogens such as psilocybin and lysergic acid diethylamide (LSD) in the treatment of addictions. Having provided a rationale for clinical investigation in this area, we discuss design issues in clinical trials using classic hallucinogens, some of which are unique to this class of drug. We then discuss the current status of this field of research and design considerations in future randomized trials.

  1. Studies of Polar Current Systems Using the IMS Scandinavian Magnetometer Array

    Science.gov (United States)

    Untiedt, J.; Baumjohann, W.

    1993-09-01

    As a contribution to the International Magnetospheric Study (IMS, 1976 1979) a two-dimensional array of 42 temporary magnetometer stations was run in Scandinavia, supplementary to the permanent observatories and concentrated in the northern part of the region. This effort aimed at the time-dependent (periods above about 100 s) determination of the two-dimensional structure of substorm-related magnetic fields at the Earth's surface with highest reasonable spatial resolution (about 100 km, corresponding to the height of the ionosphere) near the footpoints of field-aligned electric currents that couple the disturbed magnetosphere to the ionosphere at auroral latitudes. It has been of particular advantage for cooperative studies that not only simultaneous data were available from all-sky cameras, riometers, balloons, rockets, and satellites, but also from the STARE radar facility yielding colocated two-dimensional ionospheric electric field distributions. In many cases it therefore was possible to infer the three-dimensional regional structure of substorm-related ionospheric current systems. The first part of this review outlines the basic relationships and methods that have been used or have been developed for such studies. The second short part presents typical equivalent current patterns observed by the magnetometer array in the course of substorms. Finally we review main results of studies that have been based on the magnetometer array observations and on additional data, omitting studies on geomagnetic pulsations. These studies contributed to a clarification of the nature of auroral electrojets including the Harang discontinuity and of ionospheric current systems related to auroral features such as the break-up at midnight, the westward traveling surge, eastward drifting omega bands, and spirals.

  2. A Comparative Study of Current and Potential Users of Mobile Payment Services

    Directory of Open Access Journals (Sweden)

    Chanchai Phonthanukitithaworn

    2016-11-01

    Full Text Available Previous studies of mobile payment (m-payment services have primarily focused on a single group of adopters. This study identifies the factors that influence an individual’s intention to use m-payment services and compares groups of current users (adopters with potential users (non-adopters. A research model that reflects the behavioral intention to use m-payment services is developed and empirically tested using structural equation modeling on a data set consisting of 529 potential users and 256 current users of m-payment services in Thailand. The results show that the factors that influence current users’ intentions to use m-payment services are compatibility, subjective norms, perceived trust, and perceived cost. Subjective norms, compatibility, ease of use, and perceived risk influenced potential users’ intentions to use m-payment. Subjective norms and perceived risk had a stronger influence on potential users, while perceived cost had a stronger influence on current users, in terms of their intentions to use m-payment services. Discussions, limitations, and recommendations for future research are addressed.

  3. The paradox of compassionate work: a mixed-methods study of satisfying and fatiguing experiences of animal health care providers.

    Science.gov (United States)

    Polachek, Alicia J; Wallace, Jean E

    2018-03-01

    Compassionate work appears paradoxical as it may provide great rewards, but may also come at great costs to care providers. This paper explores the paradox of compassionate work by examining what interactions contribute to compassion satisfaction and what interactions contribute to compassion fatigue. This mixed-methods, cross-sectional study uses qualitative interview data from animal health care providers (N = 20) to identify work interactions that they find satisfying or stressful. Quantitative survey data (N = 572) are used to test hypotheses generated from the interviews regarding predictors of compassion satisfaction and compassion fatigue. Interview transcripts were analyzed using a directed content analysis approach. Survey data were analyzed using ordinary least squares regression. The results highlight the complex nature of compassionate work. As hypothesized, making a difference to animals and building relationships with animal patients and human clients relate to greater compassion satisfaction. Human client barriers to animal care and witnessing client grief relate to greater compassion fatigue, as predicted. None of the predictors relate to less compassion fatigue, but forming relationships with animal patients relates to both greater compassion satisfaction and compassion fatigue. This paper enhances our understanding of provider-client-patient interactions and highlights the paradox of compassionate work.

  4. A study of three-dimensional gravity currents on a uniform slope

    Science.gov (United States)

    Ross, Andrew N.; Linden, P. F.; Dalziel, Stuart B.

    2002-02-01

    In many geophysical, environmental and industrial situations, a finite volume of fluid with a density different to the ambient is released on a sloping boundary. This leads to the formation of a gravity current travelling up, down and across the slope. We present novel laboratory experiments in which the dense fluid spreads both down-slope (and initially up-slope) and laterally across the slope. The position, shape and dilution of the current are determined through video and conductivity measurements for moderate slopes (5° to 20°). The entrainment coefficient for different slopes is calculated from the experimental results and is found to depend very little on the slope. The value agrees well with previously published values for entrainment into gravity currents on a horizontal surface. The experimental measurements are compared with previous shallow-water models and with a new wedge integral model developed and presented here. It is concluded that these simplified models do not capture all the significant features of the flow. In the models, the current takes the form of a wedge which travels down the slope, but the experiments show the formation of a more complicated current. It is found that the wedge integral model over-predicts the length and width of the gravity current but gives fair agreement with the measured densities in the head. The initial stages of the flow, during which time the wedge shape develops, are studied. It is found that although the influence of the slope is seen relatively quickly for moderate slopes, the time taken for the wedge to develop is much longer. The implications of these findings for safety analysis are briefly discussed.

  5. Theoretical study of electronic transfer current rate at dye-sensitized solar cells

    Science.gov (United States)

    AL-Agealy, Hadi J. M.; AlMaadhede, Taif Saad; Hassooni, Mohsin A.; Sadoon, Abbas K.; Ashweik, Ahmed M.; Mahdi, Hind Abdlmajeed; Ghadhban, Rawnaq Qays

    2018-05-01

    In this research, we present a theoretical study of electronic transfer kinetics rate in N719/TiO2 and N719/ZnO dye-sensitized solar cells (DSSC) systems using a simple model depending on the postulate of quantum mechanics theory. The evaluation of the electronic transition current rate in DSSC systems are function of many parameters such that; the reorientation transition energies ΛSe m D y e , the transition coupling parameter ℂT(0), potential exponential effect e-(E/C-EF ) kBT , unit cell volume VSem, and temperature T. Furthermore, the analysis of electronic transfer current rate in N719/TiO2 and N719/ZnO systems show that the rate upon dye-sensitization solar cell increases with increases of transition coupling parameter, decreasing potential that building at interface a results of different material in this devices and increasing with reorientation transition energy. On the other hand, we can find the electronic transfer behavior is dependent of the dye absorption spectrum and mainly depending on the reorientation of transition energy. The replacement of the solvents in both DSSC system caused increasing of current rates dramatically depending on polarity of solvent in subset devices. This change in current rate of electron transfer were attributed to much more available of recombination sites introduced by the solvents medium. The electronic transfer current dynamics are shown to occurs in N719/TiO2 system faster many time compare to ocuures at N719/ZnO system, this indicate that TiO2 a is a good and active material compare with ZnO to using in dye sensitized solar cell devices. In contrast, the large current rate in N719/TiO2 comparing to ZnO of N719/ZnO systems indicate that using TiO2 with N719 dye lead to increasing the efficiency of DSSC.

  6. Steam generator automated eddy current data analysis: A benchmarking study. Final report

    International Nuclear Information System (INIS)

    Brown, S.D.

    1998-12-01

    The eddy current examination of steam generator tubes is a very demanding process. Challenges include: complex signal analysis, massive amount of data to be reviewed quickly with extreme precision and accuracy, shortages of data analysts during peak periods, and the desire to reduce examination costs. One method to address these challenges is by incorporating automation into the data analysis process. Specific advantages, which automated data analysis has the potential to provide, include the ability to analyze data more quickly, consistently and accurately than can be performed manually. Also, automated data analysis can potentially perform the data analysis function with significantly smaller levels of analyst staffing. Despite the clear advantages that an automated data analysis system has the potential to provide, no automated system has been produced and qualified that can perform all of the functions that utility engineers demand. This report investigates the current status of automated data analysis, both at the commercial and developmental level. A summary of the various commercial and developmental data analysis systems is provided which includes the signal processing methodologies used and, where available, the performance data obtained for each system. Also, included in this report is input from seventeen research organizations regarding the actions required and obstacles to be overcome in order to bring automatic data analysis from the laboratory into the field environment. In order to provide assistance with ongoing and future research efforts in the automated data analysis arena, the most promising approaches to signal processing are described in this report. These approaches include: wavelet applications, pattern recognition, template matching, expert systems, artificial neural networks, fuzzy logic, case based reasoning and genetic algorithms. Utility engineers and NDE researchers can use this information to assist in developing automated data

  7. Brief report on the effect of providing single versus assorted brand name condoms to hospital patients: a descriptive study

    Directory of Open Access Journals (Sweden)

    Cagle Henry H

    2001-06-01

    Full Text Available Abstract Objectives This study examined condom acquisition by persons in a hospital setting when single versus assorted brand name condoms were provided. Methods Condom receptacles were placed in exam rooms of two clinics. During Phase 1, a single brand name was provided; for Phase 2, assorted brand names were added. Number of condoms taken was recorded for each phase. Results For one clinic there was nearly a two-fold increase in number of condoms taken (Phase 1 to Phase 2; for the second clinic there was negligible difference in number of condoms taken. Conclusions The provision of assorted brand name condoms, over a single brand name, can serve to increase condom acquisition. Locations of condoms and target population characteristics are related factors.

  8. Translating knowledge into practice: An exploratory study of dementia-specific training for community-based service providers.

    Science.gov (United States)

    O'Sullivan, Grace; Hocking, Clare; McPherson, Kathryn

    2017-08-01

    Objective To develop, deliver, and evaluate dementia-specific training designed to inform service delivery by enhancing the knowledge of community-based service providers. Methods This exploratory qualitative study used an interdisciplinary, interuniversity team approach to develop and deliver dementia-specific training. Participants included management, care staff, and clients from three organizations funded to provide services in the community. Data on the acceptability, applicability, and perceived outcomes of the training were gathered through focus group discussions and individual interviews. Transcripts were analyzed to generate open codes which were clustered into themes and sub-themes addressing the content, delivery, and value of the training. Findings Staff valued up-to-date knowledge and "real stories" grounded in practice. Clients welcomed the strengths-based approach. Contractual obligations impact on the application of knowledge in practice. Implications The capacity to implement new knowledge may be limited by the legislative policies which frame service provision, to the detriment of service users.

  9. Current status of regional hydrogeological studies and numerical simulations on geological disposal

    International Nuclear Information System (INIS)

    Nakao, Shinsuke; Kikuchi, Tsuneo; Ishido, Tsuneo

    2004-01-01

    Current status of regional hydrogeological studies on geological disposal including hydrogeological modeling using numerical simulators is reviewed in this report. A regional scale and boundary conditions of numerical models are summarized mainly from the results of the RHS (regional hydrogeological study) project conducted by Japan Nuclear Cycle Development Institute (JNC) in the Tono area. We also refer to the current conceptual modes of hydrology and numerical models of unsaturated zone flow at Yucca Mountain, Nevada, which is the arid site proposed for consideration as the United States' first underground high-level radioactive waste repository. Understanding behavior of a freshwater-saltwater transition zone seems to play a key role in the hydrogeological modeling in a coastal region. Technical features of a numerical simulator as a tool for geothermal reservoir modeling is also briefly described. (author)

  10. Attitudes and perceptions among the pediatric health care providers toward influenza vaccination in Qatar: A cross-sectional study.

    Science.gov (United States)

    Alhammadi, Ahmed; Khalifa, Mohamed; Abdulrahman, Hatem; Almuslemani, Eman; Alhothi, Abdullah; Janahi, Mohamed

    2015-07-31

    Influenza is a communicable but preventable viral illness. Despite safe and effective vaccine availability, compliance rates are globally low. Neither local data on percentage of vaccination nor reasons for poor compliance among pediatric health providers are available in Qatar. To estimate the percentage of vaccinated health care providers at pediatrics department and know their perception and attitudes toward influenza vaccinations. Cross-sectional survey, conducted on 300 pediatrics healthcare professionals from January through April 2013 at the main tertiary teaching hospital in Qatar, included details of demographics, frequency, perceptions and suggestive ways to improve the compliance. From among 230 respondents, 90 physicians and 133 allied health care professionals participated in this survey. Our study showed that percentages of participants who received flu vaccination were 67.7% and those who did not receive vaccination were 32.3%. Allied HCPs (69%) are more likely to get the vaccine compared to the physicians (66%). flu vaccination was approximately 5 times likely to be higher in the age group more than 40 years (P=0.002) compared to age less than or equals 40 years. Overall 70% healthcare providers were willing to recommend immunization to colleagues and patients compared to 30%, who were not willing. The reasons for noncompliance included fear of side effects, contracting the flu, vaccine safety and lack of awareness about the effectiveness. In order to promote immunization, participants believe that use of evidence-based statement, participating in an educational campaign, provides no cost/on site campaigns and leadership support is the most practical interventions. In the present study, the vaccine coverage among pediatrics HCPs seems higher than previously reported rates. Despite their positive attitude toward influenza vaccination, low acceptance and misconceptions of seasonal influenza vaccination by pediatric HCPs may have a negative effect on

  11. Determinants of satisfaction with health care provider interactions at health centres in central Ethiopia: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Woldie Mirkuzie

    2010-03-01

    Full Text Available Abstract Background In primary health care, provider-patient interaction is fundamental platform and critically affects service delivery. Nevertheless, it is often ignored in medical research and practice and it is infrequently subjected to scientific inquiry, particularly in Ethiopia. This study aimed to assess patient satisfaction with health care provider interactions and its influencing factors among out-patients at health centers in West Shoa, Central Ethiopia. Methods A cross sectional facility based study was conducted on 768 out-patients of six health centers in West Shoa Zone, Central Ethiopia. The total sample size was allocated to each of the six health centers based on patient flow during the ten days prior to the start of data collection. Pre-tested instruments were used for data collection and the data were analyzed using SPSS version 16.0 statistical software. Factor score was computed for the items identified to represent the satisfaction scale by varimax rotation method. Using this regression factor score, multivariate linear regression analysis was performed and the effect of independent variables on the regression factor score was quantified. Results Seventy three percent of the respondents perceived that provider's empathy was good and 35% complained that providers were not technically competent enough. In addition, 82% of the respondents rated non-verbal communication by the providers to be good, very good or excellent on a five-point ordinal scale. Regardless of the process, only 34.1% of the patients implied that the consultations made a difference in understanding their illness and coping with it. Generally speaking, 62.6% of the patients reported that they have been satisfied with their visit. Perceived empathy, perceived technical competency, non-verbal communication, patient enablement, being told the name of once illness, type and frequency of visit, knowing the providers and educational status were main independent

  12. Transcranial direct current stimulation in refractory continuous spikes and waves during slow sleep: a controlled study

    DEFF Research Database (Denmark)

    Varga, Edina T; Terney, Daniella; Atkins, Mary D

    2011-01-01

    Cathodal transcranial direct current stimulation (tDCS) decreases cortical excitability. The purpose of the study was to investigate whether cathodal tDCS could interrupt the continuous epileptiform activity. Five patients with focal, refractory continuous spikes and waves during slow sleep were...... recruited. Cathodal tDCS and sham stimulation were applied to the epileptic focus, before sleep (1 mA; 20 min). Cathodal tDCS did not reduce the spike-index in any of the patients....

  13. Current-mode detector for neutron time-of-flight studies

    International Nuclear Information System (INIS)

    Bowman, J.D.; Szymanski, J.J.; Yuan, V.W.; Bowman, C.D.; Silverman, A.; Zhu, X.

    1990-01-01

    A system for the detection of high-intensity neutron bursts with instantaneous rates as high as 10 11 Hz is presented. This system uses a transient digitizer to sample the output voltage of a high-current photomultiplier tube as a function of time. The coutput voltage is proportional to the number of neutrons striking the detector. This detector is used at the Los Alamos Neutron Scattering Center to study fundamental symmetries. Design considerations, construction details and performance benchmarks are presented. (orig.)

  14. Simulation studies of current transport in metal-insulator-semiconductor Schottky barrier diodes

    International Nuclear Information System (INIS)

    Chand, Subhash; Bala, Saroj

    2007-01-01

    The current-voltage characteristics of Schottky diodes with an interfacial insulator layer are analysed by numerical simulation. The current-voltage data of the metal-insulator-semiconductor Schottky diode are simulated using thermionic emission diffusion (TED) equation taking into account an interfacial layer parameter. The calculated current-voltage data are fitted into ideal TED equation to see the apparent effect of interfacial layer parameters on current transport. Results obtained from the simulation studies shows that with mere presence of an interfacial layer at the metal-semiconductor interface the Schottky contact behave as an ideal diode of apparently high barrier height (BH), but with same ideality factor and series resistance as considered for a pure Schottky contact without an interfacial layer. This apparent BH decreases linearly with decreasing temperature. The effects giving rise to high ideality factor in metal-insulator-semiconductor diode are analysed. Reasons for observed temperature dependence of ideality factor in experimentally fabricated metal-insulator-semiconductor diodes are analysed and possible mechanisms are discussed

  15. Study of the nonequilibrium state of superconductors by large quasiparticle injection from an external current source

    International Nuclear Information System (INIS)

    Iguchi, I.

    1977-01-01

    We have studied the nonequilibrium state of superconductors by injecting large numbers of quasiparticles from an external current source into a superconducting film of a tunnel junction with low tunnel resistance (typically 0.1--1 Ω for junction area approx. = 10 -4 cm 2 ). It was observed that there was a critical tunnel current density at which a voltage appeared locally in the part of a superconducting film confined to the junction area. Its values ranged from 10 2 to 10 3 A/cm 2 for bath temperatures well below T/sub c/. Followed by this voltage onset, a transition region corresponding to the nonequilibrium intermediate resistive state was also observed. For further increase of the tunnel current, the local film resistance developed beyond the value of its normal resistance, suggesting that the nonequilibrium state extends far beyond the voltage onset point. A theory based on the modified Rothwarf-Taylor equations and Parker's T* model is presented to compare with the experimental results. The calculated critical current density yielded almost the same order of magnitude as those found experimentally. The detailed behavior, however, deviates from the theoretical predictions although the film makes a second-order transition in the broad range of temperatures. It is also shown using four-terminal analysis that our observations and those by Wong, Yeh, and Langenberg are essentially the same

  16. Limited agreement between current and long-term asthma control in children : the PACMAN cohort study

    NARCIS (Netherlands)

    Koster, Ellen S.; Raaijmakers, Jan A. M.; Vijverberg, Susanne J. H.; Koenderman, Leo; Postma, Dirkje S.; Koppelman, Gerard H.; van der Ent, Cornelis K.; Maitland-van der Zee, Anke-Hilse

    2011-01-01

    Background: Several studies have shown that predictors of asthma treatment outcomes differ depending on the definition of the outcome chosen. This provides evidence that different outcomes studied may reflect distinct aspects of asthma control. To assess predictors of asthma control, we need firm

  17. Collaborating with a social housing provider supports a large cohort study of the health effects of housing conditions.

    Science.gov (United States)

    Baker, Michael G; Zhang, Jane; Blakely, Tony; Crane, Julian; Saville-Smith, Kay; Howden-Chapman, Philippa

    2016-02-16

    Despite the importance of adequate, un-crowded housing as a prerequisite for good health, few large cohort studies have explored the health effects of housing conditions. The Social Housing Outcomes Worth (SHOW) Study was established to assess the relationship between housing conditions and health, particularly between household crowding and infectious diseases. This paper reports on the methods and feasibility of using a large administrative housing database for epidemiological research and the characteristics of the social housing population. This prospective open cohort study was established in 2003 in collaboration with Housing New Zealand Corporation which provides housing for approximately 5% of the population. The Study measures health outcomes using linked anonymised hospitalisation and mortality records provided by the New Zealand Ministry of Health. It was possible to match the majority (96%) of applicant and tenant household members with their National Health Index (NHI) number allowing linkage to anonymised coded data on their hospitalisations and mortality. By December 2011, the study population consisted of 11,196 applicants and 196,612 tenants. Half were less than 21 years of age. About two-thirds identified as Māori or Pacific ethnicity. Household incomes were low. Of tenant households, 44% containing one or more smokers compared with 33% for New Zealand as a whole. Exposure to household crowding, as measured by a deficit of one or more bedrooms, was common for applicants (52%) and tenants (38%) compared with New Zealanders as whole (10%). This project has shown that an administrative housing database can be used to form a large cohort population and successfully link cohort members to their health records in a way that meets confidentiality and ethical requirements. This study also confirms that social housing tenants are a highly deprived population with relatively low incomes and high levels of exposure to household crowding and environmental

  18. Collaborating with a social housing provider supports a large cohort study of the health effects of housing conditions

    Directory of Open Access Journals (Sweden)

    Michael G. Baker

    2016-02-01

    Full Text Available Abstract Background Despite the importance of adequate, un-crowded housing as a prerequisite for good health, few large cohort studies have explored the health effects of housing conditions. The Social Housing Outcomes Worth (SHOW Study was established to assess the relationship between housing conditions and health, particularly between household crowding and infectious diseases. This paper reports on the methods and feasibility of using a large administrative housing database for epidemiological research and the characteristics of the social housing population. Methods This prospective open cohort study was established in 2003 in collaboration with Housing New Zealand Corporation which provides housing for approximately 5 % of the population. The Study measures health outcomes using linked anonymised hospitalisation and mortality records provided by the New Zealand Ministry of Health. Results It was possible to match the majority (96 % of applicant and tenant household members with their National Health Index (NHI number allowing linkage to anonymised coded data on their hospitalisations and mortality. By December 2011, the study population consisted of 11,196 applicants and 196,612 tenants. Half were less than 21 years of age. About two-thirds identified as Māori or Pacific ethnicity. Household incomes were low. Of tenant households, 44 % containing one or more smokers compared with 33 % for New Zealand as a whole. Exposure to household crowding, as measured by a deficit of one or more bedrooms, was common for applicants (52 % and tenants (38 % compared with New Zealanders as whole (10 %. Conclusions This project has shown that an administrative housing database can be used to form a large cohort population and successfully link cohort members to their health records in a way that meets confidentiality and ethical requirements. This study also confirms that social housing tenants are a highly deprived population with relatively low

  19. Emerging Business Models in Education Provisioning: A Case Study on Providing Learning Support as Education-as-a-Service

    Directory of Open Access Journals (Sweden)

    Loina Prifti

    2017-09-01

    Full Text Available This study aims to give a deeper understanding on emerging business models in the context of education. Industry 4.0/the Industrial Internet in general and especially recent advances in cloud computing enable a new kind of service offering in the education sector and lead to new business models for education: Education-as-a-Service (EaaS. Within EaaS, learning, and teaching contents are delivered as services. By combining a literature review with a qualitative case study, this paper makes a three-fold contribution to the field of business models in education: First, we provide a theoretical definition for a common understanding of EaaS. Second, we present the state-of-the-art research on this new paradigm. Third, in the case study we describe a “best practices” business model of an existing EaaS provider. These insights build a theoretical foundation for further research in this area. The paper concludes with a research agenda for further research in this emerging field.

  20. How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark.

    Science.gov (United States)

    Jensen, Natasja Koitzsch; Norredam, Marie; Priebe, Stefan; Krasnik, Allan

    2013-01-28

    Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients' refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE). Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy in the health care management of refugees. The findings from this

  1. Calculation of the energy provided by a PV generator. Comparative study: Conventional methods vs. artificial neural networks

    International Nuclear Information System (INIS)

    Almonacid, F.; Rus, C.; Perez-Higueras, P.; Hontoria, L.

    2011-01-01

    The use of photovoltaics for electricity generation purposes has recorded one of the largest increases in the field of renewable energies. The energy production of a grid-connected PV system depends on various factors. In a wide sense, it is considered that the annual energy provided by a generator is directly proportional to the annual radiation incident on the plane of the generator and to the installed nominal power. However, a range of factors is influencing the expected outcome by reducing the generation of energy. The aim of this study is to compare the results of four different methods for estimating the annual energy produced by a PV generator: three of them are classical methods and the fourth one is based on an artificial neural network developed by the R and D Group for Solar and Automatic Energy at the University of Jaen. The results obtained shown that the method based on an artificial neural network provides better results than the alternative classical methods in study, mainly due to the fact that this method takes also into account some second order effects, such as low irradiance, angular and spectral effects. -- Research highlights: → It is considered that the annual energy provided by a PV generator is directly proportional to the annual radiation incident on the plane of the generator and to the installed nominal power. → A range of factors are influencing the expected outcome by reducing the generation of energy (mismatch losses, dirt and dust, Ohmic losses,.). → The aim of this study is to compare the results of four different methods for estimating the annual energy produced by a PV generator: three of them are classical methods and the fourth one is based on an artificial neural network. → The results obtained shown that the method based on an artificial neural network provides better results than the alternative classical methods in study. While classical methods have only taken into account temperature losses, the method based in

  2. Utilization of free dental health care services provided to the perinatally infected human immunodeficiency virus children in Bangalore: longitudinal study.

    Science.gov (United States)

    Parvathy, Beena Javaregowda

    2014-01-01

    Use of Highly active anti-retroviral therapy have increased the life expectancy of human immunodeficiency virus (HIV) infected patients and hence it is imperative that all efforts have to be made by Pediatric dentists to provide a better oral health for these children. The aim of this study was to evaluate the rate of utilization of free dental treatment provided to these perinatally infected HIV positive children who were previously screened as a part of oral health survey. Purposive sampling was used. Perinatally infected HIV children screened for oral health status. Patients not screened during the oral health survey. Attendance records of 319 perinatally HIV infected children consisting of 178 males and 141 females attending a specialized pediatric outpatient clinic at Indira Gandhi Institute of Child Health were examined to compare treatment compliance rates. The number of patients in the severe category who completed treatment was significantly less compared with mild and advanced categories (P 0.05). The results show that children with HIV have significantly lower compliance. Even though all dental treatment provided to them was free of the cost it still had no impetus to encourage them to go through with the treatment.

  3. What information is provided in transcripts and Medical Student Performance Records from Canadian Medical Schools? A retrospective cohort study.

    Science.gov (United States)

    Robins, Jason A; McInnes, Matthew D F; Esmail, Kaisra

    2014-01-01

    Resident selection committees must rely on information provided by medical schools in order to evaluate candidates. However, this information varies between institutions, limiting its value in comparing individuals and fairly assessing their quality. This study investigates what is included in candidates' documentation, the heterogeneity therein, as well as its objective data. Samples of recent transcripts and Medical Student Performance Records were anonymised prior to evaluation. Data were then extracted by two independent reviewers blinded to the submitting university, assessing for the presence of pre-selected criteria; disagreement was resolved through consensus. The data were subsequently analysed in multiple subgroups. Inter-rater agreement equalled 92%. Inclusion of important criteria varied by school, ranging from 22.2% inclusion to 70.4%; the mean equalled 47.4%. The frequency of specific criteria was highly variable as well. Only 17.7% of schools provided any basis for comparison of academic performance; the majority detailed only status regarding pass or fail, without any further qualification. Considerable heterogeneity exists in the information provided in official medical school documentation, as well as markedly little objective data. Standardization may be necessary in order to facilitate fair comparison of graduates from different institutions. Implementation of objective data may allow more effective intra- and inter-scholastic comparison.

  4. Exploring educational partnerships: a case study of client provider technology education partnerships in New Zealand primary schools

    Science.gov (United States)

    Weal, Brenda; Coll, Richard

    2007-04-01

    This paper explores the notion of educational partnerships and reports on research on client provider partnerships between full primary schools and external technology education providers for Year 7 and 8 New Zealand students (age range approx. 12 to 13 years). Educational reforms in New Zealand and the introduction of a more holistic technology education curriculum in 1995 changed the nature of the relationship between the technology education partners. The research sought to identify, from the perspective of the primary schools (clients), factors that contribute to successful partnerships between them and their technology education provider. A mixed methods approach consisting of a survey of client schools, in-depth interviews and a series of four in-depth case studies (drawing on issues derived from the survey) was employed. Issues relating to teacher subculture, leadership roles and inflexibility of official processes all surfaced. The research points to an absence of commitment, shared understanding, shared power, leadership, communication and accountability in many educational partnerships that were the focus of this work.

  5. The adoption of provider-based rural health clinics by rural hospitals: a study of market and institutional forces.

    Science.gov (United States)

    Krein, S L

    1999-04-01

    To examine the response of rural hospitals to various market and organizational signals by determining the factors that influence whether or not they establish a provider-based rural health clinic (RHC) (a joint Medicare/Medicaid program). Several secondary sources for 1989-1995: the AHA Annual Survey, the PPS Minimum Data Set and a list of RHCs from HCFA, the Area Resource File, and professional associations. The analysis includes all general medical/surgical rural hospitals operating in the United States during the study period. A longitudinal design and pooled cross-sectional data were used, with the rural hospital as the unit of analysis. Key variables were examined as sets and include measures of competitive pressures (e.g., hospital market share), physician resources, nurse practitioner/physician assistant (NP/PA) practice regulation, hospital performance pressures (e.g., operating margin), innovativeness, and institutional pressure (i.e., the cumulative force of adoption). Adoption of provider-based RHCs by rural hospitals appears to be motivated less as an adaptive response to observable economic or internal organizational signals than as a reaction to bandwagon pressures. Rural hospitals with limited resources may resort to imitating others because of uncertainty or a limited ability to fully evaluate strategic activities. This can result in actions or behaviors that are not consistent with policy objectives and the perceived need for policy changes. Such activity in turn could have a negative effect on some providers and some rural residents.

  6. Utilization of free dental health care services provided to the perinatally infected human immunodeficiency virus children in Bangalore: Longitudinal study

    Directory of Open Access Journals (Sweden)

    Beena Javaregowda Parvathy

    2014-01-01

    Full Text Available Background: Use of Highly active anti-retroviral therapy have increased the life expectancy of human immunodeficiency virus (HIV infected patients and hence it is imperative that all efforts have to be made by Pediatric dentists to provide a better oral health for these children. Aim: The aim of this study was to evaluate the rate of utilization of free dental treatment provided to these perinatally infected HIV positive children who were previously screened as a part of oral health survey. Design: Purposive sampling was used. Inclusion criteria: Perinatally infected HIV children screened for oral health status. Exclusion criteria: Patients not screened during the oral health survey. Materials and Methods: Attendance records of 319 perinatally HIV infected children consisting of 178 males and 141 females attending a specialized pediatric outpatient clinic at Indira Gandhi Institute of Child Health were examined to compare treatment compliance rates. Results: The number of patients in the severe category who completed treatment was significantly less compared with mild and advanced categories (P 0.05. Conclusion: The results show that children with HIV have significantly lower compliance. Even though all dental treatment provided to them was free of the cost it still had no impetus to encourage them to go through with the treatment.

  7. What information is provided in transcripts and Medical Student Performance Records from Canadian Medical Schools? A retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Jason A. Robins

    2014-09-01

    Full Text Available Background: Resident selection committees must rely on information provided by medical schools in order to evaluate candidates. However, this information varies between institutions, limiting its value in comparing individuals and fairly assessing their quality. This study investigates what is included in candidates’ documentation, the heterogeneity therein, as well as its objective data. Methods: Samples of recent transcripts and Medical Student Performance Records were anonymised prior to evaluation. Data were then extracted by two independent reviewers blinded to the submitting university, assessing for the presence of pre-selected criteria; disagreement was resolved through consensus. The data were subsequently analysed in multiple subgroups. Results: Inter-rater agreement equalled 92%. Inclusion of important criteria varied by school, ranging from 22.2% inclusion to 70.4%; the mean equalled 47.4%. The frequency of specific criteria was highly variable as well. Only 17.7% of schools provided any basis for comparison of academic performance; the majority detailed only status regarding pass or fail, without any further qualification. Conclusions: Considerable heterogeneity exists in the information provided in official medical school documentation, as well as markedly little objective data. Standardization may be necessary in order to facilitate fair comparison of graduates from different institutions. Implementation of objective data may allow more effective intra- and inter-scholastic comparison.

  8. A Snapshot Study of Current Practices among Sellers of Translation Services between Japanese and English

    Directory of Open Access Journals (Sweden)

    Dr. Stephen Crabbe

    2015-11-01

    Full Text Available A two-part study was launched in light of the Japan Translation Federation’s 2012 statement in its guide, 翻訳で失敗しないために翻訳発注の手引き [lit. For not getting it wrong with translation: a guide to ordering translation], that “外国語の文書を母国語に翻訳するのがプロの原則です” [lit. It is a fundamental principle that professional translators work into their native languages] (Japan Translation Federation, 2012, p. 15. The key goal is to gauge the extent to which this 2012 statement is reflected in current practices among the sellers and buyers of translation services between Japanese and English. In this paper, which describes the first part of the study, the focus is on the practices of sellers of translation services between Japanese and English: specifically, professional freelance translators. Twenty-four professional freelance translators completed an online questionnaire. The results of this questionnaire, first, suggest that current practices among sellers of translation services between Japanese and English are consistent with the Japan Translation Federation’s 2012 statement and, second, broadly support secondary literature on L1 translation (translation into the first language and L2 translation (translation into the second language. Whilst this is only a snapshot of current practices among sellers of translation services between Japanese and English, the overall results are informative. In the second, follow-up part of the study the focus will be on the current practices of buyers of translation services between Japanese and English.

  9. [A review of current studies on leisure activities performed by community-dwelling elders].

    Science.gov (United States)

    Li, Yueh-Ping; Chen, Ching-Huey

    2010-02-01

    This article reviewed and summarized the findings of previously published studies on the leisure activities of community elders over 55 years of age. A total of 17 related articles, published before 2008, were identified in the search of electronic databases, which included the Chinese Periodical Table of Contents Index Image System, CEPS, Medline and Ageline. Leisure activities measurements used in this study consisted of recoding activities either categorically or by frequency. The majority of research indicated that elderly engage in primarily static activities and that participation in leisure activities had positive effects on cognitive and psychological health. However, inconsistencies in results were found due to differences in measurement tools and sample populations used among studies, making it difficult to conduct a valid comparison of specific features of elderly leisure activities. Most current leisure activity studies utilize cross-sectional research methodologies with restricted topics, which result in limited applicability of research results. In conclusion, we suggest that future studies should develop instruments to assess leisure activities that correspond to local conditions identified through qualitative research. With such, researchers can study different age groups by applying relevant ageing theories to construct empirical data related to current elderly leisure activities.

  10. Diversity in eMental Health Practice: An Exploratory Qualitative Study of Aboriginal and Torres Strait Islander Service Providers.

    Science.gov (United States)

    Bird, Jennifer; Rotumah, Darlene; Bennett-Levy, James; Singer, Judy

    2017-05-29

    In Australia, mental health services are undergoing major systemic reform with eMental Health (eMH) embedded in proposed service models for all but those with severe mental illness. Aboriginal and Torres Strait Islander service providers have been targeted as a national priority for training and implementation of eMH into service delivery. Implementation studies on technology uptake in health workforces identify complex and interconnected variables that influence how individual practitioners integrate new technologies into their practice. To date there are only two implementation studies that focus on eMH and Aboriginal and Torres Strait Islander service providers. They suggest that the implementation of eMH in the context of Aboriginal and Torres Strait Islander populations may be different from the implementation of eMH with allied health professionals and mainstream health services. The objective of this study is to investigate how Aboriginal and Torres Strait Islander service providers in one regional area of Australia used eMH resources in their practice following an eMH training program and to determine what types of eMH resources they used. Individual semistructured qualitative interviews were conducted with a purposive sample of 16 Aboriginal and Torres Strait Islander service providers. Interviews were co-conducted by one indigenous and one non-indigenous interviewer. A sample of transcripts were coded and thematically analyzed by each interviewer and then peer reviewed. Consensus codes were then applied to all transcripts and themes identified. It was found that 9 of the 16 service providers were implementing eMH resources into their routine practice. The findings demonstrate that participants used eMH resources for supporting social inclusion, informing and educating, assessment, case planning and management, referral, responding to crises, and self and family care. They chose a variety of types of eMH resources to use with their clients, both culturally

  11. The Leadville Mine Drainage Tunnel Catastrophe: A Case Study of How Isotope Geochemistry Provided Forensic Evidence to Inform Policy Decisions

    Science.gov (United States)

    Williams, M. W.; Wireman, M.; Liu, F.; Gertson, J.

    2008-12-01

    A state of emergency was declared in February 2008 because of fears that a blocked drainage tunnel in the Leadville mining district of Colorado could cause a catastrophic flood. An estimated 1 billion gallons of metals-laden water poses an eminent threat to the city of Leadville and the headwaters of the Arkansas river. Within days of the declaration of a state of emergency, Governor Ritter and Senator Salazer of Colorado, along with a host of other local and statewide politicians, visited the site and emphasized the need to develop a fast yet safe mitigation plan. Here we provide information from a case study that illustrates how a suite of isotopic and hydrologic tools enables identification of critical, site-specific variables essential in developing a science plan to guide targeted remediation of the Leadville drainage tunnel. The isotopic tools, including both stable and radiogenic isotopes, provided clear and compelling evidence of water sources and flowpaths in an area that has undergone extensive perturbations, including the drilling of more than 2,000 mine shafts. This forensic evidence was the key information in developing a plan to plug the drainage tunnel several hundred feet underground, divert a major source of polluted water from reaching the collapsed tunnel and piping it to an existing treatment plant, and guidance on where to place pumps in additional mine shafts, and the drilling of new wells to pump water in case the plugging of the tunnel caused water to pool up and raise the water table to dangerous heights. This particular case of forensic hydrology using isotopic tools not only provides the scientific basis for an operational plan to defuse a life- and property-threatening situation, it also provides the basis for decommissioning an existing water treatment plant, which will result in savings of over 1 million annually in operational costs. Decommissioning the existing water treatment plant will pay for the tunnel mitigation within several

  12. The study of dynamics of electrons in the presence of large current densities

    International Nuclear Information System (INIS)

    Garcia, G.

    2007-11-01

    The runaway electron effect is considered in different fields: nuclear fusion, or the heating of the solar corona. In this thesis, we are interested in runaway electrons in the ionosphere. We consider the issue of electrons moving through an ionospheric gas of positive ions and neutrals under the influence of a parallel electric field. We develop a kinetic model of collisions including electrons/electrons, electrons/ions and electrons/neutrals collisions. We use a Fokker-Planck approach to describe binary collisions between charged particles with a long-range interaction. A computational example is given illustrating the approach to equilibrium and the impact of the different terms. Then, a static electric field is applied in a new sample run. In this run, the electrons move in the z direction, parallel to the electric field. The first results show that all the electron distribution functions are non-Maxwellian. Furthermore, runaway electrons can carry a significant part of the total current density up to 20% of the total current density. Nevertheless, we note that the divergence free of the current density is not conserved. We introduce major changes in order to take into account the variation of the different moments of the ion distribution functions. We observe that the electron distribution functions are still non-Maxwellian. Runaway electrons are created and carry the current density. The core distribution stay at rest. As these electrons undergo less collisions, they increase the plasma conductivity. We make a parametric study. We fit the electron distribution function by two Maxwellian. We show that the time to reach the maximal current density is a key point. Thus, when we increase this time, we modify the temperatures. The current density plays a primary role. When the current density increases, all the moments of the distributions increase: electron density and mean velocity of the suprathermal distribution and the electron temperature of the core and

  13. A Study of Frequency Mixing Approaches for Eddy Current Testing of Steam Generator Tubes

    International Nuclear Information System (INIS)

    Jung, Hee Jun; Song, Sung Jin; Kim, Chang Hwan; Kim, Dae Kwang

    2009-01-01

    The multifrequency eddy current testing(ECT) have been proposed various frequency mixing algorithms. In this study, we compare these approaches to frequency mixing of ECT signals from steam generator tubes; time-domain optimization, discrete cosine transform-domain optimization. Specifically, in this study, two different frequency mixing algorithms, a time-domain optimization method and a discrete cosine transform(DCT) optimization method, are investigated using the experimental signals captured from the ASME standard tube. The DCT domain optimization method is computationally fast but produces larger amount of residue.

  14. The current status of studies on mitochondrial DNA with tumor, radiation biological effects and aging

    International Nuclear Information System (INIS)

    Liu Qingjie; Sang Lu

    2004-01-01

    The mitochondrial plays a very important role in sustaining the normal physiological function, because it is the center of energy making and mitochondrial DNA (mtDNA) is the only genetic material outside the nuclear. The result of studies showed that many diseases have a close relationship with mtDNA mutation and deletion. This article reviewed the current status of research on mtDNA with tumor, radiation biological effects and aging, in order to initiate the application study of mtDNA in the circle of radiation medicine

  15. Study on practical of eddy current testing of core and core support graphite components in HTTR

    International Nuclear Information System (INIS)

    Ishihara, Masahiro; Iyoku, Tatsuo; Ooka, Norikazu; Shindo, Yoshihisa; Kawae, Hidetoshi; Hayashi, Motomitsu; Kambe, Mamoru; Takahashi, Masaaki; Ide, Akira.

    1994-01-01

    Core and core support graphite components in the HTTR (High Temperature Engineering Test Reactor) are mainly made of nuclear-grade IG-110 and PGX graphites. Nondestructive inspection with Eddy Current Testing (ECT) is planned to be applied to these components. The method of ECT has been already established for metallic components, however, cannot be applied directly to the graphite ones, because the characteristics of graphite are quite different in micro-structure from those of metals. Therefore, ECT method and condition were studied for the application of the ECT to the graphite components. This paper describes the study on practical method and conditions of ECT for above mentioned graphite structures. (author)

  16. Studies of currents and electric fields in the auroral zone ionosphere using radar auroral backscatter

    International Nuclear Information System (INIS)

    Greenwald, R.A.

    1980-01-01

    During the 1970s several advances have been made in the understanding of radar aurora. Recent VHF studies have shown that Doppler data obtained from radar auroral backscatter can be used to measure the E-region electron drift velocity, the F-region plasma velocity, and the ionospheric electric field. This type of measurement is particularly valuable when it is made with dual auroral radar systems similar to STARE (Scandinavian Twin Auroral Radar Experiment). Over the past two years STARE has been used to study electric field patterns associated with electrojet and field-aligned currents, magnetospheric convection, the Harang discontinuity, Pc5 micropulsations, and the substorm expansion phase. (Auth.)

  17. Clean delivery practices in rural northern Ghana: a qualitative study of community and provider knowledge, attitudes, and beliefs

    Directory of Open Access Journals (Sweden)

    Moyer Cheryl A

    2012-06-01

    Full Text Available Abstract Background Knowledge, attitudes and practices of community members and healthcare providers in rural northern Ghana regarding clean delivery are not well understood. This study explores hand washing/use of gloves during delivery, delivering on a clean surface, sterile cord cutting, appropriate cord tying, proper cord care following delivery, and infant bathing and cleanliness. Methods In-depth interviews and focus group discussions were audiotaped, transcribed, and analyzed using NVivo 9.0. Results 253 respondents participated, including women with newborn infants, grandmothers, household and compound heads, community leaders, traditional birth attendants, and formally trained health care providers. There is widespread understanding of the need for clean delivery to reduce the risk of infection to both mothers and their babies during and shortly after delivery. Despite this understanding, the use of gloves during delivery and hand washing during and after delivery were mentioned infrequently. The need for a clean delivery surface was raised repeatedly, including explicit discussion of avoiding delivering in the dirt. Many activities to do with cord care involved non-sterile materials and practices: 1 Cord cutting was done with a variety of tools, and the most commonly used were razor blades or scissors; 2 Cord tying utilized a variety of materials, including string, rope, thread, twigs, and clamps; and 3 Cord care often involved applying traditional salves to the cord - including shea butter, ground shea nuts, local herbs, local oil, or “red earth sand.” Keeping babies and their surroundings clean was mentioned repeatedly as an important way to keep babies from falling ill. Conclusions This study suggests a widespread understanding in rural northern Ghana of the need for clean delivery. Nonetheless, many recommended clean delivery practices are ignored. Overarching themes emerging from this study included the increasing use of

  18. A Pilot Study on the Effects of Slow Paced Breathing on Current Food Craving.

    Science.gov (United States)

    Meule, Adrian; Kübler, Andrea

    2017-03-01

    Heart rate variability biofeedback (HRV-BF) involves slow paced breathing (approximately six breaths per minute), thereby maximizing low-frequent heart rate oscillations and baroreflex gain. Mounting evidence suggests that HRV-BF promotes symptom reductions in a variety of physical and mental disorders. It may also positively affect eating behavior by reducing food cravings. The aim of the current study was to investigate if slow paced breathing can be useful for attenuating momentary food craving. Female students performed paced breathing either at six breaths per minute (n = 32) or at nine breaths per minute (n = 33) while watching their favorite food on the computer screen. Current food craving decreased during a first resting period, increased during paced breathing, and decreased during a second resting period in both conditions. Although current hunger increased in both conditions during paced breathing as well, it remained elevated after the second resting period in the nine breaths condition only. Thus, breathing rate did not influence specific food craving, but slow paced breathing appeared to have a delayed influence on state hunger. Future avenues are suggested for the study of HRV-BF in the context of eating behavior.

  19. Team dynamics, clinical work satisfaction, and patient care coordination between primary care providers: A mixed methods study.

    Science.gov (United States)

    Song, Hummy; Ryan, Molly; Tendulkar, Shalini; Fisher, Josephine; Martin, Julia; Peters, Antoinette S; Frolkis, Joseph P; Rosenthal, Meredith B; Chien, Alyna T; Singer, Sara J

    Team-based care is essential for delivering high-quality, comprehe